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Benchmarks' Friday Membership Webinar
with Dave Richard and Karen McLeod
October 21, 2022
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Benchmarks' Upcoming Webinars
New: Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley
Date: Thursday, November 10, 2022
Time: 8:00 am thru 9:00 am
Register
New: Benchmarks' Friday Membership Webinar with Dave Richard and Karen McLeod
Date: Friday, November 18, 2022
Time: 8:30 am thru 9:30 am
Register
Benchmarks' Collection of Past Updates
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New Standardized PHP Notification of Nursing Facility Level of Care Form
To streamline processes for nursing facility admissions and the determination of long-term care financial eligibility, NC Medicaid created a new standardized PHP Notification of Nursing Facility Level of Care Form (NC Medicaid-2039) for PHPs and nursing facilities to communicate with local Departments of Social Services (DSS).
The standardized form includes all information a local DSS needs to begin the financial determination for long-term care as required by the Centers for Medicare and Medicaid Services (CMS). Once counties conduct the financial determination and establish the patient monthly liability (PML), the PML will be shared with health plans and allow payments to proceed to nursing facilities.
To further clarify how this process works, NC Medicaid created stakeholder-specific fact sheets for counties, for health plans, and for providers (including hospitals and nursing facilities). The fact sheets outline the information flow, timelines and requirements for the long-term care financial eligibility determination process.
o County Fact Sheet
o Health Plan Fact Sheet
o Provider Fact Sheet
NC Medicaid will host stakeholder webinars to answer questions in the coming weeks, more information will be forthcoming as these webinars are scheduled. Stay tuned to the Medicaid provider bulletin for the latest information.
Please share with any interested stakeholders.
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Fee Schedule and Covered Codes webpage coming in November
Effective Nov. 3, 2022, all fee schedules currently listed on the NC Medicaid website will be moved to a new fee schedule and covered code website available to the public. The new website offers enhanced search options for fee schedules, covered procedure codes and covered revenue code data. These enhancements include:
Fee Schedules - (NC Medicaid Website Fee Schedules Only)
- Fee schedules will be made available in a formatted, standardized template
- A single link will be available to download all current and archived fee schedule files
- A single link will be available to access a new lookup tool that allows users to search for fee schedule data using filters
Covered Procedure Code Combinations and Covered Revenue Code Documents
- These documents will be moved to a new website accessible to Health Plans and Providers
- A single link will allow users to download each of the covered procedure code combinations and covered revenue code files
- A single link will be available to access a new lookup tool to search for covered procedure code combinations data and covered revenue code data using filters
All fee schedule data created prior to Nov. 3, 2022, will remain on the current NC Medicaid Fee Schedule web page. A link to the new website will be available by Nov. 3, 2022. More details will be shared closer to the launch. Please refer any questions to the NC Medicaid Contact Center at 888-245-0179.
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Changes in NC DHHS Medical Leadership
I am excited to announce a reorganization and expanded roles of some of our medical leadership to better resource our cross-departmental work and support our three overarching priorities – Behavioral Health & Resilience, Strong & Inclusive Workforce, and Child & Family Wellbeing – and ensuring a foundation of health equity and whole person health is woven throughout. These changes are reflected in our updated NC DHHS Organizational Chart.
Dr. Carrie Brown will serve as the NC DHHS Deputy Chief Medical Officer and Chief Psychiatrist. In this role, Dr. Brown will continue and expand upon DHHS’s work in promoting integrated physical and behavioral healthcare, child and family well-being and behavioral public health. She will lead the department’s Behavioral Health and Resilience priority area initiatives. She will continue her partnership with key stakeholders for behavioral health, substance use disorder, intellectual and developmental disabilities, traumatic brain injuries, and provide medical leadership for the Division of Mental Health, Developmental Disabilities, and Substance Use Services. She will also continue to serve as the Chief Medical Officer for State Operated Health Facilities. As Deputy Chief Medical Officer and Chief Psychiatrist, Dr. Brown, will continue to report directly to the Deputy Secretary for Health and will have matrix reporting to Dr. Elizabeth Tilson, NC DHHS CMO and State Health Director. This change will be effective immediately.
