BOISE — Before Monday, a Medicaid patient receiving inpatient substance abuse treatment who needed to transition to outpatient therapy would have to contact multiple organizations and navigate several systems to make sure that happened.

As of Monday, Idaho’s fragmented behavioral health care system should be more holistic as the new Idaho Behavioral Health Plan officially went live. The plan means that Medicaid, and some non-Medicaid patients, will have their mental health and substance abuse treatment and health care all overseen by one managed care organization, Magellan Health.

“This is really transformative,” said Juliet Charron, Idaho Department of Health and Welfare deputy director of Medicaid.

Previously, Idaho’s behavioral health plan, which is overseen by a third-party managed care organization, only covered outpatient services for Medicaid services. Inpatient behavioral health services are only covered under Idaho Medicaid’s fee-for-service model.

The $1.2 billion, three-year contract is also meant to increase access to services.

Magellan is required to staff and deploy mobile crisis teams across the state who can provide services and support to someone in a crisis, Charron said. The planned youth residential psychiatric facilities are part of improving access, she said. The state’s first ever facility of this kind — the Idaho Youth Ranch Residential Center for Healing & Resilience in Caldwell — opened last August, but just began billing Medicaid through Magellan as of Monday. More of these facilities are slated to open in Nampa, Idaho Falls and Twin Falls.

Idaho, like many states, has a behavioral health workforce shortage. This affects all levels of care, from outpatient therapy, to acute crisis treatment, to everything in-between. Charron said the pandemic exacerbated the issue because providers burned out and stopped accepting Medicaid patients, and now the state is trying to work with Magellan to improve access to services by attracting providers to the state and encouraging existing physicians to provide more services.

Charron said there’s a focus on improving the “in-between” care, which is more intensive than therapy but less intense than residential psychiatric treatment, and is meant to prevent a crisis and the need for residential treatment.

An example of this is the state’s assertive community treatment, or ACT, program. The health department had been administering the services through state employees with expertise in psychiatry, nursing, social work, counseling and addiction services. But the state’s capacity to provide these services was limited, and so this has been transferred to the managed care organization.

Health department staff who had been providing ACT services transitioned to a new bureau in the division called the Center for Excellence and will coach and mentor private providers across the state.

Through the Center for Excellence, the department hopes to provide training and support to any providers who want to expand on the behavioral health services that they already offer.

There are going to be people in Idaho who are in too remote of an area to access what they need in their own community, Charron said. Transportation for medically necessary reasons is covered by Medicaid.

A care coordinator would likely take a role in finding transportation to get a participant to services. The health agency had previously provided some care coordination and case management, but just didn’t have enough staff to do so comprehensively, Charron said.