June 29, 2018

Tandem Bills Passed to Move Medicaid Transformation Forward
The General Assembly passed two bills that work together, H. 403 and H. 156 , to clarify the implementation of the Standard and BH/I-DD Tailored Plans and the licensure requirements for managers under Medicaid Transformation. In a historic move, legislators passed H. 403 that moves Medicaid recipients with mild-to-moderate behavioral health needs under the Standard Plan for Medicaid services.  
Individuals with a serious mental illness, a serious emotional disturbance, a severe substance use disorder, an I/DD, US DOJ settlement consumers, or individuals who have survived a traumatic brain injury are the defined population that will fall under the Behavioral Health/Intellectual-Developmental Disability (BH/I-DD) Tailored Plan. The BH/I-DD Tailored Plan will begin one year after the Standard Plan with the LME/MCOs as the lead plan managers working with another PHP to offer the physical healthcare services for Tailored Plan Medicaid recipients for four years after that. NC DHHS will likely publish the RFP for the Standard Plan in late August or early September. They do not need CMS approval to publish the RFP.
NC DHHS Published HCBS Transition Plan
NC DHHS has published the Home and Community-Based Settings (HCBS) Final Rule Transition Plan . North Carolina has been working toward compliance with a Centers for Medicare and Medicaid Services (CMS) rule since it became effective in March 2014. The federal rule impacts three Medicaid programs-Innovations Waiver, Community Alternative Program for Disabled Adults Program and the Community Alternatives Program for Children. It is inclusive of institution, residential and even day services and highlights the optimization of independence and autonomy for each individual. 
Revision to IVC Statutes Becomes Law
The legislature passed S.630 to revise the involuntary commitment processes statewide. The bill was originally put forward last year during the 2017 long session and, after significant changes to the proposal this year, was signed into law on June 22, 2018. The general intent is to move communities further toward ensuring that IVC is the appropriate process for each individual, expanding flexibility for involved parties in IVCs and using community-based crisis services to the extent possible instead of emergency rooms. The legislature has directed State funding toward behavioral health (BH) crisis services to divert all individuals from ERs, regardless of insurance coverage for many years. This new law could be seen as one mechanism of many needed to make the culture shift from using emergency room services to using BH community crisis services.
LME/MCOs have spearheaded local initiatives to build crisis and urgent care centers to divert individuals from emergency rooms. To find BH crisis services near you, use this NC DHHS link that will direct you to your LME/MCO and the crisis services available in your county: http://crisissolutionsnc.org/.
Whole Person Care Evolving in TCLI
The State of North Carolina has been in a settlement with the U.S. Department of Justice since 2012 because the Courts found that NC was not offering individuals with Severe Mental Illness (SMI) opportunities to live in the community and that this was causing those individuals to live in more restrictive institutionalized settings such as Adult Care Homes. The State created a Transitions to Community Living Initiative (TCLI) for individuals with SMI who meet criteria to successfully live in the community. In partnership with the LME/MCOs, the State has been working to meet the standards of the US DOJ settlement--to identify individuals who can live in the community and to build appropriate community-based MH services for those individuals as set forth in the federal Olmstead Act.

i2i Spring Conference Attracts
Over 400 Participants


We are pleased to report that the i2i Center's inaugural event - Collaborating for Change -- Spring Conference, June 11-12 in Raleigh was a successful and productive event for over 400 professionals from public and private systems, advocates, consumers and state agency staff alike.

A total of ten sessions were offered on June 11th ranging from federal updates and CMS activities on care integration to value-based reimbursement and whole person care to community engagement. On the 12th, the Closing Plenary session focused on the state's plan to move the mild to moderate Medicaid MH/SUD population into a standard healthcare plan from the perspective of a professional who has consulted on such changes in other states and from a consumer's point of view through a panel discussion.
NC Suicide Prevention Lifeline Funded after Budget Snafu  
No one was more surprised than legislators that the NC Suicide Prevention Lifeline was not included in the Appropriations Act of 2018. The good news is that with the help of advocates from the MH/IDD/SUD community pointing out this important omission, the mistake was made known and the omission has been corrected. The Budget Technical Corrections and Study Bill , now State Law 2018-97, amended the Appropriations Act of 2018 to include $348,558 in non-recurring funds for the upcoming fiscal year and added the same amount in recurring funds for the 2019-2021 fiscal biennium.
Last year alone, the Lifeline received and provided personal response to more than 255 callers per day who needed life-saving help. In fact, 600 lives were saved last year due to the active interventions used through the Lifeline. The call volume has increased to an average of 600 calls per day. The Lifeline saves lives and connects those in distress with necessary interventions and crisis services through the LME/MCOs and the community crisis networks statewide. The Lifeline can be accessed by dialing 1(800) 273-TALK (or 8255).


Links of Interest

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Past i2i News Briefs


May 30, 2018 

May 10, 2018

April 23 2018

April 6 2018


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i2i Center for Integrative Health | | [email protected] | http://www.i2icenter.org
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