New Enhanced Behavioral Services to Virginians with Medicaid

Virginians need wider mental and behavioral health resource access more than ever before. On top of facing deep health inequities and many dealing with poverty in rural and urban areas of the state, they’re now enduring a years-long global pandemic. Members deserve a higher level of supportive care, and Medicaid is delivering. BRAVO, an acronym that stands for Behavioral Health Redesign for Access, Value and Outcomes, offers enhanced, fully integrated behavioral health services that provide a complete spectrum of care for Virginia Medicaid enrollees.

The goal of the redesign is to create new categories of mental health care with an improved reimbursement rate, so that when it comes to behavioral health services, no Medicaid member will be left behind.  The redesign has two phases. The first began on July 1, 2021, with the following programs and services:

Mental Health Partial Hospitalization Program (MH-PHP)       

  • Highly structured clinical programs for youths and adults designed to provide an intensive combination of interventions and services which are similar to an inpatient program, but on a less than 24-hour basis.

Mental Health Intensive Outpatient (MH-IOP)

  • Highly structured clinical programs for youths and adults designed to provide a combination of interventions that are less intensive than Partial Hospitalization Programs, though more intensive than traditional outpatient psychiatric services.

Assertive Community Treatment (ACT) services

  • A highly coordinated set of services offered by a team of medical, behavioral health and rehabilitation professionals in the community who work to meet the complex needs of adults with severe and persistent mental illness.

The second phase began on December 1, though services were introduced in July as part of Assertive Community Treatment (ACT). ACT provides long-term treatment, rehabilitation and support services to identified individuals with severe and persistent mental illness, especially those who have severe symptoms that are not effectively remedied by available treatments or who, because of reasons related to their mental illness, resist or avoid involvement with mental health services in the community. Imagine the benefits these enhancements will provide in terms of a broader health picture for residents, as more of these problems are addressed in the state.

ACT services are offered to outpatients outside of clinic, hospital or program office settings for individuals who are best served in the community. They include:

MH-PHP, MH-IOP, and ACT

  • 3-5 days a week, up to 8 hours of daily intensive clinical group counseling and wrap around services

Multi-Systemic Therapy (MST)

  • An intensive treatment program for at-risk children under age 21 with serious behavior problems or substance abuse. MST can help the child and their family understand what family, school and community-based factors are affecting the child’s behavior.

Family Functional Therapy (FFT)

  • A short-term treatment program for at-risk children ages 11-18 with a referral for behavioral or emotional problems. The referral can be from juvenile justice, behavioral health, school or child welfare systems. FFT can help the child and their family understand what family-based factors are affecting the child’s behavior.

Mobile Crisis

  • Available 24/7, this team of health professionals can quickly help people who are having a behavioral health crisis.

Community-Based Crisis Stabilization (CBCS)

  • Short-term services designed to help people in their homes or community after they’ve had a crisis response.

23 Hour Crisis Stabilization

  • Also available 24/7, this service offers up to 23 hours in a community-based facility that provides evaluation and support to people who are having a behavioral health crisis.

Residential Crisis Stabilization Unit (RCSU)

  • Short-term services from a facility that provides 24/7 evaluation and support for people who are having a behavioral health crisis and/or a substance abuse problem.

Applied Behavioral Analysis

  • A therapy that uses different strategies to help improve social, communication and learning skills.

By putting these additional mental and behavioral health resources to work, more Virginians may finally feel a sense of relief, gain confidence to begin to overcome inequities and see improved health outcomes overall.

For more information on BRAVO implementation, reimbursement and service authorization, visit https://www.dmas.virginia.gov/for-providers/behavioral-health/enhancements.

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