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Calendar of Events
NCARF Annual Training Conference
Sept. 29-Oct.1, 2010
Winston-Salem, NC |
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NCARF Headquarters
Suite 102
Raleigh, NC 27607
Phone
919-863-9486
Email
Nicole Shore
Association Executive
Michelle Eggleston
Membership Coordinator
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NCARF Members, please be on the look out for your 2010/2011 Membership Renewal. It will be emailed to the main contact at each member organization. Please contact me or the Association if you have any questions about your renewal. Your feedback is always appreciated, please let us know if there are things NCARF could be doing as an organization to better serve you.
Alicia Camacho
NCARF President 2009-2011
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Communications Bulletin #113
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Mental-Health Reform Delayed Two Months
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From Winston-Salem Journal
By Richard Craver | Journal Reporter
The state said yesterday that it is putting off its latest attempt at mental-health reform for at least two more months.
As a result, it's likely that the full effect of the Critical Access Behavioral Health Agency program, or CABHA, won't be felt until early 2011.
The decision, approved by the Centers for Medicare and Medicaid Services, means that an estimated 221 local clients of providers who are not approved to operate in the CAHBA program can remain with their existing agencies at least until September.
It also means providers who ramped up their high-level management staffing to achieve CABHA status -- many absorbing hundreds of thousands of dollars in additional annual costs -- likely won't receive revenue from new clients for several months.
As of June 18 -- the last time the state updated its CABHA list -- there were 41 certified providers, including 11 that serve CenterPoint Human Services' network in this area.
"I find it amazing how the state does business and changes the rules on a dime," said Judy Briggs, the chief executive of Carolina Behavioral Health Alliance and a local mental-health advocate. "I cannot imagine how difficult it must be for providers.
"You will never accomplish efficiencies when the rules constantly change."
For months, the N.C. Department of Health and Human Services stressed that only agencies certified as CABHA would provide services in five key categories as of today. Those that did not qualify, or chose not to, would have their clients involuntarily transferred to other agencies.
The categories are: case management; peer support for recovery initiatives; community support teams for adults; intensive in-home treatment for children; and day treatment for children and adults dealing with issues such as substance or sexual abuse.
With yesterday's decision, the state essentially gave providers -- whether they tried for CABHA status or not -- a do-over in the application process.
"Until we received approval for this extension, there was no need to keep up with who had made an effort," said Leza Wainwright, the director of the N.C. Division of Mental-Health Services.
She said agencies could submit letters saying it they would seek CABHA status by Aug. 31, and that a critical review of those that submit would be done by Sept. 30. Agencies that don't pass muster will start to have clients taken away after that time.
Meanwhile, some CABHA providers may be forced to cut costs, including cutting recent hires, until new revenue arrives, particularly if they get fewer clients than projected.
Another fear is that some providers -- bracing for the possible loss of clients -- may no longer have enough staff to maintain CABHA services for another two to three months.
Robert Beasley, the president of Youth Opportunities Inc. of Winston-Salem -- one of the local CABHA qualifiers -- said he is disappointed that "the tough measures designed to raise the bar" will not go into effect today.
rcraver@wsjournal.com
727-7376
CABHA qualifiers
There are 41 providers that have achieved accreditation for the Critical Access Behavioral Health Agency program as of June 18. Some providers serve two or all three regions. Those that serve the CenterPoint Human Services network are in italic.
· EASTERN N.C.: Access Family Services, CNC/Access Inc. (doing business as ResCare Home Care), Coastal Horizons, Coastal SE United Care, A Helping Hand of Wilmington, Le'Chris Counseling Services, Port Human Services, Pride in N.C., ReStart, Uplift Comprehensive Services, Waynesboro Family Clinic.
