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December 2015 | Vol. 5, Issue 6
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Greetings from Smoky Mountain!
Smoky makes it easy to keep up with what's going on with services for mental health, substance use or intellectual or developmental disability in western North Carolina. Whether you're an individual receiving services, a family member, a provider or a community partner, we're honored to share with you how we're striving to meet local needs in a way that only a public managed care company can. It is our pleasure to share with you information about Smoky news and events.
Join us online! | 
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CEO SPOTLIGHT:
Message from Brian Ingraham |
 The New Year is considered a time for fresh starts. It may be a time to adopt healthy habits, set new goals or reinvent one's self into something even better.
At Smoky, 2016 will be a time of reinvention as we create a new system of serving some of the state's most vulnerable residents. Will there be growing pains? Of course! Will there be opportunity? Of course! But, ultimately, we believe the changes mandated for North Carolina's Medicaid program are not an obstacle, but an opportunity to better serve the citizens of our state.
This year, the N.C. General Assembly passed legislation that will see the eventual responsibility for management of the Medicaid portion of the healthcare system to be undertaken by private managed care organizations and provider-led entities (PLE's). We'll learn more about the state's exact path to reform in 2016 through the submission of its application for an 1115 Medicaid Waiver to the Centers for Medicare & Medicaid Services. In the meantime, we know it's wise to ask ourselves what we at Smoky want to be and how we can best serve North Carolinians going forward.
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"Now, it's time for Smoky to reinvent itself - again."
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When we look back at similar transitions, like the implementation of the 1915 (b)/(c) Waiver we've operated under for the last few years, we can see that most providers successfully met the challenges associated with that new paradigm. As a result, they became even more responsive to individuals seeking care, smarter in providing community-based services and more skilled in their ability to use data and experience to determine what types of care work best. These changes helped our system thrive and led to greater access to care and better outcomes for consumers of care.
For the public policy and legislation that allowed us to develop our expertise as a public manager of specialty care, we are grateful. Now, it's time for Smoky to reinvent itself - again. Faced with a changing environment, we know that those who do not adapt and reinvent themselves perish. In that vein, we've rededicated ourselves to becoming smarter, more nimble and more willing to stay ahead of the needs of those we serve in an effort to add value to their lives and the broader healthcare system in which we all live. In the end, we'll also become better at what we do in a way that adds value to our members and the providers in our network.
As we march into 2016, we'll continue to keep the lines of communication open with our providers, community partners and individuals receiving services. We thank you for your past support that has allowed us to reach the eve of this exciting new era. Happy New Year to each and every one of you.
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N.C. Council honors partnership between Smoky, MAHEC at December conference
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| Smoky CEO Brian Ingraham and MAHEC's Elizabeth Flemming accept the N.C. Council Programs of Excellence Award
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Together, great things can happen. The N.C. Council of Community Programs honored Smoky and the Mountain Area Health Education Center (MAHEC) in December with its Programs of Excellence Award for Partnership to Improve Services in recognition of the two organizations' joint activities.
Smoky CEO Brian Ingraham and MAHEC's Associate Director of Mental Health Education, Elizabeth Flemming, accepted the award at the council's annual conference in Pinehurst. Smoky and MAHEC have worked closely together to increase access to both physical and behavioral health and intellectual/ developmental disability services throughout western North Carolina.
"Working together, like-minded organizations like Smoky and MAHEC can expand their reach to make positive, life-changing advances in the care of the people we serve," said Smoky CEO Brian Ingraham. "We're proud to have a trusted partner in helping us move our region toward integrated and collaborative care."
"As a leader in primary care innovation, MAHEC has enjoyed a robust partnership with Smoky," said MAHEC President and CEO Dr. Jeff Heck. "Both organizations recognize that the key to healthy communities and quality health services is a dynamic partnership that integrates behavioral health with primary care. Our pilot projects are already beginning to show how the synergies between our organizations can result in benefits for our communities greater than either could do alone."
Smoky and MAHEC recently partnered to create a regional workforce development program that builds providers' knowledge and skills related to whole-person and collaborative care. Additionally, MAHEC has partnered with Smoky and Mission Health on Project 1300, which provides high-quality healthcare to individuals with complex needs.
Smoky staff also facilitated a conference session, "Whole-Person Care: Raising the Bar on Interdisciplinary Collaboration," that gave an overview of Smoky's initiative to bring a whole-person care approach to services. Speakers included consultants Donna Izor and Karen Luken, MAHEC's Flemming and four Smoky staff: Chief Operating Officer Christina Carter, Chief Medical Officer Dr. Craig Martin, Director of Integrated Care Peter Rives and Rhonda Cox, Senior Director of Care Coordination.
