MHOP Clinic Open Access Pilot Program
Access to timely behavioral health services is critical to providing quality services. Many MHOP clinics struggle to achieve the HealthChoices access standard, so CBH has extended the MHOP Clinic Open Access pilot program for its new and established members from July 1, 2023, to December 31, 2023.
2023 Open Access Pilot Frequently Asked Questions
What is the essential purpose and function of the MHOP Open Access Pilot Program?
The Open Access program serves to provide CBH members seeking MHOP services such as therapy, psychiatry, and/or psychology assessment and treatment with timely access (within a time frame of seven days) to these services. By providing dedicated funding for these access opportunities, CBH supports providers in ensuring that staff time is available to meet the needs of the community. This pilot is an opportunity to assess the impacts of network-wide access improvements to reduce waitlists, and create flexible service based on the needs of participating providers.
The Open Access pilot requires the participating providers to staff the office for four hours per week to support walk-in needs. There is no set length of stay for a member during the pilot. The member can visit once or plan with the provider to engage in ongoing treatment. The intent of the pilot is to increase access to MHOP.
Should Open Access provide mental health urgent care or outpatient intake or both?
Open Access should provide prompt access to MHOP services such as assessment, therapy, and psychiatric evaluations for existing and new CBH member clients. Open Access is not meant to provide crisis evaluation or mental health urgent care services to members in crisis. Providers who offer outpatient care to CBH members should develop protocols for assisting members with urgent or emergent needs.
Is Open Access meant to provide access to an intake/assessment for ongoing treatment or to meet immediate therapy needs of members?
The terms of the 2023 pilot specifically stated that the time should not be utilized for an administrative intake. If the agency intake includes an evaluation or assessment, these processes may be utilized during Open Access contacts. The focus of Open Access hours should be therapy, psychiatry, and/or psychology assessment and treatment for new or established members, or an initial appointment with a therapist to understand needs and begin care planning.
Is separate intake paperwork needed for members utilizing Open Access services?
CBH has allowed this to be determined by the needs of each provider location participating in the Open Access pilot. Existing materials may be adapted, and if additional administrative intake time is needed, this should be scheduled with the individual, towards a goal of ongoing treatment connection and symptom reduction.
What paperwork is required from CBH? What paperwork is required for the state?
CBH requires documentation to substantiate claims for services delivered. A CBE is not required to initiate outpatient services. At a minimum, an individual meeting with the provider for the first time during Open Access should have an initial needs assessment with next steps for care. The provider should have completed consent to treatment and records of relevant demographic, diagnostic, and clinical information. Documentation for services continuing beyond 30 days must include an assessment interview and initial treatment plan, per Title 55 PA Code, Chapter 1153, and Chapter 5200.
See additional info from CBH Provider Bulletin 22-14.
Can Open Access be used for intake for a future appointment?
Documentation collected at an Open Access appointment may be used for ongoing services. CBH recognizes that many MHOP clinics conduct an initial intake, but this intake is not a licensing requirement; therefore, an intake will not be included as a service toward open access hours.
Can the intake paperwork completed with the member be transferred to another outpatient provider, if the member secures a therapist elsewhere?
Clinical documentation may transfer if the member provides consent to share and it is acceptable to the provider that the member has transferred. Each provider is responsible for understanding the needs of individuals served to develop an appropriate plan of care. Documentation of completed assessment (within 30 days of service initiation) can be used to reduce the administrative burden on members and provider staff, inform care, and determine the schedule for future re-evaluation. Some administrative documentation may need to be repeated to specify the provider and member-recipient agreement.
How does CBH view the future of Open Access?
CBH is collecting data to inform internal discussions regarding Open Access’s financial sustainability. The plan is to sustain Open Access with providers who have demonstrated effective implementation strategies. Pilot project participants will be included in opportunity development whenever possible.
Questions or Resources?
Have additional questions or resources to share regarding the MHOP Clinic Open Access Pilot Program? Please contact CBH to help us understand your needs by completing this brief Smartsheet form.
MHOP Learning Collaborative
Consider participating in the MHOP Learning Collaborative! The Mental Health Outpatient Learning Collaborative (MHOP–LC) is a peer-led thought partnership among administrators and practitioners who provide services and programming for the outpatient level of care. The collaborative seeks to provide a supportive space for learning, planning, and evaluating the unique and nuanced set of challenges that arise in the outpatient level of care. Contact CBH’s Provider Training and Development Team for details.
