Read More About National Peanut Brittle Day Here

Benchmarks' Friday Membership Webinar

Featuring Jay Ludlam & Karen McLeod

January 26, 2024

Urgent Notification for Providers: January 26, 2024

SIX MORE DAYS!

Attention ALL Eastpointe & Sandhills Center Providers

NEW TO TRILLIUM’S NETWORK!

Do you have claims to submit? Do you want to get paid after Feb. 1? Click on this link to complete the packet: New Network Provider Packet.

Take Action Now!

Step-by-Step Introductions are outlined in Clinical Consolidation Communication Bulletin #03

Tips for Success:

• Download and save the PDF. Complete all forms and signatures in the packet, and Click the Submit Button.
• If you have issues with the submit button, please email the packet to [email protected]
• If you've received an email stating that you are missing a form or signature, please revise and resubmit to [email protected]

For more information, visit our Consolidation Webpage for Providers.

Trillium Health Resources Consolidating with Eastpointe and Sandhills Center

Trillium Health Resources looks forward to serving residents in Guilford, Randolph, Montgomery, Moore, Lee, Hoke, Richmond, Anson, Scotland, Robeson, Sampson, Duplin, Wayne, Lenoir, Greene, Wilson, Edgecombe, and Warren counties starting Feb. 1, 2024.

Members will still receive the same services they do today and will be able to see the same provider.

We understand this change comes during a time of many changes affecting health care. We will be here to help you and answer any questions you may have during this transition. Please click here to view our release announcement about this consolidation.

We are hosting virtual sessions for members each Monday, and providers every day, to answer your questions. Please visit TrilliumHealthResources.org/Consolidation for the links to attend.

Members will receive a letter announcing this change from NCDHHS in January 2024, and a new Medicaid ID card from NC Medicaid with their new LME/MCO listed within one week of Feb. 1, 2024. Members can continue to use old Medicaid ID cards until they get their new card.

Members will also receive a welcome packet from Trillium with an introduction letter and a copy of our member handbook.

For recipients who do not have Medicaid and are currently getting services through an LME/MCO, they will still get services based on the county where they live.

Please call us at 1-877-685-2415 if you have any questions.

Clinical Consolidation Communication Bulletin 007

This communication provides information on where to find the new Benefit plan for all members beginning 2/1/2024. The plan includes information on Medicaid B or Medicaid Direct, B3, state funded services, Innovations services, and 1915I services.

Please click here to access the page where the plans are posted under "Benefit Plan Information."

Clinical Consolidation Communication Bulletin 008

Non-Covered Medicaid Benefits under EPSDT

Any Medicaid service that is a non-covered service, must be reviewed for prior approval. The non-covered form can be found on the Trillium website on our Early and Periodic Screening Diagnosis and Treatment (EPSDT). 

837 File Submission Requirements

The acceptable 837 formats for billing submission are .txt, .edi, and .x12 (upper and lower versions) files. Trillium also adheres to HIPAA SNIP levels for file validation – files must meet SNIP Level 1 & 2. Trillium does not currently process claims with $0.00 amount, nor are null amounts accepted.

Any of the above-mentioned will result in a rejected file that will not be processed in Trillium’s adjudication system. All providers will receive a Splitting Report in their respective folders for any 837 submitted. We encourage all providers to review these Splitting Reports for claim status. The Splitting Report is an acknowledgement file stating that the 837 file submitted was either accepted, rejected or accepted with errors. This Report will be in HTML format so no additional software is needed to open or read. This Report does not confirm that the claim submitted will pass all adjudication rules. If there is a rejection, it will be detailed in these Splitting Reports. In addition, the 999 file will be in your provider folder to acknowledge 837 receipt along with an 824 file to advise if any changes are required.

Announcement from Eastpointe for Eastpointe & Sandhills Providers Regarding the Registry of Unmet Needs and RDSE in the Midst of Consolidation with Trillium

Individuals who think they may qualify for NC Innovations services need to complete Trillium’s “Registry of Unmet Needs” (RUN) application and send it to Trillium with supporting documentation. Trillium reviews applications and adds individuals who are potentially eligible for the Innovations Waiver on the waitlist under an Innovations Waiver slot becomes available. Starting 2/1, all applications and questions for the Registry of Unmet Needs should be submitted to [email protected]. This includes new submissions for members that were previously served by Eastpointe and Sandhills. Please note that any applications previously approved by Eastpointe and Sandhills will be honored by Trillium using the member’s original date of waiting on the Registry of Unmet Needs.

