Benchmarks' Friday Membership
Webinar and Update
Benchmarks' Member Webinar 6-12-2020
Benchmarks' Member Webinar 

NC Cases:  39,481
NC Cases Hospitalized:  812
NC Deaths:   1064
   
COVID-19 Hospitalizations
Reported hospitalizations of COVID-19 patients continued to climb, with the state reporting a new high Thursday of 812 people being treated in hospitals for coronavirus infections. Hospitalizations increased by 153 patients since last Thursday. In an interview with reporters last week, Dr. David Wohl, an infectious disease expert at the UNC School of Medicine, called COVID hospitalizations "really, the truest canary in the coal mine for us. It's really the best indicator we have of where we are with the pandemic."
 
Hospitalizations is one metric state public health officials use to track the course of the coronavirus outbreak over time. It is also one of four metrics officials are using to look at whether they can move forward with easing restrictions. Positive laboratory confirmed cases is another metric. Those numbers continue to increase as well. Some increases in case counts can be attributed to an increase in testing.
 
More than 572,600 people have been tested for COVID-19 in North Carolina, which is about 19,000 more than Wednesday. The percentage of people who tested positive were 9%.

On Wednesday, Cohen, said the state has tripled its one-day testing goal, and it wants to continue those trends by testing more people, especially people in historically marginalized communities, who have been hardest hit by COVID-19.
 
In a memo Tuesday to health care providers and laboratories, DHHS said community transmission is increasing in many areas of the state and among historically marginalized populations, especially among African Americans and the LatinX community.

  Black people make up 27 percent of all positive cases, and 34 percent of all COVID-19 related deaths in North Carolina. However, they make up only 22 percent of the state's population. The memo included updated guidance on when clinicians should test patients, or arrange for them to be tested. DHHS has websites that help users decide whether they should be tested for the coronavirus, and identifies testing locations.
 
White House Worries
ADAM WAGNER AND DAVID RAYNOR, THE NEWS & OBSERVER, 6/10/20
Dr. Deborah Birx and the White House Coronavirus Task Force are worried about COVID-19's spread in a handful of North Carolina counties, including in the Triangle. On Wednesday, state health secretary Dr. Mandy Cohen said North Carolina is ramping up testing and tracing resources to several of those counties and others, including Alamance, Duplin, Durham, Forsyth, Johnston, Lee, Mecklenburg and Wake. 

A News & Observer analysis of positive tests reported by each of the eight counties since May 26 shows the doubling rate has shortened in some of the counties of concern, but lengthened in others. Doubling rate measures how long the total number of cases in each county takes to double. When the doubling time declines, that indicates the virus is spreading more quickly in those places.
Among the counties Birx expressed concern about the doubling time is generally declining in Alamance, Durham, Johnston, Mecklenburg and Wake counties. 

Durham County, for instance, reached a doubling time of 28 days on May 27. Then, on May 30, the doubling time began to drop, hitting 18 days as of Tuesday. Statewide, the doubling time for COVID-19 cases is about 23 days, recently ticking upward from 22 days. In Duplin, Forsyth and Lee counties, doubling time has grown in recent weeks. That indicates the virus is spreading more slowly in those places. There are also alarming trends statewide. 

Each day this week, North Carolina has reported a new record-high for residents hospitalized with COVID-19. On Monday, the state reported 739 patients, 774 on Tuesday and 780 on Wednesday. "That's worrisome," Cohen told a House committee Wednesday morning. "It's not just about cases, but people are actually getting quite sick."  
 
Task Force
DAWN BAUMGARTNER VAUGHAN, LYNN BONNER, AND STEVE WISEMAN, THE NEWS & OBSERVER, 6/09/20
North Carolina Gov. Roy Cooper announced Tuesday that he signed an executive action on racial equity. The executive order forms the North Carolina Task Force on Racial Equity and Criminal Justice, which Cooper said "will develop and help implement strategies and policies to help eliminate systemic racism in our criminal justice system." 

N.C. Supreme Court Justice Anita Earls and Josh Stein, the state's attorney general, will lead the task force. "For way too long, black people have not been treated equitably in the United States. We have to fix that," Stein said. "I look forward to working closely with co-chair Justice Anita Earls and the full task force to making North Carolina a safe place for every person, no matter who you are." Cooper wants a report filed to him by Dec. 1.

"They will convene a wide range of stakeholders," Cooper said, "including: community policing advocates, state and local law enforcement agencies, people who have gone through and been affected by the justice system, judicial branch representatives, people from marginalized populations and more. Their work will examine law enforcement and criminal justice practices, make concrete recommendations for how to make real improvements."
 
