Long Time Behavioral Health IMD Exclusion Provisions are Lifted
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Included in the North Carolina 1115 Medicaid waiver that was just approved by the federal Centers for Medicare and Medicaid Services (CMS) was a waiver request on the Institution for Mental Diseases (IMD) exclusion that applies to substance use disorder facilities with 16 or more beds. This waiver will allow Medicaid funds to be used to pay for treatment of Medicaid beneficiaries who are admitted to these substance use disorder facilities. In a recent webinar, DHHS approximated the time of implementation for the SUD waiver in January 2019.
In addition, the US HHS Secretary sent a letter to State Medicaid Directors stating that the IMD exclusion for inpatient psychiatric facilities could be waived by individual states. North Carolina already takes advantage of an allowance in the federal regulation, 42 CFR 438, to have a 15-day exception for mental health services provided in an acute or subacute setting. NC DHHS is currently exploring the impact of the new option presented by CMS.
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Hurricane Florence Recovery Continues
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Hurricane Florence barreled down on North Carolina through most of the week of September 10th, 2018. That seems like a long time ago, but the recovery process is ongoing. The impact-both service and cost related-is difficult to tally for the BH/IDD public system, partly because the costs can continue for several months after the actual hurricane.
The General Assembly held two special sessions in October and one in November to allocate funding where it was most needed. NC DHHS was allocated an additional $12 million during the legislative special session on October 15, 2018. Legislators also created the Hurricane Florence Disaster Recovery Fund with $850 million. Almost half of that was allocated, including the $12 million to NC DHHS. Many of those funds were allocated to public safety, public instruction and agricultural relief. The General Assembly also allocated almost $300 million in November, the majority of that going to agricultural relief and public instruction. LME/MCOs have submitted costs to the State, not just the cost to LME/MCOs but the costs to providers as well. Eastpointe LME/MCO alone, perhaps with the hardest hit counties, has submitted costs of over $800,000.
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State Institutes New Screening Tool for SMI Services and Supports
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On November 1, NC DHHS and LME/MCOs began using a new screening tool for individuals being considered for admission to an Adult Care Home (ACH). The Referral Screening Verification Process (RSVP) replaces the ACH Pre-Admission Screening Resident Review (PASRR).
This change is another means of refining and improving the statewide system that assists individuals with Severe Mental Illness (SMI) or Serious and Persistent Mental Illness (SPMI) who are being considered for admission to an Adult Care Home or have been in a State psychiatric hospital with a SMI/SPMI and are homeless or have unstable housing or individuals with SMI/SPMI who reside in a licensed ACH. This is the target population for the USDOJ settlement with North Carolina and for the NC Transition to Community Living Initiative.
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Visionary Voices Conference Convenes Over 900 Leaders!
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"We were so pleased by this year's conference turn-out" said i2i's Executive Director Mary Hooper. With over 735 registered attendees and another 200+ exhibitor participants, the event was very well attended.
"As this was the i2i Center's inaugural year, we were hopeful that our attendance would be strong and representative of all parts of the systems in which we work and people receive services....though we weren't entirely sure. Once sponsorships and registrations started rolling in, the support and interest in this year's conference and content were extremely reassuring and indicated that i2i is on the right track and suggested that the conference would be a real success. The mix of leaders and stakeholders that attended from all segments of the system was very encouraging. We had lots of private MCO participation, State DHHS and Division(s) leadership, large hospital system folks, LME/MCO leaders, Advocates, Consumers, University representation, and others. We really are very grateful that so many people came together and hope it was a valuable learning experience and productive networking opportunity." said Hooper.
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i2i Center Thanks You for Your Support
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Wishes You the Happiest of Holidays!
And a Safe and Happy New Year!
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