Additional information regarding the RUN and Innovations Waiver services can be found: NC Innovations

The RUN Application can be found: RUN Application

RDSE Communication

Effective February 1, 2024, the following change to the current Verification of Relative/Legal Guardian as Direct Support Employee (RDSE) will go into effect for members and providers previously with Eastpointe and Sandhills:

A new online form will replace the current Verification of Relative/Legal Guardian as Direct Service Employee process. Effective February 1, 2024, please use the following link to place initial and annual requests for Relative as Direct Support Employee: Innovations Waiver - Relative as Direct Support Employee Application.

Tips for Submitting RDSE Applications:

• RDSE’s are tracked by the member’s ISP year for annual recertification and, for initial RDSEs, forms should be submitted 30 days prior to the new RDSE’s proposed start date.
• Forms should be submitted for all RDSEs regardless of the number of hours per week each RDSE will provide.
• Those providing up to 40 hours/week are submitted for tracking purposes only.
• Those submitted for 41-84 hours/week are submitted for prior approval (except for those tracked under the Appendix K flexibilities that end 2/29/2024).
• Forms submitted for Appendix K flexibilities through 2/29/2024 will continue to be submitted for tracking purposes only.
• Trillium’s process is being updated to reflect the waiver amendment changes implementing 3/1/2024:
• Parents of minors can be RDSE up to 40 hours/week of Community Living and Supports.
• Adults members’ RDSEs may be approved to provide 41-84 hours/week.
• RDSEs may provide Supported Living.

Questions regarding these changes can be directed to [email protected]

Read Here

Billing and Enrollment Provider Training

The billing and enrollment team at Alliance Health will offer virtual information and technical assistance sessions for claims and enrollment related topics and questions. These sessions are formatted for provider agency staff directly involved in the submission of enrollments and claims and will include group instruction and training, as well as one-to-one provider technical assistance.

The trainings will be offered each week on Tuesday from 10 am to 12 pm. For the month of February these trainings will be held on the following dates and times.

• Tuesday, February 6, 2024, 10 am – 12 pm
• Tuesday, February 13, 2024, 10 am – 12 pm
• Tuesday, February 20, 2024, 10 am – 12 pm
• Tuesday, February 27, 2024, 10 am – 12 pm

RSVP is required as space is limited. Please RSVP

to [email protected] and include your name, agency name and the date the training you wish to attend.

Providers should attend only one of the sessions as the content will be the same for each session.

If you have any questions, please email: [email protected].

• Provider Communication Bulletin #148 (January 18, 2024)
• Davidson County Realignment Welcome Event
• NC IDD Health ECHO™ for Primary Care Providers
• Cleveland County Accepting Nominations for Governor’s 2023 Volunteer Service Awards
• Unlicensed Alternative Family Living Home Provider Attestation
• Medicaid Proposed Clinical Coverage Policies Open for Public Comment
• Request for Applications: Bipartisan Safer Communities Act
• Claims Information
• Utilization Management Updates
• State News and Updates
• Training Resource and Collaborative (TRAC)
• Community Training
• Additional Events and Training

• Provider Communication Bulletin Issue 33 (January 26, 2024)
• IN THIS ISSUE:
• Attention: IT Issues Affecting Microsoft Users
• Provider Touchpoint
• Welcome Rockingham County Providers
• Transition Support for Sandhills Network Providers
• Attestation Form for NC Innovations Waiver DCW Rate Increases
• 1115 SUD Demonstration Wavier CCPs: NCDHHS Update | Coming Soon: National Core Indicators® Survey

NC CTP Child Parent Psychotherapy (CPP) Learning Collaborative Applications are now open! 

The NC Child Treatment Program is happy to announce that applications for the 12th Cohort of our CPP Learning Collaborative are now open.

Please click on the links below to access the applications and information guides for this spring cohort. You can also go to our website to find the applications using the button below.

Starting May 2024

• Click Here to Apply to CPP Cohort 12
• Click Here for the CPP Cohort 12 Info Guide

In December 2022, The Arc of NC began providing care management to those who qualified. Tailored Care Management (also known as TCM or just Care Management)

began in December of 2022 and is designed for people who receive Medicaid and have an intellectual or developmental disability, severe and persistent mental illness, traumatic brain injury, or substance use disorder.



Care Management is designed for whole-person, integrated care. Our goal in providing care management will be to help people with IDD improve their health and overall quality of life as much as possible. 

Our staff wanted to ensure information about care management was reaching as many people as possible, so in November 2023, we launched a new care management web page that details what it is and why it's important.

We made sure to include videos of families who are receiving care management - you can hear directly from them on how it helped their family.

Click the link below for information on Care Management and how you can access this incredible program! 

Check out the Care Management Website Here

Know a Young Changemaker? Share These Leadership Opportunities With Youth!

Youth Engaged 4 Change (YE4C) seeks candidates ages 16-24 for the fifth cohort of its Editorial Board.

Would you be willing to lend a hand in spreading the word about this amazing opportunity to passionate young people? Your help could make a difference in connecting enthusiastic individuals to life-changing opportunities.

