General inquiries: 828-225-2784
Provider questions: Call 1-866-990-9712, contact your account specialist or email
Confidential Compliance Hotline for suspected fraud and abuse: Report online or call 1-866-916-4255
AlphaMCS technical support: 828-225-2784, ext. 1500, 8:30 a.m. to 5 p.m. M-F
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Crisis Response:
Comprehensive Crisis Plans and After-hours Coverage
A recent review of 2014 rapid readmits (individuals readmitted for inpatient stays within 30 days of discharge) found that 42% of individuals with an active provider either did not have a crisis plan or the plan was outdated. As part of the Crisis Solutions Initiative, the North Carolina Department of Health and Human Services (NC DHHS) has identified the importance of having a comprehensive crisis plan (CCP) as part of an effective crisis intervention strategy.
What is a comprehensive crisis plan (CCP)?
More formally known as Crisis Prevention and Intervention Plans, CCPs help individuals navigate mental health, substance use and intellectual/developmental disability crises to decrease costly emergency department (ED) visits or inpatient stays. NC DHHS requires a CCP as part of every Person-Centered Plan.
What information should a CCP include?
Supports for the individual
Known triggers
Strategies to help prevent a crisis
Instruction to guide an effective response to a crisis
Guidance to plan for successful crisis resolution
(see the links below for additional guidance)
Who is required to have a CCP?
Individuals receiving enhanced services
Innovations Waiver participants
Individuals with an I/DD diagnosis who are not enrolled in the Innovations Waiver but meet certain conditions (see Section 8 of the Provider Operations Manual for details)
Are there others who would benefit from having a CCP?
Yes, individuals who are at significant risk of crisis events, or who have experienced crisis events within the last year, including those receiving Basic Benefits services.
Tips for a strong CCP
Plan reflects the preferences of the individual and the best clinical judgment and expertise of the clinician
Plan is developed with the individual and their identified natural supports
Plan is reviewed in accordance with changes in an individual's life (i.e., moving to a new residence)
Plan is reviewed after any crisis event
Plan is revised when necessary
Who should have a copy of the CCP?
The individual
Those who the individual grants permission
Those who may be of support to the individual when in crisis
It is critical that the individual know who will be responding in a crisis and how to contact that staff person or their designee.
CCPs and any subsequent updates should be uploaded to AlphaMCS. Plans should be easily identifiable (for example, JDoe_CrisisPlan_110415) and tagged as CLINICAL DOCS - Clinical Doc Type - Crisis Plan.
Crisis and After-hours Coverage
The level of after-hours coverage is determined by the services being provided to an individual. DO NOT refer an individual to 911 or the ED unless it is a life-threatening emergency.
Basic Benefit Providers
24/7 telephonic crisis intervention/response and an after-hours contact number are required. If an answering service is used, the call must be returned within 15 minutes.
Using the individual's CCP or crisis plan, attempt to implement the defined strategies to mitigate the crisis. If telephonic intervention is not successful, mobile crisis services can be utilized to provide face-to-face assessment.
Behavioral Health Clinical Homes (BHCH) and Enhanced Services Providers (Intensive in Home, Multi-Systemic Therapy, Community Support Team, Assertive Community Treatment, Substance Abuse Intensive Outpatient, Substance Abuse Comprehensive Outpatient)
First responder services are required to be available 24/7 telephonically. If telephone intervention is unsuccessful, face-to-face response is required. Provider is responsible for filing involuntary commitment petitions (IVCs) if necessary.
Mobile crisis should be accessed only when a first responder's attempt at telephonic intervention, face-to-face intervention and implementation of the CCP have failed. All options should be explored and exhausted prior to referring an individual to the ED, as options then become more limited. The BHCH retains emergency response responsibilities for 60 days after an individual is discharged, if that individual is not connected with another provider at the time of discharge.
Innovations Waiver Providers
Innovations Waiver providers are required to respond to emergencies/crises on weekends and evenings as outlined in the applicable Innovations Waiver service definition.
State-funded I/DD Services Direct Care Providers
State-funded services direct care providers must develop CCPs for their consumers, and support persons must be trained in implementing the plan. All parties included in the crisis plan must know and understand their role in crisis response, including ability to provide 24/7 telephonic response in a crisis. If telephonic crisis response does not mitigate the crisis, the provider may contact mobile crisis for face-to-face response. (See Section 8 of the Provider Operations Manual for more details)
Thank you for providing a critical therapeutic intervention for the individuals you serve.
Further information on CCPs:
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About provider email alerts
You are receiving this alert because you are a member of the Smoky provider network or have signed up for our Provider Network Bulletin. Smoky issues email alerts to convey critical information as soon as possible. Please note that if you unsubscribe from these alerts, you will also be removed from the Provider Network Bulletin mailing list and may miss out on important information. unencrypt |
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Smoky Mountain LME/MCO | 200 Ridgefield Court, Suite 206 | Asheville, NC 28806
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Smoky Mountain LME/MCO manages publicly funded services for mental health, substance use and intellectual/developmental disabilities in Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Wilkes and Yancey counties in North Carolina. For immediate help or information about services, call 1-800-849-6127, 24 hours a day (TTY: Relay NC 711). Visit us at www.smokymountaincenter.com.
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