Community Needs AssessmentDepartment of Health and Human Services by April 1, ... treatment for...

Alliance Behavioral Healthcare

Community Needs Assessment and Gaps Analysis

March 2016

Alliance Behavioral Healthcare Community Needs Assessment and Gaps Analysis (March 2016) | 2

Table of Contents

Section One: Executive Summary and Overview ................................................................... 3

I. Executive Summary ......................................................................................................... 3

II. Update on FY 2015-16 Network Development Plan......................................................... 6

III. Description of Service Region and Demographics ......................................................... 12

IV. Methodology for Consumer and Family Input ................................................................ 16

V. Methodology for Stakeholder Input ................................................................................ 17

Section Two: Access and Choice Standards, Service Needs, Gaps and Strategies ............... 18

I. Outpatient Services ....................................................................................................... 19

II. Location-Based Services ............................................................................................... 21

III. Community and Mobile Services ................................................................................... 24

IV. Crisis Services ............................................................................................................... 27

V. Inpatient Services .......................................................................................................... 29

VI. Specialized Services ..................................................................................................... 31

VII. State-Funded Services Items ........................................................................................ 33

Section Three: Geoaccess Maps............................................................................................ 36

Section Four: Departmental (DHHS) Initiatives ....................................................................... 37

Appendices ............................................................................................................................ 42

A. Geographic Access Maps .............................................................................................. 43

B. Specialized Services List ............................................................................................... 46

C. Stakeholder Survey Questions ...................................................................................... 62

D. Community Feedback .................................................................................................... 64

E. DHHS Waiver Attachments............................................................................................ 68

Prepared by:

Carlyle Johnson, Ph.D.

Director, Provider Network Strategic Initiatives

Alliance Behavioral Healthcare

[email protected]


Section One Executive Summary and Overview

I. Executive Summary

On an annual basis Alliance conducts a review of its provider capacity, community needs and

service gaps to inform our strategic plan for improving accessibility and effectiveness of care and

supports. The report period covers Fiscal Year 2014-15 and is submitted to the North Carolina

Department of Health and Human Services by April 1, 2016 as required by DHHS-MCO contracts.

The 2016 Alliance Community Needs Assessment and Gaps Analysis includes a summary of the

previous year’s actions, review of provider capacity, assessment of service accessibility and choice,

and incorporation of community feedback about needs and gaps. The resulting analysis and

conclusions are the basis for network development priorities and the Alliance Network Development

Plan for FY16-17.

Alliance Behavioral Healthcare manages behavioral health services for Cumberland, Durham,

Johnston and Wake counties in a catchment area that includes a mix of urban and rural areas. Our

region is experiencing higher than average population growth and is challenged to meet the needs of

a diverse population with important needs such as those who do not speak English, homeless

individuals with mental illness and substance use disorders, and members of the military, veterans

and their families.

The Community Needs Assessment process has provided an opportunity to review the status of the FY16 Network Development Plan, obtain additional community input and identify strategic goals for network development for FY17. The following analysis provides a summary of information obtained through this process and the themes and objectives that have emerged as highest priority actions for FY17. Priorities were determined based on multiple factors and sources, including demographic information, utilization data, emerging trends and input from consumers, stakeholders, providers and staff. Recommendations for priority items also considered the importance of alignment with Alliance’s mission, vision and values.

Accomplishments and Updates

Alliance has made progress on a number of significant needs and gaps that were identified as priorities for the FY16 Network Development Plan. Over the past year, we have:

Expanded access to Medicaid (b)(3) services such as Individual Support and Peer Support

Added State contracts to resolve gaps identified last year

Improved crisis capacity and access through expansion of Behavioral Health Urgent Care/Same Day Access, transition of Durham crisis services to a peer recovery model, implementation of rapid response crisis services for children and adolescents, pending addition of a new crisis facility in Wake County, and training for advanced practice paramedics and support for alternative drop-off locations

Initiated pilot projects to improve outcomes for high risk youth and provide evidence-based treatment for youth with co-occurring IDD/MI

Promoted evidence-based Intensive In-Home services, treatment for first episode psychosis, and integrated behavioral health/medical care

Developed alternative service definitions and supports to improve continuity and effectiveness of care.


We have also worked collaboratively with consumers, providers and stakeholders to raise awareness of behavioral health issues through the “It’s Time to Rethink” public awareness campaign, and have developed a comprehensive plan for improving community awareness and support for principles of recovery. Alliance has refined its Mission, Vision and Values statements and made significant advancements on its Strategic Plan development. In particular, the focus on whole-person care, recovery, and evidence-based practices are significant factors that will help frame our network development efforts in the upcoming year.

Service Needs and Gaps

Alliance conducted an extensive review of service needs that included review of data and input from

consumers and families, stakeholders, providers and staff. Analysis of survey results identified

consistent issues and themes both across and within age/disability areas. Consistent with the

findings of past network gaps analysis, residential treatment, housing, and transportation remain

areas of concern and ongoing barriers for promoting treatment engagement and positive outcomes.

Other common findings include gaps in services for individuals with co-occurring IDD/MI, service

access for non-English speaking, and the adequacy of crisis, respite and hospital diversion service

capacity.

Several noteworthy priorities include:

Development of a comprehensive, evidence-based continuum of care for individuals with

substance use disorders and concerns about the increased prevalence of opioid abuse and

overdoses in our communities

Plans to address disparities between uninsured and insured, and geographic disparities in

service availability for the uninsured

Increased information about services and system navigation

Several areas identified in the FY15-16 Network Development Plan remain areas of focus for the

upcoming year and will be included in the FY16-17 Network Development Plan. These areas include

development of a more uniform State benefit package, improving accessibility of high quality mobile

crisis services, addressing gaps for individuals with co-occurring IDD/MI.

Network Development Priorities for FY17

A primary objective of the Community Needs Assessment and Gaps Analysis is to identify and

prioritize community service needs and gaps that will inform and guide further development

activities. Based on extensive review of data and community input, Alliance has identified the

following priorities for network development that will be included in the FY17 Network

Development Plan:

Expand services to meet geographic access and choice standards

Develop a more uniform State benefit package across the four-county Alliance area

Expand capacity for crisis, hospital diversion and respite services for all ages/disabilities

Increase breadth, access and quality of residential treatment and housing options

Increase capacity to serve consumers with IDD or co-occurring IDD/MI

Develop and enhance the continuum of care for individuals with Substance Use Disorders

with specific focus on increasing access to Medication Assisted Treatment

Improve access to services for underserved populations

Increase availability, tracking and oversight of specialty services and evidence-based

practices


Increase availability of resources for transportation

Increase availability of resources for employment

These priorities will serve as the foundation for FY17 network development activities and further

discussions with our consumers, stakeholders and providers on strategies for improving access,

quality and outcomes of care.


II. Update on FY2015-16 Network Development Plan The following table summarizes progress from July 1, 2015 through April 1, 2016 for the FY2015-16 Network Development Plan:

NDP Objective Project Status / Updates

Expand services to meet geographic access and choice standards

Expand Medicaid (b)(3) Individual Support (Cumberland, Johnston)

Completed; selected providers in all counties through RFP process.

Expand Opioid Treatment availability and develop Medication Assisted Treatment programs in all counties

1. Developed modified services definition and contract Scope of Work for Medication-Assisted Treatment with Buprenorphine. The modifier will increase options for provision of evidence-based medication assisted treatment for SA and enable tracking of EBP use. We are in the process of adding this service to contracts and have increased the rate for this service to promote access and use of evidence-based practices.

Add State-funded PSR services in Cumberland County.

Completed; added contract for State-funded PSR in Cumberland County

Add State-funded SACOT in Durham County

Completed; added contract for State-funded SACOT in Durham County



Reviewed Alliance benefit plan for State-funded services to identify county-specific variation and developed recommendations for addressing disparities. Results are reflected in this Community Needs Assessment and will be discussed with Alliance Board in FY17 budget preparation process.


Assure the availability of high quality, accessible and effective Mobile Crisis services in all counties and increase capacity

Completed review of Mobile Crisis data and potential services models. Preparing Scope of Work for mobile crisis management that will reflect recommendations for service models and scope of mobile crisis coverage.

Expand access to and capacity of walk-in crisis centers (Behavioral Health Urgent Care Centers), including evening hours (Tier II Same Day Access)

Completed inventory of Same Day Access providers and surveyed providers regarding service accessibility and barriers to SDA implementation.

Obtained funding for expansion of Same Day Access in Wake County to include evenings, and Monarch will begin offering expanded evening hours 4/1/16.




Further analysis will assist with identifying challenges, opportunities and cost model assumptions for further development.

Expand/Enhance Capacity of Facility Based Crisis

Completed RFP process for Durham Crisis services and selected provider.

Posted RFP for additional Wake crisis facility and vendor, Monarch, has been selected. Implementation plans are being developed and Monarch is exploring potential facility locations.

Provide education to urgent care and primary care practices about Alliance and crisis response resources and how to access them, including Open Access, mobile crisis, facility based crisis

Collaborated with CCNC to identify priority practices for training, develop joint training information, and set up primary care/behavioral health provider meetings.

Purchased software to run routine reports on primary care practices with high number of behavioral health consumers.

Established and hired new Integrated Care Director position.

Implemented CMT software with initial focus on notification for consumers who did not fill antipsychotic medication prescriptions and notifying PCPs about potential opioid abuse issues.

Developed communication strategy for education of primary care physicians about non-ED crisis services available to their patients.

Implement Advanced Practice Paramedics program in Durham

Coordinated training program for Durham CIT-certified EMS paramedics to receive additional on-line training. Both Wake and Durham EMS have completed webinar training. We received allocation letters for Wake and Durham to be reimbursed for alternative drop off destinations.

Develop capacity for IDD Crisis Respite

Working with residential provider to identify and implement service model for short-term (30-45 days) PRTF for children with autism. Provider is evaluating models from other states.

Review outcomes for rapid response crisis diversion services for children and adolescents

Completed evaluation of Wake rapid response service and additional data will be available for more extensive analysis in April. A workgroup has been convened and is working through issues related to 131D



licensure rules and crisis beds. We have also developed a Medicaid alternative service definition to expand this service to all Alliance counties and will be submitting for DMA approval in April.

Implement Critical Time Intervention (CTI) in Cumberland

Completed selection of provider through RFP and have implemented services in Cumberland.

Increase breadth, access and quality of residential options

Evaluate transitional living outcomes and capacity and determine need for expansion

Completed analysis of claims data and developed survey to gather additional information from Transitional Living providers. Follow-up evaluation of outcomes is planned for Summer 2016.

Develop Comprehensive Assessment for youth with complex needs prior to referral to residential services

Identified provider, reviewed list of standard measures that will be required in assessment, and requested rate proposal from provider. Contract pending with UNC to provide this service, with services expected to begin in April 2016.

Complete residential continuum study

Contracted with the Technical Assistance Collaborative (TAC) to conduct an evaluation of the Alliance residential continuum. Developed Alliance Housing Plan and established new Director of Housing position that will implement specific project plan to address housing gaps.

Increase capacity to serve dually diagnosed (IDD/MI) consumers

Implement pilot Youth Villages Choices model for dually diagnosed (IDD/MI) youth

Completed implementation of pilot model through Youth Villages, and program has begun serving consumers. Augmenting pilot with addition of residential services through RFP.

Evaluate increased funding support for NC START

Identified funding for an adolescent START program, based on proposal submitted by Easter Seals UCP. Contract is in place and services have initiated.

Offer dual diagnosis (IDD/MI) training for Mobile Crisis teams

Completed training.

Offer training on IDD/MI dual diagnosis issues to large behavioral health practices

Completed training



Develop plan to address service gaps between enhanced benefit and outpatient services and to address need for case management

Develop alternative service definition for Medicaid-funded outpatient treatment

Working with consultant, Partners MCO and providers to develop proposed alternative service definition. Draft has been completed and submitted to DMA.

Develop service definition to fill service gap between ACTT and CST

We have worked with a consult, Partners MCO and providers to develop alternative service definitions for Critical Time Intervention (CTI) enhanced outpatient, enhanced CST (CST Plus) and ACTT Step-Down services. CTI and ACTT Step-Down have been approved by DMA and CST Plus will be submitted to DMA in April.

Increase availability, tracking and oversight of specialty services and evidence-based practices

Increase number of evidence based practices meeting fidelity for substance abuse providers

Working with SA providers through SA Treatment Provider Collaborative, and developed contract to provide individualized provider consultations on EBPs. Requested proposals from SA providers and selected six providers who will received individualized on-site consultations. Consultation has been completed with Cape Fear and written recommendations are being prepared.

Contract for EBP models for IIH and require independent fidelity reviews

Met monthly with IIH providers to implement change in contract requiring family-oriented EBPs and have convened multiple meetings and workgroups with providers, developers and implementation resources to refine implementation plans.

Developed cost models for training and long-term sustainability of EBPs, in collaboration with providers and EBP developers.

FY17 Medicaid contracts will include Scopes of Work for IIH EBPs, and Alliance is supporting training on two EBP models that will be incorporated into contracts.

Develop process for development and implementation of EBPs with external fidelity verification

Completed.

Promote EBPs for PSR programs including peer led programs, recovery oriented programs, and for dually diagnosed (MH/IDD)

Gathered information about PSR services, EBP models and prepared written recommendations for further development of evidence-based services within PSR.



