Smoky Mountain Provider Network Bulletin

Blue corner ribbon for new items in your eshop This training will explain how CenterPoint, Partners and Smoky LME/MCOs will handle the credentialing process and will address timelines for implementation, network development decisions and application processing.

Click on the link to learn more.

Quarterly Provider Incident Report

Blue corner ribbon for new items in your eshop

Reminder: Quarterly Provider Incident Report is Due October 10, 2014.

The Quarterly Report for Level I Incidents is due to the LME/MCO on October 10, 2014. Please send your SFY 14/15 1^st Quarter report to IncidentReport@smokymountaincenter.com This email is also your contact for any questions you may have regarding incident reporting.

Recent opportunities to waive this reporting requirement (MCO Joint Communication Bulletin #J100) are being evaluated by Smoky Mountain. Future communication regarding waiver of this requirement will be announced after the decision making process has been finalized.

Residential Level III Services

To : All providers who work with children/adolescents in Residential Level III

Click on the link for the communication that explains the clinical expectations for the Residential Level III service; as outlined in Clinical Coverage Policies, Communication Bulletins, and accepted standards of Best Practice.

Comprehensive Crisis Plan requirements and Care Management

Attention all Providers:

In order to comply with the Department of Health and Human Services' (DHHS) recent communication on Comprehensive Crisis Plans (CCP)s issued August 20, 2014, providers should begin to submit Comprehensive Crisis Plans along with their Service Authorization Requests (SARS)

Comprehensive Crisis Plans are required to be completed for any service that requires a Person Centered Plan (PCP)*. This includes both Medicaid and State-funded services. These plans are to be updated when the PCP is updated or when there is any significant change in functioning. As with any revision to the PCP, a signature will be required.
Plans are required to be updated when consumers' medications are changed
For individual's with diagnosis of Intellectual Developmental Disabilities (Not on Innovations Waiver): CCP is required:
- For individuals who have been referred to or discharged from NCSTART; or
- Have been referred to or discharged from a Developmental Center; or
- Have received two unplanned restraints in one quarter.

The Comprehensive Crisis Prevention & Intervention Plan is RECOMMENDED for all consumers who are at significant risk of crisis events - including those in basic benefit services. This would include persons who have, within the past year, been psychiatrically hospitalized or received inpatient treatment for a substance use disorder, who have been arrested, attempted suicide, or used crisis services (i.e., mobile crisis team, facility-based crisis or non-hospital detox unit, walk-in crisis, NC START, or use of a hospital's emergency department for reasons related to psychiatric illness or substance use).

Care Management will begin to review these for any SAR submitted on or after October 15^th, 2014; any SARS that do not include required Comprehensive Crisis Plans may be administratively denied.

The CCP should be developed by the primary clinician or provider who completes the Person Centered Plan (PCP), in collaboration with the person served, and perhaps with input from others who know him/her well. Developing a comprehensive crisis plan requires a good working relationship and the in-depth knowledge of a person's strengths and needs that a primary provider would have. Please note that the "general characteristics / preferences" section of the crisis plan should not reflect only the views of the individual or only the opinion of the clinician, but should be completed in a truly collaborative fashion, reflecting both the preferences of the person and the best clinical judgment and expertise of the clinician.

*Note that the communication itself provides a great deal of detail about the requirements for this updated Comprehensive Crisis Plan, including services that are excluded from this requirement. Please refer to the communication linked here: http://crisissolutionsnc.org/wp-content/uploads/2014/01/crisis-crisisplnmemo8-20-14.pdf

Please call any Care Manager/Reviewer or call the Care Management line at 1-800-893-6246 X 1902 with questions about these requirements or for assistance.

Progressive Education Program

Blue corner ribbon for new items in your eshop 20th Year Reunion & Fund Raiser

September 20, 2014

1:00pm-4:00pm

Click link to learn more..

Program Integrity and Providers in Medicaid Managed Care

Program Integrity is one of the primary functions of an LME/MCO operating as a Medicaid managed care organization pursuant to 42 CFR Part 438. A standardized training has been developed to educate providers on LME/MCO Program Integrity responsibilities. The session will include an overview of the structure and day-to-day functions of LME/MCO Program Integrity including but not limited to the purpose, investigation process, referral sources, possible sanctions, and laws/regulations related to Program Integrity.

Session Objectives: Upon completion of the presentation, participants will be able to:

1. Define purpose of Program Integrity in Medicaid Managed Care

Organizations

2. Differentiate between types of investigations conducted by the

LME/MCO

3. List Program Integrity Referral Sources

4. Define Program Integrity investigation Process

5. List possible outcomes from Program Integrity investigations

6. Identify laws/Regulations/Statues related to Program Integrity

Target Audience: Provider Agencies, Licensed Independent Practitioners, Quality Management staff members, Compliance staff members.

Royal Conference Center, 3801 Hillsborough St, Raleigh, NC,

October 14, 2014 9am - 12pm

This training is offered on a first come first serve basis. (Minimum attendees: 40 registered participants needed in order for the training to occur. Maximum attendees: 72)

There are 3 CE credits available for APA, NBCC & ASWB

NC IDD Listening Sessions

DHHS Deputy Secretary of Behavioral Health and Developmental Disabilities Services to attend listening session for NC IDD services

The North Carolina Department of Health and Human Services (DHHS) is working to create a better way to provide services for people with intellectual and/or developmental disabilities (IDD) and needs your help.

In an effort to inform the State, please join Smoky as we welcome Dave Richard, Deputy Secretary of Behavioral Health and Developmental Disabilities Services, to our area. Dave will talk briefly about IDD services and the direction that North Carolina is headed in, but the most important reason for his attendance is to hear from you.

Please come prepared to talk about your experiences, suggestions and concerns.

The next session in the Smoky area will be Wednesday, October 15, 2014, 6:00pm - 8:30pm, at Haywood Community College, in the Charles Beall Auditorium.

To send feedback to the Department of Health and Human Services regarding the Listening Sessions or the future of services for individuals with IDD, please use IDDListeningSessions@DHHS.NC.Gov

Medical Loan Repayment Program

We are pleased to announce that Jerry Boylan, medical placement specialist with the NC Office of Rural Health, will be delivering an informational session on Medical Loan Repayment program, October 22^nd at MAHEC.

Click link to learn more about the Session.

Family Fun Day is scheduled for 12/13/14!!

In its 14^th year of fun and celebration Family Fun Day Holiday Fest is coming up on December 13, 2014. Located inside the Expo building of the WNC Ag. Center the 27,000 sq. foot space is transformed into a winter wonderland of holiday characters to meet, llamas to pet, food, face painters, balloonists and much more. A Wide variety of craft, games and activities are provide by the service provider programs across the area. Through the wonderful efforts of multiple agencies this event is growing . Last year there were 776 people in attendance.

The event is free to all and it offers multiple ways to be involved.

1) Provide an 'Informational Booth',

2) Provide an activity for attendees while promoting

the services you offer,

3) Be a part of the planning team for the event (meets

monthly). Deadline for this is end of September.

4) Off set the costs of the event by offering a financial

or in-kind contribution

5) Inform families about it or just come and check it

out yourself.

Consider how you can be part of this really fun day, meet families and other providers of services.

For further details please contact Roxann Colwell at 828-230-3555, roxann.colwell@msj.org.

See link to see how you can be involved..

4th Annual Regional Transition into Adulthood Fair

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

Click link for Exhibitors letter and form

Smoky Mountain LME/MCO 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.