Upcoming Benchmarks' Webinars
Please align your calendars with the dates below.

Benchmarks' Friday Membership Webinar
Dave Richard Joins Karen McLeod
Date: Friday, April 2, 2021
Time:  8:30 am thru 9:30 am

Benchmarks' Child Welfare Webinar
Lisa Cauley Joins Karen McLeod
Date: April 8, 2021
Time: 8:00 am thru 9:00 am

Benchmarks' Friday Membership Webinar
Andrew Clendenin, United Healthcare, Joins Karen McLeod
Date: Friday, April 16, 2021
Time:  8:30 am thru 9:30 am

Benchmarks' Legislative Report
Post Adoption Workshop and Training
The North Carolina Division of Social Services will host a Post Adoption Workshop on May 25, 2021. The topics of the workshop will include the Post Permanency Program-Post Adoption Support Services (PASS) and Success Coach Post Adoption Permanency Model, which will be presented by Catawba County Department of Social Services. Part II of the workshop will be a training on adoption assistance forms, DSS-5012, The Adoption Assistance Checklist and DSS-5013, the Adoption Assistance Agreement.

The workshop will highlight the importance of post adoption support services to families and significance of permanency in the lives of children. The training portion of this workshop will provide technical assistance to the county department of social services’ staff who have the responsibility to complete the adoption assistance forms.
It is recommended that staff managing these responsibilities participate in the workshop and training to learn current policies and practices. We look forward to sharing this essential information as we work towards the goal of permanency for the children of North Carolina.

Registering below will include participation in the workshop and training.

The event date and time: May 25, 2021, 9:00AM-1:00PM

Should you have questions, please contact Beth Riley at (910) 986-8078, [email protected].

Medicaid Health Equity Payments
To support the North Carolina Department of Health and Human Services’ (NCDHHS) goals to achieve health equity, NC Medicaid is introducing an enhanced payment to Carolina Access primary care practices serving beneficiaries from areas of the state with high poverty rates.
 
This initiative aims to improve access to primary care and preventive services for Medicaid and NC Health Choice beneficiaries in North Carolina at a time when historically marginalized populations are facing challenges highlighted by the COVID-19 public health emergency. These payments will be available for three months as a limited initiative from April-June 2021.
 
To be eligible for these payments, the practice must be Carolina Access I or II. Practices must meet a minimum beneficiary poverty score, determined by the average poverty rate for the census tracks of the beneficiaries assigned to each practice’s location.
 
For more information, please see the Health Equity Payment Initiative Medicaid bulletin article.

New Vax Guidance - Change in Priority Groups
Today we announced an accelerated timeline for moving to Groups 4 and 5 for vaccine eligibility. The rest of Group 4 will be eligible on March 31 and all adults eligible beginning April 7. The move will allow the state and vaccine providers to continue to get vaccines into arms quickly and continue to reach underserved and historically marginalized populations.
 
NCDHHS also announced a new public private partnership, Healthier Together: Health Equity Action Network, to enhance the state’s work to deliver equitable access to vaccines, and released a new biweekly equity data report to provide another avenue for transparency. 
 
Accelerated Timeline
Beginning on March 31, additional essential workers and people living in other congregate settings such as student dormitories will be eligible for vaccination. Essential workers include frontline workers and workers who do not have to be in-person for work in an expanded range of sectors such as construction, energy, financial services, public works and others as categorized by the Cybersecurity and Infrastructure Security Agency. A complete list is available in our Deeper Dive.
 
All North Carolinian adults 16 and older will be eligible to be vaccinated beginning on April 7.
 
Doubling Down on “Fast and Fair”
The accelerated timeline will allow the state to double down on its “fast and fair” approach to getting shots into arms. Healthier Together, a new public private partnership with the NC Counts Coalition, will help increase the number of individuals from historically marginalized populations that receive COVID-19 vaccinations and provide a foundation for a longer-term framework for health equity.
 
Healthier Together will implement strategies to drive demand and increase access to vaccines to historically marginalized populations by conducting outreach and education efforts, coordinating local vaccine events at trusted and accessible locations, helping people schedule and get to vaccine appointments, providing on-site translation services, and helping ensure people get to second dose appointments. 
 
