The National Evaluation of the CHIPRA Quality Demonstration Grant Program: Spotlight on Georgia

Publication Year: 2018
Patient Need Addressed: Behavioral health
Population Focus: Complex care, Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Staff design and care management
Type of Literature: Grey
Abstract

This brief highlights the major strategies, lessons learned, and outcomes from Georgia’s experience from February 2010 to February 2016 with the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

Georgia’s Goals: Improve services for children with complex Behavioral healths by 1) improving the quality of peer support provided by youth and caregivers 2) refining care management entities to improve coordination across child-serving agencies

Insights Results

Overview of model

  • Georgia developed a new training curriculum to prepare youth with Behavioral healths and their caregivers to provide peer support; the state certified more than 100 caregivers who thus became eligible to be reimbursed by Medicaid
  • The state trained new and existing family support organizations in grant writing, establishing a board of directors, retaining staffing, setting up non-profit organizations and understanding Medicaid billing in order to limit caregiver turnover and financial instability
  • Georgia developed an infrastructure for improving the quality of care management entities (CMEs) by: 1) Requiring monthly check-ins to discuss performance and identify improvement; and 2) Initiating quarterly reporting to CMEs that include data on service quality and youth/family outcomes (ex. school suspensions)
  • The CMEs improved their process for collecting quality data and increased their adherence to evidence-based practices for intensive care coordination

    Key takeaways/implications

    • Partnerships: Maryland and Wyoming implemented similar projects and shared best practices
    • Challenges: 1) Youth need their own training and support from the state before engaging in the curriculum development process; and 2) Efforts to improve CMEs were limited by the administrative and financial changes in the state that occurred when youth were transitioned from Medicaid FFS to the Georgia’s state Medicaid MCO