Smoky Provider Network Communication 
Issue: #155
July 17 2014
    
Quick Links

 

Medicaid Child and Adult Non-Innovations I/DD Utilization Review Guidelines

 

Medicaid Adult MH/SA Utilization Review Guidelines

 

Supported Employment Definition

 

Benefit Plan Streamlining  

NC TOPPS News....

For assistance with NC TOPPS issues email nctopps@smokymountaincenter.com

CNDS numbers can be obtained through Smoky Mountain LME/MCO for NON-Medicaid consumer. If you need to request a number please email nctopps@smokymountaincenter.com with the following information:

  • Consumer's first name, middle initial, and last name
  • Consumer's date of birth
  • Gender
  • Consumer's social security number
  • Race and ethnicity
  • Primary language spoken
  • Provider agency name and address of location services received

Be sure to use secured or encrypted email to send this information to Smoky because it contains PHI. The LME/MCO superusers will funnel those requests to Eligibility and Enrollment and get a number back to you.

 

MH/SA Supported Employment Provider

NC TOPPS are required for MH/SA Supported Employment consumers. You can begin submitting these reports now, and implementation will be mandatory on 10/1/14. Below is the new hierarchy for the responsibility of NC TOPPS submissions.

Adult SA/MH    

  • Residential Services
  • Partial Hospitalization
  • Assertive Community Treatment Team (ACTT)
  • Substance Abuse Comprehensive Outpatient Treatment
  • Substance Abuse Intensive Outpatient Treatment
  • Community Support Team
  • Opioid Treatment
  • Supported Employment or Long Term Vocational Supports
  • Periodic (State Funded SA only)
    • Consumer, Family, Group

Child SA/MH

  • Residential PRTF
  • Partial Hospitalization
  • Multisystemic Therapy Service
  • Intensive In Home
  • Substance Abuse Intensive Outpatient
  • Child and Adolescent Day Treatment
  • Residential Services (except PRTF) & Therapeutic Foster Care
  • Supported Employment or Long Term Vocational Supports
  • Periodic (State Funded SA only)
    • Consumer, Family, Group
MemoryCare Workshop      

Driving and Aging - When is it Time to Stop?

 

Date: Thursday, July 24th

Time: 2:00pm-4:00pm

 

Location: Haywood County Senior Resource Center, 81 Elmwood Way, Waynesville

Content includes: Presentation by MemoryCare Physician, Lisa Verges, MD and performance from The MemoryCare Plays

 

Registration: The workshop is free and open to the public but please register by calling 828-771-2219.   

Upcoming LBDA Webinar: The Primary Care      

Upcoming LBDA Webinar: The Primary Care Physician's Perspective - Could this be LBD?     

         
Wednesday, July 30, 2014, 2:00-3:00 pm ET
 

Join LBDA for a free, 1-hour webinar on Wednesday, July 30, 2014, at 2:00 PM ET, featuring Charles Driscoll, MD, FAAFP.    

 

Click to Learn more and to Register                       

Benefit Plan Streamlining Implementation
Click link to Benefit Plan Streamlining Implementation
  
Communication Bulletin # 142 on NC Divison of Mental Health, Development Disabilities and Substance Abuse Services 
Youth Mental Health First Aid

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

 

 

Date: August 19, 2014 (8:30a-5:00p) - Jackson

 

Training and Registration Information

Peer Academy      

A unique, intensive training opportunity offered by Meridian Behavioral Health Services in collaboration with Smoky Mountain LME/MCO

  

This training is open to individuals interested in pursuing em-ployment as a peer support specialist and obtaining certifica-tion as PSS through the Peer Support Specialist Registry from the Behavioral Healthcare Resource Program, School of Social Work, UNC-Chapel Hill.

 

August 18 - 22, 2014

154 Medical Park Loop, Sylva NC

 

Click flyer for details

B3 Supportive Employment in Benefit Plan

Effective July 1, 2014, Smoky Mountain LME/MCO offers B3 Supportive Employment in our benefit plan for I/DD and MH/SA consumers.  Please refer to the links below for specific codes and required documentation needed with the Service Authorization Request (SAR).  Your billing should reflect the correct codes for dates of service after 7/1/14.  

 

Supported Employment Definition

 

Medicaid Child and Adult Non-Innovations I/DD Utilization Review Guidelines - EFFECTIVE 7/1/2014

 

Medicaid Adult MH/SA Utilization Review Guidelines- UPDATED 7/1/2014 

How to Request Additional Units to an Existing Authorization!
Attention all MH/SA/IDD Providers:

 

When requesting additional units for an existing authorization,  providers should follow the following procedure:

 

1.   Submit a SAR for the additional units needed that includes a clinical justification statement for the additional units.  Emails and telephone requests will not be honored for this purpose.

2.   The requested start date of the newly submitted SAR should not pre-date the SAR submission date ; the end date of the newly submitted SAR should match the end date of the original authorization.

3.   No Additional documentation is required to be submitted with the SAR.

4.   The Clinical Justification should clearly state the specific date for which the original authorization should be lapsed. The number of units requested on the newly submitted SAR should reflect the number of additional units that is requestied to add to the existing authorization.

Questions regarding this process should be directed to: Judith Collins, Care Management Director, 828-586-5501 x 1260 or Judith.collins@smokymountaincenter.com

Updated Consumer Data Warehouse Requirments

Smoky Mountain LME/MCO is updating the requirements for providers in order to come into compliance with the NC Consumer Data Warehouse (CDW) data submissions. 

 

Please click link for a list of required data fields and the CDW communication

Health & Safety Reviews ...

The monitoring of Unlicensed Alternative Family Living (AFL) homes shall be conducted by the Contract Performance Team of the Smoky Mountain Provider Network Department to ensure a safe environment for the consumer.

 

See link for the entire Communication  

Updating local Modifier for Svcs: H0019U4    

Smoky Mountain LME/MCO is updating the local modifier that is attached to the Level 4 Behavioral Health Residential Long-Term Treatment procedure code, previously referenced in the Smoky AlphaMCS system as H0019U4.

 

Click link to learn more                          

NC Innovations Stakeholders Group      

Smoky Mountain LME/MCO is hosting quarterly stakeholders meetings for participants, families and providers involved in the N.C. Innovations waiver. The first meeting will be:

  
July 28, 2014
6:00pm-8:00pm
  
Please see flyer to register!   
System of Care Training      
System of Care Child & Family Team II Training
  
July 30 & 31, 2014
9:00am-4:00pm
Western Carolina University-Asheville
  
Click link to learn more...  
Person-Centered Thinking Training

This two-day workshop is designed to introduce the principles and use of Person- Centered Thinking.

 

Date: July 17th & 18th - Buncombe County

  
  
  
Date: August 28th & 29th-Caldwell County
  
  
  
Questions:  Call Lisa Allen, Training Coordinator 828-586-5501 Ext.1163 
Training Opportunities      
Adult Mental Health First Aid Train-The-Trainer
 
August 11-15, 2014
  
Location:
Alliance Behavioral Healthcare
4600 Emperor Blvd.
Durham, NC 27703
   
___________________________________________________
 
Cognitive Behavioral Therapy
 
July 29-31st, 2014
 
Location:
505 Oberlin Rd, Suite 100
Raleigh, NC
 
Developmental Disabilities Training Institute Presents:    

Cultural Diversity Training

 

August 5, 2014
9:00am-4:00pm

Thompson Child & Family Focus
1645 Clanton Rd
Multi-Purpose Room
Charlotte, NC 28208

 

Training and Registration Information  

Upcoming MAHEC Trainings      
Kimberly Strom-Gottfried, LISW, PhD presents:
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!
  
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

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)
Both courses are instructor-led online courses. Find out how to register.

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.