SECTION 450:27-9-4. Structure of Behavioral Health Home and administrative staff

(a)   The BHH policies must describe how it is organized within one of the following structures:

(1)   In-house model where the behavioral health agency is directly providing primary care performed by a qualified employee, or purchasing through a contract; or

(2)   Co-located partnership model where the behavioral health agency arranges for primary care services to be provided onsite, establishing written agreements with external primary care providers; or

(3)   Facilitated referral model, where most primary care services are not provided onsite at the facility; however, the facility has processes in place to ensure the coordination of care that is provided offsite.

(b)   In the event the BHH does not directly provide the full array of required services, there must be organizational procedures and clinical records to document that the BHH has otherwise ensured the services are coordinated on behalf of each consumer.

(c)   The facility operating the BHH will have policies and program descriptions to define how the BHH will operate a team dedicated to provide the range of specific services articulated elsewhere in this Subchapter.

(d)   The facility shall verify the health home director for adults meets or exceeds the following qualifications:

(1)   Possess a Bachelor's degree from an accredited university and have at least two years' experience in health administration;

(2)   Possess a Master's degree from an accredited university in a health or social services related field;

(3)   Be licensed as a Registered Nurse with the Oklahoma Board of Nursing; or

(4)   Be licensed as a Physician or be licensed as a Nurse Practitioner.

(e)   The BHH shall verify the Project Director for children possesses a Bachelor's degree in the field of social or human sciences from an accredited university, has at least three years' work experience in the social service field and has a minimum of one year experience in an administrative position.

(f)   The BHH will adhere to the following ratios in terms of the full time equivalent (FTE) for the health home director.

(1)   The BHH shall maintain a health home director at a ratio of 1 FTE per 500 BHH participants. BHHs with less than 500 participants shall maintain a health home director at a minimum of .5 FTE.

(2)   A health home requiring a health home director and health home nurse care manager of .5 FTE each may employ 1 FTE individual to serve in both roles, provided that individual meets the requirements for both positions.

(3)   A health home requiring more than .5 FTE health home director, may choose to designate a lead health home director and fulfill the additional FTE requirement with key management staff who meet the requirements of (1) or (2) above.

(g)   Compliance with this Section will be determined by on-site observation, review of organizational documents, signed agreements, personnel records, job descriptions, outcome monitoring and other performance improvement activity reports, and clinical records.

[Source: Added at 32 Ok Reg 468, eff 1-1-15 (emergency); Added at 32 Ok Reg 2120, eff 9-15-15]