Smoky Mountain Incident Report team (IRT) has two new staff members. Ayofemi Powell is a Smoky Mountain IRIS specialist and Critical Incident Report Committee (CIRC) facilitator, and Tashia Shamwell is an IRIS specialist and the Back-Up Staffing (BUS) specialist.

We have noticed a few trends in reporting which, if corrected, may limit the number of requests for additional information your program receives. Please double check the IRIS document before submitting to make sure that you have included the following:

� The consumer's home LME client record number.

� The consumer's correct date of birth and gender.

� A clear and detailed description of what caused the

incident.

� Actions taken in response to the incident.

� A plan that explains how this incident can be prevented

from happening in the future.

� Do not answer unknown to yes or no questions.

� Attach any supportive documentation that helps us to

better assess the incident.

Please be mindful that all Level II & III incidents must be submitted in IRIS within 72 hours from date of discovery and deaths require a 24 hour verbal notification to Smoky.

Innovations providers should submit Back-Up Staffing reports in the Alpha system. Items to address in submission include:

� Select a county in the 'County of Service Provision'

dropdown menu (not All).

� If selecting 'Other' from a dropdown menu, be sure to

give an explanation in the field that's provided.

� For now, we ask that there is only one service per report.

We thank you for your hard work improving the quality of incident reports.

Please feel free to contact us with any questions or concerns.

Ayofemi Powell - ayofemi.powell@smokymountaincenter.com

828-586-5501 ext. 1104.

Tashia Shamwell - tashia.shamwell@smokymountaincenter.com

828-586-5501 ext. 5094.

General mailbox - IncidentReport@smokymountaincenter.com

TBI Focus Group

Blue corner ribbon for new items in your eshop Your input could help improve services for individuals with traumatic brain injury in North Carolina.

To learn more on how you can participate; click on the links below:

Asheville Charlotte

Program Integrity Annual Summit

The Program Intergrity Annual Summit will be a 2 day training held in Raleigh NC on October 14th and 15th 2014. The Divison of Medical Assistance Program Integrity staff and Medicaid Investigations Division staff will present this training with a focus on effective investigative strategies and techniques, conducting claims research on high risk providers, building a strong MID referral, and case studies specifically related to behavioral health investigations and referrals.

Click link to register

Required Elements of Discharge Plans

Individualized goals and language specific to the consumer - not cut and pasted - should reflect consumer/family/guardian input
Goals are :

Specific
Realistic
Objective
Measurable

An example of a goal for step-down is "XXX will demonstrate readiness for discharge when he has maintained behavioral control to the extent that restraints are not required for a period of two weeks, when he has been able to verbalize behavioral/recovery goals, and when instances of self harm have been reduced to less than two per week through consumer's recovery efforts."

Plans for appropriate step-down care:

Plans for step-down care should include rationale for step-down level of care with specific potential step-down placements identified
Timeline for expected implementation and step-down
Timelines represent the providers best estimate of step-down readiness and should be adjusted to reflect consumer's progress as needed (at minimum, at each team meeting)
Estimated timelines do not dictate authorization - authorization is based solely on medical necessity

Discharge Medications from Broughton Hospital

Pursuant to the expectation of DSOHF, beginning January 1, 2015, the supply of medication given to consumer upon discharge will be limited to a one week supply. The patient could be given a prescription for a three week supply of medications to complete a one month supply. There may be exceptions to this practice in extraordinary circumstances, but this is consistent with the discharge protocols of Central Regional Hospital and Cherry Hospital, which are already in place. Thank you for your attention to this important matter.

NC TOPPS News

When a consumer transfers to a new provider agency, the LME/MCO super user is responsible for changing the QP for that consumer in order to give the new provider agency access to the consumer's previous NC-TOPPS submissions completed during the current episode of care. Ensuring smooth transfers of responsibility from one provider agency to another requires good communication among the LME/MCO's super user, service authorization unit, and the NC-TOPPS provider agencies involved.

When transferring a consumer to another provider please be sure the following actions occur:

Obtain consent via your agency's release of information. Keep this in your health record for the consumer.
Provide the following information to nctopps@smokymountaincenter.com:
- The provider name and address for agency receiving the transferred NC TOPPS
- The QP responsible for the NC TOPPS with the new agency
Delinquent interviews will not be transferred.

A Friendly Reminder

NC TOPPS Helpdesk cannot assist with SAR issues, billing or claims issues, ALPHA MCS issues, or network enrollment issues. Please contact your agency's designated Account Specialist or Claims Specialist for assistance with these issues.

Email any NC TOPPS questions to nctopps@smokymountaincenter.com.

2014 NC Council of Community Program's Conference and Exhibition

Blue corner ribbon for new items in your eshop Pathways to Integration

December 3-5, 2014

Exhibit at one of the largest mental health, developmental disability and substance abuse service system conferences in NC.

Click to learn more

Western Regional Partnership- Credentialing Training

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

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 Program

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): a 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

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..

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.