pt_20230217 by Vaya Health

Provider Touchpoint Friday, February 17, 2023

How does the Q&A work? • 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 and will be addressed during the Q&A session of this webinar. • If multiple similar questions are received, the Q&A moderators may combine the questions into one before posting. • If you need to ask a question that is specific to your agency or the services you provide, please contact your Provider Network Contract Manager or email provider.info@vayahealth.com. Copyright © 2023 Vaya Health. All rights reserved.

• The moderated Q&A is available in the controls bar on your screen.

• Look for the bubble with the question mark. • The Q&A feature will close at 11:50 a.m. to allow us to respond to all questions before the end of the webinar.

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Provider Touchpoint

Communication Bulletins

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Today's Vaya participants Ashley Parks, Child & Family Treatment Continuum Director Donald Reuss, VP of BH and I/DD Network Operations

George Ingram, VP of PH Network Operations and VBC Jennifer Jennings, SU Network Development Director Joanna Drury, Housing Specialist Kelly Phelps, Provider Educator Kurt Boldt, Assistant VP of Provider Network

Today's Vaya participants Lindsay Frye, I/DD In Reach and Transition Supervisor Sheree Estrada, Provider Network Contract Manager

Stephanie Justice, MHSU UM Clinician - Lead Care Management Leadership Team

Today’s production team Justine Tullos, Provider Network Operations (Q&A moderator) Lindsay Locklear, Provider Educator (producer) Shamika Howard, Provider Educator (co-producer) Tommy Duncan, Provider Communication and Education Manager

Today’s Guest Presenters Dr. Jeanne Cummings, Trainer, The Mediation Center Laura Jeffords, Executive Director, The Mediation Center

American Heart Month 5 Suggestions from the American Heart Association

Meditation

Heart Healthy Meal

Daily Activity

Annual Physical

Heart Healthy Check-in

Black History Month Mental health conditions occur in Black and African American (B/AA) people in America at about the same or less frequency than in White Americans. However, the historical Black and African American experience in America has and continues to be characterized by trauma and violence more often than for their White counterparts and impacts emotional and mental health of both youth and adults. Mental Health America-black-and-africanamerican-communities Copyright © 2023 Vaya Health. All rights reserved.

Black History Spotlight Mamie Phipps Clark, Ph.D. And Kenneth Bancroft Clark, Ph.D. Mamie Phipps Clark was the first African American woman to earn a doctorate degree in psychology from Columbia University. She previously earned both her bachelor and master’s degrees from Howard University. Her experience in college and specifically graduatelevel courses helped her realize the shortage of psychological services available to the African American community and other minorities.

Mental Health America national black-pioneers-mental-health

Black History Spotlight The Clarks are best known for the famous “Doll Study” in which more than 200 Black children participated. Both Mamie and Kenneth Clark worked on this study, providing invaluable evidence in favor of ending school segregation in the supreme court case Brown vs. The Board of Education, citing that school segregation was psychologically harmful to black children. Dr. Kenneth Clark was the first-ever black president of the American Psychological Association.

Dr. Mamie Phipps Clark's dedication and passion for adequate mental health services for all prompted Dr. Clark to open her own agency to provide comprehensive psychological services to the poor, blacks, and other minority children and families. In February 1946, Dr. Clark and her husband opened the doors of “The Northside Center for Child Development” for those in the Harlem area. She worked in the center counseling and providing other psychological services from 1946 until 1979 when she retired. Although retired, Dr. Mamie Phipps Clark served on different advisory boards and was still very active within her community. Mental Health America national black-pioneers-mental-health Copyright © 2023 Vaya Health. All rights reserved.

Black History Month Socioeconomic factors are additional barriers to the Black/African American community that can make treatment options less available. In 2020, 10.4% of Black adults in the U.S. had no form of health insurance. The Black/African American community, like other communities of color, are more likely to experience socioeconomic disparities such as exclusion from health, educational, social and economic resources. These disparities may contribute to worse mental health outcomes. Mistrust and stigma are beliefs held within the Black/African American community. Removing these barriers is imperative to getting the African American community to engage in behavioral health services. Service providers should approach individuals by utilizing Culturally and Linguistically Appropriate Services (CLAS).

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

What is the Pathways to Permanency Project? Collaboration between Vaya Health, Benchmarks and Stakeholders including:

• Department of Social Services (DSS) • Providers • Lived Experience Advisory Council

Focus on how Vaya currently serves children in DSS custody as they work towards their long-term permanency goal Development of solutions based on areas of need identified in the Landscape analysis (completed in January 2022) Focus on implementing solutions based on best practice for serving children and families that will help support the Family First Prevention Services Act.

Pathways to Permanency Communications: Survey on Waitlist for Youth Outpatient Services Vaya Health’s Pathways to Permanency project’s “Accessible, Quality Continuum of Behavioral Health Services” workgroup is requesting your feedback about the use of waitlists for Youth Outpatient Services. This feedback will be reviewed in aggregate form to provide insight into how youth across the catchment are accessing services and if there are significant delays in treatment initiation.