Learn more about Healthier Together.
  
Data Transparency
Promoting COVID-19 Vaccine Equity in North Carolina reports the share of vaccinations in the past week going to Black/African American, Hispanic/Latinx, and American Indian or Alaskan Native populations as well as key metrics for earning trust, embedding equity in vaccine operations, and promoting accountability through data transparency. The report also highlights best practices to promote equitable access to vaccinations. It will be updated every two weeks.  
 
National Recognition
North Carolina has been recognized nationally for its work to get COVID-19 vaccines to historically marginalized populations. North Carolina was named the only state to collect and publicly report race and ethnicity data for nearly 100% of vaccinations. According to the CDC, two-thirds of those vaccinated in North Carolina between December 14, 2020 and March 1, 2021 were from “highly” or “moderately” vulnerable communities, ranking the state in the top ten for equitable vaccine coverage. North Carolina was also featured in Bloomberg News for its data-driven approach to reducing disparities in vaccination rates.
 
For accurate information about COVID-19 vaccines, visit YourSpotYourShot.nc.gov.  

Visitation Guidance from DHSR
This week we had a BH-IDD Consumers and Family call. Many of the questions focused on visitation guidelines, with emphasis on home visits including overnight visits with family. The Department updated the visitation guidance on March 16, 2021. 

It addresses many of the concerns voiced by families. We appreciate the extraordinary measures our providers have used to keep clients and staff safe during the pandemic. We also strongly recognize the need to continue to employ the core principles of COVID-19 infection prevention, including maintaining physical distancing and the 3 Ws. As the guidance outlines, we must allow visitation to the maximum extent possible following the principles outlined in both updated CDC and CMS guidance.

As more clients, staff and families are fully vaccinated we need to re-calculate the risk versus benefits of facilitating home and overnight visits for vaccinated clients.

We have included the link to the updated visitation guidance on the DHHS Dashboard. The information on greater than 24 hour visits for unvaccinated clients is highlighted green and vaccinated clients is in yellow. Please work with your consumers and families to ensure safe maximum visitation. These visits are so important to your clients’ mental and physical health. Please email Michiele Elliot if you have questions or concerns. 

Easing COVID-19 Restrictions, School Guidance Update – March 2021
With North Carolina’s COVID-19 key metrics improving and vaccinations increasing, Governor Cooper announced today a continued easing of restrictions through Executive Order 204.

Throughout the pandemic, North Carolina has been guided by science and data, including a combination of four key metrics – the number of people going to the Emergency Department with COVID-like symptoms, the number of cases, the percent of tests that are positive, and the number of people hospitalized. All are showing positive trends. At the same time, we are quickly getting people vaccinated. 32 percent of North Carolinians are partially vaccinated and 19 percent are fully vaccinated (these rates include federal pharmacy programs, which will be incorporated in the public dashboard beginning on March 24).

What is staying the same?
The mask mandate remains in effect. Everyone must wear a mask indoors and in all public settings.

Businesses must also maintain the appropriate 6 feet of distance requirement and continue to implement other safety protocols as they expand their capacity.

What is changing?
While continuing to require masks and social distancing, lower risk settings will be allowed to open up to full capacity, medium risk settings will be allowed to open up to 75 percent capacity indoors, and higher risk settings will be open up to 50 percent.

  • Examples of lower risk settings that can now open up to full capacity include retail shopping businesses, child care, camps, outdoor playgrounds, personal care businesses, and museums.
  • Examples of medium risk settings that are now open up to full capacity outdoor and up to 75 percent indoor include restaurants, breweries, wineries, gyms, pools and amusement parks.
  • Examples of higher risk settings that can open up to 50 percent capacity include stadiums and arenas, conference spaces, reception spaces, movie theaters, gaming and bars.

Settings and activities are lower risk when they involve interacting with fewer people, being outside, keeping masks on the entire time, keeping interactions with people short (under 15 minutes), staying physically distant, and avoiding singing, yelling, and cheering.

