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About DHHS Open Window
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Open Window captures important information on all DHHS services, programs and the contracts that support those services. Open Window also contains key planning and performance information for DHHS as well as for our divisions and offices.
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Through Open Window, you will see what services, programs and contracts are provided, how they are funded; and whether our performance is producing results for our customers.
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Aligning Performance — Departmental Goals
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The following represents DHHS’ plan to position our department to address the future, accomplish our mission while realizing our vision. DHHS has established five draft strategic performance goals and aligned our services with the goal that each service directly supports.
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By aligning DHHS services to performance goals we will be able to:
- Set Priorities
- Effectively Measure Progress
- Be Accountable
- Improve Customer Satisfaction
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Service Name
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Adult Care Home & Family Care Home Administrators
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Licensing adult care and family care home providers is one of the services provided as part of the regulatory responsibilities of Health Service Regulation. Staff activities include:
Issuing and renewing facility licenses and star rating certificates.
Inspecting facilities annually and investigating complaints.Provide technical assistance with regulations.Issuing penalties or suspending or revoking licenses in cases of serious noncompliance.
This service protects residents of family care and adult care homes.
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Adult Care Homes
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Licensing adult and family care homes providers is one of the services provided as part of the regulatory process for Health Service Regulation. Staff activities include:
Issuing and renewing licenses and star rating certificates.
Inspecting facilities annually and investigating complaints.
Providing technical assistance with regulations.
Issuing penalties or suspending or revoking licenses in cases of serious noncompliance.
This service maintains the health and safety of residents in adult and family care homes
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Ambulatory Surgery Centers
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Overseeing ambulatory (outpatient) surgery centers is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints to monitor providers' compliance with state and federal regulations.
Conducting on-site Medicare certification surveys to qualify providers to participate in federal Medicare program.
This service protects the health and safety of people using ambulatory surgery centers.
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Asbestos and Lead Based Paint Hazard Management
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This service ensures that materials containing asbestos or lead-based paint are handled properly during construction activities. This is done through:
-Certifying and accrediting firms and individuals performing abatement (removal) of asbestos or lead paint
-Certifying firms and individuals who perform renovation activities that disturb lead paint in homes and child occupied facilities
-Inspecting abatement and renovation projects
-Issuing permits for abatement projects
-Ensuring that training courses meet proper standards
-Informing the public of the hazards of lead paint and asbestos
The service benefits the general population by protecting the public from environmental contaminants.
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Clinical Laboratories
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Overseeing clinical laboratories is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints.
Monitoring testing facilities' compliance with federal regulations.
Conducting on-site Medicare certification surveys to qualify providers to participate in the federal Medicare program.
This service protects the health and safety of the general population.
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Complaint Intake
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Complaint Intake is one of the services provided as part of the regulatory process of Health Service Regulation. Activities include:
Receiving oral and written complaints about health care facilities and agencies.
Receiving written incident reports from mental health facilities and adult care homes about deaths resulting from homicide, suicide or accident or with the use of restraints or seclusion.
Receiving reports of allegations of abuse, neglect, misappropriation of property and fraud from various agencies.
Staff members review all reports, set priorities and enter complaints into a computer database for investigation. They provide information to callers when the matter does not fall under the Division of Health Service Regulation.
The Complaint Intake Unit collaborates with other agencies and may refer some complaints to other agencies for investigation. These include accrediting agencies such as The Joint Commission; advocacy groups such as ombudsmen with the Division of Aging and Adult Services (DAAS); advocates with the Division of Mental Health, Developmental Disability and Substance Abuse Services; and protective services with the Division of Social Services, DAAS and county departments of social services.
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Construction
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Overseeing construction of health care facilities and jails is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Reviewing and inspecting construction projects for compliance with state and federal regulations.
Conducting biennial inspections of existing adult care homes and 24-hour mental health facilities, as mandated by the state.
Certifying that health care facilities receiving Medicare or Medicaid funds comply with building safety codes and federal regulations.
Investigating complaints and fires related to building construction or operation.
Providing technical support to the N.C. Medical Care Commission, which issues tax-exempt revenue bonds for capital improvements to not-for-profit health care facilities.
This service protects the health and safety of the general population.
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DHHS Criminal Records Checks
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North Carolina's Division of Child Development and Early Education (DCDEE) provides criminal record checks for everyone employed in regulated child care programs. In addition, required Department of Health and Human Services (DHHS) criminal records checks are centralized in DCDEE. Background checks are performed for adoptive and foster parents and employees of nursing homes, family and adult care homes, mental health facilities and DHHS agencies.
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End Stage Renal Disease Facilities
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Overseeing end-stage renal disease (kidney dialysis) facilities is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints to monitor providers' compliance with state and federal regulations. Federal law requires a survey every three years.
Conducting on-site Medicare certification surveys to qualify providers to participate in the federal Medicare program.
This service protects the health and safety of people using end-stage renal disease facilities.
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Environmental Health Regulation
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Environmental Health protects the public health through prevention, protection and enforcement activities in food service and lodging, child care centers and institutions, tattooing, and public swimming pools. Additionally, Environmental Health includes on-site water protection, (septic and well permitting and inspection) asbestos and lead-based paint hazard management, childhood lead poisoning prevention (including home investigations and coordinating case management) and preventing acts of agro-terrorism through food defense initiatives. The primary Environmental Health functions performed are: - Provide training to environmental health staff in local health departments - Issue authorizations to local health department staff to perform environmental health programs - Conduct inspections in state facilities - Evaluate and monitor local environmental health programs - Provide training, monitor contractors and inspect projects related to lead and asbestos activities - Collect and distribute restaurant permit fees - Collect and maintain data on environmental health operations and childhood blood lead testing - Provide consultation for local health department staff and general public - Coordinate environmental and clinical follow-up of children with elevated blood lead levels Environmental Health Specialists (Local Health Department Employees) act as agents of the state in administering Environmental Health functions.
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Forensic Tests for Alcohol
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Forensic Tests for Alcohol works to reduce deaths, injuries and public health care costs related to impaired driving on North Carolina roads. Staff members carry out these activities:
- Conduct alcohol and drug training for law enforcement officers to improve their ability to catch DWI drivers
- Provide expert testimony on the effects of alcohol and drugs on humans
- Conduct DWI checkpoints to deter impaired driving
- Work with high schools, colleges, universities and public health communities to educate young drivers about the dangers of drinking and driving
- Buy and maintain the more than 400 breath alcohol test instruments for testing impaired drivers
- Service and repair the 5,000 portable alcohol screening devices used by law enforcement
- Operate six Breath Alcohol Testing Mobile Units used at DWI checkpoints
- Provide administrative support to the Division of Motor Vehicles Driver's License Section, and Driver's Medical Review Board Physicians
This service benefits everyone traveling on North Carolina roads.
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Health Care Personnel Allegations & Investigations
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Investigating allegations of wrongdoing against health care workers is one of the services of the Unlicensed Health Care Personnel Oversight program.
Staff members receive and review reports from health care facilities concerning abuse and neglect of residents, misappropriation of property, fraud and diversion of drugs. They list pending investigations and substantiated findings on North Carolina's Health Care Personnel Registry and Nurse Aide I Registry.
