Provider Touchpoint Friday, November 4, 2022
How the live broadcast works • You are seeing the broadcast on a 30-second delay. • Your microphone is muted throughout the broadcast. • You may ask questions at any time during the broadcast through the Q&A feature. • Questions can be seen by all attendees after they are published by the moderators. • Questions submitted during the webinar will be addressed at the end of the webinar. Vaya Health | Provider Touchpoint
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Today's Vaya participants Christy Pruess, Complex Care Management Complex Care Management Team David Boyd, Provider Network Operations- Behavioral Health Donald Reuss, Provider Network Operations- Behavioral Health (host) Jessica Moore, Provider Network Operations- Behavioral Health Ruth Downey, Complex Care Management
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Provider Touchpoint Production Team Justine Tullos, Provider Network Operations (Q&A moderator) Tommy Duncan, Provider Network Operations (producer) Lindsay Locklear, Provider Network Operations (co-producer)
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GUEST PRESENTER President and CEO Benchmarks https://www.benchmarksnc.org/
Karen McLeod Vaya Health | Provider Touchpoint
GUEST PRESENTERS
Stephanie Gans Tobacco Treatment Specialist Division of Public Health Vaya Health | Provider Touchpoint
David Willard Northwest Regional Tobacco Prevention and Control Manager
Good morning and welcome
Movember: No Shave November
November is Men’s Health month. Vaya Health | Provider Touchpoint
LEGISLATIVE AND POLICY UPDATE
TOBACCO CESSATION
Stephanie Gans LCAS, MSW, NCTTP NC Division of Public Health 11/04/2022
Why Tobacco*-Free Behavioral Health Giving North Carolinians a fair chance to live a longer, happier life
People with behavioral health conditions want to quit
Quitting improves mood, anxiety & recovery
Tobacco-free policies protect clients’ rights:
People with behavioral health conditions express just as much desire to quit as people who do not have behavioral health conditions. 1
If someone’s goal is quitting other substances, treating tobacco use at the same time makes it 25% more likely they’ll maintain their recovery.3
They protect the right to clean air and safety.
A majority of people who use tobacco try to quit every year, yet few access evidence-based treatment. 2
In the long-term quitting has a positive impact on mood and anxiety. The positive effect is comparable to the effects of antidepressants 4
They protect selfdetermination through an environment that supports quitting, while not taking away anyone’s ability to use tobacco while offcampus.
The odds are stacked against people with behavioral health conditions when they try to quit One study found people who have a serious mental illness are twice as likely to live in a neighborhood with high numbers of tobacco retailers and high levels of advertising.5 Studies estimate between 5-15% of people in substance use treatment started to smoke in treatment. 6-9
50%
An estimated 50% of all people who receive substance use treatment will die due to tobaccorelated illness.10
People with behavioral health conditions can and do quit but may need longer and more intensive treatment to quit for good. 11
In the U.S., a person who has a behavioral health condition and
Behavioral health services that offer evidence-based treatment in a tobacco-free environment are hard to find in North Carolina. 12-13
smokes loses 25 years of life on average.1
You can put the odds in your clients' favor so they quit successfully. Providing a combination of FDA-approved medications and counseling in a tobaccofree environment doubles a person’s chances of quitting for good2 You don't have to do this alone! Tobacco prevention staff are here to help! Read more at breatheeasync.org
Standard of Care for Adults
*Those with co-occurring behavioral health disorder may require longer & more intensive treatment*
We’ve Made a Lot of Progress in Tobacco-free Environments in North Carolina Hospitals
UNC University System
All 127 acute care hospitals in North Carolina have 100% tobacco-free campus wide policies.
State law authorizes the 16 campuses of the UNC system to prohibit smoking on their grounds--within 100 linear feet of a building: UNC and ECU Medical Care Facilities authorized to prohibit smoking on all grounds.
State Operated Healthcare Facilities All 14 State Operated Mental Health, Developmental , Alcohol and Drug Abuse Treatment Centers are 100% tobacco-free campus-wide
Prisons State law prohibits any person from using tobacco products inside or on the grounds of a state correctional facility. There may be an exception for authorized religious purposes.
Community Colleges and Private/Independent Colleges Community colleges and private/independent colleges and universities may prohibit smoking and all tobacco product use in their buildings and on their grounds.
Public Schools K-12 State law requires local boards of education to adopt policies prohibiting the use of tobacco at all times
Public Housing
Child Care Centers
All public housing in North Carolina are now smoke-free indoors under HUD rule
All childcare centers prohibit smoking and all tobacco product use on their campuses
NC Standard & Tailored Plans Tobacco-Free Policy Requirement Starting April 1, 2023, Standard and Tailored Prepaid Health Plans will require contracted medical, behavioral health, and some IDD/TBI organizations to provide a 100% tobacco-free campus. Check out NC Medicaid’s Provider Memo about this requirement.
