HealthChoices is the managed care program in Pennsylvania for persons receiving Medical Assistance (Medicaid) benefits through the Pennsylvania Department of Human Services (DHS). All eligible participants are required to participate in the HealthChoices program, which is designed to improve access to services and quality of care while improving cost effectiveness for the Commonwealth of Pennsylvania.
The HealthChoices program went into effect on October 1, 2001 in Berks County. The County of Berks is responsible for the provision of the HealthChoices Behavioral Health component (mental health and substance use disorder services) through a contract with a behavioral managed care company. As its managed care partner, the County of Berks has selected Community Care Behavioral Health Organization (CCBH). The Berks County HealthChoices staff ensures that the program complies with the DHS's regulations through the oversight of CCBH.
Behavioral Health Services
The goals of Behavioral HealthChoices are to:
- Improve access to healthcare services
- Improve quality of care available
- Stabilize Medicaid spending (cost containment)
Services available in the Berks County HealthChoices provider network include:
Mental Health (MH) Services
- Assertive Community Treatment (ACT) (Ages 16+)
- Blended Case Management
- Crisis Intervention
- Inpatient Psychiatric Hospitalization
- Integrated Care and Wellness Center (ICWC)
- Laboratory and Diagnostic Services
- Medication Management
- Outpatient Counseling including Mobile (Adults) and School-Based (Children/Adolescents)
- Partial Hospitalization Psychiatric Evaluation and Psychological Testing
- Peer Support (Ages 14+)
- Psychiatric Rehabilitation – Site-Based and Mobile
- Clozapine Support
- Dual Diagnosis Treatment Team (DDTT)
- PCS Windmill
- Project Transition
- Community Residential Rehabilitation Host Home
- Family Based Mental Health Services
- Integrated Behavioral Health Services (IBHS)
- Multi-Systemic Therapy (MST)
- Parent-Child Interaction Therapy (PCIT)
- Residential Treatment Facilities (RTF)
- Psychiatric Rehabilitation – Clubhouse (Ages 16-30)
- Residential Treatment Facility for Adults (RTF-A) (Ages 18-25)
Substance Use Disorder (SUD) Services
- Case Management
- Hospital-Based Detox and Rehabilitation
- Level of Care Assessment
- Non-Hospital Detox and Rehabilitation
- Outpatient Counseling
- Certified Recovery Support (Ages 14+)
- Halfway House
- Intensive Outpatient
- Medicated Assisted Treatment
- Partial Hospitalization
Reinvestment and Service Expansion
HealthChoices programs are allowed to utilize unspent revenue and investment income to reinvest in programs and services to fill gaps in their county service system. These funds, called Reinvestment Funds, can be utilized to develop new or expand existing services for HealthChoices recipients. They must be spent in accordance with a DHS Office of Mental Health and Substance Abuse Services (OMHSAS) approved reinvestment plan.
Many new and innovative services have been developed through the reinvestment process, including:
When developing new programs or expanding existing services, Requests for Proposals (RFPs) are often requested, followed by a comprehensive review and provider selection process.
Resources for Members
For Medical Assistance information and applications, visit Medical Assistance (pa.gov) and COMPASS HHS Home (state.pa.us).
Individuals enrolled in the Berks County Behavioral Health HealthChoices Program are encouraged to contact the Berks County Consumer/Family Satisfaction Team to complete a survey regarding their mental health and/or drug and alcohol services.
For additional education, advocacy and support group information focused on mental health, individuals and/or their families may contact the Berks County Chapter of the National Alliance on Mental Illness (NAMI).
Resources for Providers
New providers that would like to become credentialed in the Berks HealthChoices network may visit Community Care.
Existing providers may visit Community Care for provider resources.
Fraud, Waste and Abuse
In order to prevent, detect, and eliminate Fraud, Waste and Abuse (FWA) in the HealthChoices System, Berks County HealthChoices staff ensure that the program complies with the DHS OMHSAS and Bureau of Program Integrity (BPI) guidelines, and cooperates with the Medicaid Fraud Control Section (MFCS) if indicated. The County of Berks also has an employee FWA Hotline.
For Physical Health needs, as of September 1, 2022, the Department of Human Services has contracted with the following Berks County Physical Health HealthChoices plans: