Smoky Mountain LME/MCO and the Division of MH/DD/SAS are supporting improvement in our system-wide utilization of the revised American Society of Addiction Medicine (ASAM) Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions.  This initiative will support ongoing utilization of ASAM criteria, with a focus on improved assessment and matching of clients to the appropriate level of outcomes-driven treatment and recovery services.   This outreach will include a number of components or focus areas including the following:  Multidimensional assessment and matching levels of care within a managed care environment; care management ensuring clients are regularly assessed and placed in the appropriate type and intensity of service within a flexible continuum of care based on current severity and functional level; increased focus on integration with mental health and physical heath treatment; and provider training.  The Division and Smoky Mountain will make available licenses for ASAM E-training modules for substance abuse providers with a priority for training for Substance Abuse Block Grant and Cross Area Service Program providers. The ASAM E-training modules will include three courses with a total of twelve hours of continuing education credit.   Agencies providing substance abuse assessment and treatment are also encouraged to purchase a copy of the new ASAM Criteria Manual, Third Edition.

Attention ALL Providers-This is NOT just for the I/DD community!  

Benchmarks/NCCDD/NADSP Initiative: NC Alliance for Direct Support Professionals would like to invite you to a Conference to learn about a National/Statewide movement to empower, educate and work together towards advocating for increased wages for a critical work force, Direct Support Professionals (DSP's). 

Click link for the Discount Pharmacy prices for psychiatric presciption medications. 

Visit the Pharmacy website, for more information on Presciption Drugs:

http://www.ncdhhs.gov/MHDDSAS/services/pharmacy/index.htm

Based on the feedback from Smoky providers - Smoky LME/MCO is pleased to present Care Management Alerts. The purpose of these alerts is to keep you updated regarding changes in authorization, care management processes and tips on how to best request service authorization and required documentation.

While prior authorization will not be required for testing under the Medicaid benefit as described above, providers are still required to adhere to the medical necessity guidelines for testing as presented in Clinical Coverage Policy 8C (http://www.ncdhhs.gov/dma/mp/8C.pdf) and in the Smoky Guidelines for Psychological Testing (http://www.smokymountaincenter.com/documents/providers/authinfo/SMC_Psych_Testing-Guidelines.pdf).  In particular, please note the following guidelines:

· Except to determine eligibility for I/DD services, diagnostic interviewing (e.g., a

  current Comprehensive Clinical Assessment) should be conducted first and

  Psychological Testing performed only when questions remain that cannot be

  addressed through clinical interview.

· Smoky values Psychological Testing to clarify diagnoses and to make treatment

  recommendations when those issues cannot be clarified through diagnostic

  interview.

· Psychological Testing is not covered in situations such as the following:

     o  Testing for primarily educational purposes, including for cognitive abilities,

         learning disabilities and academic achievement. 

     o  Vocational referrals, including the need for Vocational Rehabilitation 

         services, job placement, vocational interests and aptitudes, or fitness for

         duty.

     o  Referrals for preparation for civil or criminal court proceedings.

     o  Routine testing for the diagnosis of ADHD.

· No more than five units of testing per day per consumer may be billed as

  outlined in Clinical Coverage Policy 8C.

Smoky will conduct post service reviews of Psychological Testing for which claims are paid; providers could be at risk for corrective actions or recoupment if the above guidelines are not followed.

We believe that these changes will reduce the administrative burden for providers and will facilitate quicker access to services for consumers.

Should you have any questions or wish to discuss this communication further, please contact a Care Manager at (866) 990-9712, option 5. 

Click link for preview of the Smoky's Provider Selection and Retention Criteria 

Please make any comments to

Provider.Communication@smokymountaincenter.com                        

Communication Bulletin # 142 on NC Divison of Mental Health, Development Disabilities and Substance Abuse Services 

Q&A on State Target Populations and DSM-5 Changes

Changes in State Benefit Powerpoint

The NC Association of Rehabilitation Facilities (NCARF) will be holding its Annual Fall Conference at the Hawthorne Inn in Winston-Salem on Sept 25th and 26th. Come find out what's happening in the Department of Health and Human Services straight from Dave Richard and learn how changes might affect how you provide support services. Gain insight into the Division of Medical Assistance and Medicaid Reform by hearing the latest news and commentary about what the future may hold. Learn to navigate your way through the labyrinth of milestones and BEAM from Vocational Rehabilitation. Understand upcoming changes to the Innovations Waiver and how they impact you and receive the latest news from Raleigh about Provider monitoring. In addition staff will have the chance to share best practices with peers and pick up a few techniques and tools to help you work smarter, not harder. Click on the link to see the agenda and register. The early bird discount ends September 1 so be sure to register soon.

http://events.constantcontact.com/register/event?llr=9lccshrab&oeidk=a07e9mhyo9je7845869

September 7 - 13 is National Direct Support Professionals Recognition Week

Join Smoky LME/MCO in recognizing the dedication and accomplishments of Direct Support Professionals during the week of September 7 - 13.  Direct support professionals (DSPs) are people who work directly with individuals who have Mental Health, Substance Abuse, and Intellectual/Developmental Disabilities with the aim of assisting the individual to become integrated into his /her community or the least restrictive environment.  This year's celebration marks the seventh consecutive year of recognition by the U.S. Senate for this essential workforce. Disability services providers across the country will mark the week by

hosting celebrations to honor their Direct Support Professionals. "Each Direct Support Professional brings us closer as a nation to achieving the promise of the Americans with Disabilities Act of full community participation for individuals with disabilities.

These dedicated professionals work tirelessly every day of the year providing skilled and

compassionate supports to individuals with disabilities," Senator Ben Collins

To learn more about the benefits of working with or as a DSP follow this link:  https://www.nadsp.org/

To register for a free webinar during the week of September 7 - 13 on Direct Support Professionals Make a Difference: A Good Afternoon, or a GREAT Life: Click here

To register for a free webinar hosted by AAIDD and the recipient of ANCOR's National DSP Recognition award that shares DSP success stories:   Click here 

The UNC Center for Excellence in Community Mental Health and Meridian Behavioral Health Services are coordinating an effort to provide support to providers in the WNC region in increasing the use of clozapine for psychotic disorders. Clozapine is underutilized in North Carolina outside of a few geographic areas near teaching hospitals/urban areas.

This initiative includes education on clozapine and the offer of clinical consultation with psychiatrists from UNC with extensive experience and expertise in its use. Locally, Meridian will accept referrals from providers in this region to their psychiatric clinics for initiation and stabilization on clozapine over a period of 6-8 weeks. After stabilization the patient can return to the referring provider for continued care. Meridian Clinics are located in Waynesville, Sylva, Franklin, and Brevard. Patients at distances from these locations (Buncombe County) can be seen in their community and will be provided transportation to Meridian offices for appointments.

Contact information to arrange telephone consultation with John Gilmore MD and Fred Jarskog MD from the UNC Center of Excellence in Community Mental Health:

Janice Linn (919) 445-0206  

jlinn@med.unc.edu

Contact Number for referral to Meridian Behavioral Health Services'Clozapine Clinics':  

Matt Holmes, MD  (828) 400-2005  matt.holmes@meridianbhs.org

Family Support Network of WNC is gearing up for the

4th Annual Regional Transition into Adulthood Fair,

A Journey toward Independence: Positive Outcomes for Youth with Disabilities, to be held Saturday, October 4^th from 11:00am to 4:00pm at Mission Reuter Children's Center. 

Transition into Adulthold Flyer