YE4C is an extension of youth.gov and is a space for young people to lead. YE4C’s mission is to provide resources and opportunities that inspire and empower young people to make a difference in their lives and in the world around them by improving their knowledge and leadership skills.

The YE4C Editorial Board helps shape strategy and content that truly matters for diverse young people. This 12-18-month virtual, paid opportunity fosters lasting connections between young changemakers and federal staff doing interesting work, fostering lasting connections. The group is structured to accommodate geographical diversity, giving members the opportunity to learn how to collaborate effectively across time zones using different communication methods (like email, Zoom meetings, and messaging).

If someone you know is between the ages of 16 and 24, prepared to commit at least 20 hours per month, and is passionate about empowering fellow young people, please invite them to learn more on the YE4C website, where the application will be live from January 17 to February 4, 2024 (11:59 pm PT).

The Opioid Affected Youth Initiative (OAYI)- Youth National Opioid and Wellness (YNOW) Task Force

OAYI was established to support integrated and comprehensive intervention, prevention, and treatment services for youth and families who have been impacted by opioid and other substance use disorders (SUDs).

The purpose of the YNOW Task Force is to create collaborative opportunities and strategic partnerships among emerging leaders and key stakeholders; inform strategies for successful engagement in local communities; and empower youth with lived experiences to lead sustainable efforts toward stigma reduction through advocacy and action.

The YNOW Task Force reflects the voices and perspectives of youth representing diverse communities and promotes the development of a support network among young people with shared experiences that will help cultivate an advanced understanding of the impact of opioids and SUDs on youth and families.

Eligibility Requirements 

• Be between the ages of 18 and 24.
• Have at least one of the following lived experiences:
• Currently live or have lived in an opioid-impacted community
• Personal SUD
• Juvenile or criminal justice involvement
• Friend or family member (parent, sibling, or close friend) with SUD, in treatment, or in recovery
• Child welfare involvement

Find more information about the YNOW Task Force, its requirements, activity schedule, and how to apply in this flyer. Share it with the young change makers you know! Applications are due by Friday, February 16th.  

Empowering Identity: Nurturing Cultural and Family Ties in Adoption

Culture, ethnicity, and heritage help shape our identities. Acknowledging and valuing these traits can provide an opportunity to promote family well-being and build resilience for children and youth who have been adopted. For those children and youth who experience adoption, maintaining ties with their families of origin is more than just a choice—it's a crucial aspect of their well-being. These connections can significantly impact a child or youth's emotional and psychological development, influencing their identity and overall well-being.

When adoptive families support connections to families of origin, they can create ties that help bridge the gap between adopted and biological worlds and contribute to a child or youth's sense of self. Knowing where they come from adds depth to their story and fosters a sense of belonging, enriching their life with diverse familial influences.

Prioritizing these connections is part of creating and supporting kin-first culture in child welfare. Kin-first culture recognizes the importance of involving kin from families of origin, prioritizes relative adoption, and provides meaningful supports to children, youth, and families to help them stay connected. This cultural shift also honors the valuable role of relatives, fictive kin, community elders, and others in a child's overall development—such as those who can help keep a child or youth connected to their culture.

There are a variety of tools and resources that families, children, youth, and caseworkers can use to support connections to kin and culture. Margarita Hughes, an AdoptUSKids Minority Professional Leadership Development program fellow, developed the Cultural Identity and Connection Plan as a part of her action research project, which focused on staff training regarding the importance of culture and learning strategies to help children and youth develop a strong sense of ethnic-racial identity.

The tool facilitates open discussions and the creation of a cultural connection plan for the child or youth. The plan becomes a roadmap for building a strong sense of belonging and understanding by actively promoting connections with the family of origin. It includes worksheets for each member of the adoption triad, outlines concrete actions to take, and provides space for the young person and birth parent to share what they love about their culture, how they would like to stay connected, and who can support them in doing so.  Explore these tools and resources for more information and strategies to incorporate into your everyday practice.

Cognitive behavioral therapy alters brain activity in children with anxiety

NIH researchers found widespread differences in the brains of children with anxiety disorders that improved after treatment.

Researchers at the National Institutes of Health have found overactivation in many brain regions, including the frontal and parietal lobes and the amygdala, in unmedicated children with anxiety disorders. They also showed that treatment with cognitive behavioral therapy (CBT) led to improvements in clinical symptoms and brain functioning. The findings illuminate the brain mechanisms underlying the acute effects of CBT to treat one of the most common mental disorders. The study, published in the American Journal of Psychiatry, was led by researchers at NIH’s National Institute of Mental Health (NIMH). 

“The findings can help our understanding of how and for which children CBT works, a critical first step in personalizing anxiety care and improving clinical outcomes,” said senior author Melissa Brotman, Ph.D., Chief of the Neuroscience and Novel Therapeutics Unit in the NIMH Intramural Research Program.

