MDHHS/BPHASA Conflict-Free Access & Planning
Project Description:
In 2014, the Centers for Medicare and Medicaid Services (CMS) released the Home and Community-Based Services (HCBS) Final Rule. This regulation requires all beneficiaries who received HCBS to receive conflict-free case management to access and plan for their HCBS services. "In Michigan, agencies can have more than one role: access, plan development, and service delivery. If one agency is helping you to access and plan your services while providing services, there could be a conflict of interest. A conflict of interest happens when a professional uses their role to benefit themselves or their employer." (MDHHS, https://www.michigan.gov/mdhhs/keep-mihealthy/mentalhealth/mentalhealth/conflict-free-access-and-planning-workgroup) This conflict of interest may not be intended but could still affect the beneficiaries' experience of HCBS. The Michigan Department of Health and Human Services (MDHHS), Behavioral and Physical Health and Aging Services Administration (BPHASA) will now require "that assessment and coordination of services are separate from the delivery of services. This means that case management and support coordination activities are separate from the delivery of services." (MDHHS,https://www.michigan.gov/mdhhs/keep-mihealthy/mentalhealth/mentalhealth/conflict-free-access-and-planning-workgroup) effective October 1, 2024. The implementation of MDHHS/BPHASA's plan to address Conflict-Free Access and Planning (CFA&P) will be a change in requirements for the managed-care entities, Pre-Paid Inpatient Health Plans (PIHPs) and Community Mental Health Service Programs (CMHSPs) who deliver HCBS services and supports. The goal of MDHHS/BPHASA's implementation of its newly adopted CFA&P plan "is to promote choice and independence for people receiving services. Your planning process should not be influenced by provider's self-interests." (MDHHS, https://www.michigan.gov/mdhhs/keep-mi-healthy/mentalhealth/mentalhealth/conflict-free-access-and-planningworkgroup) Beneficiaries who receive HCBS will need to become information to understand how the MDHHS/BPHASA plan to address CFA&P will impact the delivery arrangements of their HCBS services. The goal of this project is to inform beneficiaries who receive HCBS and their families about MDHHS/BPHASA's plan for CFA&p.
Keyword(s):
Developmental Disabilities, Social Determinants of Health, Home and Community Based Services, conflict-free case management
Core Function(s):
Developing & Disseminating Information, Continuing Education/Community Training
Area of Emphasis
Quality Assurance
Target Audience:
Family Members/Caregivers, Adults with Disabilities, Children/Adolescents with Disabilities/SHCN
Unserved or Under-served Populations:
None
Primary Target Audience Geographic Descriptor:
State
COVID-19 Related Data:
N/A