Criminal Justice Reforms
WILL DORAN, THE NEWS & OBSERVER, 6/10/20
As protests over police brutality and racial injustice have rocked cities across the country over the last two weeks, North Carolina lawmakers are dusting off criminal justice reform proposals that had appeared to be dead. Last year, the Republican-led N.C. Senate passed two such reform bills with unanimous support. But then both bills went to the Republican-controlled N.C. House, where they spent months without ever coming up for a vote. But that changed on Wednesday.

One of the bills, H511, proposes sentencing reforms for nonviolent drug crimes that would let judges go around "mandatory minimum" laws for drug users who get treatment for substance abuse and meet other requirements. The other, S562, is aimed at letting people expunge their criminal records in certain cases. Having a criminal record can often make it difficult, if not impossible, to find a job or be approved for a lease or a loan. On Wednesday, the House passed the expunction bill unanimously, 10 months after the Senate also unanimously passed it. Democratic Gov. Roy Cooper will now decide whether to approve or veto it.
 
Legislative Highlights
 
Bills signed by the Governor into Law
  Senate Bill 476 - Mental Health Needs of Student. This bill requires the state board of education to adopt a school-based mental health policy and require K-12 school units to adopt and to implement a school-based mental health plan that includes a mental health training program and a suicide risk referral protocol.
 
Bill that passed House and Senate and awaiting Governor signature
  • House Bill 1187- Raise the Age Funding. This bill requires funding to implement Raise the Age statute.
  •  Senate Bill 562 - The Second Chance Act. This bill makes various revision to the expunction laws of the state. 
Bills on the Move
  •  Senate Bill 808 - Medicaid Funding Act. This funds the cost for Medicaid Transformation along with money to:
    • relocate DHHS from the Dorothea Dix Campus
    • pay for the child welfare case management component for NC DSS
    • pay for needed funds within the Division of Medicaid
    • pay for MH/DD/SA funds
  • House Bill 1214 - Dept of Health and Human Services Revisions. This bill does conforming and technical changes for DHHS. One section allows DHHS flexibility to adjust existing single stream funding allocations. Another requires LME/MCO utilization of standardized out-of-network agreements for behavioral health or I/DD services.
  • Senate Bill 730 - No Patient Left Alone Act. Provides patient visitation rights that will not be impacted during declared disasters and emergencies.
  • House Bill 1048 - CPS Intake Screening/PED Recommendations. Requires DHHS to make policy changes as a means to improve the consistency of child protective services intake screening process.
  •  House Bill 612 - DSS Review of Procedures/Criminal History/OAH. This bill requires the social services commission of NC DSS to review policies, guidelines and other interpretive statements (usually disseminated through the "Dear County Director Letters") and submit a report to the Office of Administrative Hearings to identify any that meet the requirements of "rule" and must go through the rule making process with the Rules Commission. It also allow for individuals who fee they have been injured by a policy or guideline that should have gone through the rule making process to file a challenge with the Office of Administrative Hearings.
Governor Cooper's Executive Orders:
  • June 5, 2020:  Extending the Certain Health and Human Services Provisions in Previous Executive Orders
  • June 9, 2020:  Establishing the North Carolina Task Force for Racial Equity in Criminal Justice
**Revised Visitation Guidance from DSS**
Benchmarks' Bill Tracker 
Updates and Announcements

SPECIAL BULLETIN COVID-19 #98 - COVID-19 Knowledge Center Now Available: A Convenient Way for Providers to Find Information

The NC Division of Health Benefits (DHB) has recently published another Medicaid Bulletin related to COVID-19:
 
SPECIAL BULLETIN COVID-19 #98: - COVID-19 Knowledge Center Now Available: A Convenient Way for Providers to Find Information
Medicaid and NC Health Choice providers now have one main hub to find all information related to COVID-19, including answers to questions received in the NC Medicaid COVID-19 mailbox (from Webinars, etc.), and resource documents such as Special Bulletins about COVID-19. The  COVID-19 Knowledge Center is an online resource collection of Medicaid developed to keep providers informed.  Learn more about this resource

New Medicaid Bulletin - Tailored Care Management Update
DHHS previously released the draft Tailored Care Management Provider Manual and application questions for providers interested in becoming Advanced Medical Home Plus (AMH+) practices or Care Management Agencies (CMAs). Updates and edits were made based on responses and aggregated into the   Memo on Tailored Care Management Updates.  
 
