Another highlight of the Annual Behavioral Health Care Conference in Chicago last week was the presentation on TJC’s new Behavioral Health Home Certification. Several BH organizations have achieved this exciting new certification option! So, here’s some information to help you decide if BHH Home Certification would be a good fit for you!
What exactly is a Behavioral Health Home?
A Behavioral Health Home is not a physical location but rather a service delivery model for the integration of primary physical health care and behavioral health care. The creation of Health Homes became an option for states under the Affordable Care Act. The target population is Medicaid enrollees with multiple chronic health conditions including mental health and substance abuse disorders.
There are three models of Behavioral Health Homes that are recognized by SAMHSA:
- In-house Model: The BH organization provides the behavioral health services and some of the primary physical health services in-house.
- Co-located Partnership Model: The BH organization arranges for health care providers to offer some basic primary physical health care services on-site at the BH organization.
- Facilitated Referral Model: The BH organization has processes in place to ensure the coordination of primary physical heath care provided off-site.
What is TJC’s Behavioral Health Home Certification?
It is an optional certification for organizations accredited under the Behavioral Health standards that provide integrated primary physical health care and behavioral health care.
What are the requirements for Behavioral Health Home Certification?
The specific requirements for Behavioral Health Home Certification are included in the Behavioral Health Care Standards Manual. The standards are identified as “For organizations that elect The Joint Commission Behavioral Health Home option.”
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Physical Exams (CTS.02.01.05 EP 2)
- If the health screening indicates need for a history and physical exam, the BHH arranges for that H&P.
Assessments (CTS.02.02.01 EP 6, 7, 8)
The assessment includes:
- The individual’s long and short term physical health care goals
- Screening for metabolic syndrome, diabetes, hypertension, heart disease, asthma, COPD, hepatitis C, HIV/AIDS, obesity
- Assessment of the individual’s ability to self manage chronic behavioral and physical health conditions
Plan of Care, Treatment or Services (CTS.03.01.03 EP 17)
The plan includes:
- The individual’s physical health care need and goals
- How the organization will help the individual achieve those goals
- The individual’s self management goals
Coordinated Care (CTS.04.01.01)
- There is an Integrated Care Team assigned to provide services for a designated panel of individuals.
- The team has a Team Coordinator.
Access to Care (CTS.04.01.07)
- 24/7 access to contact the BHH to request:
- Appointments
- Prescription renewals
- Clinical advice for urgent health care needs
- 24/7 response to urgent care needs
- Facilitating the individual’s online access to their health information (e.g. lab results) within 4 business days
- Use of certified electronic health record to provide appointment reminders
Prevention, Screening and Primary Physical Health Care (CTS.04.02.23)
- Integrated Care Team has information needed to facilitate delivery of integrated physical and behavioral health care.
- BHH staff has access to primary physical health care clinician for consultation.
- BHH staff has access to behavioral health care clinician for consultation.
Facilitating Provision of Integrated Care (CTS.04.02.25)
Manage transitions in care and facilitate access to integrated care including:
- Acute care
- Management of chronic care
- Prevention services
- Behavioral health services
- Oral health care
- Vision care
- Urgent and emergency care
Case Management/Care Coordination (CTS.06.01.05)
- The individual served partners with the Integrated Care Team to identify needs, preferences, and goals in various life domains.
- Integrated Care Team assists with achieving goals of independent living.
- All services provided are evaluated.
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Staff Orientation and Education (HR.01.04.01, HR.01.05.03)
- Staff are oriented and trained on the most common behavioral health conditions and chronic physical health conditions in the population served.
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Information Management (IM.01.01.01)
Organization uses health information technology to:
- Support continuity of care
- Document and track care, treatment, services
- Support disease management
- Support preventive care
- Create reports
- Facilitate electronic exchange of information
- Support performance improvement
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Leadership (LD.04.04.09)
- Organization identifies clinical practice guidelines and/or evidence based practices for both physical and behavioral health care.
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Performance Improvement (PI.01.01.01, PI.02.01.01, PI.03.01.01)
Data collected on
- Disease management outcomes
- Access to care
- Consumer satisfaction
- Data used to improve performance
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Right to Information about the Behavioral Health Home (RI.01.04.03)
- Individual is provided information about the functions and services of the BHH.
- Individual has right to:
- Choose clinicians
- Obtain a second opinion
- Seek specialty care
How will organizations be surveyed for Behavioral Health Home Certification?
For most organizations, the length of the survey for BHH Certification is one day. This can be conducted either as part of the organization’s triennial survey or scheduled as a separate survey. The BHH Certification will be awarded for a period of three years.
If we become certified as a Behavioral Health Home, does that mean that BHH services must be provided to all of our clients?
No, your organization determines the population that will be served by the Behavioral Health Home. This can be a defined subset of the population such as consumers living in a particular geographic area, consumers who are Medicaid enrollees, consumers with a particular diagnosis, etc.
What is the advantage to obtaining Behavioral Health Home Certification?
TJC is currently working with state authorities to acquire each state’s recognition for the new Behavioral Health Home Certification. This state recognition will help behavioral health care organizations meet Medicaid requirements and, as a result, may improve an organization’s reimbursement structure.
How can we prepare for Behavioral Health Home Certification?
The first step is to study the BHH Certification requirements in the BH manual as well as some of the background material listed in the Resources section of this article. Based on that research, determine if you organization is well positioned to pursue this certification. If so, contact us to arrange for training and technical assistance on achieving Behavioral Health Home Certification. We are currently working with several clients who are considering this new certification.