Executive Order No. 204 will also increase mass gathering limits from 25 to 50 people indoors and 50 to 100 outdoors. It also fully lifts the restriction on the late-night sale and service of alcoholic beverages on bars, restaurants, and other establishments.

Our Current COVID-19 Restrictions in NC fact sheet provides a complete list.

In addition to the Executive Order, the North Carolina Department of Health and Human Services updated guidance for schools. Schools should return to in-person instruction to the fullest extent possible while following all public health protocols in the StrongSchoolsNC Toolkit, including wearing masks all the time and cleaning of high traffic areas. Schools are highly encouraged to conduct screening testing as recommended by the CDC and provided for free to schools in partnership with DHHS.

As always, we hope you will share information about COVID-19 vaccines with your networks. We have a comprehensive communications toolkit with bilingual flyers, posters, social media graphics, a video library, and more.

COVID-19 Update
PRESS RELEASES since the last update include:
 
NEW resources since the last update include:

UPDATED guidance since the last update includes:

UPDATED reports since the last update include:

NEW EVENTS ADDED to the community testing events page
 
UPDATED Contact Tracing numbers
Upcoming Changes in NCTracks

Important Email Update
Effective March 31, NCTracks emails will come from the email address [email protected] (rather than the current address, [email protected]). Please add the new email address, [email protected], to your safe senders list to ensure you continue to receive important updates from NCTracks. Thank you!
Several important updates are coming to NCTracks next month. Providers are encouraged to review this important information to be aware of the upcoming changes.
 
Update to Pharmacy Lock-In Criteria
Effective April 25, 2021, in accordance with NC Legislation General Statutes § 108A-68.2.(e), NCTracks will implement an update to the pharmacy lock-in criteria for opiates, benzodiazepines and certain anxiolytics. This update will change the number of prescriptions and number of prescribers used in the criteria for selecting beneficiaries for the Lock-In Program. See updated criteria 
 
NCTracks to Capture and Store CAP C/CAP DA Recipient Consent Forms 
Effective April 25, 2021, a new tab will be added to the Secure Recipient Portal in NCTracks with forms for Community Alternatives Program for Disabled Adults (CAP/DA) and Community Alternatives Program for Children (CAP/C) members to access. What to tell recipients 
 
NCTracks to Verify Active Home State Medicaid Participation for Border and Out-of-State Locations 
Effective April 25, 2021, in accordance with Code of Federal Regulations 42 CFR 455.410, 42 CFR 455.414, 42 CFR 455.450 and 42 CFR 455.460, NCTracks will verify active Medicare* or home state Medicaid participation for all border and out-of-state service locations submitted on Initial, Re-Enrollment, Re-Verification and Manage Change Request Applications (MCRs), including backdated applications. Verification details 
 
Two New Dental Taxonomy Codes Added to NCTracks
Effective April 25, 2021, new taxonomy codes will be available for dental providers in the NCTracks system. Please see the chart for additional information about these new taxonomies. Review chart and taxonomy descriptions

New Medicaid Bulletins and SPECIAL BULLETIN COVID-19 #162 and #163 Available
New Medicaid Bulletins as of March 24, 2021
The NC Division of Health Benefits (DHB) has recently published several new Medicaid Bulletin articles: 
  
SPECIAL BULLETIN COVID-19 #162 and #163 Available
The NC Division of Health Benefits (DHB) has recently published two Medicaid Bulletin articles related to COVID-19:
 
SPECIAL BULLETIN COVID-19 #162: Medicaid Rate Increases for COVID-19 Vaccine Administration Codes
Effective March 15, 2021, NC Medicaid is aligning reimbursement for COVID-19 vaccine administration with the Centers for Medicare & Medicaid Services' (CMS) increased Medicare rate of $40 per dose. More information
 
SPECIAL BULLETIN COVID-19 #163: Temporary Provider Rate Increases and Clinical Policy Changes Extended
NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through June 30, 2021. Details 
 
Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.
Submission for OMB Review; Human Services Programs in Rural Contexts Study
The Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services is proposing to collect data on the challenges and unique opportunities of administering human services programs in rural contexts. Case studies of 12 communities, in combination with analysis of administrative data and qualitative comparative analysis of the qualitative data, will provide ACF with a rich description of human services programs in rural contexts and provide ACF opportunities for strengthening human services programs' capacity to promote the economic and social wellbeing of individuals, families, and communities in rural contexts.

