Agenda - 03-13-2007-9c - Laserfiche WebLink

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40 • OPC does not maintain schedules for IPRS or Medicaid service providers. Three way calls are used to schedule assessment appointments for all consumers. The lack of schedules maintained in Pro-FilerT"'' means that a STAR clinician must call the .provider and schedule the appointment over the phone. This business rule limits the actual hours we can make referrals for consumers to providers to the operating hours of the providers. We have created a strategic objective to address this issue. • Indigent consumers needing a routine mental health or substance abuse assessment (other than Driving While under the Influence) are referred to the same provider in Orange, Person and:.Ctiatham counties. =s;~ / `~~ OPC currently refers new consumers requiring an assessment for. a mental health condition to one provider in Oranges Person and Chatham counties. During divestiture, OPC released an RFP for comprehersive service agencies to deliver the services previously delivered by OPC to indigenf consumers and incorporate the then "new" service definitions. After a thorough review process only one provider was chosen as a Comprehensive Service Agency. This, decision created one "safety net" organization to receive the IPRS funds for assessmenfi'ard treatment of indigent consumers. At the time this decision focused on system iatability during the transition year. Over the past eight months, the capacity of this provider to perform the assessments within~''the; timelines, especially for urgent or emergent consumers, varies a great deal across the region. OPG acknowledges that inadequate IPRS funds limits flexibility; howeue~, we feel choice of providers for indigent consumers is too limited. A strategic objective .is listed to address the issue. ,; ~ - - ~._<. __. • OPC :uses a.._ paper system to receive and distribute authorization requests/approvals, STR forms and Person Centered Plans. -- OPGs~goal is to have,a'paper~ess~or virtually paperless system. Presently, providers of IPRS:,services submit a paper authorization form, which we enter into Pro-FilerT"' Authorization .,,requests: are printed and faxed to .providers. A process which allows providers to~,receive and submit forms electronically would reduce cost, and save time for both``providers and the LME. Full implementation of electronic capacity would correct this issue. ~~' • In order to provide services to a greater number of consumers, OPC has chosen to limit its IPRS Benefit Plan. Insufficient IPRS funds result in limited authorizations that are not always sufficient to meet the needs of the consumers. As system reform has progressed and our system has transitioned, many consumers were already engaged in traditional treatments and therapy. It takes time to transition people out of services while 40