In May of this year, the Division of Medicaid proposed to discontinue Mississippi Youth Programs Around the Clock (MYPAC) in response to a legislative funding freeze and federal feedback on how the Centers for Medicaid Services will reimburse for the service. MYPAC was discontinued July 1 as explained in this update from the Mississippi Division of Medicaid. The Division is now proposing to bring back a version of MYPAC. This proposed policy is open for comment through July 30.
Background: MYPAC began through a Medicaid waiver in the early 2000s and initially included access to flexible funds and an array of informal supports. During the waiver, the Division of Medicaid itself monitored MYPAC and provided technical assistance to providers. MYPAC later became a more clinically-focused state plan service with the Department of Mental Health monitoring the wraparound facilitation and the clinical services. The Mississippi Wraparound Institute was developed to provide ongoing wraparound training and coaching to service providers and Managed Care Organizations became more widely used. The current model’s lines of accountability are less clear than when Medicaid itself monitored MYPAC, but there appear to be good faith efforts at the state level to address this.
In response to legislative and federal changes, the Division of Medicaid proposed in May of 2021 that rather than continuing to pay mental health providers a bundled rate (that includes care coordination) of $342/day for each day a child received MYPAC services (a minimum of 30 minutes of service for up to three days/week), the Division would pay a monthly care coordination fee for Wraparound facilitation with individual medically necessary services billed separately. This proposal was open for public comment for 25 days, and a public hearing was held on June 11. The recording of the hearing has not yet been posted.
You can read more background about this policy change in this May 25 Families as Allies blog post. These are the public comments Families as Allies submitted. Our oral comments at the hearing were similar but included that a well-monitored, accountable bundled rate might be appropriate to address the issue that providers may not be able to predict what type of services are needed on any given day.
Takeaways for Families: Family Voice and Choice is the first of ten principles of wraparound. Families whose children receive Wraparound should be able to choose which agency provides their Wraparound care coordination and which agency provides their services, and wraparound should be independent of services. In other words, wraparound facilitators should be no more likely to recommend the services of the agencies that employ them than the services of any other provider organizations. Families should have a choice about their services, their service providers, and how, where and how often services are delivered.
Friends and family who are important to families should be included on families’ wraparound teams. The services that families receive through the wraparound process should be based on the goals that are important to the families, not the professionals on the team. There should be a way to tell if those goals are being met and to change the services and supports if the goals are not being met.
If your child and family are receiving or have received wraparound and/or MYPAC, you know some very important information that no one else does: what did and did not work for your family. This information can help the Division of Medicaid decide if its new proposed policy works best for families, and if it does, if it needs any changes. We encourage you to share your written comments with Medicaid before July 30.
Written comments should be sent to the Division of Medicaid, Office of the Governor, Office of Policy, Walter Sillers Building, Suite 1000, 550 High Street, Jackson, Mississippi 39201, or Margaret.Wilson@medicaid.ms.gov by July 30. All submitted comments will be compiled and available under the appropriate public notice posting.
You do not need a special form to submit comments. You can begin your comments by writing “These are my public comments on MYPAC” and then share your thoughts. You can request that your comments not be published if that is your preference.
If you are not sure if the services your family receives or received are wraparound and/or MYPAC or if you have questions about the process of submitting public comments, you are welcome to call our office at 601-355-0915.