Opening of Applications for Participation in Opioid Health Homes (OHH)

Opening of Applications for Participation in Opioid Health Homes (OHH)

MaineCare Services is pleased to announce that we are now accepting applications for participation in MaineCare’s Opioid Health Home (OHH) program. OHHs are a new component of MaineCare’s Value-Based Purchasing Initiative, providing counseling, care coordination, medication-assisted treatment, peer support, and medical consultation for individuals who have been diagnosed with an opioid dependency.

This service will be available for MaineCare members and the uninsured through grant-funded contracts with the Department of Health and Human Services’ Office of Substance Abuse and Mental Health. The upcoming application and the program requirements apply to programs serving both the MaineCare population and the uninsured (with a few minor exceptions).

Program Requirements Prior to Applying

• The OHH must be currently utilizing an Electronic Health Record (EHR)system
• The OHH must have a full team at time of application, to include at least the following personnel:
• Clinical Team Lead- A licensed clinical professional with opioid addiction treatment expertise, who may be a physician, physician’s assistant, psychologist, a licensed clinical social worker, a licensed clinical professional counselor, or advanced practice registered nurse.
• Medication Assisted Treatment Provider- A licensed health care professional with authority to prescribe buprenorphine.
• Nurse Care Manager- Shall be a registered nurse with expertise in addiction treatment, a psychiatric nurse licensed as a registered professional nurse by the state or province where services are provided and certified by the American Nurses Credentialing Center (ANCC) as a psychiatric and mental health nurse (PMHN); a Psychiatric Mental Health Advanced Practice Registered Nurse (PMH-APRN) who is licensed as a nurse practitioner or clinical nurse specialist by the state or province where services are provided, who has graduated from a child and adolescent or adult psychiatric and mental health nurse practitioner or clinical nurse specialist program, and is certified by the appropriate national certifying body; or an advance practice nurse, as defined by the Maine State Board of Nursing.
• Certified Clinical Supervisor- A clinician who is credentialed by the Maine State Board of Alcohol and Drug Counselors, 02-384 CMR Chapter 6, and must conduct supervision as defined in the regulations for Licensing/Certifying of Substance Abuse Programs, 14-118 CMR Chapter 5, Section 11, in the State of Maine.
• Licensed Alcohol and Drug Counselor- Licensed alcohol and drug counselor means a clinician who is credentialed by the Maine State Board of Alcohol and Drug Counselors, 02-384 CMR Chapter 5, who provides individual or group substance abuse outpatient therapy, is supervised by the CCS, and meets the criteria established in M.R.S., Title 32, § 6214-D.
• Peer Recovery Coach- An individual who is in recovery from substance use disorder and who is willing to self-identify on this basis with OHH members. 

• The OHH must have full implementation of the Core Standards as evidenced by reporting examples of current work for the following:
• Demonstrated Leadership
• Team-Based Approach to Care
• Population Risk Stratification and Management
• Enhanced Access
• Practice Integrated Care Management
• Behavioral-Physical Health Integration
• Inclusion of Patients and Families
• Connection to Community Resources and Social Support Services
• Commitment to Reducing Waste, Unnecessary Healthcare Spending, and Improving Cost-effective Use of Healthcare Services
• Integration of Health Information Technology (Access to HeathInfoNet for OHHs serving uninsured members) 

• As part of the application process, organizations will be asked to demonstrate that they:
• Can monitor treatment adherence and sustain recovery for their OHH members
• Have an infrastructure within the organization to perform population risk stratification and population management
• By using a report, have a way to track their own performance over time

Payment

• Option A:  Opioid Health Homes directly administering buprenorphine, buprenorphine derivatives, and naltrexone in an office setting with a pharmacist on site will be reimbursed at a rate of $1,000.00 per member per month. 

• Option B:  Opioid Health Homes providing a prescription for buprenorphine, buprenorphine derivatives, and naltrexone, to be filled at an outside pharmacy will be reimbursed at a rate of $496.00 per member per month. 

The application can be accessed online by visiting: https://www.surveymonkey.com/r/OHHApplication

A link for the MaineCare Benefits Manual, Chapter II, Section 93, Opioid Health Home Services will be available once rule has been filed.