NC Standard & Tailored Plans TobaccoRelated Policy Requirements Provider owned/controlled programs which provide residential services or Intermediate Care Facilities for Individuals with Intellectual Disabilities services, which are subject to the Home and Community Based Services final rule, have a different set of requirements. In these settings:
• Indoor use of tobacco products is prohibited. • For outdoor areas of campus, providers shall: • ensure access to common outdoor space(s) that are free from exposure to tobacco products/use; AND • prohibit staff/employees from using tobacco products anywhere on campus.
Retail Pharmacies Retail pharmacies are exempt from the tobacco-free policy requirement.
A tobacco-free policy applies to all of the property under the program’s control (that you rent or own)
What does 100% TobaccoFree Mean?
All of that property (buildings, grounds, and vehicles) is tobacco-free Tobacco includes the use of combustible, electronic, heated, and smokeless tobacco products No designated areas for tobacco use indoors or outdoors Programs do not purchase, accept as donations, or distribute any tobacco products
Tobacco-Free Policies: Business as usual or a culture shift? For some Medicaid providers, a tobacco-free campus is old news… Ex: acute care hospitals, large health systems, many health departments, primary care, specialty practices, and almost 1 in 3 NC behavioral health settings. For others a tobacco-free campus is more likely a culture shift: Ex: About 2 out of 3 NC behavioral health settings, some IDD/TBI service settings, and some medical settings.
If this feels like a big change for your organization, the good news is, you don’t have to do this alone! Start early (at least 3-6 months before implementation) & get expert support from your local tobacco control staff at www.breatheeasync.org
Communications Quitline NC
Clinical Processes
Prepare the Environment
Evaluation
Staff Training
Develop & Adopt TF Policy
Make the Case - Build Support
Tobacco-Free Organization Road Map Customize to fit your needs
Make the Case – Build Support
Develop & Adopt Tobacco-Free Policy
Staff Training
• Leadership buy-in • Leadership embrace and engagement • Organizational assessment • Survey staff • Staff motivation & buy-in • Identify champions • Form “wellness committee”
• Best practice • Educate all staff – does everyone samples know the WHY? • Define “tobacco” • Align with Human • Staff quit support – being TF during Resources the workday • Health plan quit • Clinical staff: service coverage delivering best • Plan for evaluating outcomes all along practice tobacco treatment the way • Provide tobacco treatment resources
Clinical Processes
• 5-As integration • Quitline referrals • Health Record (EHR) – build in tobacco assessment/ intervention prompts • Medication access – internal & external • Cessation billing
“Begin with the end in mind” ~Stephen Covey
QuitlineNC
Messaging and Communications
Important part of every step along the journey
• Register as referral site (web portal) • Behavioral health protocol – free NRT • Proactive referrals via fax, secure email or web • Texting feature • Young adult quitting vaping program – Live Vape Free
• Staff targeted • Equity framing • Client facing motivational • Tobacco education • Policy cards • Prominent campus signage • Posters, banners • Motivational cards • Website • Digital messaging
Prepare the Environment • Install internal & external signage • Repurpose smoking areas to wellness theme • Remove ashtrays and thoroughly clean • Healthy socialization spaces and activities
Evaluation
(How do we know how we are doing? / Quality improvement)
• Survey staff & clients (initial & at intervals) • Track EHR tobacco / health data: what can you measure? • Track # clients who receive quit RX and interventions • Assess staff training needs & knowledge of WHY (repeat) • Sustainability beyond initial implementation!
Whole Person Care. Tobacco-Free Supports Recovery. Quitting is a Journey.
How to promote adherence to your policy •Use a trauma-informed and person-centered approach • • •
someone is displaying symptoms of their tobacco use disorder on campus… that is to be expected! Not everyone is going to set a goal of quitting… nor do they need to! And that’s okay A punitive response is not trauma-informed or person-centered
•Treat the use of tobacco products on campus as a therapeutic opportunity •
Ask the question: have we given our clients all of the tools they need to be successful adhering to this policy on campus?
•Integrating tobacco use treatment at the level appropriate to your setting is key to success
Contact us! Your regional tobacco control manager is your resource for tobacco-free policies. We help you: build buy-in, train staff, integrate treatment & more.