Summarizes a series of webinars on Medicaid telehealth policy changes during the COVID-19 pandemic. Topics covered include telehealth policy developments related to the public health emergency (PHE), Medicaid program engagement and education of healthcare providers, patient education and engagement to increase telehealth access, and discussions of the future of telehealth policy. Offers specific examples from state-level Medicaid programs, with charts and data on telehealth utilization and outcomes.
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center.





Supporting Children’s Mental Health During
the COVID-19 Pandemic

Living through a pandemic can have long-term impacts on the social and emotional health of children. However, strengthening our support for children’s mental health can help them avoid these negative consequences and even thrive when faced with adversity.
 
How can the COVID-19 pandemic impact children's mental health?
The past year has forced many children and youth to cope with disruptions to their normal lives, the stress experienced by their caregivers, and feelings of fear, anger, and/or sadness associated with the pandemic. The pandemic meets the National Child Traumatic Stress Network's definition of a traumatic event. However, it will likely have varying impacts on children. Read this NYU Langone Health article for help determining whether your child is experiencing trauma and ideas for coping.
 
It is essential to equip caregivers and child welfare professionals with the right resources to strengthen their support of children’s mental health through times of hardship.
 
Caseworkers can encourage children and youth to build and maintain well-being by taking a trauma-informed approach, which allows them to address the challenges that children are facing while enhancing their resilience and well-being.
 
It is also important that caseworkers and caregivers encourage children to express their emotions and that they listen to the need being expressed behind the emotion.
 
Use the following additional resources for information about supporting children's mental health:






Private Agency Training Info
Fostering Health NC is a project of the North Carolina Pediatric Society (NCPeds), guided by the American Academy of Pediatrics’ (AAP) Standards of Care with a goal of improving the overall health and well-being of children/youth in foster care.
 
Fostering Health NC brings together care providers, local departments of social services, foster families, foster home placements, and care management entities to problem solve, collaborate and develop processes to ensure children/youth in foster care have a good link to overall healthcare. We all have a collective responsibility ensure children are healthy, safe, and thriving.
 
This training will review the impacts of trauma on the health needs of children and youth in foster care, what resources are available to support coordination of the healthcare needs of this population, and how agencies can get involved in local fostering health initiatives.
 
Date: Apr 22, 2021
Time: 12:00pm-1:00pm
Acute Pain Management Following Surgery: Safe Opioid Prescribing and Strategies to Reduce Opioid Overprescribing
Parents and caregivers across the United States are facing unprecedented challenges, role shifts, and hardships during the COVID-19 pandemic that may negatively impact their parenting and their relationships with their children. Emerging research shows that parents and caregivers are experiencing more significant increases in stress during the pandemic than non-parents. For parents with unresolved histories of adversity and trauma—resulting from experiences such as abuse, assault, or domestic violence—the risks associated with pandemic-related stress may be further compounded.

To promote positive family adaptation to the COVID-19 pandemic, policymakers should increase targeted supports, services, and policies for parents and caregivers with trauma histories. This brief includes information on the impact of COVID-19 on parents and caregivers, particularly those with trauma histories; outlines resiliency factors for this population; and provides guidance for policymakers, providers and agencies, and families on supporting parents and caregivers with trauma histories during and after the COVID-19 pandemic.
Special Events for Autism Awareness Month
The National Institute of Mental Health (NIMH)'s Office of Autism Research Coordination (OARC) is pleased to invite you to two special events to recognize National Autism Awareness Month.
On April 7th, NIMH is hosting a virtual event featuring an interview with Asperger’s Are Us, the first comedy troupe composed entirely of people diagnosed with Asperger syndrome (autism). Their comedic style focuses on deadpan wordplay and dark absurdism.

