Benchmarks' Friday Membership Webinar

Jay Ludlam & Karen McLeod

August 19, 2022

Benchmarks' Upcoming Webinars



Benchmarks' Membership Webinar: Standardized Referral Form Discussion with Benchmarks/Cansler Team

Date: Thursday, August 25, 2022

Time: 9:00 am thru 11:00 am

Register

New:  Benchmarks' Child Welfare Webinar: 

Lisa Cauley Joins Karen McLeod

Date: Thursday, September 8, 2022

Time: 8:00 am thru 9:00 am

Register

New: Benchmarks' Friday Membership Webinar: 

Dave Richard Joins Karen McLeod

Date: Friday, September 16, 2022

Time: 8:30 am thru 9:30 am

Register

Benchmarks' Collection of Past Updates

Joint Communication Bulletins

J#429:  Terminating Requirement of the Level of Care Utilization System for Adults and the Child and Adolescent Level of Care Utilization System Assessments

Effective Aug. 15, 2022, NC Medicaid will no longer require the use of the Level of Care Utilization System (LOCUS) for adults or the Child and Adolescent Level of Care Utilization System (CALOUS). Language referencing the LOCUS has been removed from Clinical Coverage Policy 8G - Peer Support Services. If you have any questions, please contact June Freeman at 919-527-7646 or [email protected].

Read Here

2022 and 2023 Advanced Medical Home Measure Targets

To ensure delivery of high-quality care under the managed care delivery system, the NC DHHS has developed the NC Medicaid Managed Care Quality Strategy and identified a set of quality metrics that it will use to assess health plans’ performance across their populations. The Department has identified a subset of these measures for health plans to use to monitor Advanced Medical Home (AMH) performance and calculate AMH performance incentive payments. 

The first quality performance period for AMHs began in January 2022.

• The 2022 and 2023 AMH Measure Targets table provides baseline data and targets for health plans.
• NC Medicaid does NOT set targets for AMHs.

These baseline data and targets are shared as a reference for AMHs. An AMH practice (NPI + location) will have its own rate that may be above or below the baseline state median rate. AMHs should negotiate target performance rates with health plans.

Additional information and resources for AMHs are available on the NC Medicaid Advanced Medical Home webpage. More information about quality strategy and metrics are available on the NC Medicaid Quality Management and Improvement webpage.

NC Medicaid Quality Survey Results Released

NC Medicaid has recently published results of two surveys. One measures patient experiences with their health care while the other describes findings from the baseline assessment (Year 1) of the provider experience and satisfaction with the traditional NC Medicaid Direct system, including the partnership with Community Care of North Carolina.

The Consumer Assessment of Healthcare Providers and Systems (CAHPS)

This is a patient experience survey that serves as a national standard for measuring and reporting respondents’ experiences with their health care. NC Medicaid administers the CAHPS surveys to adult and child Medicaid beneficiaries to understand the Medicaid beneficiary experience and inform improvements in care.

CAHPS allows states to include supplemental questions that are fielded with the standard survey questions. For 2021, NC Medicaid decided to devote the supplemental questions to gaining insight into patient experiences with the telehealth services offered due to the COVID-19 pandemic. The full report and a two-page summary are available.

The North Carolina Provider Experience Survey

This was developed and administered across all North Carolina primary care practices or their corporate parent to evaluate the influence of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices that contract with NC Medicaid.

This assessment also explored the experience of providers in early contracting with prepaid health plans (PHPs), as it overlapped with the launch of Standard Plans on July 1, 2021. The baseline assessment will serve as a comparison against PHP performance in future years. The full report and a two-page summary are available.

For more information, please visit the NC Medicaid Quality Management and Improvement webpage.

August Pharmacy Newsletter Available

The latest Medicaid Pharmacy Newsletter, dated August 2022, is now available on the N.C. Medicaid website. In addition to the September 2022 checkwrite schedule, this edition of the newsletter includes the articles:

•  NC Medicaid Pharmacy Point-of-Sale Billing for Pharmacist-Prescribed Paxlovid
• October 2022 Drug Use Review (DUR) Board Meeting
• Reminder Regarding the Naloxone Standing Order 
• Pharmacy Point of Sale Process at Tailored Plan Launch  

Providers are encouraged to review this important information. The 2022 Medicaid Pharmacy Newsletters can be viewed here. 



The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:

•  Updates to Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies
•  2022 and 2023 Advanced Medical Home Measure Targets 
• Community Alternatives Program for Children Waiver Renewal

Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.

Reminder - Call Center & Checkwrite Schedule for Labor Day Holiday

The NCTracks Call Center will be closed Monday, Sept. 5, in observance of the Labor Day holiday. (The Pharmacy Prior Approval Unit will be open holiday hours from 7:00 a.m. to 6:00 p.m.)