Provide Training and Consultation for Providers to promote improved quality and implementation of evidence based practices

Hired consultant, Promise Resource Network, to provide Peer Support training on two dates for all Peer Support providers.

Completed DBT intensive training for Alliance DBT providers. We are working with Behavioral Tech and providers regarding DBT sustainability planning.

Provided SE Collaborative to promote evidence-based MH/SA IPS model supported employment services.

Convened and supported provider collaboratives to promote EBP implementation, including CST, IIH, Substance Use Disorder treatment, and Therapeutic Foster Care.

Identify high cost/high need populations and match with EBP

Implement pilots for Youth Villages Intercept model, Kidspeace TFC and Mentor Family Centered Treatment model for high needs youth

Pilots all launched effective July 1.

Implement First Episode Psychosis Program in Wake County

Completed implementation.

Improve access to services for non-English speaking consumers

Conduct survey of providers with identified services for non-English speaking consumers. Clarify service availability and capacity for more robust bilingual/bicultural program emphasis.

Worked with Alliance Cultural Competency committee to develop and administer provider survey. Results will be included in development of FY17 Network Development Plan.

Increased capacity to serve TBI population

Participate in TBI HRSA grant

Conducted screening for TBI through Call Center and collected data for State analysis.

Working with Brain Injury Association of NC and neuroresource facilitator to develop TBI-specific provider trainings

Will begin reviewing data through TBI Grant Steering Committee.

DHHS has announced plans for a TBI waiver that will be piloted with Alliance in the first year of the waiver. There are 49 slots attached to the waiver for Alliance.



Expand integrated behavioral health/medical care

Conduct Inventory of current integrated care initiatives (e.g., Turning Point, Lincoln, UNC WakeBrook; Johnston Public Health, exploring Duke/CBC co-location and reverse co-location; FHR Dartmouth In-Shape, Southlight)

Completed inventory.

Implement integrated healthcare pilots

Developed charters and project plans for each pilot. Hired consultant to evaluate pilots. Contracts executed for new initiatives with Carolina Outreach, Easter Seals UCP, Duke, Carolina Behavioral Care and UNC.

Conduct evaluation of current integrated behavioral health/medical care initiatives and development of recommendations for further expansion

Hired NC Center of Excellence for Integrated Care to evaluate pilot projects. Evaluation is in process and the consultation report is expected in December 2016.

Increase availability of resources for transportation

Review transportation initiatives in other states, inventory provider and stakeholders efforts and develop recommendations

Review of transportation initiatives in progress.

Increase availability of resources for employment

Increase number of persons receiving MH/SA SE/LTVS

Conducted RFP for SE/LTVS services in Cumberland, selected vendor and in the process of expanding services in Cumberland. Meeting regularly with SE/LTVS providers through collaborative.

NC is now working with several other states and federal government through Vision Quest and Office of Disability and Employment Policy (ODEP) to look at sustainability of IPS at a statewide level. Alliance is participating in this planning process.

We are looking at feasibility of aligning b3 rate and service definition with State rate and service definition.

Evaluate impact of MH/SA SE-LTVS

Transitioned to Alliance Business Process Team, which will be conducting ongoing analysis of IPS SE/LTVS as part of TCLI monitoring.

Explore models and supports for consumer-run businesses

Review of consumer-run models in progress.


III. Description of Service Region and Demographics

Alliance Behavioral Healthcare comprises

Cumberland, Durham, Johnston and Wake

Counties and covers roughly 2,565 square miles

with a total population of 1,800,902. By far the

largest county by population is Wake, exceeding the

population of the other three counties combined.

Wake and Durham are the most densely populated

counties, reflecting their more urbanized settings.

Johnston is the least densely populated county,

which may create a challenge to recruit and engage

providers to offer services in this area, particularly

when there are more populous and urban areas

nearby.

The service area includes both urban and rural

areas but the majority of the population lives in

urban areas. Because of the proximity to relatively

dense population areas such as Raleigh, Durham and Fayetteville, all Alliance counties are

classified as ‘metropolitan/urban’ counties according to United States Office of Management and

Budget criteria.

County Population Square Miles Persons per

Square Mile

Medicaid

Enrollees

Cumberland 326,328 652 501 61,105

Durham 294,460 286 1030 39,463

Johnston 181,423 791 229 30,932

Wake 998,691 835 1196 94,817

Alliance Total 1,800,902 2565 689 226,282

2014 U.S. Census Bureau Estimate, State and County QuickFacts

Growth

All counties in the Alliance area anticipate growth over the next five years, and with the exception

of Cumberland, all counties are expected to grow at a rate almost double the state growth rate.

This growth will be a significant challenge for Alliance as population increases lead to increased

demand for services and competition for available resources such as transportation, housing and

public assistance.

Ethnicity

Across the Alliance area the primary ethnic group is Caucasian followed by Black and

Hispanic/Latino. There is some variability across region, however. Johnston has a higher

percentage of white population, with Black and Hispanic/Latino populations roughly the same

percentage. Compared to the state average, Alliance has a higher percentage of Hispanic/Latino

population with Durham and Johnston having the highest percentage in the Alliance area.


County White Black Asian American

Indian

Hispanic/

Latino

Cumberland 53.2% 37.6% 2.7% 1.8% 11.0%

Durham 53.0% 38.6% 4.9% 1.0% 13.4%

Johnston 80.4% 16.0% 0.8% 0.9% 13.4%

Wake 69.0% 21.3% 6.4% 0.8% 10.0%

NC 71.5% 21.5% 2.7% 1.6% 9.0%

Will not equal 100% due to more than one race being reported. Source: US Census Bureau, 2014

QuickFacts

Languages Spoken

The primary language spoken across the Alliance area is English, followed by Spanish most notably

in Durham and Johnston Counties where the rate exceeds 10% of the population. Alliance exceeds

the state average with respect to non-English languages. Although the primary non-English

language spoken is Spanish, it is noteworthy that other languages account for over 6% of the

population and that there are 20 languages or language groups for which there are over 1,000 or

more speakers in the Alliance catchment area.

Military/Veterans

The Alliance catchment area includes several important resources for active military, veterans and

their families, including the Fort Bragg military installations, VA Hospitals in Fayetteville and Durham,

Reserve Command and local units, and NC National Guard units. An estimated 135,496 veterans

live in the Alliance catchment area, according to the 2014 NC Veterans Annual Report, with the

following distributions by county:

Wake 58,436

Cumberland 47,298

Durham 15,846

Johnston 13,916

The largest concentration per capita is in Cumberland County, with approximately 14.5% of its

residents having served in the military, compared to the NC state average of 7.8%. Alliance works

closely with community stakeholders, providers, military and veterans’ organizations and all levels of

government to promote effective and accessible care for military, veterans and family members.

Alliance has developed a draft FY 2015/16 Veterans Plan that provides additional information about

current and planned initiatives to improve services for the military/veterans population.

Homeless Population

Three of the four Alliance counties have higher rates of homelessness than the surrounding region

and rates of homelessness for Cumberland and Durham exceed the state average, while Wake

County’s rate is approximately equal to the state average, based on the 2014 North Carolina Point-

in-Time Count of People Experiencing Homelessness. Rates are highest per capita for Durham and

Cumberland, but the number of homeless individuals is highest in Wake County. The highest rates


of chronic homelessness were observed in Cumberland. Homeless populations in Durham and

Wake were found to have higher rates of serious mental illness and substance use among the

homeless than were observed in Cumberland or Johnston.

Health Outcomes and Disparities

Alliance counties vary significantly with respect to health outcomes, and population health data

reveals higher needs for health care improvements particularly in Cumberland and Johnston

counties. Research has demonstrated significant health disparities for individuals with mental illness,

substance use and intellectual and developmental disabilities, and growing evidence indicates that

shortened lifespans are primarily associated with chronic health conditions, health behaviors,

substance use and limited access to appropriate medical care. Both the demographic data and

research evidence support an increased emphasis on integrated behavioral health/medical care and

on increased substance abuse prevention and treatment efforts all counties.

Description of Provider Network

Alliance has a large network of credentialed providers and most organization types are available in

each county, as are prescribers and licensed practitioners. Providers by categories for FY15 are as

follows:

1849 licensed professionals

281 agencies

291 outpatient practices

37 Hospitals/Residential Treatment Facilities


Services available in the network include a broad array of Medicaid and State-funded care, and

providers served 39,560 Medicaid consumers and 17,492 with State funds in FY15.

The following table provides a summary of service expenditures for FY16:

Source Amount % of Total

Medicaid $419,717,116 82%

State $58,851,040 11%

Local $36,758,095 7%

Total $515,326,251 100.0%


IV. Methodology for Consumer and Family Input

The process for soliciting consumer and family feedback included the following approaches:

1. Consumer and Family Advisory Committee (CFAC) Feedback

Feedback approaches included presentation and discussion at CFAC meetings, and submission

of a CFAC summary of identified needs and gaps. CFAC members also helped inform others

about the electronic survey and distributed hard copy version of the survey to those without

internet access and those who preferred to submit a handwritten response.

2. Community Survey

Feedback was solicited through an internet-based survey using SurveyMonkey®. The survey

included separate sections for Intellectual and Developmental Disabilities (IDD), Child Mental

Health/Substance Abuse (Child MH/SA), Adult Mental Health and Substance Abuse (Adult

MH/SA) and Traumatic Brain Injuries (TBI), with the option for respondents to skip those sections

with which they were unfamiliar. Additional sections were included regarding needs and gaps in

areas of housing, employment and transportation. The same questions were used for all

respondents, which included consumers and family members, stakeholders, providers and

Alliance staff. Surveys were administered anonymously and no identifying information was

required. Survey links were posted on the Alliance website and distribute to multiple consumer,

provider and stakeholder e-mail lists. A request was sent to all Alliance staff requesting that links

be forwarded to community contacts, and Alliance staff were surveyed regarding community

needs and gaps.

Community Needs Assessment Survey Questions

Introductory questions collected limited background information about respondent category, county of respondent, and respondent’s organization type if applicable. Each section of the survey included a similar format and consisted of the following sections/questions:

1. Listing of service types and Likert rating scale for availability of each service.

2. Follow-up questions (text box) for entry of additional feedback about service availability,

including:

a. Services not covered on survey questions

b. Barriers to receiving services

c. Identification of underserved groups or populations

3. Questions for all respondents soliciting input (text boxes) regarding the most significant needs

for:

a. Housing

b. Employment

c. Transportation

d. Other comments regarding service needs and gaps

Hard copy versions of the survey were posted on the Alliance website in formats that included a full version and separate versions for IDD, Child MH/SA, Adult MH/SA and TBI. The full hard copy version is available at the following link: http://www.alliancebhc.org/2016-cna-survey-full/.

http://www.alliancebhc.org/2016-cna-survey-full/


V. Methodology for Stakeholder Input

The process for soliciting stakeholder feedback included the following approaches:

1. Alliance Provider Advisory Committee (APAC) Feedback

Provider feedback included discussion at APAC meetings as well as follow-up discussion and

feedback from local PAC meetings in each county.

2. Community Survey

As described above, the online survey solicited responses from consumers, family members,

providers, stakeholders and staff.

3. Collective Feedback from Community Workgroups, Collaboratives and

Committees

Alliance staff contacted existing groups such as crisis collaboratives, System of Care

collaboratives, provider collaboratives, and Alliance staff meetings to request collective responses

regarding highest priority needs and gaps. A survey form was provided to each group with

suggested questions for group discussion, and groups submitted summaries of group

recommendations. Copies of the Alliance Staff Group Feedback Form and Alliance Stakeholder

Feedback Form are provided in Appendix C.

Community Input Sources

Numerous community groups were invited to provide input through collective responses, completion

of on-line surveys, or both. Alliance staff attended meetings of many of these groups to solicit and

summarize feedback. Sources of feedback included the following:

Consumer and Family Advisory Committee (CFAC)

NAMI-Wake, NAMI-Durham and NAMI-Cumberland

Alliance Provider Advisory Committee (APAC), including local PAC meetings in each county

Durham and Wake Juvenile Justice SA/MH Partnership (Durham JJSAMHP, Wake JJSAMHP)

Cumberland County Reclaiming Futures

MH/SA Supported Employment Provider Collaborative

Provider Collaboratives for Community Support Team (CST), Substance Abuse Treatment, Intensive In-Home (IIH), and Therapeutic Foster Care (TFC)

Crisis Collaboratives in Cumberland, Durham and Wake

SOC Community Collaboratives in each county

All-Provider Meeting

Next Steps (Wake)

Alliance Hospital Partners Collaborative

MH/SA Care Coordinators

IDD Care Coordinators

Alliance Clinical Operations Staff

Alliance Utilization Management Staff

Alliance Provider Network Evaluators

Alliance Compliance Staff

Alliance Call Center Staff


Section Two

Access and Choice, Service Needs, Gaps and Strategies Introduction

Although the counties comprising Alliance Behavioral Healthcare’s catchment area vary significantly

in population density, all are classified as “metropolitan/urban” counties according to United States

Office of Management and Budget criteria. Accordingly the DHHS-MCO contract requires that

Alliance ensure availability of providers within a 30-mile radius or 30-minute drive time for any

consumer residing in the Alliance catchment area. The following section provides a summary of

geographic access and choice data for Alliance services in several categories:

Outpatient Services include psychiatric care, medication management, evaluations, and

individual, group and family psychotherapy.

Location-Based Services include an array of services that are facility or site-based, such as

Psychosocial Rehabilitation, Child and Adolescent Day Treatment, and SA Intensive Outpatient

Treatment.

Community-Based and Mobile Services include those services that are provided in home and

community settings such as Supported Employment, Peer Support and Community Guide

services.

Crisis Services include Respite, Facility-Based Crisis and Non-Hospital Detoxification services.

Inpatient Services include inpatient psychiatric care all ages

Specialized Services includes a specific list of services, most of which are residential treatment

services.

Geographic access and choice standards are specified for each category of service and vary

depending on the service category and funding source. The following table provides a summary of

DHHS requirements for each:

Medicaid State

Outpatient TWO (2) providers within 30

miles or 30 minutes

Choice of TWO (2) providers within

30 miles or 30 minutes

Location-Based Choice of TWO (2) providers

within 30 miles or 30 minutes

Access to ONE (1) provider within

30 miles or 30 minutes

Community / Mobile Choice of TWO (2) providers

within ABH catchment area


ABH catchment area

Crisis Access to ONE (1) provider within

ABH catchment area


ABH catchment area

Inpatient Access to ONE (1) provider within

ABH catchment area


ABH catchment area

Specialized Access to ONE (1) provider within

ABH catchment area


ABH catchment area

For each category, service accessibility and provider choice were evaluated using a methodology

and report format determined by DHHS. The tables provided below include summary results of this

analysis as well as specific needs and gaps identified through the community survey, as described in

Section One.


I. Outpatient Services

A. Medicaid and State-funded outpatient services access and choice standard

All eligible individuals must have a choice of two different outpatient services provider agencies

within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences.

Outpatient behavioral health services can include psychiatric and biopsychosocial assessment,

medication management, individual, group, and family therapies, psychotherapy for crisis, and

psychological testing. Tables below were completed for outpatient services as one group, using

geomapping software to calculate the number and percentages of individuals with choice:

Medicaid State-Funded

Categories

# of enrollees

with choice of

two providers

within 30/45

miles*

# of

Medicaid

Enrollees

%

# of consumers

with choice of

two providers

within 30/45

miles*

# of

Consumer

s

%

Reside in urban counties 221,145 221,145 100 17,356 17,356 100

Reside in rural counties n/a n/a n/a n/a n/a n/a

Total (standard = 100%) 221,145 221,145 100 17,356 17,356 100

Adults (age 18+) 81,794 81,794 100 15,893 15,893 100

Children (age 17 and

younger) 139,351 139,351 100 1,463 1,463 100

Total (standard = 100%) 221,145 221,145 100 17,356 17,356 100

*”30/45 miles” is the abbreviated term used in this document for individuals having choice within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences.


If not at 100%, has an exception been requested but not yet finalized? n/a. If no, briefly explain and give date it will be requested:

If not at 100%, has written justification and a plan to meet needs been submitted? n/a. If no, briefly explain and give date it will be submitted:

If not at 100%, is an exception to the standard in place? n/a If no, briefly explain: n/a

If not at 100%, are written justification and a plan to meet needs in place? n/a attach copy to this report. If no, briefly explain: n/a

Effective date of exception approval: n/a Effective date of written justification and plan approval: n/a

Next exception review date, if applicable: n/a Next review date, if applicable: n/a

B. What outpatient service gaps were identified by consumers and family members?

Services to support development and implementation of behavior plans

Increased community awareness and education for consumers and families

Development of service to address gap between outpatient and enhanced benefit services and need for case management


C. What outpatient service gaps were identified by other stakeholders?

Need for increased community awareness and education for consumers and families

Enhanced access to an effective comprehensive continuum of care for individuals with substance use disorders

D. What specific geographic, cultural or demographic groups experience outpatient services gaps

that need to be addressed? Describe gaps and how the information was gathered.

Elderly, non-English speaking (primarily Spanish language), individuals with co-occurring IDD and mental illness, youth engaged in sexual harm, individuals with substance use disorders, LGBTQ populations and individuals with traumatic brain injuries. Underserved populations were identified through the community survey and feedback from consumer, stakeholder, provider and staff workgroups. A summary of findings regarding underserved populations and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing outpatient services gaps identified in I.A., I.B., I.C.

and I.D. Briefly identify the service gap, goal and target date for reducing or eliminating the gap,

and strategies planned or in progress to achieve the goal.

Medicaid

Service Gap Goal and Target Date Strategies to achieve goal,

noting if planned or in progress

Services to support development and implementation of behavior plans

Conduct further evaluation by 6/30/16 to determine if this area remains a gap and needs to be included in FY17 Network Development Plan.

Include in FY17 Network Development Plan If gap remains as of 6/30/16.

Development of service to address gap between outpatient and enhanced benefit services and need for case management

FY16 Network Development Plan objective in progress, with expected completion by 6/30/16

Implementation of new Medicaid service definition for enhanced outpatient services.


This is an ongoing goal of the Alliance Community Awareness Campaign, which focuses on increasing community awareness of behavioral health conditions, services and how to access care.

Alliance has an ongoing public awareness campaign and multiple collaborative efforts with community partners that focus on addressing this gap.

Service access for underserved populations such as elderly, non-English speaking and other identified populations.

Conduct further evaluation by 6/30/16 to identify extent to which populations are underserved and to clarify priorities for inclusion in FY17 Network Development Plan.

Incorporate findings of evaluation into FY17 Network Development Plan goals.


State-Funded




See above See above


See above See above

II. Location-Based Services

A. 1. Medicaid location-based services access and choice standard: All eligible individuals must

have a choice of two different provider agencies for each location-based service in the chart

below within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences.

2. State-funded location-based services access and choice standard: All eligible individuals have

access to at least one provider agency for each location-based service in the chart below within

30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences.


Service

# and % of enrollees with

choice of two providers

within 30/45 miles of their

residences

Total # of

Medicaid

Enrollees

# and % of consumers with

at least one provider within

30/45 miles of their

residences

Total # of

Consumers

# % # %

Psychosocial

Rehabilitation 81,794 100 81,794 8,986 82.56 10,884

Child and Adolescent

Day Treatment 139,215 99.90 139,351 986 90.21 1,093

SA Comprehensive

Outpatient Treatment

Program

221,145 100 221,145 3,846

100

3,886

SA Intensive Outpatient

Program 221,145 100 221,145 3,886 100 3,886

Opioid Treatment 56,743 68.53 81,794 2,847 66.61 3,824

Day Supports 221,145 100 221,145

Adult Developmental

Vocational Program 1,528 100 1,528



If not at 100%, have exceptions been requested but not yet finalized? Yes. If no, briefly explain and give dates each will be requested: n/a

If not at 100%, have written justifications and plans to meet needs been submitted? Yes

If no, briefly explain and give dates each will be submitted: n/a

If not at 100%, are exceptions to the standard in place? Yes

Please list: Waiver of provider choice has been approved by DMA; developed new service definition modifier for Medication-Assisted Treatment that will be used to expand access to opioid treatment. We will resubmit waiver request to DMA for FY17. If no, briefly explain: n/a

If not at 100%, are written justifications and plans to meet needs in place? Yes Attach copy to this report. If no, briefly explain See Appendix E

Effective dates of each exception approval: 9/22/15 Effective date of each written justification and plan approval: 3/27/15

Next review dates for each exception, if applicable: n/a Next review dates, if applicable: n/a

B. What location-based services gaps were identified by consumers and family members?

Improve service accessibility, including:

Expansion of same day access

Psychiatry availability

Transportation options

C. What location-based services gaps were identified by other stakeholders?

Improve access to short-term daily structured programs to support behavioral and emotional stability

(e.g., Day Treatment, Partial Hospitalization)

Enhanced access to an effective and comprehensive continuum of care for individuals with

substance use disorders

Improved quality and effectiveness of psychosocial rehabilitation

D. What specific geographic, cultural or demographic groups experience gaps in the location-based

services above that need to be addressed? Describe gaps and how the information was

gathered.

Elderly, non-English speaking (primarily Spanish language), individuals with co-occurring IDD and

mental illness, youth engaged in sexual harm, individuals with substance use disorders, LGBTQ

populations and individuals with traumatic brain injuries.

Underserved populations were identified through the community survey and feedback from consumer,

stakeholder, provider and staff workgroups. A summary of findings regarding underserved

populations and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing location-based services gaps identified in II.A, II.B.,

II.C. and II.D. Briefly identify the service gap, goal and target date for reducing or eliminating the

gap, and strategies planned or in progress to achieve the goal.


Medicaid

Service Gap Goal and Target Date

Strategies to achieve goal,

noting if planned or in

progress

Child & Adolescent Day

Treatment

DMA has approved Medicaid Access

and Choice Waivers for this service.

Exploring opportunities for

collaboration with Cumberland

County schools regarding Day

Treatment plans.

Opioid Treatment

Addressed in FY16 Network

Development Plan. Developed new

service definition modifier for

Medication Assisted Treatment with

Buprenorphine with plans to

implement by 6/30/16.

Continued goal for FY17

Network Development Plan.

Improved accessibility of

outpatient psychiatric

services and same-day

intake appointments

Develop plan and timeframes for

addressing in FY17 Network

Development Plan by 6/30/16.

FY17 Network Development

Plan will include specific plans

for development of Behavioral

Health Urgent Care.

Access to short-term daily

structured programs such as

Day Treatment and Partial

Hospitalization

May be addressed by current plans

and initiatives. Conduct further

evaluation by 6/30/16 to identify

extent to which this area remains a

gap and needs to be included in FY17


Include in FY17 Network

Development Plan If gap

remains as of 6/30/16.

Enhanced access to an

effective and

comprehensive continuum

of care for individuals with

substance use disorders

Develop plan and timeframes for

addressing in FY17 Network

Development Plan by 6/30/16

FY17 Network Development

Plan will include specific plans

for evaluation of barriers and

strategies for addressing this

gap.

Improved quality and

effectiveness of

psychosocial rehabilitation

FY16 Network Development Plan

objective in progress, evaluating PSR

models and preparing

recommendations for further

development, with expected

completion by 6/30/16

Continued goal for FY17


Service access for

underserved populations

such as elderly, non-English

speaking and other

identified populations.

Conduct further evaluation by 6/30/16

to identify extent to which populations

are underserved and to clarify

priorities for inclusion in FY17


Incorporate findings of

evaluation into FY17 Network

Development Plan goals.


State-Funded

Service Gap Goal and Target Date

Strategies to achieve goal,

noting if planned or in

progress

Psychosocial Rehabilitation

(no provider in Cumberland

with State contract)

Resolved: added contract with PSR

provider in Cumberland County. Completed

Child & Adolescent Day

Treatment (Cumberland)

Requests for services will be handled

through single-case agreements or

contracts with existing providers if

necessary. We will request

continuation of DMH waiver for FY17.

Exploring opportunities for

collaboration with Cumberland

County schools regarding Day

Treatment plans.

Service access for

underserved populations

such as elderly, non-English

speaking and other

identified populations.

See above See above

III. Community/Mobile Services

A. 1. Medicaid community/mobile services access and choice standard: All eligible individuals must

have a choice of two provider agencies for each community/mobile service in the chart below

within the LME-MCO catchment area.

2. State-funded community/mobile services access and choice standard: All eligible individuals

have access to at least one provider agency for each community/mobile service in the chart

below within the LME-MCO catchment area.


Service


choice of two provider

agencies within the LME-

MCO catchment area

Total #

of

Medicaid

Enrollee

s


access to at least one provider

agency within the LME-MCO

catchment area

Total # of

Consume

rs

# % # %

Assertive Community Treatment Team

81,794 100 81,794 10,884 100 10,884

Community Support Team

81,794 100 81,794 14,725 100 14,725

Intensive In-Home 139,351 100 139,35

1 1,093 100 1,093

Mobile Crisis 221,145 100 221,14

5 17,356 100 17,356

Multi-systemic Therapy 139,351 100 139,35

1 1,093 100 1,093

Home-based I/DD

Services 221,145 100

221,14

5



Service


choice of two provider

agencies within the LME-

MCO catchment area

Total #

of

Medicaid

Enrollee

s


access to at least one provider

agency within the LME-MCO

catchment area

Total # of

Consume

rs

# % # %

(b)(3) MH/SA

Supported Employment

Services

221,145 100 221,14

5

(b)(3) I/DD MH/SA

Supported Employment

Services

221,145 100 221,14

5

(b)(3) Waiver

Community Guide

221,145 100 221,14

5

(b)(3) Waiver Individual

Support (Personal

Care)

221,145 100

221,14

5

(b)(3) Waiver Peer

Support

221,145 100 221,14

5

(b)(3) Waiver Respite

221,145 100 221,14

5

I/DD Supported

Employment Services

(Innovations)

221,145 100 221,14

5

I/DD Supported

Employment Services

(State-funded)

1,528 100 1,528

MH/SA Supported

Employment Services

(IPS-SE) (State-funded)

14,725 100 14,725

Developmental

Therapies (State-

funded)

1,528 100 1,528


If not at 100%, have exceptions been requested but not yet finalized? n/a If no, briefly explain and give dates each will be requested: n/a

If not at 100%, have written justifications and plans to meet needs been submitted? n/a

If no, briefly explain and give dates each will be submitted: _ n/a

If not at 100%, are exceptions to the standard in place? n/a Please list. If no, briefly explain: n/a

If not at 100%, are written justifications and plans to meet needs in place? n/a attach copy to this report. If no, briefly explain n/a

Effective dates of each exception approval: n/a Effective date of each written justification and plan approval: n/a

Next review date of each exception, if applicable: n/a Next review dates, if applicable: n/a


B. What community/mobile services gaps were identified by consumers and family members?

Improved availability of services to assist with vocational and educational needs

Improved access to services to provide relief to primary caretakers (Respite, Crisis respite, emergency

and planned respite)

Improved quality and accessibility of community-based intensive treatment services (e.g., Community

Support Team, Assertive Community Treatment Team), especially for uninsured

C. What community/mobile services gaps were identified by other stakeholders?


Enhanced quality of mobile crisis and capacity for to serve children and dually diagnosed IDD/MH

population

D. What specific geographic, cultural or demographic groups experience gaps in the

community/mobile services above that need to be addressed? Describe gaps and how the

information was gathered.





stakeholder, provider and staff workgroups. A summary of findings regarding underserved populations

and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing community/mobile services gaps identified in III.A.,

III.B., III.C. and III.D. Briefly identify the service gap, goal and target date for reducing or

eliminating the gap, and strategies planned or in progress to achieve the goal.

Medicaid



Improved access to services to provide relief to primary caretakers (Respite, Crisis respite, emergency and planned respite)

Develop plan and timeframes for continuing this goal in FY17 Network Development Plan by 6/30/16.

This objective will continue in FY17 Network Development Plan.


FY16 Network Development Plan objectives in progress related to Supported Employment and consumer-operated businesses, with expected completion by 6/30/16.

Develop plan and timeframes by 6/30/16 for continuing this goal in FY17 Network Development Plan





Improved quality of community-based intensive treatment services (e.g., Community Support Team, ACTT)

Develop plan and timeframes for addressing this gap in FY17 Network Development Plan by 6/30/16. Include in objectives for FY17 provider collaboratives.


Enhanced quality of mobile crisis and capacity for to serve children and dually diagnosed IDD/MH population

FY16 Network Development Plan objective in progress related to Mobile Crisis, with expected completion by 6/30/16.

Develop plan and timeframes for continuing and expanding this goal in FY17 Network Development Plan by 6/30/16.





State-Funded



Same as above See above See above

IV. Crisis Services

A. Medicaid and State-funded crisis services access and choice standard: All eligible individuals

must have access to at least one provider agency for each crisis service in the chart below within

the LME-MCO catchment area.

Service Number Facilities in LME-MCO

Catchment Area with Medicaid Contract

Number Facilities in LME-MCO

Catchment Area with Contract for

State-Funded Services

Facility-Based Crisis 4 3

Respite 69 10

Detoxification

(non-hospital) 2 2



If standard not met, have exceptions been requested but not yet finalized? n/a . If no, briefly explain and give dates each will be requested: n/a

If standard not met, have written justifications and plans to meet needs been submitted? n/a


If standard not met, are exceptions to the standard in place? n/a If no, briefly explain: n/a

If standard not met, are written justifications and plans to meet needs in place? n/a; attach copy to this report. If no, briefly explain n/a


Next review dates, if applicable: n/a Next review dates, if applicable: n/a

B. What crisis services gaps were identified by consumers and family members?

Expanded crisis continuum, including access to respite and crisis respite services


C. What crisis services gaps were identified by other stakeholders?

Need for an expanded crisis continuum, including access to respite and crisis respite services

D. What specific geographic, cultural or demographic groups experience gaps in the crisis services

above that need to be addressed? Describe gaps and how the information was gathered.

Elderly, non-English speaking (primarily Spanish language), individuals with co-occurring IDD and mental illness, youth engaged in sexual harm, individuals with substance use disorders, LGBTQ populations and individuals with traumatic brain injuries.

Underserved populations were identified through the community survey and feedback from consumer, stakeholder, provider and staff workgroups. A summary of findings regarding underserved populations and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing crisis services gaps identified in IV.A., IV.B., IV.C.

and IV.D. Briefly identify the service gap, goal and target date for reducing or eliminating the gap,


Medicaid



Expanded crisis continuum,

including access to respite

and crisis respite services

Develop plan and timeframes for addressing in FY17 Network Development Plan by 6/30/16

FY17 Network Development Plan will include specific plans for evaluation of barriers and strategies for addressing this gap.








State-Funded




V. Inpatient Services

A. Medicaid and State-funded inpatient services access and choice standard: All eligible individuals

must have access to at least one inpatient provider agency listed in the chart below within the

LME-MCO catchment area.

Service Number Facilities in LME-MCO

Catchment Area with Medicaid

Contract

Number Facilities in LME-MCO

Catchment Area with Contract for

State-Funded Services

Inpatient Hospital – Adult

a. Acute care hospitals with adult inpatient psychiatric bed

b. Other hospitals with adult inpatient psychiatric beds

c. Acute care hospitals with adult inpatient substance use beds

d. Other hospitals with adult inpatient substance use beds

4 3

3 2

1 1

1 1

Inpatient Hospital – Adolescent

a. Acute care hospitals with adolescent inpatient psychiatric beds

b. Other hospitals with adolescent inpatient psychiatric beds

c. Acute care hospitals with adolescent inpatient substance use beds

d. Other hospitals with adolescent inpatient substance use beds

0 0

2 1

0 0

0 0

Inpatient Hospital – Child

a. Acute care hospitals with child inpatient psychiatric beds

b. Other hospitals with child inpatient psychiatric beds

0 0

2 1



If standard not met, have exceptions been requested but not yet finalized? n/a . If no, briefly explain and give dates each will be requested: n/a

If standard not met, have written justifications and plans to meet needs been submitted? n/a


If standard not met, are exceptions to the standard in place? n/a If no, briefly explain: n/a

If standard not met, are written justifications and plans to meet needs in place? n/a ; attach copy to this report. If no, briefly explain n/a


Next review dates of each exception, if applicable: n/a Next review dates, if applicable: n/a

B. What inpatient services gaps were identified by consumers and family members?

Inpatient psychiatric treatment for dually diagnosed IDD/MI

C. What inpatient services gaps were identified by other stakeholders?

Lack of inpatient psychiatric beds (both short-term and long-term) for MI and SA

D. What specific geographic, cultural or demographic groups experience gaps in the inpatient


gathered.

Elderly, non-English speaking (primarily Spanish language), individuals with co-occurring IDD and mental illness, youth engaged in sexual harm, individuals with substance use disorders, LGBTQ populations and individuals with traumatic brain injuries.

Underserved populations were identified through the community survey and feedback from consumer, stakeholder, provider and staff workgroups. A summary of findings regarding underserved populations and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing inpatient services gaps identified in V.A., V.B., V.C.

and V.D. Briefly identify the service gap, goal and target date for reducing or eliminating the gap,


Medicaid

Service Gap Goal and Target Date Strategies to achieve goal, noting

if planned or in progress

Lack of inpatient psychiatric beds (both short-term and long-term) for MI and SA

This item reflects statewide service needs and gaps that will require ongoing planning efforts.

Address through participation in statewide advocacy, development and strategic planning efforts.


Inpatient for dually diagnosed IDD/MI

Goal for this area will be to evaluate options for decreasing inpatient utilization and development of appropriate alternatives to inpatient care.






State-Funded

Service Gap Goal and Target Date Strategies to achieve goal, noting

if planned or in progress


VI. Specialized Services

A. Medicaid and State-funded specialized services access and choice standard: All individuals

eligible for the services below must have access to at least one provider agency.

A chart is available in Appendix B with a listing of Medicaid and State-funded specialized

services that Alliance contracts with, by county served. The following table provides a list of

Specialized Services and whether there is availability of services in the Alliance catchment area:

Service Medicaid State

Partial Hospitalization No No

MH Group Homes N/A Yes

Psychiatric Residential Treatment Facility Yes N/A

Residential Treatment Levels 1-4 Yes N/A

Child MH Out-of-Home Respite Yes N/A

SA Non-Medical Community Residential Treatment Yes Yes

SA Medically Monitored Community Residential Treatment

Yes Yes

SA Halfway Houses N/A Yes

I/DD Group Homes and AFLs Yes N/A

I/DD Out-of-Home Respite Yes N/A

I/DD Facility-Based Respite Yes N/A

Intermediate Care Facility/IDD Yes N/A


B. What specialized services gaps were identified by consumers and family members?

ICF/IDD

Short-term daily structured programs to support behavioral and emotional stability (e.g. Partial

Hospitalization

C. What specialized services gaps were identified by other stakeholders?

Effective residential treatment options, including short-term residential treatment for substance abuse,

transitional living, half-way houses, and housing with supports

Therapeutic secure residential treatment for children and adolescents (e.g., Psychiatric Residential

Treatment Facility (PRTF) and Level IV residential treatment)

Improved access and quality of residential options such as Group Living, Supervised Living,

Residential Supports, and Semi- and/or independent living

D. What specific geographic, cultural or demographic groups experience gaps in the specialized


gathered.





stakeholder, provider and staff workgroups. A summary of findings regarding underserved populations

and detailed feedback regarding needs and gaps is available in Appendix D.

E. Goals, strategies and timelines for addressing specialized services gaps identified in VI.A., VI.B.,

VI.C. and VI.D. Briefly identify the service gap, goal and target date for reducing or eliminating the

gap, and strategies planned or in progress to achieve the goal.

Medicaid



Partial Hospitalization This gap will be resolved by 6/30/16 by addition of provider contracts.

N/A





State-Funded



Effective residential

treatment options and

supports

Completed comprehensive evaluation of residential continuum and development of Alliance Housing Plan.

Housing and residential treatment needs and gaps will be addressed through the Housing Plan.

New Director of Housing position will provide leadership for implementation of housing plan initiatives, pending availability of funds.

Therapeutic secure

residential treatment

(Psychiatric Residential

Treatment Facility (PRTF),

Level IV)

Goal for this area will be to evaluate options for decreasing out of home placement


See above


See above See above

VII. State-Funded Services Items

The following two items apply to services referenced in:

State-Funded Enhanced Mental Health and Substance Abuse Services 2015 effective 8/1/15

State-Funded ACT Policy

State-Funded DMHDDSAS Service Definitions 2003-2014 effective 8/1/14

Individual Supportive Employment with Long-Term Vocational Supports YP630/YM645

For additional information, see http://www.ncdhhs.gov/providers/provider-info/mental-health/service-definitions. A. For State-funded services, describe any geographic discrepancies in services included in the

LME-MCO’s local Benefit Plan. That is, are residents of some counties excluded from coverage

under the LME-MCO benefit plan, or have stricter eligibility requirements? Include which services,

why this occurred, and whether there is a plan in place to ensure equal access based on need

across all geographic areas.

http://www.ncdhhs.gov/providers/provider-info/mental-health/service-definitions

http://www.ncdhhs.gov/providers/provider-info/mental-health/service-definitions


The following summarizes current geographic discrepancies in the Alliance Non-Medicaid Benefit Plan

for each population. Explanations for discrepancies and plans for ensuring equal access are discussed

at the end of this section, unless noted specifically within the list below.

Child MH/SA Benefit Plan Discrepancies

Child & Adolescent Day Treatment: available in Cumberland and Wake only

SAIOP: adolescent SAIOP in Cumberland only

Community Respite: benefit plan does not include Cumberland due to lack of provider in this county

Adult MH/SA Benefit Plan Discrepancies

Psychological Testing is limited to adults only for Durham & Wake counties.

Access to residential treatment services varies by county, including: Halfway House (Durham only),

Group Living High (stricter requirements for Johnston), Group Living Moderate (does not include

Johnston due to lack of provider in this county), Supervised Living-Low (Cumberland only), and

Supervised Living-Moderate (Wake only).

IDD Benefit Plan Discrepancies

IDD Supported Employment-Individual: only available in Cumberland

IDD SE Long Term Vocational Services: authorization limits vary by county, with different annual

limits for Wake (36 hours/year) Johnston and Durham (52 hours/year) and Cumberland (84

hours/year).

IDD SE-Group: Available in Cumberland and Wake only

Developmental Therapies (professional): available in Cumberland and Wake only; stricter benefit

limits for Cumberland

Developmental Therapies (paraprofessional): available in Johnston and Wake only

Personal Assistance: not available in Cumberland, and stricter eligibility requirements for Johnston

Developmental Day: Wake and Johnston only; stricter eligibility limits for Johnston (Pre-K only);

different benefit plan limits and timeframes; contract also in Cumberland

ADVP: stricter limits for Cumberland

Community Respite: not available in Cumberland due to lack of provider in this county

Day Activity: Cumberland and Durham only, and stricter limits for Cumberland

Hourly Respite: not available in Durham; stricter limits for Cumberland and Johnston (10

hours/month for one month vs. 12 hours/month for full year)

Psychological Testing: adults only in Durham and Wake

Access to residential treatment services varies by county, including: Group Living Moderate (not

available in Wake), Group Living Low (Cumberland and Wake only), Supervised Living 1-6 (not

available in Wake), and Supervised Living-Low (Cumberland and Wake only)

Explanation of Discrepancies

Alliance Behavioral Healthcare formed in July 2012 as a multi-county LME-MCO comprising four

counties that had previously served as single-county LMEs. As LMEs, each county program had

established separate networks and benefit plans that reflected different provider capacity, service

demand, community resources and levels of State and local funding. As a result, the creation of a


unified Non-Medicaid benefit plan resulted in geographic discrepancies that have been partially but not

completely resolved. Alliance has adjusted the benefit plan to achieve consistency when possible, but

some adjustments will require either additional State funding or service reductions, which require planful

consideration of impact on communities and consumers.

