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The Mississippi Division of Medicaid published a number of proposed changes to policies this past week. One of the proposed changes is to “remove Mississippi Youth Programs Around the Clock (MYPAC) coverage and reimbursement.” This policy appears to be proposing to change the billing methodology for MYPAC from using an all-inclusive mental health per diem rate ($347.74 per day for up to 115 days per year) to using a targeted case-management model with additional medically necessary mental health services being billed separately.

We spoke with Drew Snyder, executive director of the Division of Medicaid, about the proposed policy change. He shared that the change was made to be compliant with methodology changes the Center for Medicaid Services (CMS) may require at the federal level and a provider payment freeze implemented by the state legislature effective July 1, 2021. He said that although payment methodologies may change, the Division of Medicaid is dedicated to children continuing to receive the services they need.

Any time a policy change is proposed, the public can comment on it. We encourage families and others who have feedback about MYPAC or this policy to submit public comments. Written comments should be sent to the Division of Medicaid, Office of the Governor, Office of Policy, Walter Sillers Building, Suite 1000, 550 High Street, Jackson, Mississippi 39201 or Margaret.Wilson@medicaid.ms.gov by June 4. Public comments will be published and available for review.

To help you in thinking through any comments you might want to share, here is some background information about MYPAC:

According to the Division of Medicaid: “Mississippi Youth Programs Around the Clock (MYPAC) is a home- and community-based Medicaid program for children and youth with Serious Emotional Disturbance (SED), that follows the High Fidelity Wraparound process. MYPAC provides an array of services, as an alternative to traditional Psychiatric Residential Treatment Facilities (PRTF).  Wraparound is an all-inclusive planning process that is youth-guided and family-driven. This process is based on a strength-based philosophy of care that brings community services and natural supports together from various parts of the youth and family’s life. The all-inclusive planning process is a way to help children and youth with complex mental health needs, and their families, achieve their hopes and dreams.  Parents and/or guardians are much more involved with the planning and implementation of the services provided for their child while in MYPAC. Youth may be eligible for the MYPAC program if:

• They meet the clinical criteria for PRTF (psychiatric residential treatment facility) admission.
• They are under age 21.
• They meet the financial criteria for Medicaid.
• Individuals enrolled in CHIP are not eligible for MYPAC services.
• MYPAC Fee Schedule”

MYPAC is offered through a number of mental health providers including Brentwood, Canopy Children’s Solutions, Catholic Charities, Choices Coordinated Care Solutions, Marion Counseling, North Mississippi Commission on Mental Illness, Region IV Mental Health, Region VI Mental Health, Region Ten Mental Health, Region Twelve Mental Health, United Methodist Children’s Home Services and Youth Villages.

Medicaid issues this guidance document to potential MYPAC providers. The Mississippi Department of Mental Health certifies Wraparound, the philosophical approach that MYPAC is charged with using.  You can read the Department’s standards for Wraparound on pages 277 and 278 of its Operational Standards.

One of the most fundamental values of Wraparound is “family voice and choice”. The Wraparound Process User’s Guide: A Handbook for Families and this Wraparound Family Flyer describe in more detail what wraparound and family voice and choice should look like. Family voice includes selecting the Wraparound or MYPAC provider of your choosing and also being offered a wide array of options by whoever facilitates the process – not just services from the agency providing the wraparound facilitation.

[Photo by Kindred Hues Photography on Unsplash]