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Recovery in action: Smoky welcomes newest WRAP facilitators
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Smoky's newest WRAP facilitators, with trainer Vicki Sturtevant (center),
show off "recovery links" to help them motivate themselves and others.
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Smoky and provider partners can now reach even more western North Carolinians with messages of recovery and wellness following the graduation of 14 new Wellness Recovery Action Plan (WRAP) facilitators on December 4.
Six additional staff members from Smoky, seven from RHA Health Services and one from Daymark Recovery Services will now facilitate WRAP trainings throughout the region. A self-designed prevention and wellness tool, WRAP is used by people is mental health and/or substance use recovery and others to help make positive, effective life changes.
Facilitators use not only their training, but also their personal experience using WRAP in their own lives to inform and inspire others. "(The training) was nice to be in a safe environment where I could share my story and feel surrounded by others who have had he same struggles," said graduate Jannielle Hoyt, a Smoky Consumer and Family Advisor. "Going forward, I'll be using WRAP to help others live the life they've always wanted."  Other Smoky graduates were In-Reach Specialist Benjamin O'Neal, Peer and Family Support Specialists Hugo Santos and Rich Willey, Family Partner Julia McClure and In-Reach Specialist Kevin Mahoney, who has since joined RHA. Vicki Sturtevant, a clinician with Smoky's Geriatric and Adult Mental Health Specialty Team, served as facilitator trainer. WRAP is one of Smoky's evidence-based programs offered for free to western North Carolinians. Smoky's first group of eight facilitators was trained in 2013. For more information on WRAP, visit www.mentalhealthrecovery.com. |
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YouTube: When fairies come to town
Small acts of kindness can build resiliency in our lives, the lives of others and entire communities.
"The Gnomist," a 17-minute film from Great Big Story and CNN, explores a forest of fairy homes in Overland Park, Kansas. Where did they come from? What do they mean? Watch and learn.
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We want to hear from you! Help us improve healthcare services in WNC
Be on the lookout in January for your chance to help Smoky improve healthcare services for people living throughout western North Carolina.
 E ach year, Smoky conducts a survey to find out what various types of individuals think about the state of services for mental illness, substance use disorder and intellectual/ developmental disabilities. The Community Needs Assessment Survey gives participants the opportunity to report any services currently needed in their community, as well as other related topics, throughout the 23-county region where Smoky operates.The 2016 survey will be available from Monday, January 11, through Friday, January 23. News You Can Use subscribers will receive an email in early January with a link to the survey webpage. This link will also be featured on the Smoky website at www.smokymountaincenter.com. |
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From the doctor
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Dr. Craig Martin is Smoky's Chief Medical Officer
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In our April newsletter, I explored the question of whether psychiatrists place "too many kids" on psychiatric medications. A recent New York Times article claimed antipsychotic medication prescriptions for children ages 2 or younger increased 50 percent between 2013 and 2014. Are these medications always prescribed so frequently, and are they always necessary?
Smoky is fortunate to have two child psychiatrists on staff and a behavioral pharmacist for consultations as they oversee treatment in our region. Approximately 158,000 residents in our area are eligible for Medicaid, and another 165,000 are uninsured. Each month, we serve roughly 4,600 people.
Of these, about 200 are under age 5. Of those, fewer than 10 have ever been prescribed antipsychotic medication paid for by Medicaid, and none were under age 2. Our Utilization Management and Care Coordination staff monitor prescriptions and consult with our Medical Team on any psychiatric medications for children under age 5.
Most medication use in children this young is "off-label," with best clinical practices demanding a trial of family or play therapy, or environmental intervention, before starting medication. We still know very little how antipsychotics impact developing brains, with most published data for children coming from a different class of medication, psychostimulants, when started in grade school for Attention Deficit Hyperactivity Disorder. For these children, clinical outcomes are better, with higher academic achievement and lower rates of drug and alcohol use, than those not treated.
Smoky's Medical Team includes Dr. John Nicholls, Dr. Heather Cree and yours truly. We regularly consult with staff and providers to improve the health and clinical outcomes for people in our communities, including preschoolers and toddlers. We know this is the right thing to do, and with the Smoky team, we're helping build a better future for all of us.
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Comment sought from N.C. residents with disabilities, wider community
 The N.C. Council on Developmental Disabilities (NCCDD) is seeking public comment on its proposed Five-Year State Plan from people with intellectual or developmental disabilities, as well as their families, caregivers, advocates and other members of the public. The plan includes three goals recommending increased financial security, increased community living and increased advocacy for people with disabilities and their families. Public comment is open through January 14 on the NCCDD website.