Health care employers use the registry (available on the Web or by telephone) in the hiring process of unlicensed health care workers.
This service protects North Carolina's general population.
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Home Health & Home Care Agencies
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Overseeing home health and home care agencies is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints to monitor providers' compliance with state and federal regulations.
Issuing required licenses to provide health care services.
Conducting on-site Medicare certification surveys to qualify providers to participate in the federal Medicare program.
This service protects the health and safety of people using home health and home care agencies.
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Hospice
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Overseeing hospice (facilities that care for people near the end of life) is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints to monitor providers' compliance with state and federal regulations.
Conducting on-site Medicare certification surveys to qualify providers to participate in the federal Medicare program.
This service protects the safety of people using hospice facilities.
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Hospitals
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Overseeing hospitals is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting initial, follow-up and recertification surveys and investigating complaints to monitor providers' compliance with state and federal regulations.
Issuing required licenses to provide health care services.
Conducting on-site Medicare certification surveys to qualify hospitals to participate in the federal Medicare program.
This service protects the safety of people using hospitals.
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Intermediate Care Facility for Individuals with Intellectual Disability (ICF-IID)
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Overseeing intermediate care facilities for Individuals with intellectual disabilities (ICF-IID) is one of the services provided as part of the regulatory process of Health Service Regulation. (An intermediate care facility provides medically related services to people who do not need the degree of care provided by a hospital or skilled nursing facility.) Staff activities include:
Processing federal documentation when there is a change of ownership, service location or capacity.Investigating complaints to see that the facility complies with federal rules; following up to be sure problems are corrected.Conducting certification and annual recertification inspections.
This service protects the safety of people using intermediate care facilities.
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Jails & Detention
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Overseeing jails is one of the services provided as part of the regulatory process of Health Service Regulation. This includes all county, municipal and regional jails and detention centers. Staff activities include:
Conducting twice-yearly inspections to make sure jails comply with statutes and rules.
Reviewing plans for new jail construction and renovation.
Meeting and consulting with local government officials concerning matters such as exceeding jail capacity. Staff members may attend county commissioner meetings and meet with the sheriff as needed to discuss ways of correcting compliance issues.
Responding to grievances against jails.
Collecting data on jail population statistics and inmate deaths.
This service protects jail inmates and the general population.
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Medication Aide
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Overseeing the qualifications of medication aides is one of the services of the Unlicensed Health Care Personnel Oversight program. Staff activites include:
Administering tests throughout the state to people applying for adult care medication aide positions (at no charge to the applicant).
Updating the Health Care Personnel Registry with the names of those who qualify and those who meet renewal criteria. Health care employers use the registry during the hiring process.
This service protects North Carolina residents using health care services.
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Mental Health/Developmental Disability/Substance Abuse
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Overseeing mental health/developmental disability/substance abuse (MH/DD/SA) facilities is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Processing initial applications and issuing licenses.
Processing applications for change of ownership, location or capacity.
Conducting initial, annual, change and follow-up investigations to check compliance with state rules.
Investigating complaints and identifying deficiencies.
This service protects the safety of people using MH/DD/SA facilities.
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Nurse Aide
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Overseeing the qualifications of nurse aides is one of the services of the Unlicensed Health Care Personnel Oversight program. Staff activities include:
Administering a standardized statewide Nurse Aide I competency evaluation.
Overseeing the Nurse Aide I training programs.
Maintaining the Nurse Aide I Registry of competency and training information as well as any allegations or findings of wrongdoing. Health care employers use the registry before hiring nurse aides.
This service protects North Carolina residents using health care services.
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Nursing Homes
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Licensing nursing homes is one of the services provided as part of the regulatory process of Health Service Regulation. Staff activities include:
Conducting routine and complaint investigations to ensure compliance with state and federal regulations.
Educating providers about new requirements.
Offering nursing homes an informal opportunity to dispute cited deficiencies.
Administering grants and contracts.
Processing changes of ownership and license renewals.
This service protects the safety of nursing home residents.
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Radiation Protection
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Radiation Protection is one of the services provided as part of the regulatory process for Health Service Regulation. Activities performed include:
-Issuing licenses and registrations to facilities containing radioactive materials, x-ray machines and tanning beds
-Issuing penalties for non-compliance with NC health and safety regulations
-Perform routine inspections to determine compliance with health and safety regulations
-Revocation of licenses issued to tanning beds when found to be in non-compliance with health and safety regulations
This service maintains the health and safety of facilities containing radioactive materials, x-ray machines and tanning beds.
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Regulation of Child Care
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The NC Division of Child Development licenses child care centers and family child care homes statewide.
Licensing consultants make unannounced visits to child care facilities to make sure they are complying with requirements for their star rating (level of licensure). Field staff members also make visits for technical assistance at the request of the providers.
This service benefits infants and children in child care.
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Service Name
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Building Capacity for Service Delivery
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This service provides funding and technical assistance which enables local health departments to carry out their essential functions that meet community needs. This includes:
- Accrediting and maintaining accreditation on a four-year cycle. In 2006 the General Assembly passed legislation making accreditation for local health departments mandatory and specifying that the Accreditation Board be established within the Institute. They also support to the site visit process. For FY11 there will be 10 local health departments seeking initial accreditation and 12 seeking re-accreditation.
- Non-categorical funding for the local health departments.
The beneficiaries are 85 NC local health departments and the clients they serve.
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Capacity Building and Professional Development for Aging and Adult Services
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The Division of Aging and Adult Services, Adult Services
Section, provides training throughout the state to each of the county
DSS. The training is intended to help adult services social workers and
supervisors understand and address the needs of older adults, adults with
disabilities and their families. Training topics include:
Adult Protective Services:
Basic Skills Adult Protective Services:
Assessing an Adult’s Capacity to ConsentAdult Protective Services:
Financial Exploitation Guardianship: Basic Skills, A
Systematic ApproachGuardianship: Decision Making,
An Ethical PerspectiveMedicaid Administrative
Claiming for Adults (Classroom and Webinar formats)Service Planning (Webinar
format)Effective Social Work Practice
in Adult Services: A Core CurriculumSevere and Persistent Mental
IllnessState-County Special Assistance
In-Home Case Management
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Certificate of Need
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The North Carolina Certificate of Need (CON) Law requires health care providers to obtain a CON from the Department of Health and Human Services (Department) before developing or offering a “new institutional health service.” The purpose of the CON program is to enhance access to health care and reduce healthcare costs by restricting unnecessary duplication of healthcare facilities and services within the state. Staff activities include: Responding to requests for exemption and no review. Conducting pre-application meetings with potential applicants. Evaluating applications for compliance with policies and need determinations in the SMFP and other criteria and approving or denying the proposal within 150 days.In competitive reviews, comparing proposals to each other to determine which is the most effective alternative. Defending decisions in administrative hearings if they are appealed. Monitoring projects for compliance. This service benefits all North Carolinians.
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Child Care Resource and Referral (CCR&R) Core Services
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Child Care Resource and Referral (CCR and R) Core Services provide a link between child care providers, families who need care and employers and community planners who address child care needs. Basic (core) services provided by CCR and Rs statewide include:
-Helping parents make informed choices about child care.
