A Message from NCTracks on Behalf of NC Medicaid State-funded Services White Paper Released

The Department of Health and Human Services is pleased to share for public comment, “North Carolina’s Design for State-funded Services Under Behavioral Health and Intellectual/Developmental Disability Tailored Plans.”

While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department continues to work on the design of Tailored Plans to serve individuals with behavioral health and intellectual disabilities in lieu of Standard Plans. In addition to managing Medicaid services, Behavioral Health I/DD Tailored Plans also will be responsible for managing State-funded behavioral health, intellectual/developmental disability (I/DD), and  traumatic brain injury (TBI) services as the Local Management Entities-Managed Care Organizations (LME-MCOs) do today for the uninsured, underinsured and Medicaid beneficiaries.

Through Medicaid Transformation, the Department seeks to not only ensure that North Carolinians can continue to access vital State-funded behavioral health, I/DD, and TBI services, but also to improve the delivery of State-funded Services. This policy paper details the Department’s vision for the delivery of State-funded behavioral health, I/DD, and TBI services, as well as the continuation of critical “local health functions” (functions focused on health prevention and promotion) under Behavioral Health I/DD Tailored Plans and covers the following areas:

  • Provision of State-funded Services under Behavioral Health I/DD Tailored Plans, including eligibility, available services, care management, provider networks, and handling of complaints and appeals;
  • Continuing the Transitions to Community Living Initiative (TCLI) principles through Behavioral Health I/DD Tailored Plans and extending the functions of in-reach, transition, and diversion to additional populations;
  • Engagement and coordination of local health functions in the context of Medicaid Transformation; and
  • Accountability for State-funded Services, TCLI functions, and local health functions.

Please share your comments on the policy paper with the Department at Medicaid.Transformation@dhhs.nc.gov by Jan. 29, 2020.

The Department will host a webinar for stakeholders in January 2020 that will walk through aspects of State-funded Services design included in the policy paper and address stakeholder questions. Further details on the webinar will be forthcoming.

As a reminder, North Carolina’s move to Medicaid Managed Care has been suspended. Individuals will continue access Medicaid and State-funded behavioral health, I/DD and TBI services through the LME-MCOs as they do today.