Plans to Ensure Equal Access

As reflected in the FY16 Network Development Plan, Alliance has prioritized the revision of its Non-

Medicaid Benefit Plan to improve geographic consistency, and we will continue to address discrepancies

in the upcoming fiscal year when possible. This issue will be discussed with the Alliance Board in the

budget planning process for FY17, but will be impacted significantly by any reductions in State

MH/IDD/SA funding.

B. For State-funded services, describe any services that were closed to new admissions or not

offered during the year. Include which services, why this occurred, the period of time, and how the

LME-MCO ensured priority populations continued to access appropriate levels of care.

Services were closed to new admissions for consumers in Durham for ADVP and Personal Assistance.

See above for an explanation of reasons for this discrepancy and Alliance plans for addressing in the

upcoming fiscal year.


Section Three

GeoAccess Maps

For each of the Location-Based and Community/Mobile services, geographic access was evaluated using specialized software that calculated identified the location of both consumers and

providers to evaluate whether services are accessible within a 30-mile radius. Separate approaches

were used for Medicaid and State-funded services:

For Medicaid-funded services, accessibility was determined by using the addresses of all

Medicaid recipients for the Alliance catchment area from July 1, 2014 through June 30, 2015.

For State-funded services, addresses were used for individuals who received State-funded

services between July 1, 2014 and June 30, 2015.

For both Medicaid and State-funded services, accessibility calculations were based only on

those who met the age/disability requirements for the service being evaluated. For example,

Child and Adolescent Day Treatment access was evaluated based on Medicaid-eligible or

uninsured children and adolescents.

As required by DHHS, geographic access maps are provided (See Appendix A) for services where

less than 90% of consumers have the required access and/or choice. The following services did not

meet the 90% benchmark:

Psychosocial Rehabilitation (State): 82.6%

Opioid Treatment (Medicaid): 68.5%

Opioid Treatment (State): 66.6%

As noted in Section Two, the following actions have been taken to address accessibility gaps for

these services:

Psychosocial Rehabilitation (State)

This gap was noted for FY15 due to the lack of a State-funded provider in Cumberland County. This

gap has been addressed by addition of a contract for PSR in Cumberland County.

Opioid Treatment (Medicaid and State)

This area has been an identified goal for the FY16 Network Development Plan, which has led to the

development of a Medicaid service definition modifier to expand access to Medication-Assisted

Treatment in all counties. This area will remain as a priority in the FY17 Network Development Plan.


Section Four

Departmental (DHHS) Initiatives

The NC Department of Health and Human Services (DHHS) has established seven priority initiatives

for MCOs for the past year. The following section provides an update on the status of each initiative,

including goals, actions taken, accomplishments and plans for further development.

Recovery-Oriented System of Care

Through our strategic planning process, Alliance Behavioral Healthcare began an initiative to

develop a transformation plan to help shift the paradigm towards a recovery oriented system of care

in our communities. Operating a managed care organization within a recovery oriented system of

care is the right thing to do, and is the most cost effective way to manage our behavioral healthcare

costs. This organization has already taken many steps toward implementing recommendations

identified in this planning process. It is recognized that changing a system is not a quick or easy

task, however Alliance remains committed to move forward to establish a system that honors the

people it serves, believes and invests in their ability to live a life of quality, meaning and purpose,

and treats people with dignity and respect. Below is a strategic framework that is being utilized to

implement the recommendations made by our cross departmental initiative team.

Strategic Framework

Establish a Recovery and Self-Determination steering committee to oversee this transformation.

(Include at least 1 member of the Executive Leadership Team)

Adopt the guiding principles for recovery and self-determination outlined in this document

Develop a Recovery Education Institute to offer additional training to our staff, providers,

consumers and families, and other community partners

Align our policies and procedures with a recovery-oriented system of care

Put “teeth” in our contracts and align outcomes in our contracts with a recovery oriented system

of care

Consider all of our service array recommendations as well as other evidence-based and

emerging best practice models

Include consumers and families in the transformation process

Utilize effective Peer Support Services and family partners

Fund consumer operated services throughout our catchment area.

Invest in the future of this organization and our communities by funding this transformation

process appropriately

Additional actions taken include:

Implementation of a peer recovery based program in our Durham Crisis facility, the Durham

Recovery Response Center.

Development of a white paper outlining our commitment to implementing a Recovery-Oriented

System of Care and convened a workgroup of diverse and interested employees to implement

the vision.


Training for providers focused on improvement in the quality of Person-Centered Plans (PCPs),

particularly in health and safety elements, the comprehensive crisis plan, and individualization

of goals and interventions.

Crisis Solutions Initiative

Alliance is an active participant in initiatives focused on improving accessibility, quality and

performance of the crisis system. We have established crisis collaboratives in Cumberland, Durham

and Wake counties that include representation from multiple community stakeholders such as

hospitals, crisis centers, law enforcement, judicial system, providers, paramedics and others.

Alliance has also responded to three Crisis Solutions Initiative funding opportunities from DMH and

has been awarded grants that resulted in the following:

Implemented First Episode Psychosis Clinic to expand identification and treatment of first

episode psychosis for youth and young adults in Wake County.

Established Critical Time Intervention program in Cumberland County to provide evidence-

based jail post-release services that target more effective engagement and treatment for

individuals with mental illness and substance use disorders who have been released from the

Cumberland County jail. Developed Medicaid alternative service definition with plans for

implementation in FY17.

The Community Paramedicine grant has assisted in development of policies and procedures

related to advanced paramedicine in Durham County and MH/SA training in preparation for

designating alternative drop-off locations other than hospital emergency departments.

We have implemented a peer recovery based program in our Durham Crisis facility, the Durham

Recovery Response Center, and we are locating a second facility for Wake that will use a peer

recovery approach as well. We are drafting the Rapid Response definition to improve crisis

response for youth and plan to submit to DMA be approved as a Medicaid Alternative Service.

Crisis Services QIP – Alliance identified opportunities for improvement in crisis services,

particularly in Wake and Cumberland Counties, due to the regular overcapacity of the Wake

County crisis facility in the evenings and high rate of Emergency Department use primarily for

psychiatric reasons in Cumberland. Alliance is expanding the availability of Tier II services after

regular business hours in Wake County and evidence-based, intensive services for youth in

Cumberland County.

Additional Tier IV facility – Due to the rapid population expansion in the state’s largest county,

Alliance identified resources and issued an RFP for an additional Tier IV in Wake County. The

contract has been awarded and the provider is identifying potential sites in the highest need

location based on data from Alliance’s geo-access mapping.

Advancing Technology

Over the past year Alliance has partnered with Night Owl and Simply Home to provide several family

and consumer education sessions regarding the availability of independence enabling technology

that can be provided under the Innovations Waiver. The sessions allowed individuals to learn about

technology and how technology and professional and natural supports can be combined to enhance

and individuals’ ability to live safely and more independently in the community. A number of

consumers have elected to implement a range of technologies and are in the implementation

process, which consists of significant levels of person centered planning regarding the types of

devices and monitoring that will be implemented.


Additionally, Alliance is developing a technology enabled transition home that will be used to help

individuals and families learn to use independence enabling technology is a safe and closely

supervised home. The goal is that over time, direct staff oversight is faded until a consumer can

move into a their own home or apartment that has been outfitted with the technology devices and

monitoring can occur through either paid staff, natural supports or some combination.

Employment

Several FY16 Network Development Plan initiatives have addressed employment goals, including

continued implementation of evidence-based Supported Employment services and exploration of

models and supports for consumer-run businesses. Progress updates on these initiatives are

provided above on page 11.

Housing

Contracted with TAC to complete a study of the Alliance residential continuum.

Prepared Alliance Housing Plan per DHHS request

Housing Plan includes overview of current community-based housing initiatives, identified

needs relating to housing capacity and access to quality affordable permanent supportive

housing, wraparound services and supports needed to promote sustainable housing, and crisis

planning objectives for consumers

Alliance has created a new Director of Housing position to provide leadership for housing

initiatives

Current housing initiatives:

o Independent Living Initiative

o Transitions to Community Living Initiative

o Ready to Rent training: plan to expand to all counties

o Voucher and subsidized housing, including Section 8 Housing Choice Vouchers, Shelter

Plus Care

o Exploring further partnerships with public housing authorities

o Included housing allocation in Alliance savings reinvestment plan.

o Exploring Master Leasing agreements and piloting in Wake for TCLI

o Exploring financial incentives to developers

o Expanding wraparound services and supports

o Convening a Housing Learning Collaborative

o Training for providers on supportive housing

o Exploring expansion of key treatment services that support housing tenure

o Continued consultation with TAC and Corporation for Supportive Housing

Children’s Services

Implemented pilot programs, including Intercept, Enhanced Therapeutic Foster Care (E-TFC)

and Family-Centered Treatment (FCT) to expand the continuum of children’s’ services by

allowing additional intensive community based options for families. In addition, we have

submitted OPT+ for approval which will give youth and families a more intensive service

between OPT and IIHS, and we also are drafting a Medicaid alternative service definition for

Rapid Response, a crisis prevention and respite program, for implementation in all Alliance

counties.


Intensive In-Home QIP – Alliance identified a need to improve outcomes and emotional well-

being of youth receiving Intensive In-Home services. Alliance has identified evidence-based

models, in collaboration with contracted providers, that will be the required modes of service

delivery. Providers have an opportunity to select the model to deliver and receive training,

subsidized by Alliance, no later than December 2016.

Implemented Therapeutic Foster Care Collaborative, with focus on implementation of evidence-

based interventions by therapeutic parents and development of a more trauma-informed

network of care.

Integration of Physical and Behavioral Health Care

Alliance has multiple initiatives that promote integration of behavioral health and medical care. We

believe this is a priority area for continued development and is consistent with research findings,

emerging evidence-based practices and identified community needs. We have recently established

and filled a new position, Director of Integrated Care, to promote and guide the development of

integrated care initiatives. Current initiatives include the following:

Conducted inventory of integrated care initiatives

Implemented multiple integrated care initiatives and hired consultant to conduct evaluation of

these pilot projects.

Wake County integrated care project with Turning Point Family Care, Urban Ministries and

Alliance Medical Ministry. Services include integrated, on-site, bilingual behavioral health

services at two agencies that serve the uninsured, many of whom speak Spanish.

Integrated care clinic operated by UNC Health Care on the WakeBrook campus that includes

crisis and assessment, facility-based crisis, non-hospital detoxification and inpatient psychiatric

services.

Alliance Care Coordinator located on-site at Duke.

Fellowship Health Resources is implementing the Dartmouth “In Shape” model within their PSR

program in Wake County. This program, funded by a combination of grant and Alliance

funding, provides health promotion and wellness activities for individuals with serious mental

illnesses.

Integration of Lincoln Community Health Center services at Durham Crisis and Assessment,

including assessments, lab work, medical examinations and follow-up treatment.

Duke Outpatient Clinic has received technical support to integrate behavioral health licensed

consultants into the practice. Implemented a set of routine mental health screening, workflows

and protocols to provide team based care to address total health needs within the practice.

Carolina Behavioral Care, in Partnership with the Duke Division of Community Health and

Northern Piedmont CCNC to integrate primary care services into their outpatient psychiatric

practice. Model includes an embedded nurse care manager who helps address consumers

overall needs.

Alliance is supporting efforts for the UNC ACTT team to receive primary care consultation and

for the ACTT Team medical staff to assist in the provision of primary care during routine client

visits.

Carolina Outreach has placed a behavioral health clinician within a large primary care Practice,

Eastover medical. The clinician provides consultation to primary care providers, brief

counseling and behavior change support to patients of the practice and coordinates referral to

and from the behavioral health system


Alliance will be expanding pilots to include an initiative with Southlight Healthcare to address

physical care gaps within their organization, including providing them with enhanced data

analytics to better manage their entire patient population. Additionally, Alliance is working with

a representatives for the IDD Council and local providers to pilot an IDD Health Home model.