· CENTRAL N.C.: The Children's Home, CRSE Advanced Placement Homes Inc. (doing business as Advanced Placement BHHS), Daymark Recovery Services, Easter Seals/UCP N.C., Freedom House Recovery Center, National Mentor Healthcare LLC (doing business as N.C. Mentor), People Helping People of N.C., Southlight, Saguaro Group (doing business as Triumph), Youth Focus, Youth Haven Services Inc., Youth Opportunities Inc. · WESTERN N.C.: Alexander Youth Network, A Caring Alternative, Carolina Healthcare (doing business as CMC-Randolph), Catawba County Social Services (doing business as Family NET), Elida Homes, Families Together, Institute for Family Centered Services Inc., Meridian Behavioral Health Services, Monarch, New River Service Authority (doing business as New River Behavioral HealthCare), October Road, Parkway Behavioral Health, RHA Health Services, Support Inc., Thompson Child and Family Focus, True Behavioral Healthcare, Turning Point Homes, Universal Mental Health Services
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Special Implementation Update #75
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Special Implementation Update #75 has been posted and can be viewed at: http://www.ncdhhs.gov/mhddsas/servicedefinitions/servdefupdates/index.htm
Subjects include:
- Transition Timeframe for Full CABHA Implementation
- Revised CABHA Letter of Attestation Submission Process
- Update on Subcontracting between a CABHA and Provider Agencies
- Extension of Case Management Services under CSS
- Update on CST, IIH and Day Treatment Training Requirements
- CST Service Revised Rate and Effective Date
- CST Revised Authorization Limit and Effective Date
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Special Implementation Update #75 Revised
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A revision has been made to the Implementation Update #75 .. This can be viewed at http://www.ncdhhs.gov/mhddsas/servicedefinitions/servdefupdates/index.htm
Revised CABHA Letter of Attestation Submission Process - see below.
In order for providers of CST, IIH, and Day Treatment to obtain CABHA certification on or before December 31, 2010 there must be benchmarks established to allow sufficient time for completion of the three stage review process. Therefore, current providers of these three services that have not yet achieved applied for CABHA certification, must submit a completed Letter of Attestation on or before August 31, 2010. This deadline will provide adequate time for the DHHS to complete the desk review portion of the CABHA certification process by September 30, 2010.
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Hi NCARF Members,
I am wondering what types of software programs you are using to provide services, specifically around billing, notes and case records. Is anyone using a purchased solution? If so, who are you using and what are the pluses and minuses of that particular system? If you are using your own system, would you be willing to show me what you are doing? We have developed our own systems, but I would like to improve on what we are doing and I'm just trying to get some ideas.
Thanks in advance for your input.
Alicia
Alicia Camacho
Executive Vice President
DECI
919-596-1341
acamacho@deci.org
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June 2010 Disability Employment Statistics Released
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Save the Date!
Wake Enterprises Golf Tournament
September 23, 2010
Lonnie Poole Golf Course
Raleigh, NC
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MHA/NC 2010 Annual Conference
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MHA/NC 2010 Annual Conference, September 22-23, Featuring Mariel Hemingway
MHA/NC presents our 2010 Annual Conference, Wellness, Recovery, & Action. The conference will be held September 22-23, 2010 at The Holiday Inn Resort at Wrightsville Beach. Educational breakout sessions will include fascinating and groundbreaking topics such as: Integrated Health Care; Evidence-Based Practices for Recovery; Suicide Prevention, Intervention, and Aftermath; Latinos and Mental Health; Bipolar Disorder; Addiction; and How Non-Profits Can Best Utilize Online Social Networking Applications. In addition, the highlight of this year's conference is keynote speaker Mariel Hemingway. Learn more at www.mhainnc.org.
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Coalition Members - A full report from Coalition Budget/Legislative Committee Chairs will be available soon. Below, find various reports and information that have been sent in the last 24 hours. - Jennifer Mahan.
From Mark Binker's Blog (www.news-record.com):
http://mm.news-record.com/drupal/files/documents/fmap%20provision%20062810%20final.pdf
UPDATE: I have re-written this post to reflect the final version of the budget cemented at 4:45 p.m. Monday afternoon. The order of FMAP cuts were rewritten, but the cuts themselves stay the same.
The House and Senate budget negotiators have completed their final run-through on the budget today (previously). What was really kind of a funny is they had a budget deal Saturday, but still had to figure out Monday what exactly they agreed to.
One of the last points of contention was what will happen if they don't get the $525 million in FMAP Medicaid money. They had identified the eight items that might be cut, but memories seem to be a bit hazy on the order of operations for how it'd work.
They have since figured out (with help from Gov. Bev Perdue) that they'll make the following eight cuts, in this order, depending on how much money is forthcoming from the federal government:
1) Transfer from the disaster relief fund ($30 million)
2) Transfer of unclaimed lottery prize money and excess receipts. ($35 million)
3) Use of interest from all other funds. ($50 million)
4) Use of balance in General Fund Availability left over from current year ($23.5 million)
5) Reduction of Medicaid provider rates ($26.6 million)
6) Use of Funds from the Savings Reserve (rainy day) Fund ($37.3 million)
7) Reduction in retirement system contributions. ($139 million)
8) One percent management flexibility cut. ($177.5 million)
Regarding Item 8: agencies will be required to start planning for that cut and setting money aside July 1, even if they don't end up taking it.
