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| SPA 13-009 N.C Session Law 2013-306 Presentation | |
Attention Personal Care Services Providers: Implementation of SPA 13-009: N.C. Session Law 2013-306 Webinar
On Friday May 23, 2014, DMA conducted Webinars to outline the implementation of N.C. Session Law 2013-306. The presentation rendered during the Webinars is now available and applies to providers and beneficiaries of State Plan PCS.
Additional questions on the implementation of N.C. Session Law 2013-306 may be submitted to PCS_Program_Questions@dhhs.nc.gov
Click link to view Presentation
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| NC Family Retreat | Save the Date: June 19-20, 2014
Attn: Caregivers, Self-Advocates, Service Providers, School and College
Administrators and Community Agency Personnel
~Planning ahead with individuals with intellectual disabilities (ID)~
See flyer for more information
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| CA/LOCUS Documentation |
Attention Medicaid Basic Benefit (Outpatient Individual, Family and Group Therapy) Providers:
As mentioned in previous Communication Bulletins, effective June 1, 2014, Smoky Mountain LME/MCO will no longer require prior authorization for Medicaid-funded individual, family or group therapy services. In response to an inquiry concerning expectations for documentation of the CA/LOCUS score for consumers receiving basic benefit services, Smoky Mountain LME/MCO encourages all basic benefit providers to review the CA/LOCUS manual which outlines the following expectation of frequency for using this tool:
"Since CA/LOCUS is designed as a dynamic instrument, scores should be expected to change over time. Scores are generally assigned on a here and now basis, representing the clinical picture at the time of evaluation. In some of the parameters, historical information is taken into account, but it should not be considered unless it is a clear part of the defined criteria. In certain crisis situations, the score may change rapidly as interventions are implemented. In other situations, where a subject may be living under very stable circumstances, scores may not change for extended periods of time. Clinical judgment should prevail in the determination of how frequently score should be reassessed. As a general rule, they will be reassessed more frequently at higher levels of acuity and at the higher levels of care or resource intensity."
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| 2-Day Provider Summit | |
Benchmarks and our Board of Trustees Present: Two-Day Consultation w/ David Lloyd
With the many system changes happening here in NC and the continual merging of MCOs, it is very important that your agency understands how to adjust your business practices in order to remain viable and progressive.
June 9th: 10:30am-4:00pm and
June 10th: 8:30am-3:30pm
Hawthorne Inn
Winston Salem, NC
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| NC Council of Community Program Training | |
Register Early to save on Current Trainings
June 3-4, 2014
Clinical Supervision in Behavioral Healthcare
Approved for 12 hours of APA, NBCC or ASWB CEUs
Location:
Royal Conference Center
3801 Hillsborough St.
Raleigh, NC 27605
Click Here for Flyer
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June 5, 2014
Ethics for Social Work
2 Hour Training
Location:
NC Council of Community Programs
505 Oberlin Rd, Suite 100
Raleigh, NC 27605
Click Here for Flyer
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July 9, 2014
Screening and Treatment Planning for Individuals With Co-Occurring Disorders
Approved for 6 hours of APA, NBCC or ASWB CEUs
Location:
NC Council of Community MH/DD/SA Programs
505 Oberlin Rd, Suite 100
Raleigh, NC 27605
Click Here for Flyer
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| NCTracks Communications and Updates | |
N.C Medicaid and N.C Health Choice Preferred Drug List Changes
Effective with a date of service of May 17th, 2014, the N.C. Division of Medical Assistance (DMA) made changes to the N.C. Medicaid and N.C. Health Choice Preferred Drug List (PDL).
Click link for highlights of some of the changes!
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| Intellectual/Developmental Disability Summit | |
Benchmarks Hosts an I/DD Summit
June 18, 2014
10:30am-3:30pm
Royal Conference Center
3800 Hillsborough Street, Raleigh NC
Training and Registration Information
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| Smoking Cessation Class | |
The Free Clinic is sponsoring a Smoking Cessation Class
Tuesday Evenings 6:00p-8:00p begining 7/01/14 - 8/12/14
The class is free for anyone who is interested in quitting smoking!
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| NCTOPPS Process Update | |
As of May 5, 2014 the LME/MCO oversight responsibility for NCTOPPS transferred to Provider Network. The two staff members managing NC TOPPS issues are Alison McCall and Amy Douglas-Green. The process for requesting assistance has changed slightly. Please be sure to send all requests through NCTOPPS@smokymountaincenter.com. This will allow your request to come to both Alison and Amy. In your request for assistance please provide the site address you are referencing. If you are having trouble with an interview regarding a specific consumer, please include the LME record number, initials of the consumer, and date of birth of the consumer. This will help us to respond to your requests in the timeliest manner.
In the near future, provider network will begin conducting focused monitorings on agencies that do not meet the state expectations for appropriate and timely submissions. More information will be provided about this soon.
If you have any questions please email the above cited address.