In keeping with the published approved 2022 checkwrite schedule, because of the federal holiday, the checkwrite date will be on Wednesday, Sept. 7. The posting and availability of funds to provider bank accounts will depend on the provider's financial institution. Bank of America customers should see their payments in their accounts on the day that the EFT is processed, which will be Thursday (9/8/2022). Providers who bank at other financial institutions should see payments the business day following the date that the EFT is processed, which will be Friday (9/9/2022) afternoon. (Some may post sooner.)

The 2022 checkwrite schedules can be found under Quick Links on the NCTracks Provider Portal home page.

Effective Mathematics Instruction for Students with Significant Cognitive Disabilities

The Office of Exceptional Children is pleased to offer Effective Mathematics Instruction for Students with Significant Cognitive Disabilities series. This course aligns the Foundations of Math with the Extended Content Standards. It is a four-day offering in which three days are devoted to participants learning Evidence-Based Practices in Mathematics specific to the Components of Number Sense, assessing students with significant disabilities on these skills, and how to deliver instruction based on those assessment results. The fourth day integrates understanding the extended content standards and connecting the standards to the newly learned mathematical concepts. Participants will attend days one and two, then break for a period in order to apply the content with students in which they work, before returning for days three and four. At the end of this series participants will be awarded 3.0 CEUs. Participants must be able to attend all sessions and partial credit will not be awarded. Attendance is limited to the first 30 registrants for each location.

Please register through this link: https://ncdpi.az1.qualtrics.com/jfe/form/SV_02ulZRPGkVBpmPc.

If you have any questions, please contact Matthew Martinez at [email protected].

Sessions: Each session will be from 8:30-3:30.

Location: Asheville, NC

Dates: September 20-21 and October 5-6, 2022

Registration Closes: September 6, 2022

Location: Greensboro, NC

Dates: September 28-29 and October 26-27, 2022

Registration Closes: September 14, 2022

Location: Lillington, NC

Dates: March 21-22 and April 18-19, 2023

Registration Closes: March 7, 2023

Location: Wilmington, NC

Dates: March 29-30 and April 26-27, 2023

Registration Closes: March 15, 2023

Healthy Blue Initiative and Foster Family Alliance collaboration for CRM training for professionals and separate for foster families

The Foster Family Alliance and the Healthy Blue Initiative are collaborating together to host introduction workshops for staff working with children,

youth and families in foster care (September) and 90 minute workshops for

foster parents (October) to learn the internationally used, biology-based wellness

skill model called the Community Resiliency Model®. The model teaches skills

and concepts to recognize and manage stress in order to re-set and stabilize

the nervous system. Participants will learn skills to help before, during, and

after stressful events and experiences as well as skills to manage the

activities of daily living at home and at work that can be easily shared with

their social networks. 

The workshops for professionals will take place on Friday,

September 16 at 11:00 a.m. - 12:00 p.m. and Friday, September 23 at 9:00

a.m.-10:00 a.m. to learn the foundational concepts of the model and

opportunities to bring at no cost to them or their organization. The workshops

for foster parents will be Thursday, October 6 at 7:00 p.m.- 8:30 p.m. and

Thursday, October 13 at 7:00 p.m. - 8:30 p.m.

Flyers and Information:

• CRM One-Page Flyer
• Trauma Resource Overview
• FFA & HBI CRM Workshop 3
• FFA & HBI CRM Workshop 4

Worker Classification 101: Employee or independent contractor

It’s critical for business owners to correctly determine whether the people providing services are employees or independent contractors. IRS Tax Tip 2022-117 provides information to help businesses avoid problems that can result from misclassifying their workers.

Health-Care Coverage for Children and Youth in Foster Care—and After

Children and youth in foster care often have significant health-care needs (Bilaver et al., 2020). Provisions in the Patient Protection and Affordable Care Act (ACA) and Family First Prevention Services Act (FFPSA) have increased access to and affordability of health care for

some of our most vulnerable children and youth.

This issue brief reviews the eligibility pathways that enable children and youth in foster care to receive Medicaid or other health-care coverage

and includes resources to help youth and young adults understand their health-care options.

It also provides resources for child welfare agencies to assist children, youth, and families in accessing health-care services, including

resources related to the COVID-19 pandemic.

Read Brief

Facebook Event: The Youth Mental Health Crisis

On August 11, 2022, NIMH Deputy Director Shelli Avenevoli, Ph.D., led a discussion on the youth mental health crisis during a Facebook Live Event. Dr. Avenevoli discussed youth suicide, the effects of technology and the pandemic on the developing brain, and what the research says about supporting the mental health of current and future generations of youth.