Dr. Shannon Dowler will serve as the NC DHHS Deputy CMO for Health Access, in addition to remaining the Chief Medical Officer for Medicaid. In this more expanded DHHS role, Dr. Dowler will work at the direction of Debra Farrington, Chief Health Equity Officer, in supporting the Health Equity Portfolio and Health Equity team as they provide departmental leadership to health equity. She will bring clinical and operational expertise to multiple health equity issues which align with Departmental priorities with a focus on embedding equity in payment models and in clinical frameworks and policy. She will continue her strong leadership in the Medicaid program where she oversees the Clinical, Quality and Population Health teams. In this new role, Dr. Dowler, will continue to report directly to Deputy Secretary for Medicaid and will have matrix reporting to Dr. Elizabeth Tilson, NC DHHS CMO and State Health Director State. She will begin to transition into this role immediately and will be fully effective 1/1/2023.
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Transitions to Community Living (TCL) Employment Incentive Plan
The Transitions to Community Living (TCL) Settlement Agreement lists supported employment as a vital service to support people with serious mental illnesses (SMI) in community-based housing. The Settlement Agreement requires provision of supported employment services to individuals with SMI who reside in or are at risk of entering congregate living facilities.
State services data and reports from the Independent Reviewer continue to indicate low rates of enrollment in the Individual Placement and Support (IPS) service and low rates of competitive, integrated employment (CIE) for TCL members, including individuals receiving In-Reach services and those in diversion, as well as individuals living in community-based housing, with or without TCL housing slots.
The Department of Health and Human Services (DHHS) is committed to improving access to supported employment services and opportunities for competitive, integrated work in the community for TCL members before the expected settlement end date of June 30, 2023.
To this end, the Division of Mental Health, Development Disabilities and Substance Abuse Services (DMH/DD/SAS) developed an employment incentive plan that will be incorporated effective Oct. 1, 2022, into the TCL incentive plan developed by the DHHS TCL/Olmstead office.
• Transitions to Community Living (TCL) Employment Incentive Plan
• TCL Employment Incentive Plan Workbook
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Revision to the State-Funded Community Living and Support Service
A revision has been made to the State-Funded Community Living and Support (CLS), Intellectual and Developmental Disabilities (I/DD) and Traumatic Brain Injury (TBI) service definition to provide clarification to the service limitations section.
• Revision to the State-Funded Community Living and Support Service
• State-Funded Community Living & Support (I/DD & TBI) Service Definition
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NC One Community in Recovery Call for Proposals
14th Annual NC “One Community in Recovery” Conference
SAVE THE DATE!
March 1-3, 2023 | Greensboro, NC
The Annual NC “One Community in Recovery” Conference is a yearly conference planned by a statewide committee of behavioral health providers and advocates, many of whom have lived experience with recovery from mental health and/or substance use.
Call for Proposals
The planning committee for the NC “One Community in Recovery” Conference is excited to announce the dates for our 14th annual program. The conference will be held in person at the Embassy Suites Greensboro Airport.
We are actively seeking proposals that will explore diverse topics and disseminate new concepts about recovery and resiliency throughout our state. To apply, please complete this application and return by October 28, 2022.
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The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:
Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.
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Rapid Access to Residential Supports for Children and Youth Announcement-UPDATE
Effective October 1, 2022, Eastpointe, in conjunction with all other LMEs-MCOs, has established a standardized rapid access Utilization Management and Review protocol to ensure children and youth can receive medically necessary residential services without delay. Please reference the following links for information on this new protocol:
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Effectively Responding to a Child in Crisis
Responding effectively to a child in crisis is an essential skill for parents who foster or adopt a child who has a history of trauma and loss. While most parents know the challenge of responding to a child who is having the dreaded “meltdown,” parents who have adopted or are fostering may face these challenging behaviors more frequently. Knowing how to effectively respond improves parents’ ability to ensure the child’s safety, and it can also be an opportunity to help the child learn to handle their feelings more constructively while also strengthening their relationship with the child.