On April 28th, NIMH will feature presentations from the National Institutes of Health, the Centers for Disease Control and Prevention, the U.S. Department of Education, and the U.S. Department of Labor on issues related to health, education, and employment for people with disabilities during the pandemic, followed by a discussion with leaders from the autism advocacy community. 
Can We Ask if Employees Have Been Vaccinated?’
The above question may be the most frequent one we have encountered from employers in the past several weeks. As more COVID-19 vaccines become available, employers are increasingly curious about the number of their employees who have received partial or full vaccination. This question could aid in return-to-the-office planning or in determining continuing COVID-19 prevention strategies.

The short answer to this question is yes. Employers can ask employees about their vaccination status. Late last year, the Equal Employment Opportunity Commission issued updated guidance confirming that vaccinations are not medical examinations as defined under the Americans with Disabilities Act. This means that employers can ask employees whether they have been vaccinated without having to demonstrate business necessity under the ADA.
The EEOC did say that questions associated with vaccination status may involve disclosure of medical information prohibited under the ADA. For example, employers should not follow up on the vaccination question with ones asking employees why they have not received a vaccine. The answer to this question could involve disclosure of a medical condition that prevents an employee from receiving immunizations.

Employers that decide to ask employees about vaccination status may face some resistance. Some employees may view the question as intrusive. Others may suspect that an affirmative answer to the question will prompt the employer to “force” vaccinated workers to end remote-working arrangements. Regardless, employers have the flexibility to ask this question and use the information obtained to guide COVID-19 policies going forward.

Federal Appeals Court Says Selective Retention Raises May Discriminate Against Female Employees
Employers concerned about losing valuable employees may take the initiative to provide salary increases intended to deter them from seeking alternative employment. A new decision from the Ninth Circuit Court of Appeals cautions employers about the dangers of picking and choosing which comparable employees receive such retention raises.

In Freyd v. Univ. of Oregon, a female professor filed a disparate impact sex discrimination lawsuit, alleging that the university paid comparable female professors less than male ones. The district court granted summary judgment to the university on the basis that its reasoning for providing retention raises to some professors was job related and consistent with business necessity.

On appeal, the Ninth Circuit partially reversed the district court and remanded the case for trial. In its decision, the Ninth Circuit noted that female professors made about $15,000 less than male ones on average, and that the use of retention raises to male professors could account for a significant portion of this disparity. The Ninth Circuit agreed that the plaintiff should be able to present a jury with evidence that female professors either were not offered retention raises at the same rate as males, or that they were less successful at negotiating such raises. In addition, the plaintiff will have a chance to argue that the university could retain talent by offering general raises that do not have a disparate impact against women.

This decision should serve as a cautionary tale to employers that provide salary increases among comparable employees based on subjective views of their value to the organization and risk of departure. True merit raises should be based on documented evaluation of clear performance criteria. Retention bonuses should be granted based on a policy that provides for an equitable valuation of comparable people, and that does not leave the amount of the salary increase up to the negotiating skills of individual employees.

When Must Employers Pay Employees Who Are On Call?
We have had a number of recent questions from clients regarding when employees must be paid if they are on standby or on-call duty. Typically, this means that the employee must leave a number where they can be reached and, if contacted, must report to work within a certain period of time. Prior to the days of universal cellphone use, on-call time presented wage and hour challenges for employers. In more recent times, wage payment lawsuits associated with on-call time have diminished.

Under regulations issued under the Fair Labor Standards Act, employers must pay a non-exempt employee for on-call time if he or she “is required to remain on call on the employer's premises or so close thereto that he cannot use the time effectively for his own purposes. An employee who is not required to remain on the employer's premises but is merely required to leave word at his home or with company officials where he may be reached is not working while on call.”

The U.S. Department of Labor has interpreted this rule to mean if employees are permitted to go about their daily activities, the fact that they are on call does not mean such status is compensable working time. Employees who can be reached through a cellphone are not restricted in terms of their employer’s ability to contact them. If the employer provides 30 minutes or more for the contacted employee to report to work, DOL considers this a reasonable restriction on the employee’s activities.