Watch the Recording

The Collaborative Reform Initiative Technical Assistance Center is a partnership between the COPS Office and many professional law enforcement organizations throughout the field to provide technical assistance to law enforcement agencies on request. In its first four years, the center fielded close to 700 requests for assistance from campus, local, county, and state agencies on critical issues like community engagement; active shooter response; de-escalation; crime analysis; mass demonstrations; school safety; and recruitment, hiring, and retention.

This report shows how the center has supported agencies in their efforts to ensure public safety in their communities. The COPS Office is committed to continue working diligently with our partners to provide high-quality, relevant, and timely assistance by the field, for the field.

View Publication

WRAL:

Whistleblower lawsuit filed following WRAL Investigation into Medicaid misspending

A whistleblower who claims North Carolina misspent millions of taxpayer dollars on a computer overhaul of the state’s Medicaid system is now suing for wrongful termination and defamation.

Rob Morehead, who’s represented by the Noble Law Firm, filed the lawsuit Thursday in Wake County. The defendants are state Department of Information Technology secretary and state chief information officer James Weaver and state Department of Health & Human Services assistant secretary of technology services Charles Carter.

Morehead is suing NCDIT for wrongful termination — saying he was a contract worker at the time of his firing.

The lawsuit blames Weaver and Carter for spearheading the firing, including making false statements about Morehead. He’s seeking back pay, restoration of benefits and other damages.

Read Here

NC Medicaid providers say they're owed big bucks while children go without care

One year into a multibillion-dollar overhaul of North Carolina’s Medicaid program, providers complain that billing delays from insurance companies that manage claims are leaving patients without full treatment and the providers with financial problems.

Providers who’ve reached out to the state’s help line to complain describe the transition as a debacle. Some fear losing their businesses as late payments stretch into six figures.

“I’m losing sleep wondering if I am going to be able to make payroll,” Sharon Jordan, the chief executive of a Charlotte speech therapy company, said in an email to the state ombudsman charged with troubleshooting problems.

“I’m so tired,” Jordan wrote in a June email released through the state open records act. “I’m so depleted. I am tired of fighting. If this is what the state of North Carolina intends to happen with this change, then you’ve won.”

Read Here

Carolina Public Press:

FAQ: What happened with Cherokee County’s Department of Social Services?

Cherokee County recently agreed to pay its share of a combined $53 million in settlements, jury awards and attorney fees related to nearly two dozen federal lawsuits against its Department of Social Services. 

The lawsuits followed actions by local social workers who convinced parents to give up their children without any judicial oversight. This is unlawful in North Carolina, a judge ruled in early 2019, a few months after the scheme was uncovered.

Lawyers for the county said its social workers were responsible for 30 child removals from 2009-18. Lawyers for the children and parents, however, say there could be dozens more.

One criminal case is pending, involving a former county attorney, Scott Lindsay. The settlement amounts against this county-run DSS are unprecedented in North Carolina for cases of this type.

Read Here

New:  Tuesday, August 23, 2022

The state Behavior Analyst Licensure Board holds a public hearing via Zoom to discuss possible rule changes

Time: 4:00 pm thru 5:00 pm

Join Here

New: Wednesday, August 24, 2022

Medicaid and CHIP Continuous Enrollment Unwinding: What to Know and How to Prepare

Time: 12:00 pm thru 1:00 pm

Register

New: Wednesday, August 24, 2022

Navigating Complex Care Models – 5 Stages of Complex Care and Reimbursement Model Experience

Time: 1:00 pm thru 2:00 pm

Register

New:  Thursday, August 25, 2022

Somebody's Child or Nobody's Child

Time: 1:00 pm thru 2:00 pm

Register

Watch Part 1

New:  Thursday, September 8, 2022

Lisa Cauley Joins Karen McLeod for Benchmarks' Child Welfare Webinar

Time: 8:00 am thru 9:00 am

Register

New: Saturday, September 10, 2022

Hear. Share. Act!  Reich College of Education Building, 151 College Street, Boone, NC 28608 

Time: 9:30 am thru 12:30 pm

Register

New:  Wednesday, September 14, 2022

Kinship Families Affected by Substance Use and Mental Health Disorders

Time: 1:00 pm thru 2:30 pm

Register

New:  Friday, September 16, 2022

Dave Richard Joins Benchmarks' Friday Membership Webinar

Time: 8:30 am thru 9:30 am

Register

New: Saturday, September 17, 2022

Hear. Share. Act!  Unity Church, 4301 South Charles Boulevard, Greenville, NC 27858 

Time: 9:30 am thru 12:30 pm

Register

New:  Wednesday, September 21, 2022

Competitive Integrated Employment Series

Time: 12:00 pm thru 1:00 pm

Join Here