Keep in mind that children need their parents the most during the tough times, and one of those tough times is when a child has lost control and their behavior is escalating. It is important that parents understand what is underneath the behavior. As human beings, our bodies and minds respond to fear and stress with a fight, flight, or freeze reaction, which are useful responses when we are in danger. For the child who has experienced trauma and loss, the threshold for feeling fearful and stressed is lower, so the child may move faster and more quickly into a fight, flight, or freeze response, even when it looks to us like there is no apparent danger. Remember, that at some point in the child’s life, these responses were necessary for the child’s emotional, and perhaps physical, safety. The child may not have been able to consistently rely on receiving help and comfort from adult caretakers, so it may take time and many repeated positive moments to help the child understand that the parent will be there to support the child in managing their fears and stressors.
But first, it is essential for parents to build self-awareness of their own reactions to fear and stress. Remember that we are only human, so it is likely that our bodies and minds might react with a fight, flight, and freeze response to the child who has lost control of their behavior and emotions. Emotional states are often contagious. Parents will need to be proactive in planning for how to respond to a crisis. It will take good self-awareness, increased knowledge, and lots of practice for parents to respond to the child in ways that are helpful in calming the child rather than in ways that may escalate the child’s behavior. Parents need good support and resources to help them build skills in this area. One useful resource for learning more about responding effectively to a child in crisis is the National Training and Development Curriculum’s (NTDC’s) Right-Time theme, Responding to Children in Crisis.
This Right-Time theme includes many helpful resources, including a video featuring professionals and parents sharing their real-life experiences with helping children in crisis. One important section of the video involves a discussion about the importance of understanding the following four phases of a crisis and their key points:
- Triggering: A trigger for a crisis can be an internal or external event that reminds the child of an emotion that they have had before. Sometimes triggers are obvious, but sometimes they are not. Building awareness of what has triggered the child may be a good strategy in working to prevent a future a crisis.
- Escalation: It is important to recognize the signs of escalation and react in a way that may help the child remain calm, such as using a calm voice and keeping words to a minimum, keeping body language related and open, and using distraction if possible. The immediate goal for this and the next phase is to keep the child safe.
- Crisis: The most important thing for a parent to do is to stay calm and help the child remain calm. Remember that consequences and punishment do not work in this phase and often make the situation worse. Focus on the child’s feelings rather than behavior. The role of the parent during this phase is to be a soothing presence.
- Recovery: After the child has calmed, this time can be used for learning and building connection between the child and parent. This can be a time to reflect on what was and was not helpful and to problem solve around what to do to avoid or help during a crisis.
Parenting a child with a history of trauma and loss offers rewards and challenges. It is important that parents be proactive in getting the support and resources they need to be successful. The NTDC Right-Time themes can be a useful resource, and the link is provided below as one of the three resources for learning more about this topic.
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Incentive Pricing TJC Accreditation
We have a couple incentive pricing programs in place for organizations who are converting from CARF or COA accreditation to Joint Commission Accreditation. Organizations are eligible once they submit their TJC application.
They are as follows: (No end-date to these incentives)
- Organizations with < 20 sites
- 7% discount on first cycle annual fees
- 1 Year Policy Source Subscription
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BHC Annual Conference Registration for 1st Year of Initial Cycle
- Organizations 20 or greater sites
- 10% discount on first cycle annual fees for 1 cycle commitment; 10% discount on annual fees for 2 cycle commitment
- 1 Year Policy Source Subscription and 1 annual BHC Conference Registration for the first year of cycle 1 and the first year of cycle 2 commitments
For all other organizations that submit an application by November 30, 2022 we can provide a free print Accreditation Standards Manual.
Reach out to Julia Finken for more information.
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New Clearinghouse Ratings
H/T CCR's Sarah Pfau!
The Title IV-E Prevention Services Clearinghouse released new program ratings last week.
- Arizona Kinship Support Services - Supported
- Bounce Back - Promising
- BRAVE - Does Not Meet Criteria
- Cognitive Behavioral Intervention for Trauma in Schools - Promising
- Functional Family Therapy - Child Welfare - Does Not Meet Criteria
- Functional Family Therapy - Therapeutic Case Management - Does Not Meet Criteria
- Guiding Good Choices® - Well Supported
- Multimedia Circle of Life - Does Not Meet Criteria
- Multisystemic Therapy - Substance Abuse - Does Not Meet Criteria
- Multisystemic Therapy - Prevention - Does Not Meet Criteria
- SafeCare Augmented (Re-Review) - Does Not Meet Criteria
- Strong African American Families - Well Supported
- Strong African American Families – Teen - Does Not Meet Criteria
Of note, with the addition of Arizona Kinship Support Services, there are now 2 Kinship models that are rated promising or above.