2010 Budget Information for The Coalition
From Sally Cameron: Last night (Monday June 28) the House and Senate sessions, the budget conferees in each chamber reported out Senate bill 897 as well as the money report. The bill is calendared for Tuesday's session which begins at 3 pm in both chambers. The House has it first on the agenda, the Senate has it last.
To see these documents go to www.ncleg.net - on the home page on the left are the links to the actual committee report which contains the special provisions and the money report.
Here are some highlights
SPECIAL PROVISIONS - HHS is pages 49-95
Pg 50 - local inpatient beds - $9m additional
Page 52 - CAP MR/DD service eligibility provision
Page 53 - Dix Hospital - HHS must submit a budget for 2010-11 by 8/1 to the appropriations committee - no mention of closing
Page 64 - Medicaid special provisions begin
Page 65 - mental health medications provision - somewhat expected language
Page 67 - 1915b/c waiver provision - only expand to 2/no PBH expansion until DHHS doe an evaluation and reports to legislature
Page 82 - independent assessment provision
MONEY REPORT
HHS is section G-1 - page 33
Mh/dd/sa begins on page 36
#9 local inpatient beds $9m
#11 community services $40m NR
Medicaid begins on page 42
MH/DD/SAS Funding (from the money report)
$40,000,000 NR
Provides funding for community services administered through Local Management Entities. This funding fully restores the mental health, developmental disabilities, and substance abuse services funding reduced for FY 2010-11. This amount includes $30,559,012 of funds transferred from Department of Public Instruction's Office of Early Learning.
Local In-Patient Bed Capacity
$9,000,000 R
Increases funds available for the three-way contracts to purchase local hospital bed capacity for crisis response within communities. These funds will support additional community hospital beds, bringing the total funding to $29 million annually.
Special Provisions (Not all the provisions related to MHDDSAS are listed, just several that have been of interest to The Coalition and member organizations)
STATEWIDE EXPANSION OF CAPITATED 1915(B)/(C) BEHAVIORAL HEALTH WAIVERS
SECTION 10.24.(a) The Department of Health and Human Services (Department shall select up to two additional Local Management Entities (LMEs) to implement the capitated 1915 (b)/(c) Medicaid waiver as a demonstration program during the 2010-2011 fiscal year.
The waiver program shall include all Medicaid-covered mental health, developmental disabilities, and substance abuse services. Expansion of the waiver to additional LMEs shall be contingent upon approval by the Centers for Medicare and Medicaid Services.
SECTION 10.24.(b) The Department shall conduct an evaluation of the capitated 1915(b)/(c) Medicaid waiver demonstration program sites to determine the programs' impact on consumers with developmental disabilities. The evaluation shall include a satisfaction survey of consumers. The Department shall consider the impact on ICF/MR facilities included in the waiver to determine and, to the extent possible, minimize potential inconsistencies with the DMA-ICF/MR rate plan and the requirements of G.S. 131E-176 and G.S. 131E-178 without negatively impacting the viability and success of the waiver program. The Department shall consult with stakeholders and evaluate all other waiver options, including the possibility of a waiver without a 1915(b)/(c) combination. The Department shall report to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Fiscal Research Division no later than April 1, 2012, after which time the Department may expand the capitated 1915(b)/(c) Medicaid waiver to additional LMEs.
The Department shall not approve any expansion of the Piedmont Behavioral Healthcare LME (PBH) beyond its existing catchment area until after the Department has completed its evaluation and made its report pursuant to this subsection.
IMPLEMENT INDEPENDENT ASSESSMENTS ON MENTAL HEALTH SERVICES
SECTION 10.36.(a) The Department of Health and Human Services, Division of Medical Assistance, shall require that, prior to the delivery of enhanced mental health services in the Medicaid program, an independent assessment be conducted that meets all of the following criteria:
(1) An initial assessment or a continuing need reassessment is performed by an Independent Assessment Entity (IAE) that is not the provider of the services in question.
(2) The IAE authorizes the type and amount of service to be provided based on the specific health condition and needs of the intended recipient of the service.
SECTION 10.36.(b) If the Department of Health and Human Services, Division of Medical Assistance, does not achieve the required savings as a result of implementation of the independent assessment activities set forth in subsection (a) of this section, then, in addition to the independent assessments required by subsection (a) of this section, the Department of Health and Human Services, Division of Medical Assistance, shall also require that targeted independent assessments be conducted prior to the delivery of services to each of the following categories of individuals:
(1) Individuals exiting inpatient facilities.
(2) High-cost/high-risk individuals with high behavioral health or medical needs.
(3) Individuals for whom additional continuing care authorizations are being requested.