However, as a result of the Public Health Emergency COVID-19, the Tailored Care Management certification process has been suspended.   Find out the next steps here.

Annual Provider Survey Deadline Extended
The NCTracks Annual Provider Survey for 2020 was originally scheduled to close next Monday, June 15, however, the deadline has been extended to allow those who have not yet taken it to do so. The new deadline to take the survey is Monday, June 22, 2020.
 
Thank you to those who have already taken the survey and we encourage those who have not yet taken it to do so now - it is newly designed to take less than 10 minutes to complete.
 
The survey focuses on the aspects of NCTracks that involve direct customer interaction, such as the Call Center, Provider Relations, Training and Communications, as well as Functional Areas, such as Pharmacy Prior Approval and Provider Enrollment. Unless otherwise noted, the time period for which this survey applies is from July 1, 2019 to present. The survey is anonymous unless you choose to identify yourself and is authorized by the NC Department of Health and Human Services (DHHS).
 
We appreciate your participation as we strive to continue to improve our service to providers. Your feedback is valuable to us! Click HERE to start the survey now.

DMHDDSAS Virtual Town Hall Meeting on Suicide Prevention

Resolution of Federal Complaint Filed by CPR and Partners Makes Clear Hospital Visitor Policies Nationwide Must Accommodate Patients with Disabilities During COVID-19 Pandemic
Today, in response to the first federal complaint challenging discriminatory hospital "no-visitor" policies, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services announced a  resolution making clear that federal law requires hospitals and the state agencies overseeing them to modify policies to ensure patients with disabilities can safely access the in-person supports needed to benefit from medical care during the COVID-19 pandemic.

Strict no-visitor policies put in place at hospitals have prevented patients with disabilities from safely receiving support from family members or staff necessary for them to effectively communicate with medical personnel or otherwise receive equal access to medical treatment. These accommodations are required by federal civil rights laws, including the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act (Section 504) and Section 1557 of the Affordable Care Act (ACA). No-visitor policies have disproportionately impacted Black people with disabilities, who have higher rates of infection and   hospitalization. 

The   complaint, filed against the State of Connecticut  last month by the Center for Public Representation, Disability Rights Connecticut, The Arc of the United States, CommunicationFirst and Connecticut partners, alleged that Connecticut's COVID-19 no-visitor policy denied people with disabilities equal access to medical care and effective communication, deprived them of their right to make informed decisions and provide informed consent, and resulted in harms such as unnecessary physical and chemical restraints. CPR and partners also filed a  separate complaint against  Hartford Hospital regarding its discriminatory treatment of 73-year-old " Patient G.S." who has speech and short-term memory disabilities but was not allowed access to in-person supports necessary for her to communicate, which was also recently resolved and publicly announced today.

Highlights from the  hospital policy announced by OCR and Connecticut include that it:
  • Requires all hospitals and other health care facilities to allow designated persons (family members, staff, or others) to support any disabled patient that may need such support;
  • Requires hospitals to provide available personal protective equipment (PPE) to support persons to keep them safe;
  • Includes procedures for screening support persons for COVID-19 symptoms and for supporters to safely take breaks and leave and re-enter the hospital; and
  • Encourages hospitals to mitigate the risk associated with support persons supporting COVID-19-positive patients.

More information on hospital visitor policies during the COVID-19 pandemic and their impact on disabled people, as well as a framework stakeholders can use to evaluate those policies and a collection of state policies, can be found here.

Trump Administration Releases Aid For Disability Service Providers
Amid questions about delays, the Trump administration is sending billions of dollars in aid to disability providers and others funded by Medicaid who have been hard hit by the pandemic.

The U.S. Department of Health and Human Services said this week that some $15 billion will go toward providers serving individuals covered by Medicaid and the Children's Health Insurance Program, including home- and community-based services providers.

The money is part of the $175 billion Public Health and Social Services Emergency Fund that federal lawmakers created in a pair of coronavirus relief bills earlier this year to help health care providers.

While HHS has already distributed billions of dollars from the fund, little has gone toward providers funded primarily by Medicaid.

That has   drawn the ire of disability advocates and lawmakers alike. Just last week, a bipartisan group of congressional leaders wrote to HHS Secretary Alex Azar to inquire about the holdup.

Agencies supporting people with developmental disabilities - which rely on Medicaid funding - have struggled greatly in the face of the COVID-19 pandemic, according to the American Network of Community Options and Resources, or ANCOR, a national trade group representing disability service providers. Unable to continue offering day programs and other services, providers have seen revenues decline while their costs for staffing, personal protective equipment and other needs have grown.