-Providing professional development for child care workers.
-Supporting child care providers through technical assistance and training.
-Collecting and analyzing information about child care needs and supply.
-Educating and encouraging communities to address child care needs and issues.
Activities are contracted to a three-agency council that works with 18 regional lead agencies. CCR and R services are part of the Child Care Quality and Availability Program, which serves infants and child in child care. In addition, the network of CCR and R agencies address concerns about challenging behaviors of children in care.
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Child Care WAGE$ Project
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The Child Care WAGE$ Project provides annual salary supplements to child care workers who obtain college-level education related to child development and remain in their jobs for a specific length of time. The project is designed to provide preschool children (birth to age 5) more stable relationships and better-educated teachers by rewarding teacher education and continuity of care.
The project is offered statewide as a funding collaboration between local Smart Start partnerships and the Division of Child Development's Child Care Quality and Availability Program.
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Child Care Workforce
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North Carolina's child care licensing system sets education standards for the child care workforce. All child care workers are required to obtain approved in-service training hours annually. Staff members of the Child Care Workforce Standards section of the Division of Child Development make sure these standards are met. The service benefits infants and children in child care.
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Child Welfare Collaborative
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The Collaborative strengthens public child welfare services by increasing the number of well trained and highly committed BSW and MSW social workers employed in local departments of social services.
The Collaborative provides educational, and employment support for selected social work students who will commit to work in a North Carolina county department of social services. This is provided through cooperation between the Division of Social Services, the North Carolina Association of County Directors of Social Services, and the North Carolina University System.
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Child Welfare Training
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North Carolina’s child welfare training system is delivered to county child welfare staff that addresses the knowledge and skills needed to complete their daily tasks in the areas of child protective services, permanency planning, on-going child welfare services, foster home licensing, and adoption. Training is delivered in-person in classroom settings and virtually through self-paced modules, live and recorded webinars. Each level of training serves as a foundation for the next series of trainings. The Division of Social Services contracts to provide four regional training centers throughout the state through which some of the classroom trainings are delivered. Other classroom trainings take place throughout the state at various community-based locations enabling county child welfare staff to access learning close to the community in which they serve. Training is delivered by dedicated staff with the Division of Social Services and by contracts with both university based trainers.
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Community Health Grants
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Community Health Grant funds by statute, support safety-net organizations such as federally qualified health centers, health centers that meet the criteria for federally qualified health centers, state-designated rural health centers, free clinics, public health departments, and school-based health centers that provide care to underserved populations throughout the state. The purpose of the funds is fourfold:
-To increase access to preventive and primary care services for medically vulnerable patients in existing or new health center locations;
-To establish primary care safety net services in counties where no such services exist;
-To create new services or augment existing primary care and preventive medical services provided;
-To increase capacity necessary to serve low income patients by enhancing or replacing facilities, equipment, or technologies.
Continued support and recurring funding for the Community Health Grant program has strengthened North Carolina's health care safety net infrastructure to ensure that all of the state's low income and vulnerable residents (Uninsured, Underinsured, Medicare and Medicaid) have access to affordable and appropriate quality medical care.
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Critical Access Hospital Network Development
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Critical Access Hospital (CAH) network development provides federal funding to small rural hospitals and requires hospitals to collaborate to make the best use of limited health care dollars. Hospitals in the network agree to reduce the number of acute beds (for patients who need a high level of care) to 25 or fewer while ensuring emergency services are available.
The Rural Hospital Flexibility Grant Program (Flex Grant Program) focuses on small and rural hospitals, including CAHs, to improve their viability, quality, and integration with the rest of the health care system. Specifically, the Flex Grant Program is focused on: (1) improving quality of care in CAHs and other rural care providers, (2) improving the financial and operational performance of CAHs, and (3) encouraging health system development through the engagement of the rural community with CAHs and other care providers, and (4) integrating rural Emergency Medical Services (EMS) into the health care system while ensuring the quality of services provided.
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Disability Determination Services Medical Eligibility Decisions-SSDI/SSI (Title II and Title XVI)
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Medical Eligibility Decisions-SSDI/SSI (Title II and Title XVI) is part of North Carolina’s Disability Determination Services (DDS). It makes decisions on disability claims for the Social Security Administration. The goal of the service is to make medical eligibility decisions as efficiently, quickly and accurately as possible.
This service benefits individuals applying for disability payments through Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI).
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Disability Determination Services Medical Eligibility Decisions-Title XIX (Medicaid)
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Medical Eligibility Decisions-Title XIX (Medicaid) is part of North Carolina’s Disability Determination Services (DDS). It makes decisions on disability claims for Medicaid. The goal of the service is to make decisions on Medicaid applications as efficiently, quickly and accurately as possible.
This service benefits individuals applying for disability payments through Medicaid.
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Emergency Shelter Grants Operations Support
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The purpose of the Emergency Shelter Grants services is to help improve the quality of emergency shelters and transitional housing for the homeless; to make available additional shelters; to provide essential social services to homeless individuals, and to provide homelessness prevention activities.
Local community homeless shelters apply for the federal assistance to support costs such as rents and utilities.
The shelters receiving grants must make monthly, midyear and annual reports on their services.
The services benefit homeless individuals and families.
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Hospital Preparedness
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Hospital Preparedness is one of the services provided under North Carolina's Emergency Medical and Disaster Preparedness Program.
This service focuses on helping the State Medical Response System prepare for disasters or other events requiring extraordinary efforts. Efforts include:
Conducting disaster-related training through conferences and contracts with hospitals.
Creating an online registry, SERVNC, for volunteers willing to respond in a disaster or emergency.
Tracking available resources and personnel with the State Medical Asset and Resource Tracking Tool (SMARTT).
Setting up medical communications systems and training people to use them.
Federal grant funding supports these efforts.
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Local Emergency Medical Services
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Assistance to local Emergency Medical Services (EMS) is provided under North Carolina's Emergency Medical and Disaster Preparedness Program to ensure that all North Carolina residents have access to quality emergency medical care.
Staff activities under this service include:
Technical assistance and oversight to all EMS systems in North Carolina.
Credentialing of EMS workers, licensing of EMS providers and issuing permits for ambulances.
Assistance to local officials and EMS decision-makers to enhance the quality of emergency medical care.
Auditing EMS systems, specialty care transport programs and EMS educational institutions to see if they are in compliance with plans.
Credentials for EMS workers are good for four years and require completion of an approved educational program and written exam. To renew, the worker must complete continuing education. Licenses for providers of EMS services are good for six years; they are issued after evaluation of an application. EMS ambulance permits are good for two years; program staff inspect ambulances to ensure they meet safety standards and also conduct unannounced inspections throughout the licensing period.
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Medical, Psychiatric, and Dental Provider Recruitment
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The Office of Rural Health serves as the lead agency for recruiting primary medical, psychiatric, and dental care providers to North Carolina's rural and underserved communities by using a matching service database to link potential candidates with communities. Recruiters attend state and national conferences, as well as career fairs, and visit residents to promote opportunities to practice in North Carolina. Rural residents benefit from the placement of medical care providers in their communities. The medical professionals may also receive incentives in the form of loan repayment or high needs service bonuses.
