Community Mental Health Center (CMHC) Healthcare Homes

In October, 2011, the Centers of Medicare and Medicaid (CMS) approved Missouri's State Plan Amendment (SPA) establishing Medicaid reimbursement for health homes, making MIssouri the first state in the nation to have such an approved SPA for health home services. This first SPA established CMHC Healthcare Homes serving individuals with serious mental illness. A companion SPA establishing Primary Care Health Homes in Missouri was approved in December, 2011. Both SPAs were effective January 1, 2012.

This website provides information regarding the development, and current status, of Missouri’s CMHC Healthcare Homes. Information regarding Missouri’s Primary Care Health Homes can be accessed at the following website: http://dss.mo.gov/mhd/cs/health-homes/

Background

Missouri’s health home initiative is a collaborative venture involving the State’s Medicaid Authority (MO HealthNet), the Department of Mental Health, the Missouri Coalition for Community Behavioral Healthcare (formerly known as Missouri Coalition of Community Mental Health Centers), and the Missouri Primary Care Association. During the spring and summer of 2011, representatives of these organizations, as well as the Missouri Hospital Association, met together regularly, with the assistance of consultants funded by the Missouri Foundation for Health, and sought CMS and SAMHSA guidance, to collaboratively develop Missouri’s CMHC Healthcare Home and Primary Care Health Home models and SPAs. Consequently, the two SPAs are identical in many respects, differing only where necessary and appropriate to reflect differences in the populations served.Though the SPAs are administered separately, the coordinator for each initiative regularly participates in the implementation team meetings of their counterpart, and monthly meetings of the key stakeholders of both initiatives continue to assure consistent implementation across the initiatives.

What is a CMHC Healthcare Home?

Community Mental Health Centers providing community psychiatric rehabilitation services under the Medicaid Rehabilitation Option with sufficient capacity to sustain a viable health home are recognized by the Missouri Department of Mental Health to serve as CMHC Healthcare Homes.

CMHC Healthcare Homes assist individuals in accessing needed health, behavioral health, and social services and supports; managing their mental illness and other chronic conditions; improving their general health; and developing and maintaining healthy lifestyles.

Who is eligible to be served by a CMHC Healthcare Home?

Individuals covered by MO HealthNet are eligible to be served by a CMHC Healthcare Home if they have:

  • A serious mental illness (including children and adults receiving psychiatric rehabilitation services under the Medicaid Rehabilitation Option), or
  • A mental health condition and a substance abuse disorder, or
  • A mental health condition or a substance abuse disorder, and one of the following chronic conditions or risk factors:
    • Diabetes
    • Asthma/COPD
    • Cardiovascular Disease
    • Developmental Disability
    • Overweight (BM >25)
    • Use Tobacco

Click on the bold titles of the following sections to access the documents described in each section.

Source Documents - The documents within this link illustrate the process leading to the development of Missouri’s approved CMHC Healthcare Home State Plan Amendment (SPA) beginning with the CMS letter to State Medicaid Directors introducing the Health Home Option and describing the expectations of CMS regarding the purpose, nature, and impact of the Health Home Option; and including copies of some of the questions raised, and answers provided, by both CMS and Missouri during the process of negotiation leading to the approved SPA.

Introducing the CMHC Healthcare Home Initiative - The documents within this link include the various presentations, letters, and other instruments used to introduce the CMHC Healthcare Home initiative to CMHC staff, new health home team members, consumers enrolled in the health home initiative, primary care providers serving health home enrollees, and Missouri hospitals.

CMHC Healthcare Home Tools - The documents within this link include guidelines for the annual health assessment that CMHC Healthcare Homes are required to perform; the User's Guide for the web-based data analytics system developed by Care Management Technologies (CMT), the data analytics company that developed and manages the statewide CMHS Healthcare Home registry and data reporting system, as well as a link to CMT's website; documents outlining the roles and responsibilities of Primary Care Physician Consultants and Psychiatrists/Psychiatric Prescribers in CMHC Healthcare Homes; and a narrative description of how an individual might be served in a CMHC Healthcare Home.

Disease Management 3700 (DM 3700) - Prior to the development of the CMHC Healthcare Home initiative, the Department of Mental Health and MO HealthNet collaborated to reach out and engage high cost individuals in service who had a psychiatric diagnosis but who had not previously been connected with a CMHC. Click on the bold title of this section to read more about this project.

CMHC Healthcare Home Progress Reports

2015 APA Achievement Award - Missouri Gets the Gold Award

CMHC Healthcare Home PMPM Rate Chart

Achievements of Missouri's CMHC Healthcare Homes

Missouri CMHC Healthcare Homes Outcomes