Transcript Document

Florida Statewide
Managed Medicaid
Susan Bramer, LCSW
AVP Behavioral Health, Amerigroup
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Source for Today’s Overview (Slides 2-6)
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Amerigroup Policy & Procedure re: Members
involved in DJJ/Criminal Justice System
Process Overview:
A member may be identified as being admitted into the corrections facility through case management;
concurrent review as member discharges from inpatient hospitalization to a corrections facility; or
member or correctional facility calling in for mental health services referral, diversion (pre-booking site),
or discharge planning (post booking site).
1. Once a member is identified, the Behavioral Health Manager will send the adult member and
correction facility information to Provider Relations.
2. Provider Relations will send a cooperative agreement to the corrections facility explaining the
procedure to contact the Behavioral Health Manager who can assist with behavioral health
service referrals.
3. Provider Relations will request that the agreement to be signed and sent back within 10
business days of receipt.
4. Provider Relations will document their efforts to develop this agreement with the justice
facilities in Salesforce.
5. The cooperative agreement will provide the Behavioral Health Manager’s contact information
and an explanation of how to coordinate BH services once a member is to be released from the
corrections facility.
6. If the Behavioral Health Manager is notified that the member is discharging from the corrections
facility, BH Manager will assist with referring member to a psychiatric practioner within 24 hours
of discharge.
7. This call will also be recorded in the member’s record in Facets.
8. The Manager of Case Management will be notified if the member is in need of Amerigroup Case
Management services and assign the services accordingly.
9. For children or adolescents sent to a juvenile detention facility, a stabilization case manager will
be assigned to offer services to the parent(s) or guardian(s) to ensure that any needed
behavioral health services are coordinated.
Reference: AHCA Contract No. FP021, Attachment II, Exhibit II-A, section V,f,5
Policy- Behavioral Health Community Services for Medicaid Recipients Involved with the
Justice System - FL
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Questions?
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