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Funding & Medicaid Standards

Downloadable documents discussed on the web page are listed below for your convenience.
MST Services' position on Medicaid funding for MST programs sums up our current “lessons learned” regarding the strengths and challenges of using Medicaid funding to support MST implementation. Medicaid funding has emerged as an important facilitator in the growth of MST and it is playing a critical role in the financial sustainability of many MST programs across the United States.  However, we caution stakeholders against viewing Medicaid as a “silver bullet” solution to their funding troubles due to the potential challenges of using Medicaid funds to support the model-adherent implementation of MST. For the full “Position Statement on Medicaid Funding for MST Programs” click here.

The standards and service descriptions for Medicaid or other funding sources for MST of various states are summarized below. Information on each state's MST standards is provided as well as an assessment of how consistent these standards are with MST. Suggested elements to be included in an MST Medicaid Standard are presented in the MST Preferred Service Description document. For an example of how states can be rated using this preferred service description, review our Sample MST Preferred Service Description Rating Form.

While some states use the current Multisystemic Therapy H2033 HCPCS code (see page eight) for Medicaid billing, many states have created MST funding mechanisms under other HCPCS codes or have chosen to use pre-existing Medicaid codes such as those for “Intensive In-home Services”. In the table below, rating information is provided on how consistent each state's standards are with the MST evidence base.

These state Medicaid standards are rated by placing them in one of four categories (i.e., Highly Consistent, Consistent, Mostly Consistent, or Minimally Consistent) by comparing them to the list of recommended program practices and requirements presented in the MST Preferred Service Description document. These recommended program practices and requirements have been developed to replicate the characteristics of clinicians, training, clinical supervision, consultation, monitoring and program support provided in the successful clinical trials of MST and have been refined through extensive experience with MST program replications throughout the United States and in growing a number of sites internationally.

The goals of MST programs include providing clinically effective, family-based services with high levels of provider accountability for outcome. Thus, the functional mission and current service array of the MST host agency must be examined for compatibility with the MST treatment approach.  The Success of MST depends on the provision and proper management of these necessary resources.

For those individuals interested in assistance with RFP development, please refer to Draft MST RFP Template. This file is helpful in writing an RFP as it contains the elements that should be included in the RFP for MST.

For technical assistance in developing funding or Medicaid standards for MST, please contact Melanie Duncan, Project Manager, at melanie.duncan@mstservices.com. For other technical assistance  in the planning and implementation of financing and management of other human services and mental health treatments not specific to MST, contact John Morris (jmorris@tacinc.org) from the Technical Assistance Collaborative (TAC) at www.tacinc.org.

STATE / COUNTY
SERVICE DESCRIPTION MEDICAID / FUNDING STANDARD
LEVEL OF CONSISTENCY W/ MST EVIDENCE BASE
ADDITIONAL INFORMATION / COMMENTS
Alabama
No MST standard has been identified
N/A
N/A
Alaska
No licensed MST teams operating
N/A
N/A
Arizona
The accepted definition of MST is:
Consistent - This standard is consistent with the MST evidence base due to the requirement that the "contractor will implement the MST service in strict adherence to the Blueprints Project MST model".
This state standard is silent in many critical areas including, quality assurance practices and staff training, program staffing and program operational requirements. The main strength is the requirement of implementation to be in strict adherence to the Blueprints Project MST model.
Arkansas
No licensed MST teams operating
N/A
N/A
California
Copy of standard not obtained Outpatient Mental Health Services - Medi-Cal
N/A
 
Colorado
No MST standard has been identified
N/A
 
Connecticut
Review under development
 
Delaware
N/A
 
District of Columbia
Copy of standard not obtained Community Based Intervention (CBI) Level I
N/A
 
Florida
No MST standard has been identified
N/A
N/A
Georgia
No MST standard has been identified
N/A
N/A
Hawaii
Mostly Consistent - This standard is mostly consistent with the MST evidence base. Fortunately the HI MST system has practice standards that demand adherence to the MST model in areas where this standard is silent (e.g. QA, MST licensure, etc.). HI - MST Service Description Rating
 
Idaho
No licensed MST teams operating
N/A
N/A
Illinois
No MST standard has been identified
N/A
N/A
Indiana
No licensed MST teams operating
N/A
N/A
Iowa
No licensed MST teams operating
N/A
N/A
Kansas
No licensed MST teams operating
N/A
N/A
Kentucky
No licensed MST teams operating
N/A
N/A
Louisiana
Highly Consistent- This standard is highly consistent with the MST evidence base.
MST is a state plan service in Louisiana under the rehab option and is an open access service with a post payment review process set up, as opposed to prior authorization, with no prescribed limits on duration of treatment although there are limits on the number of units (244 15 min. units) that can be billed without additional approvals.
Maine
Highly Consistent- This standard is highly consistent with the MST evidence base.
The Children's Home and Community Based Treatment Services rule within the Mainecare Behavioral Services Medicaid Assistance Program is inclusive of MST.
Maryland
MST Medicaid standard under development
Review under development
N/A
Massachusetts
No MST standard has been identified
N/A
N/A
Michigan
No MST standard has been identified
N/A
N/A
Minnesota
No MST standard has been identified
N/A
N/A
Mississippi
No MST standard has been identified
N/A
N/A
Missouri
No MST standard has been identified
 
N/A
Montana
No licensed MST teams operating
N/A
N/A
Nebraska
NE MST Medicaid Standard Multi-Systemic Therapy Intensive Outpatient Program
Highly Consistent - This standard is highly consistent with the MST evidence base although it lacks specifying the significant exclusionary criteria for standard MST.
N/A
Nevada
No MST standard has been identified
N/A
N/A
New Hampshire
No licensed MST teams operating
N/A
N/A
New Jersey
Not Consistent- This standard is not specific to MST and is reported to be administered in such a way as to hinder the delivery of MST.
N/A
New Mexico
Highly Consistent - This standard is highly consistent with the MST evidence base although it lacks specifying the significant exclusionary criteria for standard MST. NM - MST Service Description Rating
 
New York
No MST standard has been identified
N/A
N/A
North Carolina
NC MST Medicaid Standard Federal H2033 Multisystemic Therapy (MST) code NC LME Standards
Consistent - This standard is consistent with the MST evidence base. While this  standard is intended to fund the use of MST within the evidence-based referral range of youth 12-17 years old, it was written with a broader age range of 7- 17 to enable the formal evaluation of using MST with youth down to an age of 7 years old in hopes of facilitating further development of the MST evidence base.
Provider organizations must demonstrate that they meet these standards by being endorsed by the LME.
North Dakota
No licensed MST teams operating
N/A
N/A
Ohio
OH Intensive Home Based Treatment Service Description Intensive Home Based Treatment (IHBT) Service
This standard is not specific to MST and has not been reviewed.
The Intensive Home-Based Treatment rule is inclusive of MST.
Oklahoma
Federal H2033 Multisystemic Therapy
Not Consistent - This standard does not provide adequate specification of the MST model. OK - MST Service Description Rating
This standard fails to provide adequate specification of the service to insure adherent implementation of the MST model and gives almost no guidance regarding critical implementation requirements and target population criteria.
Oregon
No MST standard has been identified
N/A
N/A
Pennsylvania
PA Draft MST Medicaid Standard
Highly Consistent - This standard is highly consistent with the MST evidence base although it fails to specify how staff training and program QA are to be addressed, or the significant exclusionary criteria for standard MST. PA - MST Service Description Rating
N/A
Rhode Island
No MST standard has been identified.
N/A
All MST providers are funded through two "Networks" of child-serving agencies contracted with the state Department of Children, Youth, and Families to provide services to Department-involved youth (including juvenile justice). MST services are Medicaid reimbursable for the state through "Costs not otherwise matchable" (CNOM) under the Rhode Island Global Consumer Choice, Section 1115(a), Demonstration Waiver.
South Carolina
Mostly Consistent - While this standard is not specific to MST it is mostly consistent with the MST evidence base.  Fortunately the SC MST system has practice standards that demand adherence to the MST model in areas where this standard is silent (e.g. QA, staff training, etc.). SC - MHS-NOH Service Description Rating
N/A
South Dakota
No licensed MST teams operating
N/A
N/A
Tennessee
No MST standard has been identified
N/A
N/A
Texas
No MST standard has been identified
N/A
N/A
Utah
No licensed MST teams operating
N/A
N/A
Vermont
No licensed MST teams operating
N/A
N/A
Virginia
No MST standard has been identified
N/A
N/A
Washington

Washington State MST Pilot Project Medicaid Standard

Federal H2033 Multisystemic Therapy

This standard was established for a specific pilot project and does not provide full specification of the MST model and therefore has not been reviewed.
This standard was created for a limited pilot program which does not fully specify the service but does state it will fund “MST services as defined by MST, Inc.”
West Virginia
No licensed MST teams operating
N/A
N/A
Wisconsin
No licensed MST teams operating
N/A
N/A
Wyoming
No MST standard has been identified
N/A
N/A