HB 916 Summary

• Directs the Department of Health and Human Services to expand the 1915(b)/(c) Medicaid Waiver statewide by July 1, 2013, to consolidate management of mental health, intellectual and developmental disabilities, and substance abuse services under Local Management Entities (LMEs).

• Requires LMEs to merge or align through interlocal agreements by January 1, 2013, with catchment areas containing minimum populations of 300,000 by July 1, 2012, and 500,000 by July 1, 2013.

• Establishes operational requirements for approved LMEs including care coordination, utilization management, local presence, stakeholder communication, and limits outsourcing of managed care functions to specified activities (information systems, customer service, claims processing, provider credentialing, and treatment planning).

• Phases out the CAP-MR/DD Waiver as the new waiver expands and requires LMEs to contract with previous targeted case management providers for Community Guide services under the Innovations Waiver.

• Mandates the Department submit a strategic plan by October 1, 2011, and status reports on January 1, April 1, and October 1, 2012, plus February 1 and October 1, 2013.