2 – Vacant email Steph Gansin interim
Mitchell
Madison
tobin@mountainwise.org
Graham Cherokee Clay
Ashe
Haywood
Swain
Jackson Macon
Yancey
Buncombe
Henderson Transylvania
Caldwell
Burke McDowell
Lincoln
Rutherford Polk
Cleveland
Gaston
Carleen.Crawford@mecknc.gov Lead Counties
Forsyth
Guilford
Cabarrus
Wake
Chatham Lee
Stanly
Franklin Durham
Alamance
Randolph
Rowan
Union
Person
Orange
Davidson
Moore Montgomery
Anson
Richmond
6 – Sanquis Graham 910-433-3614
Hoke
sgraham@cumberlandcountync.gov
Edgecombe
Martin
Pitt
Lenoir
Craven
Duplin Onslow Pender New Hanover
Columbus
American Indian Commercial Tobacco Coordinator Lu McCraw, Luanna.McCraw@dhhs.nc.gov
Washington TTyyrrrell
Dare
HHyyddee
Pamlico
Jones
Sampson
Bladen
Chowan
Beaufort
Greene Wayne
Scotland Robeson
Perquimans
Wilson
Harnett
Currituck
Pasquotank
Bertie Nash
Camden
Gates Hertford
Halifax
Johnston
Cumberland
Local Tobacco Coordinators Durham County Health Department – Vacant, contact nrthompson@dconc.gov Forsyth County Health Department – Vacant, contact david.willard@apphealth.com Mecklenburg County Public Health- Kim Bayha, Kimberly.bayha@mecknc.gov Orange County Health Department- Rita Krosner rkrosner@orangecountync.gov Statewide Tobacco Use Treatment Integration: Stephanie Gans, stephanie.gans@dhhs.nc.gov
Caswell
Northampton
Warren Vance Granville
Mecklenburg
4 – Carleen Crawford 704-249-5889
Rockingham
Davie
Iredell Catawba
Stokes
Yadkin
Alexander
Teresa.Beardsley@arhs-nc.org
stephanie.gans@dhhs.nc.gov
Surry
Wilkes
Watauga Avery
Alleghany
9 – Teresa Beardsley 252-340-0407
7 –Email Steph Gans in interim
nrthompson@dconc.gov
David.Willard@apphealth.com
stephanie.gans@dhhs.nc.gov
1 – Tobin Lee 828-349-2480
5 –Natalie Thompson 919-560-7895
3 – David Willard 828-457-2110
Brunswick
Carteret
10 – Tiffany Thigpen 252-902-2330
Tiffany.Thigpen@pittcountync.gov
8 – Ernest Watts 910-334-1488
ernest.watts@hth.co.robeson.nc.us
Learn more at www.breatheeasync.org
ON YOUR RADAR
Current Network Needs SERVICE
LOCATION OF NEED
Adolescent Substance Use Services
All counties
Child and Adolescent Day Treatment
School system based
*Emergency Respite (child and adolescent)
*All counties
*Emergency Respite (adult I/DD overnight)
*All counties
Financial Support Agency
All counties
Psychological/Psychiatric Services: I/DD Testing All counties Psychosocial Rehabilitation (PSR)
Rural counties
Research Based – Behavioral Health Treatment
Rural counties
Therapeutic Foster Care
All counties
For more information, contact your Provider Network Contract Manager, or provider.info@vayahealth.com . Vaya Health | Provider Touchpoint
Fee Schedule (Dec. 1, 2022)
Vaya Health COVID PHE Rate Supplements sunset November 30, 2022 Vaya Health | Provider Touchpoint
Fee Schedule (Dec. 1, 2022) • All Vaya Health COVID/Public Health Emergency (PHE) Rate Supplements in place currently end: Nov. 30, 2022 (date of service). • Standard Rates Schedules for each Benefit Plan (Medicaid 1915 (b) and (b-3); Medicaid 1915(c) and Non-Medicaid) are maintained and are available on the Vaya website in Provider Central. • Updated Standard Rate Schedules were posted on Nov. 1, 2022.
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Sunsetting Community Guide/Navigator • Tailored Care Management (TCM) begins Dec. 1, 2022. • TCM duplicates many activities currently included in the Community Navigator and (b)(3) Community Guide service definitions. • Provider Communication Bulletin 2022-23, Issue 23
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Sunsetting Community Guide/Navigator Impact: • NC Innovations Waiver participants who receive provider-directed services will no longer be eligible to receive Community Navigator services after Nov. 30, 2022, if they choose to receive Tailored Care Management (TCM) as of Dec. 1, 2022. • Community Guide/Community Navigator will be available until March 31, 2023, for all persons who are not receiving TCM. • On April 1, 2023, and after, Community Navigator will only be available to persons who are self-directing their services through the NC Innovations Waiver to support activities related to self-direction. Vaya Health | Provider Touchpoint
Sunsetting Community Guide/Navigator Impact: • Authorizations for Community Navigator will be lapsed on Nov. 30, 2022, for all members who elect to receive TCM as of Dec. 1, 2022. • All other authorizations for Community Guide/Community Navigator for persons who opt out of TCM will continue through March 31, 2023. Affected members will receive letters notifying them of these changes. • Members who self-direct some or all services (including those who use Agency with Choice or Employer of Record) may continue to receive Community Navigator Services.