The plan must be submitted to the Administration on Intellectual and Developmental Disabilities (AIDD) for approval by August 15, 2016, and will take effect on October 1.
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State news: Preparations begin for Medicaid reform
Eleven N.C. health systems announced plans in December to explore creating a provider-led and provider-owned prepaid health plan that would manage Medicaid funds throughout the state.
Those systems are Mission Health, Cape Fear Valley Health System, Carolinas HealthCare System, Cone Health, Duke University Health System, New Hanover Regional Medical Center, Novant Health, University of North Carolina Health Care System, Vidant Health, Wake Forest Baptist Medical Center and WakeMed Health, reports the Asheville Citizen-Times. Medicaid reform passed by the N.C. General Assembly allowed for the creation of provider-led entities and commercial managed care organizations to oversee funds in either regions of or all of the state.
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Need services? We're here to help. |
 Smoky Mountain LME/MCO manages services for mental health, substance use and intellectual and 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. For immediate help or information about services, call us toll-free, 24 hours a day, 7 days a week, at 1-800-849-6127 (TTY calls: Relay NC at 711). unencrypt |
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OUR MISSION
Smoky is a public manager of care for individuals facing challenges with mental illness, substance use and/or intellectual/ developmental disabilities. Our goal is to successfully evolve in the healthcare system by embracing innovation, adapting to a changing environment and maximizing resources for the long-term benefit of the people and communities we serve.
OUR VISION
Communities where people get the help they need to live the life they choose
OUR VALUES
Person-centeredness ~ Integration ~ Commitment Integrity
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Polk Health Center opens
Blue Ridge Community Health Services has opened a new site in Polk County.
The Polk Health Center in Columbus will offer primary care, pediatric, psychiatric, pharmacy, nutrition and other services, as well as access to case management and dental services.
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Medicaid: Changes ahead
Medicaid reform in North Carolina is mirroring national trends, a statewide health expert told listeners at the N.C. Council of Community Program's December conference in Pinehurst.
Tara Larson, Senior Healthcare Policy Specialist at Cansler Collaborative Resources, said 80 percent of the national Medicaid population is in some sort of managed care, according to N.C. Health News, a drastic increase from five years ago. Read more.
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Mental illness and violence
"Violent crimes," writes New York Congressman Paul Tonko, "are committed by violent people. ... Study after study has shown that there is no connection between those with mental illness and violence."
In a widely shared blog post in December, Tonko argues against further stigmatization of people with mental illness. Read more on the Huffington Post.
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Autism Society conference coming in March
The Autism Society of North Carolina will hold its 2016 conference, "Autism Through the Ages," on March 11-12 in Charlotte.
Nationally and internationally recognized speakers include Dr. Geri Dawson and Katherine Davlantis from the Duke Center for Autism and Brain Development. Register online.
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Counties to host community health forums
The Rutherford Polk McDowell Health District will sponsor several community health forums in January.
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CDC updates public health profiles
The Centers for Disease Control and Prevention has released an updated Community Health Status Indicators (CHSI 2015) tool that produces public health profiles for all U.S. counties.
Each profile includes key indicators of health outcomes, such as healthcare access and quality, health behaviors, social factors and the physical environment. Access the CHSI online.
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NAMI: Mental health funding declines in majority of states
A new report from the National Alliance on Mental Illness (NAMI) finds that despite some gains for mental health care, funding for mental health services fell in more states than it grew.
"State Mental Health Legislation: Trends, Themes and Effective Practices" reports that fewer than half of states increased mental health budgets this year. The rest reduced funding, including North Carolina. Read the full report on the NAMI website.
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Media training on tobacco issues
Learn best practices for news media interviews about tobacco prevention and control issues from Ann Houston Staples with the N.C. Division of Public Health, Tobacco Prevention and Control Branch. Public health advocates, health educators, health directors and community members from western North Carolina are encouraged to attend a training on January 29 in Asheville.
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SAMHSA app helps start conversations on underage drinking
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a new app to help parents talk to their children about underage drinking. The "Talk. They Hear You" app features an interactive simulation that shares advice on bringing up the topic of alcohol, what questions to ask and ideas to keep conversations going. Learn more.
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Naloxone use on rise, saving lives in NC
Harm reduction advocates say a 2013 North Carolina law has saved the lives of more than 1,500 people who overdosed on heroin or other opioid drugs.
The legislation increased access to naloxone, which can reverse the effects of an overdose, and granted immunity to individuals possessing small amounts of drugs who seek medical help for themselves or another person who is overdosing. Read more in the (Raleigh) News & Observer.
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