Effective September 1, 2014, Smoky Mountain LME/MCO will no longer mail copies of Notices of Decisions (aka "Denial Letters" and "Reconsideration Letters") to Providers.  Providers may view copies of such correspondence in AlphaMCS in the SAR module by going to the "SAR Justification" tile.  We are making this change because mailed copies of letters often do not get to the individuals involved in a consumer's treatment, and because of the significant cost of copying and mailing such notices to Providers.  If you have questions about this change or about a specific case, please contact the Appeals Department at 1-800-893-6246, ext. 1400.

Dear Community Partners,

The Division of MH/DD/SAS released a new Comprehensive Crisis Prevention and Intervention Plan (CCP) last fall.  As part of the release, we committed to a continued evaluation of the new tools based on feedback from the field.  Since that time we have had conversations with many of you and reviewed hundreds of survey responses about your experience using the new tools. 

Based on your help, we are now releasing a "new and improved" CCP.  Please forward the attached memo, flyer, and revised forms to all MH/DD/SAS providers for use beginning October 12014.  These instructions and materials will supersede any previously released information. This communication will also be posted at  www.crisissolutionsnc.org.

Crisis Plan Crosswalk

Crisis Plan Flyer

Crisis Plan Memo

Crisis Prevention and Intervention Plan 

As part of our ongoing efforts to accurately understand the high utilization of Emergency Departments by individuals in behavioral health crisis, the Division of MH/DD/SAS has developed a very short survey that we want to get to as many diverse service providers as possible.  This survey will help us to assess the "Resource Availability for Persons Experiencing a Mental Health or Substance Use Crisis".  We welcome completion by traditional MH/DD/SAS provider agencies and independent practitioners, as well as by other community responders and partners such as hospital emergency departments, DSS staff, EMS, law enforcement, primary care providers, and any others who may need to interface with behavioral health crisis resources on behalf of their clients. 

Please forward the attached link to all providers within your organizations and networks.  It should take only 3-5 minutes to complete. The survey will be open for one month, closing on September 26.  Thank you in advance for partnering with us in this DHHS Crisis Solutions Initiative survey.

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

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. 

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 

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