Of course, on-call duty can be unpopular in that it restricts employees from long-distance travel and requires them to remain in a condition suitable for working. As a result, many employers provide voluntary incentives, such as extra pay for on-call time or, if they are actually called into work, a shift premium or a minimum hours of payment. Employers should also note that some states have laws that require certain payments in the event of on-call duty that differ from the federal FLSA.
Upcoming Events
New: Monday, March 29, 2021
NC FFTA Meeting

Time:  10:30 am thru 12:30 pm

 
Tuesday, March 30, 2021
Rehabilitative or Habilitative:
What is the Difference and How Does it Affect Services

Time:  12:00 pm thru 1:00 pm
 
Tuesday, March 30, 2021

Time:  1:00 pm thru 1:30 pm
 
Watch the livestream event on NIMH’s 
Facebook or Twitter feeds. 
Tuesday, March 30, 2021
Youth At-Risk of Homelessness (YARH2) Webinar Series

Time:  1:00 pm thru 2:00 pm
 
Tuesday, March 30, 2021
Police Interactions and Creating Positive Outcomes

Time: 2:00 pm thru 3:00 pm
 
New: Thursday, April 1, 2021
Joint NC DMHDDSAS and DHB COVID 19 Update for NC Providers

Time:  3:00 pm thru 4:00 pm
 
Friday, April 2, 2021
Benchmarks' Friday Membership Webinar
Dave Richard Joins Karen McLeod

Time:  8:30 am thru 9:30 am
 
New: Tuesday, April 6, 2021
COVID-19 & Funding Resiliency Series
Time:  11:30 am thru 1:00 pm
 
Wednesday, April 7, 2021
Identifying Bias and Addressing Stigma in the Clinical Setting

Time: 12:00 pm thru 1:00 pm

These sessions are approved for continuing education credits for doctors, nurses, and social workers (live attendance only). The University of Vermont designates each session of this internet live activity for a maximum of:
  • 1 AMA PRA Category 1 credit(s)TM: each physician should claim only those credits commensurate with the extent of their participation in the activity;
  • up to 1 Nursing Contact Hours; and 
  • 1 general continuing education credits for social workers completing this course
  • 1 Interprofessional Continuing Education (IPCE) Credit     
Thursday, April 8, 2021
Benchmarks' Child Welfare Webinar
Lisa Cauley Joins Karen McLeod

Time:  8:00 am thru 9:00 am
 
New: Tuesday, April 13, 2021
Medicaid Transformation 101 Webinar

Time:  4:00 pm thru 5:00 pm
 
Friday, April 16, 2021
Benchmarks' Friday Membership Webinar
Andrew Clendenin, United Healthcare Joins Karen McLeod

Time:  8:30 am thru 9:30 am
 
Wednesday, April 21, 2021
Bridging The Gap From Data To Data-Driven Performance

Time:  10:00 am thru 11:15 am
 
New: Wednesday, April 21, 2021
Integrated, Exposure-Based Treatment of Co-Occurring PTSD and Substance Use Disorders

Time:  12:00 pm thru 1:00 pm
 
New: Thursday, April 22, 2021
Private Agency Training Info

Time:  12:00 pm thru 1:00 pm
 
April 28, 2021
The Ethics of Feedback within the Therapeutic Milieu 

Time: 9:30 am thru 11:45 am
 
Wednesday, April 28, 2021
Understanding the Harm Reduction Approach:
 Principles and Practice

Time: 12:00 pm thru 1:00 pm

These sessions are approved for continuing education credits for doctors, nurses, and social workers (live attendance only). The University of Vermont designates each session of this internet live activity for a maximum of:
  • 1 AMA PRA Category 1 credit(s)TM: each physician should claim only those credits commensurate with the extent of their participation in the activity;
  • up to 1 Nursing Contact Hours; and 
  • 1 general continuing education credits for social workers completing this course
  • 1 Interprofessional Continuing Education (IPCE) Credit     
Wednesday, May 26, 2021
Developing New VBP Services That Increase Quality & Decrease Service Costs 

Time:  10:00 am thru 11:15 am