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Mental Health, Developmental Disabilites and Substance Abuse Workforce Development
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Workforce Development within the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) is intended to enhance the education, training and professional development of staff members who work with consumers across disability groups and in policy management. Services include:
-Training professionals, paraprofessionals and other direct service providers on evidence-based practices (that is, using scientific studies and research to determine the best interventions and treatments).
-Enhancing staff members’ professional knowledge in mental health, developmental disabilities and substance abuse.
This service is carried out through various contracts.
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Performance Improvement and Accountability
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This service monitors the quality of the North Carolina Public Health system at the state and local levels. This includes Public Health Incubator Collaborative, Local Boards of Health training and Nurse and Administrative Consultation.
It provides technical assistance and training to state and local health departments on improving their performance in clinical and administrative areas.
This includes consultation, technical assistance and professional development activities to local health departments in the areas of: policies, procedures and protocols; quality and performance improvement; grant writing; and nursing practice related to all services provided, compliance of records, documentation, state and federal reporting requirements, budgets and contracts; consultation on program eligibility, fee establishment and accounts receivable; aid-to-county funding; compliance monitoring of each local agency; training of administrative support staff in procedures and processes related to contracts and administrative/medical records management; assisting in local staff development and organization and training on the Health Information System (HIS).
Incubators - There are a total of six (6) incubator collaboratives working currently, consisting of up to 18 local health departments each. These collaboratives are teams of local health departments working together, voluntarily, to address pressing public health issues. They enable the sharing of resources and ideas such that autonomous local health departments can focus on their community health needs while benefiting from regional public health initiatives.
Local Boards of Health training provides quality training as required in both the Consolidated Agreement between the Division of Public Health and local health departments and the new mandatory Local Health Department Accreditation Program. As a result of the training, Board members will have a better understanding of their role and responsibilities as well as legal authority, and will be better advocates for the health of the public within their communities.
The beneficiaries are North Carolina state and local health departments, their employees and the clients they serve.
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Public Health Workforce Development
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This service helps local health departments recruit and train skilled public health workers. The courses provided through this contract target public health nurses and new managers in all programs and have been in place for many years; they support the goal of having available quality educational programming to support local health departments having staff that can perform their roles more efficiently and effectively. Also for FY13 we will be adding webinar capacity to provide trainings to a variety of local health department staff to enhance their ability to perform their public health roles. Note: The PHTIN contract, formerly included, was terminated 11/30/11 due to budget cuts. The beneficiaries are 85 North Carolina local health departments, their employees and the clients they serve.
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Rural Health Centers Support
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Support is provided to state-designated, 501(c)(3) rural health centers for primary care services, technical assistance, capital projects, and practice transformation.
Funding is provided for access to primary care services for underserved and uninsured rural residents. This population is afforded access through the Medical Access Plan (MAP). MAP services are available for patients with incomes up to 200% of Federal Poverty Guidelines. ORH currently reimburses rural health centers $100 for each MAP patient visit. The patient is required to pay a copayment that is determined by each rural health center's Board of Directors. Currently, twelve rural health centers are supported across the state through MAP grants. Grant funding is also available for practice transformation to patient centered medical home (PCMH) certification or development and maintenance of technological infrastructure/Meaningful Use (MU).
All funding initiatives must demonstrate the ability to create systems and processes that promote sustainability of the organization being funded.
In addition to operational assistance, state-designated rural health centers are also eligible to apply for funding to support capital projects. Capital projects may include roof repair, minor renovations, technological upgrades, HVAC replacement or new construction. The number and type of capital projects will vary from year to year, based on identified needs.
State-designated rural health centers, other organizations, or communities may also receive technical assistance from ORH. Technical assistance includes providing guidance with financial and personnel policy development, ICD -10 training, practice transformation and other areas as needed. These services are provided to assist centers with sustainability efforts.
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Small Rural Hospital Improvement Program Grants (SHIP)
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These Federal funds are intended to address four (4) key areas of hospital operations as identified by the Health Resources and Services Administration (HRSA): 1) Prospective Payment Systems, 2) Accountable Care Organizations, 3) Value Based Purchasing, and 4) Bundled Payments. Qualified hospitals must propose specific initiatives to address one or more of the four key areas. This service supports the goal of improving financial operations, quality of care provided, and viability of rural hospitals, thus enhancing health care in rural areas.
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Smart Start Child Care Related Activities
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Child Care Related Activities are a service provided under the Smart Start program, which serves children from birth to age 5.
Local communities carry out activities designed to maintain or improve the quality of child care homes and centers. These may include:
-Activities to maintain or increase a facility's star rating (level of licensure)
-Teacher training
-Supplemental teacher pay for professional development, such as enrollment in for-credit courses related to early childhood development
Services are provided statewide through 75 local Smart Start partnership organizations.
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State Medical Facilities Plan
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The SMFP is an annual document developed by the SHCC with support from Agency staff. The SMFP includes need projections for certain health care facilities, services, and equipment within the state for which a Certificate of Need (CON) may be applied. Agency staff collects data from various sources including annual license renewal applications; registration and inventory of medical equipment forms; regional kidney organizations; the CON Section; substance abuse data forms; data from Thomson Reuters; the statewide data processor and population data from the Office of State Budget and Management. The process of creating the SMFP includes these steps:Scheduling SHCC and SHCC committee meetings and providing technical support during those meetings.Scheduling SHCC workgroups and providing technical support during those meetings.Scheduling and convening public hearings to receive comments for changes to the need methodologies and policies in the proposed SMFP.Uploading draft documents to the Agency website in advance of hearings and meetings for public review. Receiving and analyzing petitions and drafting agency reports and recommendations for consideration by the SHCC. Revising the SMFP in accordance with the SHCC's recommendations.Reviewing the final SMFP with the Governor's staff prior to the Governor's review. This service benefits the general population of North Carolina.
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Teacher Education and Compensation Helps (T.E.A.C.H.) Early Childhood Project
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The T.E.A.C.H. (Teacher Education and Compensation Helps) Early Childhood Project aims to increase child care workers' education and wages while reducing child care staff turnover. The service provides scholarships to child care workers to complete coursework in early childhood education. Scholarships help pay the cost of tuition and books. Child care givers apply for scholarships through a contractor. The service is part of the Child Care Quality and Availability Program, which serves infants and children in child care.
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Telemedicine
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Through the use of special equipment that connects patients in rural and underserved areas with health care providers in other locations, telemedicine increases access to primary and behavioral health in areas where such services are unavailable. Currently, the Division oversees the establishment and administration of a statewide telepsychiatry program that allows referring sites to use consulting providers at a remote site to provide timely psychiatric assessment and rapid treatment for patients who are experiencing an acute mental health or substance abuse crisis. A long-term objective of this effort is to create a sustainable telepsychiatry program throughout the state.
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Workforce Development
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TBD
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Service Name
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Analytics and Innovations
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Within the Office of Rural Health, the Analytics & Innovations (AI) Team creates and improves performance measures through constructing study designs, research methodologies and statistical techniques that will further enhance healthcare research. The team’s focus is to inform community and policy makers of the story behind the data to help improve access and quality of healthcare. In rural North Carolina, residents die at an earlier age due to avoidable chronic disease and unintentional injury. The AI Team works within and across teams, providing data to improve awareness and targeting ways to combat this challenge. In addition, the AI team designs creative solutions to financing and delivering health care services for Medicaid, the uninsured and other vulnerable populations. Leveraging existing infrastructure, including DHHS divisions, local communities, and academia, the AI team strengthens health delivery systems to improve access and coverage, enhance the quality and coordination of care, and contain unnecessary growth in healthcare expenditures.
