REGIONAL DISCHARGE ASSISTANCE PROGRAM
The goal of the Discharge Assistance Program (DAP) is to discharge and support in a community setting those targeted State Hospital patients clinically ready for discharge and for whom additional community supports are required. The program is managed regionally by the Catawba Regional Partnership (CRP) Project Manager with participation from a committee which includes Community Services Board (CSB) and State Hospital staff. The Catawba Regional Partnership (PPR 7) Regional DAP (RDAP) Committee includes representatives from Catawba Hospital, Blue Ridge Behavioral Healthcare and the Catawba Regional Partnership Project Manager. There is also a non-voting representative from the Department of Behavioral Health and Developmental Services.
RDAP funding can occur as an annual plan which is continually monitored and renewed yearly as needed, or as a one-time plan for items and services needed on a one time basis initially upon hospital discharge. A RDAP operating protocol has been established which outlines the procedures for authorizing, managing and reviewing the use of the RDAP funds. The process is coordinated by the CRP Project Manager. The RDAP committee meets monthly to develop, review, and manage RDAP plans and review the ready for discharge list at Catawba Hospital. Additionally, plans are presented by conference call weekly. Utilization reviews of RDAP funded services as specified on the Individual Discharge Assistance Program Plans (IDAPP) are conducted during the monthly meetings. The case management CSB is responsible for development and monitoring of the IDAPP. IDAPPs for annual plans as well as one-time RDAP plans are reviewed quarterly.
The goal of the review is to ensure that the services are the most appropriate, effective, and efficient services that meet the clinical needs of the individual receiving services. Prior to the quarterly utilization reviews, providers of RDAP funded services are expected to provide necessary and comprehensive information on the cost and utilization of services.
This utilization review process may result in revisions of IDAPPs or adjustment to or redistribution of RDAP funds. Current RDAP allocations may also be terminated if the individual has returned to the State Hospital or been incarcerated for a period exceeding 30 days.
To discharge and support in a community setting those targeted State Hospital patients clinically ready for discharge and for whom additional community supports are required.
In order to be eligible for RDAP funding a patient must be identified by the State Hospital as clinically ready for discharge. Highest priority is given for patients who have been clinically ready for discharge for more than 30 days followed in priority by those who have been clinically ready for discharge for less than 30 days.
Timely submission of bills for RDAP funded services is essential in promoting more clarity and accuracy in RDAP accounting, and ultimately allowing more unused funds to be unencumbered for future use. Providers are expected to submit bills for any services funded by RDAP for payment within 15 days of the close of the service month. Bills submitted after that time will not be paid.
Monthly reports are required from any provider of specific, identified mental health services such as mental health supports or case management. The reports should include a summary of the client’s clinical presentation for the month, identified service goals, and progress toward those goals. Reimbursement for services is contingent upon receipt of the monthly report by the managing CSB.
Agencies receiving RDAP funding for any service which can be back-billed following reinstatement of insurance is required to complete the back-billing process. Documentation is required that the service agency has attempted to back-bill for services. If an individual’s income or benefits are reinstated and are made retroactive to cover time of RDAP funded services, reimbursement of RDAP funds for those services is expected. This includes payments for upfront expenses covered by Auxiliary Grant, SSI, or other income.