NC TIDE 2020- VIRTUAL Event Due to COVID-19

Brief Intro to Virtual Learning, Announcements, Meeting the Candidates for NC TIDE Executive Team 2020 elections. No CEUs offered for this session.

North Carolina 1115 Substance Use Disorder (SUD) Waiver The United States has been facing an opioid crisis that has intensified in recent years. As part of its commitment to expand access to treatment for substance use disorders, North Carolina and the Department of Health and Human Services pursued and obtained a section 1115 demonstration waiver to strengthen its SUD delivery system. Elements of the 1115 SUD waiver include expanding SUD benefits to offer the complete American Society of Addiction Medicine (ASAM) continuum of SUD services and obtaining a waiver of the Medicaid institution of mental diseases (IMD) exclusion for SUD services. This presentation will provide attendees with an overview of the NC 1115 SUD Waiver following which time they will be knowledgeable of the SUD Clinical Coverage Policies involved in the waiver, the ASAM training changes involved with clinicians conducting SUD assessments and the IMD waiver. In November 2018, the Centers for Medicare and Medicaid Services (CMS) announced an opportunity for states to apply for an 1115 SMI/SED demonstration waiver to improve care for adults with serious mental illness and children with serious emotional disturbances. North Carolina and the DHHS are pursuing this opportunity. The 1115 SMI/SED demonstration waiver is comparable to the 1115 SUD waiver with a focus on demonstrating improved care for individuals with serious mental health conditions in inpatient or residential settings that qualify as IMDs as well as through improvements to community-based care. This presentation will provide an overview of the SMI/SED demonstration waiver opportunity, describe the goals and milestones identified by CMS, and review key components of the proposed 1115 SMI/SED demonstration waiver.

Individuals with Intellectual and Developmental Disabilities (I/DD) experience maltreatment at higher rates than the general population. Trauma-Informed Care refers to the ability to recognize the impact of past maltreatment as trauma and its possible impact on behavior. This session will focus on recognizing trauma in individuals with I/DD and will include information on how to provide Trauma-Informed Care strategies.

Creating a grass-roots advocacy movement to inform the State and their contracted payers about an opportunity to move our system of care toward integrated and value-based services. This option will result in achieving meaningful outcomes, while addressing social determinants of health.

Come hear a true success story from Zac Talbott. Zac will share with you his addiction journey with opioids, how he used medication-assisted therapy to recover from addiction, and how he helps others today. Zac is the Chief Clinical Officer for ReVIDA Recovery Centers in Nashville, Tennessee.

Our panel will provide insight into barriers and achievements as we work to implement North Carolina's first TBI Waiver.

In the last few years, addiction recovery centers have been the focus of FWA investigations. Many different schemes concerning the delivery and billing of these services have been identified and investigated both in the private and public arenas. Unfortunately, these some of these facilities are still focused more on increasing revenue than the care of their patients. Some continue to bill in the same patterns while others continue to evolve In order to effectively identify and investigate these schemes, certain factors should be considered: • Understanding of what services comprise of addiction recovery care. • Understanding of how these services are billed and how this billing can be used to obtain inappropriate payments. • Understanding your specific organizations vulnerabilities to inappropriate payment schemes. • Development of methods to identify, address and prevent these vulnerabilities. By exploring these factors, investigators and organizations will have an increased awareness and have the basis for strategies to use when addressing issues from this area of practice.

Evolution continues in the World of Behavioral Health. In this session, the learner will be provided with updates regarding activity at the state level and will assist in providing perspective on the plan moving forward. The Deputy Secretary will cover recent policy issues, legislative issues, budget issues, and discuss how these will affect the future direction of behavioral health in North Carolina. Time will be allowed after the presentation for questions from participants.

NCCARE360 is the first statewide network that unites health care and human services organizations with a shared technology that enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina. NCCARE360 helps providers electronically connect those with identified needs to community resources and allow for feedback and follow up. This solution ensures accountability for services delivered, provides a “no wrong door” approach, closes the loop on every referral made, and reports outcomes of that connection. NCCARE360 will be available statewide in all 100 North Carolina counties by the end of 2020.

Healthcare Fraud Schemes & Current Trends

It takes a Village! Hear the story of one man’s journey through his struggles with war, reintegration & finding himself!

Changes at work got you down? Changes occur both in and outside organizations, therefore we have to change along with them. This presentation will address the impact of change, the stages of Process Grief, phases of Process Improvement, and how these tools can be used to inform successful Change Management. We will review how using accurate data, a little bit of humor, and a lot of patience can help the team navigate the change process in an effective manner that leads to results. The session will also examine the human side of resistance to change and the benefit of not always doing things the same way.

Medicaid Transformation presents new complexities for Program Integrity organizations. Multiple new plans and plan types, new providers, and new services complicate oversight. Integration is now fundamental to data management and analytics strategies. It drives important capabilities and insights. It enables more efficient, preventative actions - like automation, entity analysis, and comprehensive risk-based scoring - to decrease the burden on Program Integrity resources. Configured on an accessible platform - it can boost information sharing and collaboration. Sound data management and analytics strategy in Medicaid Transformation prioritize integration to advance fraud, waste, and abuse detection and prevention. Learn about how to implement an integration-driven data management and analytics strategy for Program Integrity in this session.