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Child Fatality Prevention Team
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The Child Fatality Prevention Team serves North Carolinians by investigating the deaths of children from injury or neglect.
The team aims to reduce the deaths of North Carolina children from preventable causes
It recommends policies to protect the state's children
It conducts training for local law enforcement, health care and other agencies on proper techniques for child death investigations
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Communicable Disease Surveillance and Control
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Through this service Communicable Disease staff members detect and track the spread of diseases. This includes:
Overseeing identification and enrollment of data sources such as hospital emergency rooms for disease tracking (via the NC Disease Event Tracking Epidemiologic Collection Tool, or NC DETECT)Training new system users
Monitoring data daily for potential public health threats
Investigating potential threats in collaboration with local and state public health partners
Monitoring, analyzing and responding to communicable disease reports submitted through the North Carolina Electronic Disease Surveillance System (NCEDSS)
Communicable Disease staff members also help control diseases that are spread by animals (vectorborne diseases) and by spoiled or contaminated foods (foodborne diseases). They do this by:
Responding to and investigating foodborne and vectorborne disease outbreaks
Informing health care providers and the public of the results of such outbreak analyses
Educating health care providers and the general public on topics related to foodborne and vectorborne diseases
Major activities of this service include:
Provision of communicable disease surveillance to evaluate the impact of communicable diseases.
Provision of consultation and education to local health department staff, healthcare providers and consumers regarding disease investigation and control strategies.
Utilization of data from the Syndromic Surveillance system to monitor and respond to instances of widespread disease or injuries such as those resulting from hurricane or other weather-related risks or injuries.
The general public benefits from the monitoring and response to public health threats.
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Evaluation and Technical Assistance
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Evaluation and Technical Assistance encompasses 1) Systematic assessment of design, implementation, and outcomes of a program to determine and measure effectiveness, improve performance, and ensure accountability of achieving intended goals; 2) Provide subject matter expert technical assistance to build capacity, optimize process and support the achievement of desired Dra. Evaluation and Technical Assistance help to identify areas of program improvement and to inform future program design to ensure meaningful impact and resource allocation.
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Injury and Violence Prevention
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Injury and Violence Prevention gathers information and addresses the major statewide issues of injury and violence by working to implement the statewide strategic plan for injury and violence prevention. The components of the plan are:
Data and Surveillance: Increase the use of injury and violence prevention data through a comprehensive, coordinated injury surveillance system that is accurate, readily available and sustainable and that is utilized to guide injury and violence prevention programs and policies at the local, regional and state level.
Messaging, Policy and Environmental Change: Develop strong, vocal community support for injury and violence prevention and the creation of safe environments by reframing unintentional injuries and violence as unacceptable and promoting policies that support injury and violence prevention.
Saving Lives: Reduce the rate of morbidity and mortality caused by injury and violence by implementing prioritized, data-driven strategies and programs, policies, and innovative and tested practices. Specific areas of prevention work include: Preventing unintentional poisonings, also known as drug overdoses from prescription medications. Population focus: ages 25-54; Preventing falls. Population focus: ages 65 and older; Primary prevention of sexual violence. Population focus: adolescent males ages 10-14; Preventing youth suicide. Population focus: ages 10-24; Preventing motor vehicle crashes. Population focus: ages 15-25 and ages 70 and older; Preventing residential fires. Population focus: low income groups, homes with children under age 10, and adults over age 65.
Building the Injury Prevention Community: Increase coordination among Injury and Violence Prevention partners at the local, regional and state level to create a more efficient system and a broader, stronger constituency. Examples of partners include researchers, aging specialists, mental health experts, sexual and domestic violence prevention organizations, direct medical service providers, law enforcement agencies, and fire officials.
Workforce Development: Develop a statewide injury and violence prevention workforce that meets core injury and violence prevention competencies as outlined by the National Training Initiative for Injury and Violence Prevention (NTI) and the Safe States Alliance.
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Medical Examiner System
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The Medical Examiner System serves North Carolinians by investigating deaths that are the result of injury or accident; that are sudden, unexpected or suspicious; that occur in jail, prison, correctional institution, police custody or state-operated facility; or that are not attended by a doctor. The system ensures that the cause and manner of death is properly certified.
Local Medical Examiners (MEs) and pathologists or Office of Chief Medical Examiner (OCME) staff order an autopsy if necessary to document the extent of injury or disease, and to complete death certificates.
Blood or tissue specimens are sent to the OCME Toxicology Laboratory for forensic analysis (using science and technology to investigate the facts).
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Occupational Surveillance
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This service monitors work-related illnesses and injuries in North Carolina.
- It describes occupational risks to health using occupational health indicators.
- It investigates occupational risks of concern through targeted surveillance programs.
- It promotes safer workplaces through consultation and prevention activities.
The service benefits workers, employers, health and safety professionals, and the general public.
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State Center for Health Statistics
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The State Center for Health Statistics (SCHS) documents the occurrence of disease and disability in North Carolina and their effect on the population. SCHS also provides expert research and analyses to help address health policy issues affecting the state. SCHS serves a variety of customers, including federal, state, and local agencies; researchers; and the general public. Services offered by SCHS include:
Providing analyses about the health of North Carolinians.
Ensuring that timely, accurate and high-quality health-related data are available.
Collaborating with other public and private agencies to improve the availability of health databases and their analyses.
Supporting the Division of Public Health (DPH) and the Department of Health and Human Services (DHHS) in data processing, survey operations and statistical analyses.
Health data collection, coordination, analysis and dissemination activities are carried out by data analysts, data managers and quality and field services staff. These staff ensure data and analyses meet timeliness and quality needs of public health programs, researchers and the public to reduce the burden of disease in North Carolina.
The service benefits the general population of North Carolina.
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State Laboratory Services - Testing, Training & Consultation
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This service provides more than 125 clinical tests and more than 65 environmental tests, as well as training and consultation, for the following groups:
-Local health departments.
-Hospitals.
-Commercial laboratories
-Private health care professionals
-Community-based organizations
-State and regional staff from the Division of Public Health and certain other state and regional agencies
The aim is to enhance both patient health and effective disease control through this direct laboratory service. This benefits the general population of North Carolina.
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Vital Records
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Vital Records service collects the records of important human events, including births, deaths, marriages, divorces and fetal deaths, and archives them in a systematic manner so the records can be retrieved as needed.
- Where the records come from: Local partners (such as county Register of Deeds, health departments, hospitals and funeral homes) gather and process information on occurrences of vital events. Vital Records staff members review electronic and paper records for completeness and accuracy. Vital Records provides training and technical assistance for local partners.
- How certificates are issued: Vital record certificates are issued in person and by mail; the program collects fees for those records.