Please note that any information collected through the survey is for informational purposes only, by use of the workgroup, to develop solutions to support both providers and youth in foster care. Please click here to complete the survey by February 23, 2023. Copyright © 2023 Vaya Health. All rights reserved.

Treat Them Like Gold Learning Collaborative Vaya will host a virtual Treat Them Like Gold learning collaborative that was developed by stakeholders involved in the Pathways to Permanency project. The learning collaborative is open to public and private stakeholders offering family foster care and therapeutic foster care in Vaya’s region. Please review the memo below for details, registration, and dates of the training. • Day 1: Tuesday, March 28, 2023 • Day 2: Monday, April 17, 2023

• Day 3: Wednesday, May 3, 2023 • Day 4: Tuesday, May 16, 2023 • Day 5: Thursday, June 8, 2023

Pathways to Permanency Communications: Need for Daytime Respite (b)(3) Providers Based on the work of the “Pathways to Permanency” project, a collaboration among Benchmarks, Vaya, and local Department of Social Services (DSS) agencies within Vaya’s region, Vaya is announcing a need for providers of daytime Respite (b)(3) services. Vaya is seeking responses from child-placing agencies, residential childcare facilities, residential treatment providers, current (b)(3) Respite providers, and DSS agencies interested in providing periodic Respite services to Vaya Medicaid members (in particular, youth experiencing school suspension). Services may be provided in a group or family setting given that the provider remains within capacity requirements. Please see PCB 02-09-23 Issue 39 | Vaya Health for additional information and contact Ashley Parks: ashley.parks@vayahealth.com if interested.

Education for members residing in ICF/IID homes and state development centers In preparation for Tailored Care Plan launch, Vaya is increasing efforts to provide education and support to members who receive care in institutional settings. These efforts are focused on members who reside in intermediate care facilities for individuals with intellectual disabilities (ICF/IID) homes and state developmental centers and whose Medicaid is managed through Vaya.

These efforts are called in-reach. Members of the Vaya I/DD In-Reach and Transition Team and are focused on several interconnected activities: • In-reach provides education about home and community-based services (HCBS) that allow people to live the life they choose in the community of their choice. • Vaya team members visit with and learn about members in institutional settings and attend their annual person-centered plan meetings. Copyright © 2023 Vaya Health. All rights reserved.

Education for members residing in ICF/IID homes and state development centers • Members and legally responsible persons (LRPs) have access to team members as questions and concerns arise to ensure their understanding of the benefits of HCBS.

• In-reach team members work collaboratively with facility staff to ensure continuity of care and a smooth transition. The I/DD In-Reach and Transition Team also links with all ICF/IID homes where Vaya-supported members reside to establish relationships, exchange documentation, and accept invites to annual person-centered plan meetings. The team will continue efforts to connect with members in ICF/IID level of care settings and offer community choice following Tailored Plan implementation. Vaya’s goal is to educate all members and LRPs of the services and supports available in their communities. PCB 02-09-23 Issue 39 | Vaya Health Copyright © 2023 Vaya Health. All rights reserved.

NC 1915(i) Assessment Tool • As part of the transition to the 1915(i) Waiver, the Department is requiring that all members currently receiving B3 services will need to have an Independent Assessment completed. • MAHEC provided training to Tailored Care Managers on this assessment tool. To access the training, please visit the following link: https://mahec.net/home/event/70629 • To access a copy of the Assessment tool, please visit the following link: https://medicaid.ncdhhs.gov/tailored-care-management • Vaya is currently working to identify the members who will need to be assessed and will communicate with providers once all the information has been gathered.

Upcoming Changes to 837 Claims File Submission Beginning April 1, 2023, Vaya will require providers utilizing 837 file submission to submit EDI files via CrushFTP. Before that date, all impacted providers will receive CrushFTP login information, job aids, and additional educational resources.

If you have questions about this change, email ServiceDesk@vayahealth.com.

Service and Authorization Updates

UM CST CCA addendum requirement As of Nov. 1, 2019, NCDHHS amended the Community Support Team (CST) service definition in NC Medicaid Clinical Coverage Policy 8A-6 to reflect the following change to documentation requirements for concurrent CST services beginning January 2020: When it is medically necessary for CST services to be authorized for six months or more for a member, a new CCA (Comprehensive Clinical Assessment) or CCA Addendum to the original CCA must be completed and submitted with each re-authorization service request. The new CCA or CCA Addendum must be completed within 30-days of the start date of the concurrent Service Authorization Request (SAR) that is being submitted. Please note that the initial pass-through period is included in the six-month timeframe.

JCB J438 Reminder • Please remember that Individuals with I/DD or TBI, and who are currently enrolled in the following non-Medicaid residential services, must transition to Residential Supports (Levels 1-3), Supported Living Periodic, or another available service by April 1, 2023. • Providers must submit a SAR if a recipient/member is currently using a service that is sunsetting and needs to transition to the new service codes. • Service requests will continue to be authorized based upon medical necessity.