APPENDICES


Appendix A: Geographic Access Maps

The following maps are provided per funding source only for services where less than 90% of

consumers have the required access and/or choice:


Appendix B: Specialized Services

Specialized Service Provider Location(s) Funding Source

Child MH Out-of-Home Respite The Alpha Management Community Services,Inc. Durham State

Child MH Out-of-Home Respite Stan B Treatment Services Inc Johnston State

Child MH Out-of-Home Respite Lutheran Family Services in the Carolinas Wake State

Child MH Out-of-Home Respite National Mentor Healthcare, LLC Wake State

Child MH Out-of-Home Respite Pinnacle Family Services of North Carolina, LLC Wake State

I/DD Facility-Based Respite A Bridge to Learning Davidson Medicaid

I/DD Facility-Based Respite A Caring Heart Case Management, Inc. Johnston Medicaid

I/DD Facility-Based Respite A Small Miracle, Inc. Wake Medicaid

I/DD Facility-Based Respite A TOUCH OF GRACE INC Cumberland Medicaid

I/DD Facility-Based Respite Abilities Inc Lenoir Medicaid

I/DD Facility-Based Respite ACI SUPPORT SPECIALISTS INC Cumberland, Wake Medicaid

I/DD Facility-Based Respite ADG Associates LLC Cumberland Medicaid

I/DD Facility-Based Respite Advanced Health Resources, Inc. Johnston, Wake Medicaid

I/DD Facility-Based Respite Advantage Care In Home Services, Inc. Durham, Vance Medicaid

I/DD Facility-Based Respite Alberta Professional Services, Inc. Caswell Medicaid

I/DD Facility-Based Respite Alpha Management Services, Inc. Durham Medicaid

I/DD Facility-Based Respite Autism Services, Inc. Wake Medicaid

I/DD Facility-Based Respite Autism Society of North Carolina, Inc. Cumberland Medicaid

I/DD Facility-Based Respite BAILEY'S RESPITE CARE, INC Wilson Medicaid

I/DD Facility-Based Respite BAYADA HOME HEALTH CARE, INC. Guilford Medicaid

I/DD Facility-Based Respite Bethesda Care dba Keston Care Orange Medicaid

I/DD Facility-Based Respite Bob Inman Inc. dba Inman Home Health Cumberland Medicaid

I/DD Facility-Based Respite CANAAN CARE HOME LLC Wake Medicaid

I/DD Facility-Based Respite Caring Hands and Supplementary Enrichment Education

LLC Durham Medicaid

I/DD Facility-Based Respite Changing Outcomes, LLC Cumberland Medicaid



I/DD Facility-Based Respite CNC/ACCESS dba ResCare HomeCare Durham, Wake Medicaid

I/DD Facility-Based Respite Community Alternative Housing, Inc. Cumberland Medicaid

I/DD Facility-Based Respite Community Based Developmental Services Inc Cumberland Medicaid

I/DD Facility-Based Respite COMPREHENSIVE COMMUNITY CARE INC Durham Medicaid

I/DD Facility-Based Respite Eagle Healthcare Services, Inc Wake Medicaid

I/DD Facility-Based Respite Easter Seals UCP North Carolina & Virginia, Inc. Durham, Wake, Guilford, Surry Medicaid

I/DD Facility-Based Respite Educare Community Living Corporation - NC dba

Community Alternatives North Carolina Wake Medicaid

I/DD Facility-Based Respite Elite Care Service Inc Cumberland Medicaid

I/DD Facility-Based Respite Enhancement Health Care Durham Medicaid

I/DD Facility-Based Respite Great Expectations Day Facility and Enrichment Program,

LLC Cumberland Medicaid

I/DD Facility-Based Respite Guardian Trac LLC dba GT Independence Wake Medicaid

I/DD Facility-Based Respite HomeCare Management corporation Columbus, Edgecombe, New

Hanover Medicaid

I/DD Facility-Based Respite House of Care, Inc. Durham Medicaid

I/DD Facility-Based Respite Howell Support Services Wayne Medicaid

I/DD Facility-Based Respite J-1 CONSULTANTS, LLC Orange Medicaid

I/DD Facility-Based Respite Jeanette Purifoy dba Michael's World Cumberland Medicaid

I/DD Facility-Based Respite Johnson's House of Hope Family Care Home, LLC Durham Medicaid

I/DD Facility-Based Respite Kaleo Supports Inc Cumberland Medicaid

I/DD Facility-Based Respite Lee County Industries Lee Medicaid

I/DD Facility-Based Respite Life Based Conceptions LLC Durham Medicaid

I/DD Facility-Based Respite Lindley Habilitation Services, LLC Wake Medicaid

I/DD Facility-Based Respite MAKIN' CHOICES INC. Durham Medicaid

I/DD Facility-Based Respite Maxim Healthcare Services, Inc. Cumberland, Durham, Wake,

Guilford Medicaid

I/DD Facility-Based Respite MHS Unlimited, Corporation Durham Medicaid

I/DD Facility-Based Respite MULTI-THERAPEUTIC SERVICES, INC. Davidson, Forsyth, Randolph Medicaid



I/DD Facility-Based Respite Murchison Residential Corporation Wake Medicaid

I/DD Facility-Based Respite NEW BEGINNINGS OF NORTH CAROLINA Cumberland Medicaid

I/DD Facility-Based Respite Parker Investments, LTD. Cumberland Medicaid

I/DD Facility-Based Respite Pathways for People, Inc. Wake Medicaid

I/DD Facility-Based Respite Patterson Home Care, Inc. Cumberland Medicaid

I/DD Facility-Based Respite Pearl's Angel Care Inc. Cumberland Medicaid

I/DD Facility-Based Respite Person County Group Homes Inc Person Medicaid

I/DD Facility-Based Respite Philip House Therapeutic Services, Inc. Wake Medicaid

I/DD Facility-Based Respite PHP of NC, Inc. Durham Medicaid

I/DD Facility-Based Respite Professional Family Care Services, Inc Cumberland Medicaid

I/DD Facility-Based Respite Q- CLINICAL CONSULTANTS LLC Wake Medicaid

I/DD Facility-Based Respite QC, Inc. Wake, Franklin Medicaid

I/DD Facility-Based Respite Quest Provider Services, LLC Mecklenburg Medicaid

I/DD Facility-Based Respite Rainbow 66 Storehouse, Inc. Durham Medicaid

I/DD Facility-Based Respite Rainbow of Sunshine, Inc. Cumberland Medicaid

I/DD Facility-Based Respite ReNu Life, LLC Wayne Medicaid

I/DD Facility-Based Respite Restoration Family Services, Inc. Johnston Medicaid

I/DD Facility-Based Respite RHA Health Services, Inc. Cumberland, Durham, Wake,

Bumcombe, Granville, Harnett, Iredell, Robeson, Rowan

Medicaid

I/DD Facility-Based Respite RUSMED CONSULTANTS LLC Wake Medicaid

I/DD Facility-Based Respite Securing Resources for Consumers, Inc. Durham Medicaid

I/DD Facility-Based Respite ShineLight, Inc. Cumberland Medicaid

I/DD Facility-Based Respite Sophia B. Pierce & Associates, Inc. Cumberland Medicaid

I/DD Facility-Based Respite Specialized Services and Personnel Wake Medicaid

I/DD Facility-Based Respite Spigner Management Systems dba BJ Hill and

Associates Cumberland Medicaid

I/DD Facility-Based Respite Structured Family Interventions, LLC Durham Medicaid



I/DD Facility-Based Respite SUCCESSFUL SOLUTIONS MHS INC. Durham Medicaid

I/DD Facility-Based Respite The Alpha Management Community Services,Inc. Durham Medicaid

I/DD Facility-Based Respite The Arc of North Carolina, Inc. Cumberland, Wake, New

Hanover Medicaid

I/DD Facility-Based Respite The Arc of the Triangle Inc Orange Medicaid

I/DD Facility-Based Respite TLC Operations, Inc. dba Tammy Lynn Center for

Developmental Disabilities Wake Medicaid

I/DD Facility-Based Respite Touchstone Residential Services Wake Medicaid

I/DD Facility-Based Respite Triangle Comprehensive Health Services, Inc. Franklin, Wayne Medicaid

I/DD Facility-Based Respite Turning Point Services Wake, Ashe Medicaid

I/DD Facility-Based Respite United Support Services, Inc. Mecklenburg Medicaid

I/DD Facility-Based Respite Unity Home Care, Inc. Cumberland Medicaid

I/DD Facility-Based Respite Universal Mental Health Services, I Wake, Wilson Medicaid

I/DD Facility-Based Respite Victor & Associates, Inc. Lee Medicaid

I/DD Facility-Based Respite WAKE ENTERPRISES INC Wake Medicaid

I/DD Facility-Based Respite Yelverton's Enrichment Services, Inc. Wake Medicaid

I/DD Facility-Based Respite YOUR CHOICE SERVICES INC Wake Medicaid

I/DD Group Homes and AFLs A TOUCH OF GRACE INC Cumberland, Robeson Medicaid

I/DD Group Homes and AFLs A TOUCH OF GRACE INC Cumberland, Robeson Medicaid

I/DD Group Homes and AFLs Above & Beyond Care, LLC Cumberland Medicaid

I/DD Group Homes and AFLs ACI SUPPORT SPECIALISTS INC Cumberland, Wake, Hoke,

Robeson, Sampson Medicaid

I/DD Group Homes and AFLs ACI SUPPORT SPECIALISTS INC Wake State

I/DD Group Homes and AFLs ADG Associates LLC Cumberland Medicaid

I/DD Group Homes and AFLs Advance Behavioral Health Services, Inc Lenoir Medicaid

I/DD Group Homes and AFLs Advanced Health Resources, Inc. Wake Medicaid

I/DD Group Homes and AFLs Advanced Health Resources, Inc. Wake State

I/DD Group Homes and AFLs Advantage Care In Home Services, Inc. Durham, Granville, Vance Medicaid



I/DD Group Homes and AFLs Alberta Professional Services, Inc. Guilford Medicaid

I/DD Group Homes and AFLs Alpha Home Care Services, Inc. Wake State

I/DD Group Homes and AFLs Alpha Management Services, Inc. Durham, Johnston, Wake,

Franklin Medicaid

I/DD Group Homes and AFLs Ambleside, Inc. Davidson, Greene, Lenoir Medicaid

I/DD Group Homes and AFLs Autism Services, Inc. Durham, Wake Medicaid

I/DD Group Homes and AFLs Autism Services, Inc. Durham, Wake State

I/DD Group Homes and AFLs Autism Society of North Carolina, Inc. Cumberland, Wake Medicaid

I/DD Group Homes and AFLs BETTER LIVING CONCEPTS OF DURHAM LL Durham Medicaid

I/DD Group Homes and AFLs Break Out, LLC Durham Medicaid

I/DD Group Homes and AFLs Bridging the Gap Residental Services LLC Durham Medicaid

I/DD Group Homes and AFLs CANAAN CARE HOME LLC Wake Medicaid

I/DD Group Homes and AFLs Caring Hands and Supplementary Enrichment Education

LLC Durham, Wake, Alamance,

Granville, Person Medicaid

I/DD Group Homes and AFLs Carolina Residential Services, Inc. Onslow Medicaid

I/DD Group Homes and AFLs Community Alternative Housing, Inc. Cumberland, Moore Medicaid

I/DD Group Homes and AFLs COMPREHENSIVE COMMUNITY CARE INC Durham Medicaid

I/DD Group Homes and AFLs COMPREHENSIVE COMMUNITY CARE INC Durham State

I/DD Group Homes and AFLs Crandell's Enterprises Inc. Wake State

I/DD Group Homes and AFLs Cumberland Residential & Employment Services &

Training Inc Cumberland State

I/DD Group Homes and AFLs Cyrus Home, LLC Wake Medicaid

I/DD Group Homes and AFLs DEVEREUX RESIDENTIAL SERVICES LLC Durham Medicaid

I/DD Group Homes and AFLs Durham County Community Living Programs Inc Durham Medicaid

I/DD Group Homes and AFLs Durham County Community Living Programs Inc Durham State

I/DD Group Homes and AFLs E D Emmanuel Homes, LLC Wake Medicaid

I/DD Group Homes and AFLs Eagle Healthcare Services, Inc Wake Medicaid



I/DD Group Homes and AFLs Easter Seals UCP North Carolina & Virginia, Inc. Cumberland, Durham, Wake,

Franklin, Greene Medicaid

I/DD Group Homes and AFLs Easter Seals UCP North Carolina & Virginia, Inc. Wake, Ashe State

I/DD Group Homes and AFLs Educare Community Living Corporation - NC dba

Community Alternatives North Carolina Cumberland, Johnston, Wake,

Duplin Medicaid




Community Alternatives North Carolina Wake State

I/DD Group Homes and AFLs Edwards Community Support Services Inc Greene, Wilson State

I/DD Group Homes and AFLs Elite Care Service Inc Cumberland State

I/DD Group Homes and AFLs Enhancement Health Care Durham, Person Medicaid

I/DD Group Homes and AFLs Fayetteville Street Community Living Home Durham Medicaid

I/DD Group Homes and AFLs Fresh Start Residential Facility, Inc Cumberland, Hoke Medicaid

I/DD Group Homes and AFLs GHA Autism Supports Stanly Medicaid

I/DD Group Homes and AFLs Guardian Angel Healthcare, LLC Vance Medicaid

I/DD Group Homes and AFLs HERBERT REID HOME, INC. Wake Medicaid

I/DD Group Homes and AFLs Herbert Way of Living, LLC Durham Medicaid

I/DD Group Homes and AFLs HomeCare Management corporation Columbus, Edgecombe, New

Hanover Medicaid

I/DD Group Homes and AFLs House of Care, Inc. Durham, Wake, Franklin Medicaid

I/DD Group Homes and AFLs Inez's House Durham Medicaid

I/DD Group Homes and AFLs JMJ Enterprises, LLC Guilford Medicaid

I/DD Group Homes and AFLs JMJ Enterprises, LLC Guilford State

I/DD Group Homes and AFLs Johnson's House of Hope Family Care Home, LLC Durham, Wake Medicaid

I/DD Group Homes and AFLs Jones Health Services, Inc. Durham Medicaid

I/DD Group Homes and AFLs Kaleo Supports Inc Cumberland Medicaid

I/DD Group Homes and AFLs KidsPeace National Centers of North America, Inc. Durham Medicaid

I/DD Group Homes and AFLs Lift Day Activity Center LLC Wake Medicaid



I/DD Group Homes and AFLs Lindley Habilitation Services, LLC Wake Medicaid

I/DD Group Homes and AFLs Lutheran Family Services in the Carolinas Wake, Davidson, Forsyth Medicaid