- Where reports are sent: Vital Records reports data to federal programs such as the Center for Disease Control and Prevention National Center for Health Statistics and the Social Security Administration. The State Center for Health Statistics receives data extracts. Death reports are sent to Clerks of Court and N.C. Division of Motor Vehicles.
- Other services: Vital Records provides consultation to the public and to partner agencies for changes to certificates, helping to ensure legal compliance. Vital Records processes Special Registrations (adoptions, paternities, name changes, amendments).
The service benefits the general population of North Carolina.
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Service Name
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Assistive Technology Technical Assistance, Training, Demonstration, Equipment Loan, and Information & Referral
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The direct services of the N.C. Assistive Technology Program (which include Technical Assistance, Training, Demonstration, Equipment Loan, and Information and Referral) provide access to and information about technology that can help people become more independent in home, school, work and community life.
Services are available statewide through 11 full-service centers and 13 satellite centers; in the home, school or work setting; or by phone or e-mail. This service is state and federally funded. It benefits individuals with disabilities of all ages, as well as the professionals who work with them and employers.
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Client Assistance Program (CAP) Consumer Advocacy
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The Client Assistance Program acts as a consumer advocate for people with disabilities who are having problems applying for or receiving rehabilitation services. Staff members are knowledgeable about laws, regulations and policies and can help clients understand their rights and work with the system. They can give advice, negotiate on the client’s behalf and help with appeals.
Consumer Advocacy staff ensures that North Carolinians can exercise their rights under the federal Rehabilitation Act and gain access to services available through the Division of Services for the Blind (DSB) or the Division of Vocational Rehabilitation Services (DVRS).
Individuals can find out more about these services through human services and disabilities support group offices and newsletters as well as by standard mail, e-mail, toll-free telephone or TTY. This service benefits applicants for and individuals determined eligible for DVRS or DSB services.
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Client Assistance Program (CAP) Information and Referral
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The Client Assistance Program (CAP) information and referral service lets people with disabilities know about rehabilitation services available in North Carolina and how to qualify for them.
Staff members provide information and referrals to anyone who contacts CAP (by mail, e-mail, toll-free phone or TTY). CAP also publicizes its services through human services and disabilities support group offices and newsletters. Individuals also may be referred to CAP through Carolina Legal Assistance, North Carolina’s Disability Law Center (NC Protection and Advocacy) and the Department of Health and Human Services (DHHS) Customer Services Center.
This service benefits applicants for and those determined eligible for services through the Division of Services for the Blind (DSB) or the Division of Vocational Rehabilitation Services (DVRS).
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Community Based Legal Services
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Individuals sometimes need legal help with civil (non-criminal) matters. For those age 60 or older who cannot afford to pay privately, legal assistance is available through the Older Americans Act Legal Services Program. Funding goes to the Area Agencies on Aging (AAA) in North Carolina, which contract for legal services with Legal Aid of North Carolina (Legal Aid NC) and a few private attorneys. Services generally include simple wills, powers of attorney and advance medical directives such as health care powers of attorney and living wills. Legal Aid NC offices also offer help with housing, foreclosure, consumer debt, utilities and benefits cases.The federal Older Americans Act funds this service and specifies that it target seniors in the greatest need without using economic means testing. The services benefit adults age 60 and older, with emphasis on those who are in the greatest economic or social need (that is, isolation or limitation due to some physical or mental disability). It provides assistance to the homebound, residents in long-term care settings and congregate (group) meal sites.
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Comprehensive Cancer
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North Carolina Comprehensive Cancer works to reduce the incidence and mortality of cancers by the development and implementation of effective strategies to prevent, detect, and promote activities that enhance comprehensive initiatives. Comprehensive cancer initiatives are a process by which resources are pooled via partnerships, collaboratives, and individual groups and institutions to reduce the burden of cancer. Comprehensive Cancer does not provide direct patient services.
Through the comprehensive cancer initiatives process work is done to:
-Reduce cancer risk
-Detect cancer earlier
-Improve cancer treatment
-Enhance quality of life for cancer survivors beginning at time of diagnosis
Primary activities include:
-Provide support and guidance to the North Carolina Advisory Committee on Cancer Coordination and Control (Advisory Committee). The Advisory Committee is legislatively mandated to prepare and oversee the implementation of the North Carolina Cancer Plan.
-Promote partnerships and collaboration with agencies, health facilities, and educational institutions to actively work toward the goals and objectives of the North Carolina Cancer Plan.
-Collaborate with communities to foster cancer control awareness through regional groups, coalitions, and partnerships.
-Provide public and professional education opportunities for prevention and early detection.
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Enforcing Underage Drinking Laws
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The Enforcing Underage Drinking Laws (EUDL) Program/Preventing Underage Drinking Initiative service supports efforts by communities to prevent the sale of alcohol to minors (under age 21) and to prevent minors from buying or consuming alcoholic beverages. This is accomplished by providing grants, education and technical assistance to Community Collaboratives. A Collaborative (or coalition) is an organized alliance among individuals or groups within a community joining together for a common cause. The Collaboratives support enforcement of underage drinking laws by monitoring retailers and through statewide efforts to raise awareness of the potential harm associated with underage drinking. The Enforcing Underage Drinking Laws (EUDL) Program/Preventing Underage Drinking Initiative is funded by the Substance Abuse and Mental Health Services Administration (SAMSHA) Substance Abuse Block Grant and implements various strategies to prevent underage drinking. Primary strategies focus on: -Decreasing underage access to alcohol; -Changing community norms that promote underage and high risk alcohol use; and, -Addressing policies pertaining to underage drinking.
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Food and Nutrition Services Nutrition Education
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TBD
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Food and Nutrition Services Nutrition Education
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Food and Nutrition Education is an optional component of Food and Nutrition Services to provide nutrition and physical activity education services that increase the likelihood that those recipients of Food and Nutrition Services make healthy food choices consistent with the most recent dietary advice as reflected in the Dietary Guidelines for Americans and the Food Guide Pyramid.
The Nutrition Education component is an optional component of the Food and Nutrition Services that provides various nutrition education activities throughout the state.
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Heart Disease and Stroke Prevention
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The Heart Disease and Stroke Prevention service works with health systems to prevent and manage heart disease and stroke among North Carolinians. Activities include: Promoting the adoption and use of electronic health records within health care systemsPromoting clinical guidelines for blood pressure control and cholesterol managementImplementing team-based care for patients with high blood pressure and high blood cholesterolLinking community resources and clinical services that support systematic referrals, self-management, and lifestyle change for patients with high blood pressure and high blood cholesterol Collaborating with the Stroke Advisory Committee and the Justus-Warren Heart Disease and Stroke Prevention Task Force
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Industrial Hygiene Consultation
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This service evaluates biological, chemical and physical hazards, primarily in the workplace, and recommends ways to control them. This is accomplished through:
-Consulting
-Training
-Providing educational materials
The service provides expertise to other state agencies, industry, local health departments and the general public of North Carolina.
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National Toxic Substance Incidents
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This service monitors uncontrolled or illegal acute releases of any toxic substance that can reasonably expected to cause adverse human health effects.
- It conducts routine surveillance
- It enhances surveillance for a database that incorporates multiple environmental and public health surveillance systems into one source.
- It conducts prevention outreach measures through regional forums, data dissemination, and lessons learned.
