Case Study: Georgia Department of Human Resources

Georgia Department of Human Resources, Division of Mental Health, Developmental Disabilities, & Addictive Diseases (DMHDDAD)

Georgia Child & Adolescent Consumer Supports Program – Third Party Administrator (TPA)

Prior to the start of the Georgia Child & Adolescent Consumer Supports Program, consumer and family support services in the State of Georgia were funded by contract. Consumer supports are used to supplement the behavioral health services that consumers receive on an ongoing basis. Eligible consumers include children and adolescents with severe emotional disturbances and/or substance use disorders. DMHDDAD felt an increasing need to expand access to support services to these consumers throughout the state. The division wanted to create a program that would allow for referring provider agencies to easily locate qualified vendors to deliver services to meet the needs of consumers. The State had a dedicated amount of funds to be administered through this program and was looking for a third party to manage the service dollars while providing fiscal monitoring and vendor network development.

Public Partnerships, LLC (PPL) contracted with the State of Georgia as a Third Party Administrator.
Working with the State, PPL was able to apply past experience and financial management
knowedge as a partner in the design and implementation of the C&A Consumer Supports
Program. PPL:

• Worked with the division to create policies, procedures, and the necessary operational
  structure to support the development of the program;
  
• Developed a fully web-based information system, allowing for consumer enrollment, vendor
  registration and credentialing, submission and tracking of service referrals, and submission of vendor invoices;
  
• Customized PPL’s information technology platforms to the State’s unique program
  requirements and ensured that the platforms interfaced directly with the web portal;
  
• Conducted training sessions and developed training materials to help program participants
  learn the program rules and navigate the web-based system;
  
• Established a local office to support program users and provide customer service, along with
  ongoing vendor network development, including credentialing and training;
  
• Hired two regional network developers dedicated to vendor recruitment and support of both
  traditional and non-traditional vendors within their designated regions.

• Within the first four months of operation, 650 consumers received at least one approved service referral. The number grows each day;
• Service referrals are approved or denied in real-time via the web-based validation system;
• Vendors are able to submit invoices at any time through the web and PPL issues payments weekly;
• PPL’s network development team has worked to credential and supports over 115 vendors across the State and is continuously recruiting and engaging additional vendors;
• PPL continues to work with the State and other stakeholders to monitor program trends and utilization and to implement program design improvements.