Sixty-nine unmedicated children diagnosed with an anxiety disorder underwent 12 weeks of CBT following an established protocol. CBT, which involves changing dysfunctional thoughts and behaviors through gradual exposure to anxiety-provoking stimuli, is the current gold standard for treating anxiety disorders in children.

Read Here

New Merger Enforcement Toolkit: FTC and DOJ Release Final 2023 Merger Guidelines 

On December 18, 2023, the Federal Trade Commission (“FTC”) and the Department of Justice (“DOJ”) (collectively, the “Agencies”) published the long-awaited final 2023 Merger Guidelines. The 2023 Merger Guidelines are informed by almost two years of considerable engagement between antitrust regulators, practitioners, economists, and the general public. The final 2023 Guidelines were updated by the Agency in response to public comment after the release of an initial draft in July 2023, but the final version of the Guidelines remain largely unchanged in substance from the summer draft.

More on 2023 Merger Guidelines Here

FTC Approves Use of CIDs in Nonpublic Investigations of AI Products 

Recently, the Federal Trade Commission (FTC) unanimously approved a resolution that authorizes use of compulsory process in examining companies’ “products and services that use or claim to be produced using artificial intelligence (AI) or claim to detect its use.” This action underscores the urgency of the FTC and other federal regulators to monitor the swift integration of AI across many sectors of the economy and to provide oversight of its use in consumer products and services.

More on CIDs in Nonpublic Investigations Here

Advancing Health Equity in North Carolina

North Carolina, a state with a rich history and diverse population, has embarked on a significant journey to address health equity, recognizing the importance of ensuring that all residents have the opportunity to attain their highest level of health. Health equity, defined as the absence of unfair and avoidable health differences among different groups, has become a focal point for policymakers, healthcare professionals, and community leaders in North Carolina.

Learn about North Carolina’s efforts to address health equity with partnerships between government agencies, nonprofit organizations, and the private sector in our latest insight.

Read Here

Charting a plan to stave off expected health care workforce shortages

By Rose Hoban

North Carolina, like many other states, is staring at a growing gap between the number of people who will need some form of health care over the next 10 years and the number of people who will be trained and available to provide it.

Before the pandemic, workforce researchers were predicting North Carolina would have a shortage of about 12,500 nurses by 2033. Those predictions have changed in the wake of staffing shortages, increased caseloads, increasing violence and other stressors that COVID-19 put on health care institutions. Now prognosticators are saying that within a decade, there could be a need for 21,000 more nurses. 

That’s in addition to the need for more than 186,000 personal caregivers for older adults and for people with disabilities like Aguilar’s kids. That number only stands to grow as many health care workers head for the exits, burned out by the pandemic and the multiplying demands at their workplaces. 

Read more

Medicaid expansion bringing swift benefits in North Carolina

By Jaymie Baxley

Lori Kelley was decorating her Concord home for Christmas when she pierced her finger on a shard of glass from a broken ornament.

It seemed like a minor injury at first. Kelley wasn’t in pain, and the glass hadn’t cut deeply enough to draw blood. “I totally ignored it,” she said. 

Two days later, she was hospitalized with a “horrible” bacterial infection that required surgery. Her procedure was covered thanks to Medicaid expansion.

The long-awaited measure officially took effect on Dec. 1, making hundreds of thousands of low-income North Carolinians eligible for Medicaid. Kelley, who had been without health insurance since 2008, was among the first wave of people to enroll.

Read more

NC: After 15-year-old beaten to death, 9 Investigates if NC is doing enough to protect children (Includes video)

WSOC - January 23, 2024

This week marks three years since a teenager died after being beaten at his Rockingham home. His mother and her boyfriend were charged. Now, three years later, 9 Investigates is looking back on the teen's death and the systems responsible for preventing it. "Children who are facing abuse, neglect, most things that many of us could not even imagine -- we're just not making them a priority, " said Brett Loftis, a child welfare advocate. Those children include 15-year-old Casey Johnson. He was sophomore at Richmond Senior High School. He was in JROTC and was a big brother.

Read more

NC: Steps taken to ease process for families in juvenile court (Includes audio)

State Port Pilot - January 24, 2024

Brunswick County's juvenile court participated in a select nationwide training project last week that is designed to help identify and improve issues related to the child welfare system. Judge Pauline Hankins applied last year to the National Council of Juvenile and Family Court Judges' (NCJFCJ) Implementation Sites Project, a program funded by the U.S. Department of Justice that provides state neglect courts with training, technical assistance and support to guide program improvement, sustainability and performance. NCJFCJ selected 11 neglect courts from across the country to participate in the program, including the county's 13th Judicial District Court led by Hankins.

Read more