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Vaya Provider Portal: Systems Access Administrator Designation • We began issuing Systems Access Administrator (SAA) on Nov. 1, 2022. If your organization has not submitted your SAA Designation Form, please do so immediately. • Each provider organization will identify one SAA within their agency. • The SAA will be responsible for managing the creation, support, and deactivation of user access to the Provider Portal for users within their organization.
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Vaya Provider Portal: Systems Access Administrator Designation • Provider Enrollment staff are currently reaching out to all contracted providers who have not completed the SAA Designation Form. • Please Note: your organization will not be granted access to the Provider Portal until your SAA is assigned and receives their log-in. • Provider Communication Bulletin 2022-23 Issue 18
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TAILORED CARE MANAGEMENT
Tailored Care Management Updates Go Live: Dec. 1, 2022. Auto-Assignment: •
Providers with executed TCM contracts as of Oct. 27, 2022, were included in the first round of TCM auto-assignment (which took place the week of Oct. 30, 2022).
•
Initial TCM Assignments made by the Department will be shared with the LME/MCOs today (Nov. 4, 2022).
•
Vaya will notify TCM providers of their assigned members via the Beneficiary Assignment File which will be sent by Nov. 13, 2022.
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Tailored Care Management Updates Auto-Assignment: •
Vaya documented and transmitted Member choices (the primary factor per the DHHS algorithm to determine TCM assignment) to DHHS.
•
Per Vaya and DHHS agreements, members who did not indicate choice AND who have complex needs (generally with issues across multiple service systems) have been assigned to Vaya for TCM.
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Tailored Care Management Updates Auto-Assignment: •
Other members have been assigned to a TCM entity (Vaya, CMA or AMH+) based on the "best fit" DHHS algorithm for TCM assignment.
•
After April 1, 2023, Vaya will be responsible for the assignment process (information will be validated by DHHS).
•
As more certified TCM providers are added, the assignment algorithm will consider these and make assignments based on member choice.
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Tailored Care Management Updates Member Engagement: • All members who are eligible for TCM will receive a notification letter and TCM insert from Vaya informing them of their assigned TCM provider and who to contact if they would like to change providers. • TCM Care Managers must initiate contact with assigned enrollees and make their best effort to start the Care Management Comprehensive Assessment within three months of Tailored Care Management enrollment. • Non-TCM providers may begin to receive outreach from TCM providers to begin coordinating care.
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BH I/DD TAILORED PLAN
Vaya Health Tailored Plan Contracting Tailored Plan (TP) contracts mailed as of Nov. 3, 2022: • TOTAL number of TP contracts mailed= 1,863 (100%) • TOTAL number of TP contracts unsigned = 325 (17.44%). • TOTAL number of TP contracts counter-executed= 1,538 (82.56%) • Behavioral Health (BH)= 1076 • Physical Health (PH)= 457 • Hospital/Hospital System= 3 • Clinically Integrated Network (CIN)= 2 Questions GENERAL: provider.info@vayahealth.com TP: tpcontracting@vayahealth.com BH: contracts@vayahealth.com Vaya Health | Provider Touchpoint
Q&A SESSION
Questions? Thoughts? Ideas?
Our next Provider Touchpoint Friday, November 18, 2022 11 a.m. – 12 p.m.
ADDITIONAL INFORMATION & RESOURCES
Transition to Competitive, Integrated Employment Monday, Nov. 7, 2022, 4 - 6 p.m. Transition to Competitive, Integrated Employment • This CIE information session is an opportunity for individuals living with I/DD, families, providers, and State Representatives to share knowledge about the transition to competitive integrated employment.
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Permanent Supportive Housing Training Dec. 13, 14, 20, and 21, 2022, 9 a.m.-1:30 p.m. • This online Vaya training will support Community Support Team (CST) and Assertive Community Treatment (ACT) providers by improving their understanding and practice of the Permanent Supportive Housing (PSH) model. • The training is open to providers in the Vaya, Alliance Health, and Partners Health Management regions. Register online: Permanent Supportive Housing Training For more information, email provider.training@vayahealth.com Vaya Health | Provider Touchpoint
Workforce Development Resources • US Government Accountability Office (GAO) in a 10/2022 report identified three categories of barriers that pose challenges to recruiting and retaining behavioral health providers: financial , educational, and workplace Behavioral Health: Available Workforce Information and Federal Actions to Help Recruit and Retain Providers • Local universities have no-cost online job or internship posting sites that can help with recruitment for both unlicensed and licensed positions. For licensure supervision, there are inventive ways that these university systems may be able to help. Vaya Health | Provider Touchpoint
Workforce Development Resources • For more information, please visit the following: • WCU's Center for Career and Professional Development • APP State's Career Development Center • UNC Chapel Hill's Career Center • NC Central University's Career Center • UNCA's Career Center
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