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Office of Minority Health
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Minority Health and Health Disparities works with faith-based organizations, local nonprofits, tribes, health departments and other organizations to reduce barriers to health care and other health gaps in their communities. To equip these organizations, staff members provide a range of services including training, leadership and skills development, financial assistance, consultation and technical assistance.
This approach has helped community-based organizations use sound business practices, ensure fiscal accountability, write successful grants, influence local and state policies and legislation, and build coalitions to address health disparities.
The broad scope of this service encompasses:
-Partnership and staff development
-Information and referrals
-Preventive care and intervention
-Operational functions of a non-profit organization
By assisting organizations and agencies that serve African-Americans, Hispanics/Latinos, American Indians and other minority populations in North Carolina, this service indirectly benefits individual members of those minority groups.
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Physical Activity and Nutrition
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The Physical Activity and Nutrition service helps to make communities, worksites and early care and education centers healthier places to live, earn and learn. It encourages change to policies and environments to help community members eat smart, move more and achieve a healthy weight. Activities include:
·
Integrating nutrition
and physical activity standards into statewide early care and education
systems ·
Providing system level
supports to early care and education systems that help providers, technical
assistants, and facilities meet established nutrition or physical activity
standards. ·
Enhancing physical
activity through activity-friendly transportation plans and
policies
·
Encouraging employers
to support healthy eating as well as places and time for breastfeeding in the
workplace
·
Promoting continuity
of care/community support for
breastfeeding
·
Supporting the
implementation of food service guidelines in community and worksite
venues
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Public Health Preparedness and Response
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This service is designed to protect everyone in North Carolina by increasing the ability of the public health system to prepare for, detect, respond to and recover from public health emergencies. These emergencies might include acts of terrorism, disease outbreaks and natural disasters.
This service provides training, planning and technical consultation to all local health departments (LHDs); seven Public Health Regional Surveillance Teams (PHRSTs); other state agencies; hospitals; health care providers; and law enforcement, emergency management and other response partners. It works to ensure a coordinated federal, tribal, state, regional and local response to public health emergencies.
Activities include:
Training, planning and technical consultation. Exercises to evaluate response plans. Laboratory services. Information technology services.Supporting other state agencies, including the Office of the Chief Medical Examiner, General Communicable Disease Control, Occupational and Environmental Epidemiology, and Health Promotion.
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Relay NC
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Relay NC is a dual-party telephone relay service available by dialing 711. Deaf, Hard of Hearing, Deaf-Blind and speech-impaired individuals are ensured functional equivalency in accessing community resources via the telecommunications system.
A contracted vendor provides dual-party telecommunications service. The level of demand is measured by the number of outbound calls made via the 711 Relay NC number. Demand for tradional relay service is expected to maintain a downward trend. At the same time, demand for internet-based relay services will continue to increase sharply.
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Senior Center General Purpose Funds
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To provide funding to senior centers to develop programming and services, to support general operations or to construct, renovate or maintain senior center facilities.
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Services to Agencies and Organizations – Local/Regional Level
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Services to Agencies and Organizations –Local/Regional Level
To break down barriers to communication with the deaf, hard of hearing and deaf/blind individuals, the division works with various agencies and organizations including:
· Public
· Private
· Non-Profit
· For-Profit
Core activities provided by seven regional centers in all 100 counties include:
· Consultation
· Training and workshops
· Information and referral
· Dissemination of educational and resource materials
· Collaboration on joint initiatives
Information and services are provided to numerous entities to help ensure compliance with the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973 and other related statutes.
Agencies and organizations include, but are not limited to:
· Health care providers.
· Emergency management entities
· Law enforcement agencies
· Correctional facilities
· Hospitals
· County social service agencies
· Local governmental entities
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Vocational Rehabilitation Service Access Grants
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Service Access Grants include services that are provided through external grants or other sources of funding.
Work Incentives Planning and Assistance (WIPA) provides benefits counseling to SSDI and SSI beneficiaries on how employment earnings and other income will affect these benefits. Community Work Incentives Coordinators provide one-on-one and group counseling to SSDI and SSI beneficiaries. Counseling or training is also provided on the use of Social Security Work Incentives. NC DVRS serves twenty-seven counties under this project. Three other projects serve the rest of the state. Funding is provided by the Social Security Administration (SSA)
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Women's Health Public Education
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This service educates North Carolina residents on maternal and child information. It does so through public education/information campaigns. It provides information about:
-Preventing birth defects by encouraging women to consume folic acid before pregnancy
-Preventing teen pregnancy
-Family planning
-Preparing for a healthy pregnancy; prenatal care
-Infant care and appropriate parenting skills
Contracts currently with NC Healthy Start Foundation, SHIFT NC and the March of Dimes provide the service.
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Service Name
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Best Practices in Children's Health
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Services are provided to help assure quality and efficiency in health services for children by providing child health data, consumer survey data, and research for all child health programs. This service:-Identifies the most effective ways of addressing health issues of children and spreads the word through local health departments, local review teams, offices, and commissions-Promotes the health of adults and children with disabilities by spreading the word to community health and disability organizations about the most effective ways of staying healthy based on research findings-Collects and reports child health data to help programs design and implement interventions and measure accomplishments This service benefits children, families, and people with disabilities.
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Child and Adult Care Food (CACFP)
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TBD
This is one a of 7 funds across DHHS that assures that the delivery of quality health and safety services is sustained and continually improved for children and/or adults The Child Nutrition programs reimburse providers for nutritious meals. The Child and Adult Care Food Program (CACFP) pays caregivers based on the number of meals served per month to eligible individuals.
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Child Maltreatment Prevention
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The purpose of this service is to lead the implementation of the comprehensive statewide child maltreatment prevention plan developed by a NC Institute of Medicine Task Force. There are evidence-based initiatives that support families to achieve a range of positive child outcomes, ranging improved school readiness to reduced child maltreatment. This service has played a central role in supporting the implementation of several evidenced-base services, including the Nurse Family Partnership, Incredible Years and Strengthening Families. The service works closely with public and private stakeholders (including DPH, Prevent Child Abuse North Carolina, DSS, DMH/DD/SAS, DPI, the Duke Endowment and the Kate B. Reynolds Foundation) to ensure a coordinated approach to family support and child maltreatment prevention.
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Children's Preventive Health Services
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Children's Preventive Health Services supports initiatives addressing availability, accessibility and utilization of health services for children from birth to 21 years of age. Working with agencies, organizations, and families statewide, this service is designed to affect policy, environment and practice changes to:-improve nutrition and physical activity patterns-enhance parenting skills-decrease risk factors for child abuse and neglect-provide specialized outreach to hard-to-reach populations-increase health promotion and injury prevention in child care settings Children's Preventive Health Services works closely with community child serving organizations such as local health departments, child care centers, local social service and mental health agencies, and local child health care providers.
