Medicaid Transformation Begins as Open Enrollment Goes Live
Moving to Medicaid managed care has been a roller coaster ride in North Carolina. There have been budget impasses, postponements and lawsuits. All of those challenges seem to have been overcome. The money has been appropriated to get started. Standard Plan members are currently in an open enrollment period to choose their Prepaid Health Plans and primary care offices. And the date of July 1 for go-live of the Standard Plan and Tribal Option is fast approaching.
BH/IDD Tailored Plan Care Management a Work in Progress
The care management function under the BH/IDD Tailored Plan (Tailored Plan) appears to be evolving. The care management function under the Standard Plan and BH/IDD Tailored Plan have significant differences in requirements based on the needs of the members of these plans. An initial difference is that an Advanced Medical Home under the Standard Plan requires an attestation to NC DHHS that the practice meets the requirements. To be a care manager under the BH/IDD Tailored Plan, an agency must be certified by NC DHHS to meet the requirements as an Advanced Medical Home Plus (AMH+) or Care Management Agency (CMA). NC DHHS is now providing more information about the Tailored Plan care management role and has extended the Round 1 application deadline from March 1, 2021 to June 1, 2021.
If you are a consumer or family member, perhaps the most important aspect of this transformation is assurances that moves between plans, providers and emergency services will not be disruptive. The Transition of Care policy that NC DHHS has published covers the responsibilities of the Prepaid Health Plans (PHPs) in these circumstances:
when a Medicaid beneficiary disenrolls from a PHP Standard Plan, which could be because the beneficiary moves to another PHP or to the LME/MCO (later to be the BH/IDD Tailored Plan) and Medicaid Direct (fee-for-service primary care until Tailored Plans launch in 2022);
NC General Assembly Allocates New COVID-19 Funding
Two bills have been signed into law that allocate federal COVID-19 funding and appropriate additional funding to address the pandemic in communities. The most recent bill, SL 2021-3: 2021 COVID-19 Response and Relief was signed into law by the Governor on March 11th. Some of the provisions include:
For the Community Mental Health Block Grant:
o $47 million for mental health services in response to the COVID-19 pandemic.
o $2.1 million for the North Carolina Statewide Telepsychiatry Program (NC-STeP).
This year will be a Long Sessionfor the General Assembly and we can expect there to be a lot of legislative action and changes that could affect MH/IDD/SUD. To give you an idea of what to keep an eye on, we are sharing the legislative priorities of some of NC's key advocacy groups:
Congress passed the HR 1319, the American Rescue Plan Act of 2021, and it did include funding for mental health and substance use disorder services as well as home and community based services. Some of the largest allocations for BH/IDD in the American Rescue Plan include:
$1,500,000,000 in funding for block grants for community mental health services.
$1,500,000,000 in funding for block grants for prevention and treatment of substance use disorders.
i2i's Executive Director, Ann Rodriguez recently presented to over 200 healthcare practitioners - physicians, nurses, advanced practice providers and others at a two day event on Optimizing Care for Adults with Intellectual/ Developmental Disabilities: Creating Communities of Belonging sponsored by Southern Regional AHEC.
Rodriguez's presentation focused on Medicaid Transformation and Integrated Care for Individuals with I/DD. You can access this presentation at i2i's new Training and Resource Sharing page along with links to webinars, trainings and other resources.
Center for Healthcare Strategies President & CEO to Keynote Spring Conference
The Opening Plenary keynote for the Spring Conference will be Allison Hamblin, MSPH, President and CEO of theCenter for Health Care Strategies (CHCS). She will be discussing national trends and innovations in Medicaid behavioral health and healthcare, the progress of integrated care, the role of value based care and serving individuals with complex needs.
In addition to a great keynote, the Spring Conference will be offering session on the most important issues of the day: Medicaid Transformation, Adapting Services to meet Quality Standards in TP & SP, Population Health, Expanding Telehealth and Technology, addressing Diversity and Inclusion, Social Determinants of Health and much more.
Today’s environment compels you to demonstrate the value of the services your organization provides. You typically put a great deal of effort into creating and conceptualizing programs but don’t always take the critical step of using data to showcase your value and make informed decisions. Using data intentionally to demonstrate and facilitate meaningful results may require you to change the way you think about your data and your approach to decision-making. Learn more
Mary Hooper Honored with Order of the Long Leaf Pine Award
During an unbelievably enjoyable virtual party attended by stakeholders from ever segment of our service system, i2i's retiring Executive Director Mary Hooper was suprised with the announcement that she had been awarded North Carolina's highest honor - the Order of the Long Leaf Pine which is reserved 'for persons who have made significant contributions to the state and their communities through their exemplary service and exceptional accomplishments.' "Hooper's
30 years of dedicated service to the public behavioral health and I-DD system and her strong focus on collaboration and partnerships certainly deserves this high honor" said Kurtis Taylor, i2i Board Chair.
Moving tributes were made by so many, from state leaders, advocates, providers, former legislators, i2i interns and others. In all about 40 invited guests participated in her virtual reception.