I/DD Group Homes and AFLs Lutheran Family Services in the Carolinas Wake State

I/DD Group Homes and AFLs MAKIN' CHOICES INC. Cumberland, Durham Medicaid

I/DD Group Homes and AFLs MHS Unlimited, Corporation Durham Medicaid

I/DD Group Homes and AFLs MONARCH Johnston, Wake, Randolph,

Montgomery, Stanly Medicaid

I/DD Group Homes and AFLs MONARCH Johnston State

I/DD Group Homes and AFLs Moores House Durham Medicaid

I/DD Group Homes and AFLs More Than Conquerors Youth Center, Inc. Granville Medicaid

I/DD Group Homes and AFLs Multicultural Resources Center, Inc. Hoke State

I/DD Group Homes and AFLs MULTI-THERAPEUTIC SERVICES, INC. Davidson, Randolph Medicaid

I/DD Group Homes and AFLs Murchison Residential Corporation Wake Medicaid

I/DD Group Homes and AFLs NEW BEGINNINGS OF NORTH CAROLINA Cumberland, Wake Medicaid

I/DD Group Homes and AFLs New Destinations, Inc. Durham State

I/DD Group Homes and AFLs New Hope Management Service Wake Medicaid

I/DD Group Homes and AFLs Omni Visions, Inc. Wake Medicaid

I/DD Group Homes and AFLs Onas's Place, Inc. Buncombe, Rutherford Medicaid

I/DD Group Homes and AFLs Parker Investments, LTD. Cumberland Medicaid

I/DD Group Homes and AFLs Pathways for People, Inc. Durham, Wake Medicaid

I/DD Group Homes and AFLs Patterson Home Care, Inc. Cumberland Medicaid

I/DD Group Homes and AFLs Person County Group Homes Inc Caswell, Person Medicaid

I/DD Group Homes and AFLs Philip House Therapeutic Services, Inc. Wake Medicaid

I/DD Group Homes and AFLs PHP of NC, Inc. Durham, Person Medicaid

I/DD Group Homes and AFLs Professional Family Care Services, Inc Cumberland, Harnett, Lee Medicaid

I/DD Group Homes and AFLs Q- CLINICAL CONSULTANTS LLC Durham, Wake, Chatham,

Harnett Medicaid

I/DD Group Homes and AFLs QC, Inc. Wake Medicaid



I/DD Group Homes and AFLs Quest Provider Services, LLC Wake, Franklin Medicaid

I/DD Group Homes and AFLs Rainbow of Sunshine, Inc. Cumberland Medicaid

I/DD Group Homes and AFLs ReNu Life Extended Wayne State

I/DD Group Homes and AFLs ReNu Life, LLC Wayne Medicaid

I/DD Group Homes and AFLs Residential Services, Inc Durham, Orange Medicaid

I/DD Group Homes and AFLs Residential Support Services Wake State

I/DD Group Homes and AFLs Resources for Human Development Wake Medicaid

I/DD Group Homes and AFLs Resources for Human Development Durham, Wake State

I/DD Group Homes and AFLs RHA Health Services NC, LLC Cumberland, Wake, Bladen, Granville, Harnett, Robeson,

Rowan, Sampson Medicaid

I/DD Group Homes and AFLs RHA Health Services NC, LLC Wake, Granville, Harnett,

Robeson State

I/DD Group Homes and AFLs RHA Health Services, Inc. Cumberland, Durham, Wake,

Bladen, Granville, Harnett, Robeson, Rowan

Medicaid

I/DD Group Homes and AFLs RHA Health Services, Inc. Durham, Wake, Bladen,

Granville, Harnett, Robeson, Rowan

Medicaid

I/DD Group Homes and AFLs RHA Health Services, Inc. Wake, Granville, Harnett,

Robeson State

I/DD Group Homes and AFLs RUSMED CONSULTANTS LLC Durham, Wake Medicaid

I/DD Group Homes and AFLs Saguaro Group, LLC dba Community Innovations, Inc. Columbus, Harnett Medicaid

I/DD Group Homes and AFLs Securing Resources for Consumers, Inc. Durham Medicaid

I/DD Group Homes and AFLs Securing Resources for Consumers, Inc. Durham Medicaid

I/DD Group Homes and AFLs Serenity Therapeutic Services, LLC Cumberland, Hoke Medicaid

I/DD Group Homes and AFLs Serenity Therapeutic Services, LLC Cumberland, Hoke State

I/DD Group Homes and AFLs ShineLight, Inc. Cumberland Medicaid

I/DD Group Homes and AFLs Sophia B. Pierce & Associates, Inc. Cumberland Medicaid



I/DD Group Homes and AFLs Specialized Services and Personnel Wake Medicaid

I/DD Group Homes and AFLs Specialized Services and Personnel Wake State

I/DD Group Homes and AFLs Spigner Management Systems dba BJ Hill and

Associates Cumberland Medicaid

I/DD Group Homes and AFLs Spirit of Excellence Community Outreach, Inc. DBA

Guardian Care Onslow State

I/DD Group Homes and AFLs The Arc of the Triangle Inc Wake Medicaid

I/DD Group Homes and AFLs THE LOVING HOME INC Cumberland Medicaid

I/DD Group Homes and AFLs THE LOVING HOME INC Cumberland State

I/DD Group Homes and AFLs TLC Operations, Inc. dba Tammy Lynn Center for


I/DD Group Homes and AFLs Touchstone Residential Services Cumberland, Wake Medicaid

I/DD Group Homes and AFLs Touchstone Residential Services Wake State

I/DD Group Homes and AFLs Turning Point Services Wake Medicaid

I/DD Group Homes and AFLs United Living LLC Guilford Medicaid

I/DD Group Homes and AFLs United Methodist Agency for the Retarded Western NC,

Inc. Forsyth, Guilford Medicaid

I/DD Group Homes and AFLs United Residential Services of North Carolina, Inc. Cumberland Medicaid

I/DD Group Homes and AFLs United Support Services, Inc. Durham, Wake, Franklin,

Granville Medicaid

I/DD Group Homes and AFLs Unity Home Care, Inc. Cumberland Medicaid

I/DD Group Homes and AFLs Universal Mental Health Services, I Durham, Wake, Franklin,

Orange Medicaid

I/DD Group Homes and AFLs Upscale Residential Care, Inc. Sampson Medicaid

I/DD Group Homes and AFLs Victor & Associates, Inc. Harnett Medicaid

I/DD Group Homes and AFLs YOUR CHOICE SERVICES INC Wake Medicaid

I/DD Out-of-Home Respite Community Based Developmental Services Inc Cumberland State

I/DD Out-of-Home Respite Easter Seals UCP North Carolina & Virginia, Inc. Durham Medicaid

I/DD Out-of-Home Respite Easter Seals UCP North Carolina & Virginia, Inc. Cumberland, Wake State

I/DD Out-of-Home Respite Lutheran Family Services in the Carolinas Wake State



I/DD Out-of-Home Respite Murdoch Developmental Center Granville Medicaid

I/DD Out-of-Home Respite RHA Health Services NC, LLC Craven Medicaid

I/DD Out-of-Home Respite RHA Health Services, Inc. Craven Medicaid

I/DD Out-of-Home Respite Saguaro Group, LLC dba Community Innovations, Inc. Cumberland, Wake Medicaid

I/DD Out-of-Home Respite SAVIN GRACE LLC Johnston State

I/DD Out-of-Home Respite Specialized Services and Personnel Wake Medicaid

I/DD Out-of-Home Respite Stan B Treatment Services Inc Johnston State

I/DD Out-of-Home Respite The Alpha Management Community Services,Inc. Durham State

I/DD Out-of-Home Respite TLC Operations, Inc. dba Tammy Lynn Center for

Developmental Disabilities Wake State

I/DD Out-of-Home Respite Touchstone Residential Services Wake State

I/DD Out-of-Home Respite Universal Mental Health Services, I Caldwell State

ICF-IDD Autism Services of Mecklenberg County, Inc Mecklenburg Medicaid

ICF-IDD Autism Services, Inc. Durham, Wake Medicaid

ICF-IDD Carobell, Inc. Onslow Medicaid

ICF-IDD Carter Clinic, PA Cumberland Medicaid

ICF-IDD Caswell Developmental Center Lenoir Medicaid

ICF-IDD Center for Comprehensive Services, Inc. dba

NeuroRestorative Florida Out of State Medicaid

ICF-IDD Comserv, Inc. Burke Medicaid

ICF-IDD D & L Health Care Services, Inc. Cumberland Medicaid

ICF-IDD Educare Community Living Corporation - NC dba


ICF-IDD GHA Autism Supports Stanly Medicaid

ICF-IDD Greater Image Healthcare, Corp. Moore Medicaid

ICF-IDD Horizons Residential Care Center Forsyth Medicaid

ICF-IDD Howell Support Services Lenoir Medicaid

ICF-IDD Irene Wortham Residential Center, Inc. Buncombe Medicaid

ICF-IDD J. Iverson Riddle Developmental Center Burke Medicaid



ICF-IDD KEYWEST CENTER INC Durham Medicaid

ICF-IDD Life, Inc. Brunswick, Halifax, Wayne,

Wilson Medicaid

ICF-IDD Lutheran Family Services in the Carolinas Forsyth Medicaid

ICF-IDD MID STATE HEALTH SYSTEMS INC Cumberland Medicaid

ICF-IDD MONARCH Craven, Forsyth, Richmond,

Montgomery, Stanly Medicaid

ICF-IDD Murdoch Developmental Center Granville Medicaid

ICF-IDD NOVA-IC, INC. Lenoir, Wayne Medicaid

ICF-IDD O'Berry Neuromedical Treatment Center Wayne Medicaid

ICF-IDD Person County Group Homes Inc Person Medicaid

ICF-IDD Residential Services, Inc Orange Medicaid

ICF-IDD RHA Health Services NC, LLC

Cumberland, Durham, Wake, Bumcombe, Granville, Harnett,

Iredell, Lenoir, Lincoln, Robeson, Rowan, Guilford, Hoke, Mecklenburg, Moore, Pitt, Transylvania, Watauga

Medicaid

ICF-IDD Saguaro Group, LLC dba Community Innovations, Inc. Wake, Columbus, Guilford,

Hertford, Lee, Randolph Medicaid

ICF-IDD Skill Creations, Inc. Durham, Halifax, Pitt,

Edgecombe, Nash, Sampson, Wayne

Medicaid

ICF-IDD Sophia B. Pierce & Associates, Inc. Cumberland Medicaid

ICF-IDD T.L.C. HOME, INC. Lee Medicaid

ICF-IDD TLC Operations, Inc. dba Tammy Lynn Center for


ICF-IDD UNC TEACCH Chatham Medicaid



ICF-IDD VOCA Corporation of North Carolina Durham, Johnston, Wake, Lee,

Wilkes Medicaid

ICF-IDD Wake County Specialized Residential Home for Children,

Inc. dba Hilltop Home Wake Medicaid

MH Group Homes New Destinations, Inc. Cumberland State

PRTF Alexander Youth Network Mecklenburg Medicaid

PRTF Brynn Marr Hospital, Inc. Onslow Medicaid

PRTF Chestnut Hill Mental Health Center dba Springbrook

Behavioral Health Out of State Medicaid

PRTF Cornerstone Treatment Facility Program, Inc. Cumberland, Moore, Robeson Medicaid

PRTF Cornerstone Treatment Facility, Inc. Anson, Hoke Medicaid

PRTF Eliada Homes Inc. Buncombe Medicaid

PRTF Grandfather Home for Children, Inc Avery Medicaid

PRTF NEW HOPE CAROLINAS, INC. Out of State Medicaid

PRTF Nova, Inc. Lenoir, Wayne Medicaid

PRTF SBH-Charlotte, LLC dba Strategic Behavioral Center Mecklenburg Medicaid

PRTF SBH-Raleigh, LLC dba Strategic Behavioral Center -

Garner Wake Medicaid

PRTF SBH-Wilmington, LLC dba Strategic Behavioral Center Brunswick Medicaid

PRTF Thompson Child & Family Focus Mecklenburg Medicaid

PRTF VENICE PSYCHIATRIC RESIDENTIAL TREA Out of State Medicaid

PRTF Village Behavioral Health, LLC Out of State Medicaid

PRTF Whitaker PRTF Granville Medicaid

PRTF Yahweh Center Inc New Hanover Medicaid

PRTF Youth Focus, Inc. Guilford Medicaid

Residential Treatment Levels I-IV

Access Family Services, Inc. Wake, Buncombe,

Mecklenburg Medicaid


ACI SUPPORT SPECIALISTS INC Wake Medicaid




Alamance Academy, LLC Alamance Medicaid


Alberta Professional Services, Inc. Caswell Medicaid


Alexander Youth Network Mecklenburg, Moore Medicaid


All God's Children of Burlington, LLC Alamance Medicaid


Children Under Construction Treatment Center, Barnes Inc.