(4) Individuals moving to a higher, more intensive level of care.
SECTION 10.36.(c) The Department of Health and Human Services, Division of Medical Assistance, shall provide a report of savings generated and other findings relating to the implementation of this section to the Senate Appropriations Committee on Health and Human Services, the House of Representatives Appropriations Subcommittee on Health and Human Services, and the Fiscal Research Division on or before April 1, 2011.
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Budget Wrap-Up and Managed Care Update
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From The Arc of NC
June 29, 2010
The General Assembly conference committee on the Budget finished its work yesterday. Today the proposal will be taken to the full General Assembly for review and a vote today and tomorrow. Although there will be speeches for and against, we believe the report will pass and the state will have a budget prior to the close of the fiscal year.
Since there can be no amendments to the conference report, what is listed in the report is what the final budget will look like. Though the budget does not make the MHDDSA system whole it could have been much worse and a special provision on "Managed Care" was included with the budget bill.
- We are pleased that the 40 million dollars taken from the MHDDSA system last year is returned and the source of funding looks as though it will not have significant restrictions.
- The special provision on Managed Care waivers does not remove DD but has specific enough language about reviewing the effect on DD and slowing the process down that we believe we can have real input on the future of our system. The provision limits the expansion of Managed Care to two new sites only.
- The legislature did include contingency cuts in case Congress does not extend the enhanced FMAP. The contingency is established in a manor that allows congress six months to act and allows for tiered reductions based upon how much money may be included in an extension.
- In the budget bill, the legislature does make many other policy and funding changes that will impact our system. We have seen much of what is included and believe it will not have significant negative impact on people with developmental disabilities.
That is not to say that this will not be a difficult year. We are still faced with the effects of deep Medicaid cuts from last year, policy changes that have a negative impact on people with mental illness, and the uncertainty of how these will play out. With that said, we should all be proud of the grassroots advocacy ........this budget could have been much worse for people with DD and the reason it isn't worse is because you and our advocacy partners were active and effective. Legislators heard you and they attempted to craft a bill that responded.
We will have a much more comprehensive analysis for you by next week. If you would like to see detail now the budget bill along, with the money reports are available on our website. Julia has also posted some of the more important information on our Policy Blog .
If you have questions or need more information please call.
Thank you for all of your hard work! Every phone call and e-mail made a difference and this E-Alert Network generated incredible amounts of advocacy.
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ECVC President Announces Retirement, New President Named:
 After serving as ECVC's President since 1982, Daneel L. le Roux, officially announced his retirement today. After this announcement, ECVC's Board of Directors voted to accept ECVC's current Executive Vice President, Bob Jones, as the new President for the company. Le Roux will remain at ECVC as CEO during a transition period until December 2011.
Mr. Jones has been with ECVC since 1978. He began his career as the Recycling Production Supervisor and then, Recycling Department Manager. In 1988, he was promoted to Production Director and later to Executive Vice President. Originally from Pittsburg, California; Jones attended Old Dominion University and ECU. He is a U.S. Army veteran and between his father, his siblings, and himself, the family has 59 years of active duty in the U.S. Army and 22 years of Army Reserve Duty.
ECVC's Board Chairman, James Dupree stated, "I am very excited to have Bob move into the President's position at ECVC. He is highly qualified for this position and I am sure he will do a superb job. He is a man of high integrity with a proven record of serving ECVC in several capacities over 32 years. We are very fortunate to have a person of his qualifications already on board. I look forward to working with him as we move forward."
Formed in 1965, ECVC is a non-profit company with the social mission of "helping people with disabilities attain a higher quality of life through the achievement of their vocational goals." Today ECVC is self-sustained through federal government contracts (batteries, picture/ certificate frames, battery terminal lugs, drill bits, and a Servmart Store at MCAS Cherry Point), local government contracts (job placement & training, recycling, and janitorial services for Pitt and its surrounding counties), and commercial services (custom framing & chair caning - Fine Finishes).
For additional information or interviews, contact Susan Daughtry at 252-317-3123 or sdaughtry@ecvcinc.com.
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Save the Date!
NCARF Annual Training Conference
September 29-October 1, 2010
Embassy Suites
Winston-Salem, NC
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News to Share?
Please send any news you wish to include in the weekly updates to
NCARF Staff
***The information in the NCARF Weekly Update is presented for informational purposes. Unless expressly stated, opinions may not be the opinion of NCARF as an organization. Inclusion of information in the Weekly Update is not meant to imply endorsement by NCARF or its member organizations. NCARF cannot guarantee the accuracy of all information that is passed along from various outside sources. |
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