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Basic Benefit Individual, Family Therapy, and Group
Therapy |
Medicaid Providers of Basic Benefit Individual, Family Therapy, and Group Therapy
In an effort to improve access to care for clients and administrative burden for providers, effective June 1, 2014, Smoky Mountain LME/MCO will no longer require prior authorization for individual, family or group therapy services. As a result of this change, providers will no longer need to submit authorization requests beyond the previously unmanaged limits of eight (8) visits for Adults (ages 21 and up) and sixteen (16) visits for ages for Children and Adolescents below age 21.
Evidenced- based practice indicates that individual and family therapy should be provided no more than 1-3 times time a week, with titration to bi-weekly and/or monthly. Episode of care and desired treatment outcomes for this level of care is typically obtained within six months. Group therapy may be indicated 1-2 times a week for 8-12 weeks. Outpatient services are expected to be short term and recovery focused. Any combination of these services at a higher intensity may trigger clinical review.
While prior authorization is not required for these basic benefit services, utilization of basic benefits will be monitored. Higher utilization may be subject to post payment reviews for medical necessity and paybacks as indicated. Post service monitoring may include desk review, on site visits, paid claims review or a combination. Basic benefits are typically not indicated for clients receiving enhanced services except in specific circumstances outlined in Clinical Coverage Policies. SM LME/MCO will monitor for stacked services where exclusionary criteria apply.
Psychological testing remains limited to 16 unmanaged visits per calendar year for clients under the age of 21, and 8 unmanaged visits per calendar year for clients ages 21 and over. Visits beyond the calendar year limits will continue to require prior authorization. Although authorization is not required for the individual and family therapy, these services will still count toward the basic benefit unmanaged limit that will be applied when testing services are requested.
Providers are responsible for understanding billing edits and limitations of services as indicated in the National Correct Coding Initiative Policy Manual for Medicaid Services (Coding Policy Manual) and Clinical Coverage Policy 8C. Currently, Clinical Coverage policy limits testing to 5 units/sessions per day.
This change in management of basic benefit therapy will streamline administrative responsibility for providers and enable additional time for treatment and coordination of care. Providers continue to be responsible for maintaining documentation as specified in the Records and Documentation manual and may be subject to routine monitoring. These items include:
- Written consent for treatment
- Comprehensive clinical assessment/update
- Individualized treatment plan with client and provider signatures. (Parent must also sign for minors when the services are not provided under the direction and supervision of a physician)
- Individual Service/Progress Notes
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Clients under age 21: Verbal or written individual referral. Copy of the written order for service after the 16th visit (N/A for physician or PhD psychologists) - Clients aged 21 and over: Copy of the written order for service after the 8th visit (N/A for physician or PhD psychologists)
Note that state-funded individual and family therapy services will remain a basic benefit subject to the 8/16 unmanaged visit rules.
Should you have any questions or wish to discuss further, please contact a Care Manager at 1-866-990-9712 option 5.
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| Youth Mental Health First Aid | |
Date: June 2, 2014 (8:30a-5:00p) - Henderson
Presenters: Ann Dupre Rogers & Marilyn Kaylor, SMC Community Outreach Team
Training and Registration Information
Date: July 31, 2014 (8:30a-5:00p) - McDowell
Presenters: Melissa Ledbetter & Robin Winkler, SMC Community Specialist
Training and Registration Information
Date: August 7, 2014 (8:30a-5:00p) - Polk
Presenters: Ann Dupre Rogers & Marilyn Kaylor, SMC Community Outreach Team
Training and Registration Information
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| Keeping Our Children Safe | |
Steward of Children is a prevention training program that teaches adults how to prevent, recognize, and react responsibly to child sexual abuse.
August 5, 2014-Caldwell
5:00 pm to 8:00 pm
Smoky Mountain Office
825 Wilkesboro Boulevard, Lenior, NC
Training and Registration Information
October 14, 2014-McDowell
9:00 am to 12:00 pm
Smoky Mountain Office
408B Spaulding Road, Marion, NC
Training and Registration Information |
| NC-TOPPS Training Opportunity- Asheville |
Smoky Mountain LME/MCO presents NC-TOPPS Training!
June 11, 2014
10:00 am to 12:00 pm
Smoky Mountain Asheville Office
356 Biltmore Avenue, Asheville, NC 28801
Room 248
NC-TOPPS is a Division web-based system for gathering outcome and performance data on behalf of mental health and substance abuse consumers over the age of six years who are in North Carolina's public system of services. The NC-TOPPS system provides reliable information that is used to measure the impact of treatment and to improve service and manage quality throughout the service system. This training will teach attendees how to access the system, schedule for completion, use the report options, and understand why you need a super-user in your agency. Any provider of child, adolescent, or adult Mental Health or Substance Abuse Services, including clinical and direct care staff, QM/QA personnel, and others involved in treatment may attend.
