CBFS Fact Sheet (Word)

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					                       The Massachusetts Department of Mental Health
                            Community Based Flexible Supports

The Department of Mental Health (DMH) provides services to adults with serious and persistent
mental illness to facilitate and support their maximal integration in the community. This is
accomplished by providing services that are responsive to the preferences and needs of
individuals and their families and focused on rehabilitation and recovery. DMH funded
community services for adults with serious and persistent mental illness include residential
options, Program of Assertive Community Treatment (PACT), clubhouses, respite care, peer
operated programs and DMH case management services.

Beginning in September of 2007, DMH launched a review of its adult community service system
to determine its efficacy and to align the public mental health service delivery system with the
needs and preferences of clients and their families. Additionally, DMH re-procured many
components of its system to meet statutory and regulatory requirements because several
contracts had expired. The procurement of the DMH adult system is consistent with the
Administration’s Community First initiative and recently enacted legislation (C. 257 Acts of 2008)
requiring the Division of Health Care Finance and Policy to establish rates for reimbursement of

The result of DMH’s review, including input from stakeholders, is a new activity code for
DMH called Community Based Flexible Supports (CBFS). The cornerstone of DMH’s
community mental health system for adults, CBFS services provides rehabilitative
interventions and supports in partnership with clients and their families to promote and
facilitate recovery. Services include, but are not limited to, interventions and supports that
manage psychiatric symptoms in the community, restore or maintain independent living in
the community, restore or maintain daily living skills, promote wellness and the
management of medical conditions, and assist clients to restore or maintain and utilize the
skills necessary to undertake employment.

Services provided through CBFS are not new types of services: most services that are currently
provided today under existing contracts will continue under the new CBFS contracts, though
there may be changes in vendors. While services do not change, the delivery approach of such
services is being enhanced and transformed to meet the needs and preferences of clients and
to afford contracted CBFS vendors flexibility in delivering quality care to clients and their
families. CBFS services are designed, in part, to maximize flexibility, to strengthen consumer
driven care and treatment planning, to integrate peer workers, and to develop and monitor
person-focused outcomes.

In December of 2008, DMH released a Request for Response (RFR) for the delivery of CBFS
services. As required by law, the RFR was an open, competitive bidding process. Most
contracts for CBFS services were awarded to vendors by April 17, 2009. Enrollment into CBFS
services commences on July 1, 2009. In many instances, vendors who have existing contracts
with DMH for activity codes being replaced by the CBFS activity code have been awarded a
CBFS contract. Between April and July 1, there is a contract readiness period whereby DMH is
working collaboratively with CBFS awardees to transition clients to the new CBFS activity code.
In instances where a vendor currently has a contract with DMH for services under an activity
code being replaced by the CBFS activity code, and the vendor did not receive a CBFS award,
DMH is working diligently to successfully transition clients with the existing vendor to the new
CBFS vendor. Client needs and preferences are being resolved at the local level. DMH has
several implementation committees designed to address operational and administrative
changes necessary to support CBFS activities and to ensure that clients receive access to care.