HealthChoices is managed care of the Behavioral benefits for Medical Assistance members seeking mental health and substance abuse treatment services. The Medical Assistance Program has existed for decades in Northampton County. Prior to Behavioral HealthChoices, County residents had Access cards and could seek service from any participating Medical Assistance provider. The problem was that some consumers could not find providers who could accept them in a timely manner, resulting in waiting lists and delays in obtaining needed services. HealthChoices is all about access to certain services prescribed by the State's Department of Public Welfare (DPW). In certain cases, these services must be available 24 hours per day and seven (7) days per week. For all of the services required by DPW (see Healthchoice Services), there must be a choice of at least two (2) providers available within a reasonable commuting distance (30 minutes driving time for Northampton County).
HealthChoices is a program initiated by the Commonwealth. Northampton County agreed to participate in the Managed Care initiative by answering a Request for Proposal issued by the DPW. This response indicated the County's agreement to accept oversight responsibilities for Behavioral Health services provided in the County. In turn, the County used a competitive Request for Proposal process to select a managed care company to operate the program. The managed care company selected was Magellan Behavioral Health of Pennsylvania. There are a myriad of Federal and State requirements governing every aspect of the HealthChoices program.
Northampton County is responsible to DPW for insuring compliance with these stringent requirements, e.g. resolving complaints and grievances, quality assurance, access to services, and timely reporting, etc. The HealthChoices Coordinator reports to the Director of the Human Services Department. The Coordinator and four (4) staff provide oversight for the County. A detailed organization chart of the entire program can be found under Northampton Behavioral HealthChoices Organization Chart.pdf