JCB J438 reminder Non-Medicaid Residential Services for the I/DD & TBI Benefit Plan that sunset on March 31, 2023: Name of Service Family Living Low Family Living Moderate Family Living High Group Living Low Group Living Moderate Group Living High Residential Supports

NCTracks Code YM740 YP750 YM755 YP760 YP770 YP780 YM850

Supervised Living Low Supervised Living Moderate Supervised Living 1-6

YP710 YP720 YM811, YM812, YM813, YM814, YM815, and YM816

JCB J438 Reminder New non-Medicaid Residential Services for the I/DD & TBI Benefit Plan Name of Service

NCTracks Code

Residential Supports (I/DD & TBI): Level 1

YM846

Residential Supports (I/DD & TBI): Level 2

YM847

Residential Supports (I/DD & TBI): Level 3

YM848

Supported Living Periodic (SLP)

YM854

BH I/DD Tailored Plan Updates

Tailored Plan Third Party Vendors: eviCore Starting April 1, 2023, Vaya will manage physical health and pharmacy services for Tailored Plan Medicaid members in addition to behavioral health, I/DD, and traumatic brain injury (TBI) services. (Please note that Vaya will not manage physical health or pharmacy services for Vaya NC Medicaid Direct PIHP members or Tailored Plan recipients of State-funded services.)

Vaya has contracted with several vendors in specific service areas to assist in serving the Tailored Plan Medicaid population. In the next several Provider Communication Bulletins, we will provide additional information about and educational resources from these vendors.

Tailored Plan Third Party Vendors: eviCore eviCore Healthcare: We have contracted with eviCore Healthcare to provide utilization management for radiology and cardiology services, specialized services (speech, physical, and occupational therapies), and durable medical equipment (non-Innovations Waiver requests). Learn more about eviCore Healthcare. eviCore is also offering a series of provider orientation opportunities. For registration and additional information:

Durable Medical Equipment Cardiology, Radiology, and Specialized Therapies

Vaya Health Tailored Plan Contracting Tailored Plan (TP) contracts mailed as of February 16, 2023: • Total number of TP contracts mailed= 2045 (100%) • Total number of TP contracts unsigned = 219 (10.71%).

• Total number of TP contracts counter-executed= 1,826 (89.29%) • Behavioral Health (BH)= 1203 • Physical Health (PH)= 600

• Hospital/Hospital System= 5 • Clinically Integrated Network (CIN)= 3 Questions General: provider.info@vayahealth.com TP: tpcontracting@vayahealth.com BH: contracts@vayahealth.com Copyright © 2023 Vaya Health. All rights reserved.

Learning and Participation Opportunities

Overview of Medicaid Managed Care Provider Training The Behavioral Health and I/DD Tailored Plan required provider training “Medicaid Managed Care” is now available in the Vaya Learn Portal. This is one of three trainings required for all Vaya network providers.

For more information about Vaya’s required trainings and educational resources, please see Provider Communication Bulletin 2022-23 Issue 37 (Jan. 26, 2023).

Provider Portal Training Vaya is announcing two trainings for Provider

March 8, 2023, 2 p.m. - 4:30 p.m.

Portal. The first training will be Provider Portal Claims Training and there will be three trainings available for providers:

Click here to join the meeting Meeting ID: 270 992 923 536 Passcode: Wq7N2a

March 2, 2023, 2 p.m. - 4:30 p.m. Click here to join the meeting

Meeting ID: 264 683 087 092 Passcode: 8csPLw

March 15, 2023, 2 p.m. - 4:30 p.m.

Click here to join the meeting Meeting ID: 255 989 875 388 Passcode: afiS6k

Provider Portal Training The second training will be Provider Portal which will contain education about the rest of Provider Portal which will include enrollment, authorizations, documents and resource page. There will be three trainings available for providers: March 7,2023, 2 p.m. - 4:30 p.m. Click here to join the meeting Meeting ID: 219 233 504 480 Passcode: Rwy2mJ

March 14, 2023, 1 p.m. - 3:30 p.m. Click here to join the meeting Meeting ID: 296 370 102 563 Passcode: uhPQem March 21, 2023, 9:30 a.m. - 12 p.m.

Click here to join the meeting Meeting ID: 213 575 973 518 Passcode: rtLYak

Permanent Supportive Housing Training This free virtual training supports CST and ACT providers by improving their understanding and practice of the Permanent Supportive Housing model. In order to receive credit for the training, participants must attend all four days. Participants are required to have their camera on and audio capability for this training. Please register only 3 staff from your agency. This training is only available to CST and ACT providers within the Vaya, Alliance, and Partners LME/MCO catchment areas. March 9th, 10th, 16th, and 17th 2023 @ 9:00 a.m. – 1:30 p.m.

To register, please RSVP at Permanent Supportive Housing | Vaya Health . A link for the training will be sent the week prior to the training. If you have additional questions, contact Provider.training@vayahealth.com.

Thank You Our Next Provider Touchpoint: Friday, March 3, 2023, 11 a.m. – 12 p.m.