Johnston Medicaid


COASTAL BEHAVIOR HEALTH SERVICES, INC. Cumberland Medicaid


Community Support Service, LLC Guilford Medicaid


Easter Seals UCP North Carolina & Virginia, Inc. Wake Medicaid


Echelon Consulting, Inc dba Echelon Care Mecklenburg Medicaid


Educare Community Living Corporation - NC dba Community Alternatives North Carolina

Wake Medicaid


Eliada Homes Inc. Buncombe Medicaid


FACT Specialized Services, LLC dba Methodist Home for Children, Inc

Wake, Onslow Medicaid


Falcon Crest Residential Care, Inc. Alamance Medicaid


Family Services of America Corp (ICAN) Cumberland Medicaid


FIRM FOUNDATION, INC. Cumberland Medicaid


Grandfather Home for Children, Inc Avery Medicaid


Heartfelt Alternatives Inc Wake Medicaid




Improving Life, Inc. Cumberland Medicaid


Inspirationz, LLC Forsyth Medicaid


Keep Hope Alive, LLC Pitt Medicaid


KidsPeace National Centers of North America, Inc. Wake Medicaid


KMG Holdings, INC Johnston, Wake Medicaid


Life Changez, Inc Wake Medicaid


Life Opportunities Therapeutic Home Robeson Medicaid


Life Opportunities, Inc. Robeson Medicaid


Lutheran Family Services in the Carolinas Mecklenburg Medicaid


New Possibilities Home for Children, LLC Alamance Medicaid


Omni Visions, Inc. Cumberland, Wake, Alamance,

Wayne Medicaid


Pearl's Angel Care Inc. Cumberland Medicaid


Pinnacle Family Services of North Carolina, LLC Cumberland, Wake Medicaid


PRECIOUS HAVEN INC. Cumberland, Hoke Medicaid


Quality Care Solutions, Inc. Durham, Wake Medicaid


S & T WeCare, Incorporated Cumberland Medicaid


S. Martin, LLC dba Inner Wealth Residential Durham Medicaid




SAVIN GRACE LLC Johnston Medicaid


SIERRAS RESIDENTIAL SERVICES INC Cumberland, Harnett Medicaid


Stan B Treatment Services Inc Johnston Medicaid


STEPHENS OUTREACH CENTER INC Columbus, Robeson Medicaid


Successful Transitions, LLC Guilford Medicaid


Sunlight Behavior Center, Inc. Cumberland Medicaid


Sunrise Pointe, LLC Alamance Medicaid


The Alpha Management Community Services,Inc. Durham Medicaid


The Bair Foundation Buncombe Medicaid


THE BRUSON GROUP, INC. Wake Medicaid


The Children's Home Forsyth Medicaid


The Methodist Home for Children Wake Medicaid


Thompson Child & Family Focus Union Medicaid


Timber Ridge Treatment Facility Rowan Medicaid


Touchstone Residential Services Wake Medicaid


United Family Network Wake, Harnett Medicaid


Unity Home Care, Inc. Cumberland Medicaid




VOCA Corporation of North Carolina Pitt Medicaid


WesCare Professional Services, LLC Guilford, Rockingham Medicaid


Yelverton's Enrichment Services, Inc. Wake Medicaid


Youth Builders, LLC Alamance Medicaid


YOUTH ENRICHMENT GROUP HOME, INC. Caswell, Guilford Medicaid


Youth Focus, Inc. Guilford Medicaid

SA Halfway House Freedom House Recovery Center, Inc. Durham State

SA Halfway House Recovery Connections Durham State

SA Medically Monitored Community Residential

Treatment UNC Wake Medicaid

SA Medically Monitored Community Residential

Treatment UNC Wake State

SA Non-Medical Community Residential Treatment

Community Choices dba CASCADES Durham State

SA Non-Medical Community Residential Treatment

Southlight Wake State


Appendix C: Stakeholder Survey Questions

Alliance Staff Group Feedback Form Alliance Behavioral Healthcare is conducting its annual assessment of service needs and gaps and is requesting feedback from the community about service needs, gaps and priorities. In addition to electronic surveys that will be administered in January 2016, we are encouraging collective responses from staff groups that would like to provide input. The questions below are recommended as a framework for a collective group response, although groups are welcome to submit feedback in other formats. Please send responses to Carlyle Johnson at [email protected] by Feb. 1, 2016.

Group Name: Submitted by (name and e-mail contact information): Group Feedback:

1. Describe the population(s) with which the group is most familiar.

2. For each population, what are the most significant service needs and gaps in your

community?

3. What are the most significant barriers to accessibility of these services?

4. Identify any groups or populations that you believe are underserved, have special needs or

have difficulty obtaining needed care.

5. Has your group prepared any written reports, surveys, or other documents in the past year

that discuss community needs and service gaps? Are you aware of any other

documentation of community needs that has been prepared by other organizations? If so,

please provide additional information about how to access these reports and/or send

copies by e-mail to [email protected].

6. Do you have any other feedback that may help Alliance understand community needs,

service gaps and priorities for network development?

7. What actions or strategies would you recommend as Alliance priorities for the upcoming

year to help address these needs and gaps?

mailto:[email protected]



Alliance Stakeholder Feedback Form Alliance Behavioral Healthcare is conducting its annual assessment of service needs and gaps and is requesting feedback from the community about service needs, gaps and priorities. In addition to electronic surveys that will be administered in January 2016, we are encouraging collective responses from local community organizations, committees, collaboratives and other stakeholder groups that would like to provide input. The questions below are recommended as a framework for a collective group response, although groups are welcome to submit feedback in other formats. Please send responses to Carlyle Johnson at [email protected] by Feb. 1, 2016. Group Name: Group Scope (e.g., counties covered, organizations represented, and general missions and goals): Submitted by (name and e-mail contact information): Group Feedback:

1. Describe the population(s) with which the group is most familiar.

2. For each population, what are the most significant service needs and gaps in your

community?

3. What are the most significant barriers to accessibility of these services?

4. Identify any groups or populations that you believe are underserved, have special needs or

have difficulty obtaining needed care.

5. Has your group prepared any written reports, surveys, or other documents in the past year

that discuss community needs and service gaps? Are you aware of any other

documentation of community needs that has been prepared by other organizations? If so,

please provide additional information about how to access these reports and/or send

copies by e-mail to [email protected].

6. Do you have any other feedback that may help Alliance understand community needs,

service gaps and priorities for network development?

What actions or strategies would you recommend as Alliance priorities for the upcoming year to help address these needs and gaps?




Appendix D: Community Feedback The process for soliciting community feedback included multiple approaches, including input provided through an on-line survey, stakeholder

meetings and collective feedback from consumer, provider, stakeholder and staff groups. Additional details about the survey methodology are

contained in Appendix C. The tables below provide summaries of survey data, focus group and stakeholder feedback data.

Survey Responses

The survey was conducted during the month of January 2016 and yielded a total of 573 responses, including 49 hard copy submissions. The

following provides a breakdown of submissions by respondent group:

Consumer and Family ................. 126

Provider ....................................... 242

Stakeholder ................................... 72

Staff ............................................. 133

TOTAL......................................... 573

Analysis of responses by county indicates that, although all counties are represented in each respondent group, Johnston representation is

relatively low for consumers/families and stakeholders while Cumberland has relatively strong representation from both groups. Note that provider

counts are duplicated because many providers are present in multiple counties.

County Consumers and Families Providers Stakeholders

Cumberland 54 64 27

Durham 13 74 17

Johnston 7 69 7

Wake 42 150 25


Feedback from Consumer, Stakeholder, Provider and Staff Groups As noted in Appendix C, collective input was solicited from multiple community groups and collaboratives in addition to individual input provided

through the on-line survey. The following groups submitted feedback regarding community needs, gaps and priorities (abbreviations are for

reference in reviewing subsequent tables):

Consumer and Family Advisory Committee (CFAC)

Alliance Provider Advisory Committee (APAC), including local PAC meetings in each county

Durham and Wake Juvenile Justice SA/MH Partnerships (Durham JJSAMHP, Wake JJSAMHP )

Cumberland, Durham and Wake Crisis Collaboratives (Crisis Collabs)

Wake County Community Collaborative for Children & Families (WCCC&F)

Alliance Hospital Partners Collaborative (Hospital Partners)

Alliance MH/SA Care Coordinators (MHSA CC)

Alliance IDD Care Coordinators (IDD CC)

Alliance Utilization Management Staff (UM Staff)

Alliance Provider Network Evaluators (PN Evaluators)

Alliance Compliance Staff (Compliance)

Alliance Call Center Staff (Call Center)

Autism Society The following tables provide summaries of community feedback:

1. D-1: Summary of Community Priorities

2. D-2: Summary of populations identified as underserved


Table D-1: Summary of Community Priorities

ID

D S

urv

ey

CM

H/S

A S

urv

ey

AM

H S

urv

ey

TB

I S

urv

ey

CF

AC

AP

AC

MH

SA

CC

ID

D C

C

Ca

ll C

ente

r

UM

Sta

ff

Co

mp

liance

Du

rha

m J

JS

AM

HP

Wa

ke J

JS

AM

HP

WC

CC

&F

Ho

spita

l P

art

ners

Crisis

Co

llabo

rative

s

PN

Eva

luato

rs

Au

tism

So

cie

ty

Transportation

Services for uninsured / State benefit plan limitations

Crisis Continuum

Education and Awareness

Enhanced Benefit Development

Evaluation & Consultation

Services for co-occurring IDD/MI

Psychiatry/medication

Quality of Care Concerns

Substance Use Disorder Continuum

Residential Treatment

Housing

Service accessibility

Bilingual/bicultural services (Spanish)

Services for Transition-Age Youth


Table D-2: Summary of Populations Identified As Underserved

ID

D S

urv

ey

CM

H/S

A S

urv

ey

AM

H S

urv

ey

TB

I S

urv

ey

CF

AC

AP

AC

MH

SA

CC

ID

D C

C

Ca

ll C

ente

r

UM

Sta

ff

Co

mp

liance

Du

rha

m J

JS

AM

HP

Wa

ke J

JS

AM

HP

WC

CC

&F

Ho

spita

l P

art

ners

Crisis

Co

llabo

rative

s

PN

Eva

luato

rs

Au

tism

So

cie

ty

Bilingual/bicultural services (Spanish)

Transition-Age Youth

Co-occurring IDD/MI

Autism Spectrum

Youth engaged in sexual harm

Deaf and hard of hearing

Traumatic Brain Injuries

Substance Use Disorders

LGBTQ

Forensic/judicial involvement

Others Listed

1. Individuals with complex presenting problems, co-occurring medical and psychiatric conditions

2. individuals needing specialized treatment

3. Elderly, including those with co-occurring dementia needing residential placement

4. Youth offenders / DJJ involvement

5. Youth with complex medical problems

6. Aging IDD population

7. Co-occurring mental illness & substance use disorder

8. Homeless and those needing housing or residential treatment


Appendix E: FY16 DMH Waiver Request As requested in Section Two (see above, page 22), the Alliance waiver request to the Division of

MH/IDD/SA is provided below.


To: Dennis Farley

From: Beth Melcher, Ph.D; Chief Network Development and Evaluation

Date: 3/27/15

Re: Request for Waiver of Access and Choice Standards

Based on the recently completed Community Needs and Gaps Analysis, Alliance would like to request

a waiver of the geographic access requirement (30 miles/30 minutes) for the following:

Child and Adolescent inpatient psychiatric

treatment in Cumberland Co.

Service expansion constrained by limited

statewide availability of this service as well as

the CON process required for new inpatient

psychiatric beds. Alliance has contracts with

hospitals for this service but outside of the

standard, approximately an hour drive.

Child and Adolescent Day Treatment for

Cumberland, Durham, and Johnston

Counties

Most consumers utilizing this service have

Medicaid, and utilization by State-funded

consumers has been low in Wake. Limited

service volume and availability of funding. If

an individual need were identified Alliance

would develop a person specific contract with

a Medicaid provider. If a service capacity

need were identified Alliance could offer a

State contract to an existing Medicaid

provider.

Non-Hospital Detoxification for Johnston

County

Southeastern portion of Johnston County is

beyond geographic access standard. This is

a very rural, low population area. Service

expansion is constrained by limited service

volume and availability of funding. Individuals

may access services in both Wake and

Cumberland Counties

Facility Based Crisis for Johnston County

Southeastern portion of Johnston County is

beyond geographic access standard. This is

a very rural, low population area. Service

expansion is constrained by limited service

volume to support sustainability. Health

Department offers crisis beds in the local

emergency department to respond to crisis

needs. Facility based crisis services may be

accessed in Wake and Cumberland counties


TBI non-residential for Cumberland and

Johnston

Access standard is not met in these two

counties but since this is a community-based

service access is available in all Alliance

counties.

Alliance would like to request a waiver of the provider choice requirement for the following:

Child Adolescent Day Treatment for

Cumberland, Durham, and Johnston

Counties

Choice of provider is constrained by limited

service demand and funding availability. If an

individual need were identified Alliance would

develop a person specific contract with a

Medicaid provider. If a service capacity need

were identified Alliance could offer a State

contract to an existing Medicaid provider.

Opioid Treatment for Durham, Wake,

Cumberland and Johnston

Alliance is committed to developing access to

this service in all counties. Choice of provider

is constrained by limited service demand and

funding availability. Access will be available

in other counties.

PSR for Cumberland and Durham


funding availability. If an individual need were

identified Alliance would develop a person

specific contract with a Medicaid provider. If a

service capacity need were identified Alliance

could offer a State contract to an existing

Medicaid provider.

SACOT for Durham


service demand and funding availability. If an

individual need were identified Alliance would

develop a person specific contract with a

Medicaid provider. If a service capacity need

were identified Alliance could offer a state

contract to an existing Medicaid provider.

Thank you for your consideration of this request. Feel free to contact me if you have additional

questions.

cc: Shealy Thompson

Carol Potter

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