You may register online here: http://events.constantcontact.com/register/event?llr=pqthpymab&oeidk=a07e9835nh2f1eccdf6 |
| LOCUS Training Opportunities |
Smoky Mountain LME/MCO presents LOCUS Trainings!
June 19, 2014 LENOIR
825 Wilkesboro Blvd. SE Lenoir, NC 28645
9:00 am to 12:00 pm
June 20, 2014 ASHEVILLE
356 Biltmore Avenue, Asheville, NC 28801
9:00 am to 12:00 pm
The Level of Care Utilization System (LOCUS) is a system for determining appropriate level of care for adults based on six inter-related life domains. The LOCUS provides reliable, research-based recommendations that are used to determine appropriate level of care, develop treatment plans, assess appropriateness of the consumer's level of care, and help track progress. This training will teach attendees how to accurately complete the level of care tool, determine level of care recommendations, and translate those recommendations into services. Any person completing a Mental Health Service/Treatment Authorization Request for a consumer over the age of 18 is required to have the training. Consumers, family members, and other stakeholders are welcome to attend the training and learn how the Level of Care Utilization System works.
You may register for the LENOIR training online here: http://events.constantcontact.com/register/event?llr=pqthpymab&oeidk=a07e948e89k5ae1fed5
You may register for the ASHEVILLE training online here: http://events.constantcontact.com/register/event?llr=pqthpymab&oeidk=a07e948e89k5ae1fed5 |
| CALOCUS Training Opportunities |
Smoky Mountain LME/MCO presents CALOCUS Trainings!
June 19, 2014 LENOIR
825 Wilkesboro Blvd. SE Lenoir, NC 28645
1:00 pm to 4:00 pm
June 20, 2014 ASHEVILLE
356 Biltmore Avenue, Asheville, NC 28801
1:00 pm to 4:00 pm
The Child & Adolescent Level of Care Utilization System (CALOCUS) is a system for determining appropriate level of care for adults based on six inter-related life domains. The CALOCUS provides reliable, research-based recommendations that are used to determine appropriate level of care, develop treatment plans, assess appropriateness of the consumer's level of care, and help track progress. This training will teach attendees how to accurately complete the level of care tool, determine level of care recommendations, and translate those recommendations into services. Any person completing a Mental Health Service/Treatment Authorization Request for a consumer between the ages of 6 and 17 is required to have the training. Consumers, family members, and other stakeholders are welcome to attend the training and learn how the Child & Adolescent Level of Care Utilization System works.
You may register for the LENOIR training online here:
http://events.constantcontact.com/register/event?llr=pqthpymab&oeidk=a07e948f6313a3c8cef
You may register for the ASHEVILLE training online here: http://events.constantcontact.com/register/event?llr=pqthpymab&oeidk=a07e9atkwmj1a0f2ecc |
| Training - NC-SNAP | |
Date: June 16, 2014 (9:00-12:00 & 1:00-4:00) and
June 17 (9:00-12:00)
Questions: Call Lisa Allen, Training Coordinator 828-586-5501 Ext. 1163 |
| Training - Person-Centered Thinking | |
This 2 day, 12 hour workshop is designed to introduce the principles and use of Person Centered Thinking.
Date: June 5th & 6th - Buncombe County
Date: June 25th & 26th - Watauga County
Date: August 28th & 29th-Caldwell County
Questions: Call Lisa Allen, Training Coordinator 828-586-5501 Ext.1163 |
| 2015 marks 40 years of IDEA & 25 years of the ADA | |
Six National Goals by end of 2015
Honor the legacy of our past and help build a new future by joining our effort to achieve six national goals by the end of 2015.
The employment goal is for six million working age adults with disabilities be part of the American workforce.
- The community living goal is that at least six states will elect to implement the Community First Choice Option so that their Medicaid recipients with disabilities have access to long-term services and supports in the community.
- The education goal is at least six additional states graduate at least 60 percent of their students with disabilities with a regular high school diploma.
- The transition goal is at least six states commit to supporting successful and outcome-based programs and strategies for high school transition services and close the labor force participation gaps for youth and young adults with disabilities.
- The healthy living goal is that at least six states commit to including people with disabilities as an explicit target population in all state public health programs.
- Finally, the early childhood goal is that at least six states increase by 15 percent the proportion of children ages 0-3 who receive recommended developmental screening.
Please visit http://sixbyfifteen.org/ for more information and to see how you can get involved. |
| Training - NC Council of Community Programs | |
June 3-4: Clinical Supervision in Behavioral Healthcare (12 hours of APA, NBCC or ASWB CEUs)
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| t3 Think Teach Transform - onlineTrainings | |
Upcoming trainings starting in May include:
- Beyond the Basics - Motivational Interviewing (15 hrs CEU credits)
- Housing First - (10 hours CEU credits)
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Smoky Mountain Center's Access Call Center is available 24 hours a day, 7 days a week to provide information, screening, triage and referrals for mental health, substance abuse and intellectual/developmental disability services. The toll-free phone number is 1-800-849-6127. |
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