ANCOR has warned that the situation is so dire that a  recent survey of 689 of its member organizations found that more than half only had enough cash on hand to continue providing services for another five or six weeks.

HHS said that starting this week it is launching an enhanced portal for eligible providers to report their annual patient revenue. Each provider will receive at least 2 percent of its reported gross revenue from patient care, the agency said.

The money is expected to help several hundred thousand providers ranging from pediatricians to assisted living facilities and those offering behavioral health and home- and community-based services, HHS said.

"This is obviously very welcome news and we're grateful to HHS for finally taking this positive step forward," said Sean Luechtefeld, a spokesman for ANCOR, who noted that it's been 74 days since the fund was established and this is the first money to be designated just for Medicaid providers. "At the same time, we're just starting to scratch the surface in terms of the overall need."

Luechtefeld indicated that ANCOR is pushing for more money from the emergency fund to be directed to community-based services providers that rely on Medicaid and the group is seeking funds specifically tagged for these providers in the next round of relief legislation from Congress.


Reminder, Please Consider  Supporting 
This Important Campaign

Please don't forget that CareForNC is launching a COVID-19 #FacesOfTheFrontline campaign during May and June. We work amongst healthcare warriors every day in our field and we're asking you to send in photos and short videos we can share to help our state and communities see the many faces of frontline workers!
 
These images will be used in our CareForNC campaign #FacesOfTheFrontline. Make sure you sign up to receive our #CareForNC posts and on our Facebook page so your agencies can repost the CareForNC posts! Be sure to use one or all the hashtags listed below on your agency posts.
  • #FacesoftheFrontlines     
  • #NCHeroes     
  • #CareforNC     
  • #TogetherOnTheFrontLine
To make it easier for you, we have created a Google Drive site with guidance and a submission form for uploading your photos and videos.:  https://forms.gle/7ZFx1DCnsqKs7vvq8
 
If you do not have a google account to use the Google drive, you can email your pictures and videos to carefornc@gmail.com. Many video attachments may be too large to send via email. In that case, please upload your videos to YouTube privately, Dropbox, or use WeTransfer and send a link to the CareForNC email so we can download the file. Be sure to include:
  • Your Name
  • Organization Name 
  • County or Counties You Serve             
  • Email
  • Description of Content              
  • Any Additional Information
Below are some links to provide you additional information to help you create your own #FacesOfTheFronline posts and for video and picture submissions to CareForNC.
 
Brand/Technical Guidance:  Google Doc     
Provider Guide/Directives:  Google Doc  
Upcoming Events
Monday:  June 15, 2020 
Connecting Expertise to Communities to Support Comprehensive Care for People with I/DD: Building on North Carolina's Assets 

Time:  11:00 am to 12:00 pm

New:  Monday:  June 15, 2020 
Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call
For BH/IDD Consumers, Family Members and Community Stakeholders

Time:  2:00 pm

PLEASE NOTE NEW NUMBER
Toll-Free:
877-336-4441
 
Access Code:
9264293

Closed Captioning
Tuesday:  June 16, 2020 
Provider Q&A Sessions:  All Providers Including Crisis Providers, Adult and Child MH/SUD Providers, Adult/Child IDD, TBI, and Residential Providers

Time:  10:00 am to 11:00 am

New:  Wednesday:  June 17, 2020 
Thursday:  June 25, 2020 
Adapting Community Inclusion to Circumstances of 2020

Time:  2:00 pm thru 3:30 pm

Wednesday, July 1, 2020 
Ongoing Staff Development in Disability Services

Time:  2:00 pm EST

Monday:  July 20, 2020 
PCIT Information Calls

Time:  10:00 am
 
Meeting number: 730 385 489
You can also dial 173.243.2.68 and enter your meeting number. Or, join by phone: 1-650-479-3207 Access code: 730 385 489 
LME/MCO Updates
Please click on each of the following links to view details sent out from each LME/MCO.

Benchmarks' wants to be sure to make the following list handy for our members to visit and suggests a peek at least once per week to find information that may be pertinent to your agency and contracts.
    • Appendix K 2nd Wave Provider Summary
    • Update on Telephonic Codes
    • NCTracks Annual Provider Survey
    • Treatment Authorization Requests-Unable to Process:  Identified Trends for January-April
    • Changes to Community Guide Service Description
    • Alpha System Downtime
    • COVID-19 Updates
    • Tailored Plan Care Management Update
    • Special Bulletin
    • Finance Update