Here you can find the entire list of rated programs along with those programs under review and re-review.
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Workforce shortages in DHHS creating wider problems
As North Carolina’s chief medical examiner, Michelle Aurelius says she has trouble sleeping at night.
It’s not just because of the nature of her work — seeing that violent, suspicious and overdose-related deaths are adequately investigated from a medical perspective.
What troubles her is that medical examiner system cases in North Carolina have increased by almost 25 percent in just four fiscal years. In her office alone, which deals with some of the more complex cases, the autopsy workload has gone up by 49.9 percent since 2019.
Her workforce has not increased in years. Instead, it has shrunk over time as some pathologists retire and others burn out and leave.
Recruiting has its own obstacles and hurdles. Some pathologists just fresh out of medical fellowships head for other states that offer starting salaries tens of thousands of dollars higher than the $180,000 per year that North Carolina offers. Aurelius said she saw a flier recently for a $300,000 starting salary.
Read Here
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Monday, October 24, 2022
North Carolina Medicare-Medicaid Integration: Advancing Whole-Person Care
Time: 12:00 pm thru 1:00 pm
Register
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New: Monday, October 24, 2022
Joint DMH/DD/SAS & DHB Monthly Consumer Webinar
Time: 2:00 pm thru 3:00 pm
Register
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New: Monday, October 24, 2022
FDIC to Convene Meeting of its Advisory Committee of State Regulators
The meeting’s agenda includes a discussion of banking conditions; a dialogue regarding state and federal coordination; a briefing on the amended Deposit Insurance Fund restoration plan and deposit insurance assessments; and an update on minority and community development banking. Read the full agenda.
Time: 2:00 pm thru 3:00 pm
Live Webcast Here
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Tuesday, October 25, 2022
Virtual PCS Stakeholder meeting
Time: 10:00 am thru 11:00 am
Register
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New: Wednesday, October 26, 2022
NAMI Diversity, Equity, & Inclusion
Time: 12:00 pm thru 1:00 pm
Register
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New: Wednesday, October 26, 2022
Working Solutions for Working Women
Time: 1:00 pm thru 2:00 pm
Register
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New: Thursday, October 27, 2022
National Substance Use Prevention Month: Working Together to Prevent Substance use and Misuse
Time: 11:00 am thru 12:30 pm
Register
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New: $$$ Friday, November 4, 2022
Youth Resilience Summit
Time: 8:30 am thru 4:45 pm
Buy Tickets Here
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New: Tuesday, November 8, 2022 (and November 10, 15, & 17)
Fostering School Success: How Caregivers and Social Workers Can Support the Educational Needs of Children
Time: 12:00 pm thru 2:00 pm
Register
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New: Thursday, November 10, 2022
Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley
Time: 8:00 am thru 9:00 am
Register
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New: Thursday, November 10, 2022
A New Approach to Evaluate Outcomes of Complex Care Randomized Controlled Trials: The Distillation Method
Time: 12:00 pm thru 1:00 pm
Register
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New: Wednesday, November 16, 2022
Teletown Hall: Year in Review and What's New for 2023
Time: 12:00 pm thru 1:00 pm
Register
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New: Friday, November 18, 2022
Benchmarks' Friday Membership Webinar with Dave Richard and Karen McLeod
Time: 8:30 am thru 9:30 am
Register
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Tailored Care Management Educational Offerings
Ongoing Webinar Sessions and Trainings: Some are free, some require a fee, and some are for CMA organizations that have passed the desk review only.
NC AHEC has partnered with the NC Department of Health and Human Services and Division of Health Benefits to equip Tailored Care Management (TCM) candidates with the tools and knowledge to effectively provide care management services to North Carolina’s Tailored Plan beneficiaries through Continuing Professional Development (CPD) opportunities. Find a list of monthly offerings below and join us for one or for all!
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