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Diabetes Awareness, Education & Health Care Delivery
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The Diabetes Prevention and Management service assists communities, worksites, pharmacies, health systems and individuals in North Carolina to prevent and manage diabetes. Activities include: Increasing access to and availability of quality diabetes self-management education and supportIncreasing access to and the use of diabetes prevention programsPromoting adoption of clinical guidelines for diabetes screening, prevention and managementPromoting diabetes prevention and management in places where people work, live, and receive medical servicesProviding training and technical assistance to promote diabetes prevention and management activities in health care practices and pharmaciesSupporting a statewide coalition of stakeholders who are leaders in diabetes prevention and management
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General Behavioral Health Prevention
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Prevention refers to actions, strategies, or measures taken to stop an event or condition from occurring or to minimize a problem's potential impact to the general population. Prevention focuses on proactive and upstream efforts to address risks or contributing factors before they lead to negative outcomes. Key aspects of prevention services are+ to 1) Reduce or eliminate risk or adverse outcomes 2) Prevent the initial occurrence of a problem, focus on early detection and intervention to reduce severity or progression of a problem, or reduce the long-term impact of an existing problem by helping manage the problem.
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General Substance Abuse Prevention
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General Substance Abuse Prevention services are aimed to inform the general public about risk factors for substance use or abuse. Services are focused to prevent the use of alcohol, tobacco, and other drugs among youth families and communities statewide. Services are delivered through the Substance Abuse and Mental Health Services Administration/ Center for Substance Abuse Prevention. ( SAMHSA/ CSAP Substance Abuse Prevention and Treatment Block Grant required six prevention strategies that include: -Information dissemination -Education -Alternatives -Problem identification and referral - Community based (that is, through policy, media, education and advocacy) and - Environmental Strategies The majority of prevention services are Information distribution and education to the public. Providers of these prevention services use several set approaches that have been found to be effective based on evidence. These evidence based programs, policies and practices are deemed as effective and listed on the National Registry of Evidence based Programs and Practices. Substance abuse prevention messages that were designed to be appropriate for diverse groups within our culture are delivered by providers via media and include radio, television, and print. Substance abuse prevention activities include the implementation of evidence based curricula for universal, selective, and indicated populations. Tobacco use prevention initiatives attempt to reduce youth access to tobacco products as required by the federal Synar Amendment. Areas of focus include community collaboration, merchant education, and law enforcement related activities.
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NC Rated License Assessment Project
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The NC Rated License Assessment Project helps to define the quality of child care in the state and helps parents recognize and choose child care.
The Division of Child Development awards the NC Star Rated License to child care centers, family child care homes and school-age programs based upon total points earned in two areas: program standards and staff education levels.
The University of North Carolina at Greensboro contracts with the Division to retain well-trained and qualified staff to assess programs statewide. This assessment is the foundation for the NC Rated License and is required to earn a license of four or five stars.
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North Carolina Senior Games, Inc.
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North Carolina Senior Games provides locally organized Senior Games as well as cultural and health education activities designed to provide exercise and promote healthy lifestyles for those 55 and older. This is accomplished through:
-A network of local Senior Games in all 100 counties.
-Annual State Finals for top performers in local Senior Games.
-Silver Arts, which provides an opportunity to use visual arts, dance and literary talents.
-Silver Striders, which encourages seniors in walking regularly.
Local participation is through area agencies on aging, councils on aging and county health departments.
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Smart Start Family Support Activities
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Smart Start offers family-focused services that improve parenting, promote parent involvement and impact the environment in which parenting takes place and serves children 0-5 years of age.
Smart Start supports:
-Home visiting services to help new parents and parents-to-be by providing education, information and resources
-Parent education programs that empower parents by increasing their knowledge of early childhood development and positive parenting practices
-Early literacy services
Smart Start services are provided statewide through 75 local partnership organizations.
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Tobacco Prevention and Control
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Tobacco Prevention and Control works to improve the health of the people of North Carolina by reducing tobacco use and exposure to seconhand smoke. This is done by building support for evidence based policies and programs, and by working with organizations and communities achieve these four goals:
Prevent young people from starting to smoke/use tobacco.
Eliminate exposure to secondhand smoke.
Promote quitting among all smokers and tobacco users.
Eliminate tobacco-attributable health disparities.
Tobacco Control and Prevention builds support for and provides evidence based tobacco control services with all local health departments (LHDs) (and specifically with funding for 8 LHDs serving 23 counties), Chronic Disease Programs, Oral Health, Maternal and Child Health Programs, Health and Wellness Trust for Teen Tobacco Prevention, Healthy Carolinians, Community Health Centers, and Medicaid providers. The Tobacco Prevention and Control Branch works with Local Health Departments on the implementation of the smokefree restaurant and bars law in NC that went into effect in January, 2010.
Tobacco use is the leading preventable cause of death in North Carolina and the nation. It is responsible for one in five deaths in North Carolina. It is a risk factor for heart disease, many cancers and asthma. For each death, there are 20 more people who are sick or disabled because of tobacco use. Direct medical costs from smoking are estimated at $2.4 billion each year.
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Wellness and Health Promotion
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Health Promotion and Disease Prevention encompasses a variety of activities that maintain and improve the health of older adults. These activities include:
-Exercise and physical fitness training. i.e. NC Senior Games-Nutrition education.-Guidance on managing medications.-Evidence-based health promotion programs; that is, activities such as Living Healthy,-Living Healthy with Diabetes, Arthritis Foundation Exercise, Matter of Balance and Walk with Ease that have been shown to have a positive effect on health.-Accident prevention.-Smoking cessation.-Immunizations.-Screening for dental health, vision care, foot care and environmental health issues.Area Agencies on Aging and county aging agencies, contract with local groups to provide services to older adults.
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Service Name
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Community Focus Infant Mortality
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Community Focus Infant Mortality provides services for women and their infants with a specific focus on African-American and Native American families in certain North Carolina counties and communities. Services include: Outreach, case management and health education before, during and after pregnancy to improve health outcomes.Supportive services for women and their children for two years after delivery.Depression screening/referralInterconceptional care coordinationReproductive life planningInfant safe sleep practicesTobacco cessation and prevention These programs include Baby Love Plus, Infant Mortality Reduction and Healthy Beginnings and are in local health departments and community based organizations across the state.
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Family Planning
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Family Planning services includes a wide array of services provided in inpatient and outpatient setting for the purposes of family planning. The types of services include: physician exams, family planning drugs (contraceptives and other birth control devices), sterilization procedures, screening for and treating sexually transmitted diseases, etc. Men and women are eligible to receive family planning services.
Family Planning services are reimbursed by the federal government at a higher rate than other types of Medicaid services.
Family Planning services are mandatory.
Some people are in a Family Planning waiver program which limits the types of family planning procedures they can receive.
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Farmer's Market Nutrition
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Through the issuance of food benefits, the WIC Farmers’ Market Nutrition Program (FMNP) provides access to fresh, unprepared, locally grown fruits and vegetables to women and children over age 2 who have been certified to receive WIC program benefits. The FMNP expands the awareness, use of, and sales at participating farmers’ markets statewide. The FMNP increases participants’ access to healthy local produce, encourages consumption of locally grown fruits and vegetables, and expands awareness of and sales at participating farmers’ markets.
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Farmer's Market Nutrition
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Through the issuance of food benefits, the WIC Farmers’ Market Nutrition Program (FMNP) provides access to fresh, unprepared, locally grown fruits and vegetables to women and children over age 2 who have been certified to receive WIC program benefits. The FMNP expands the awareness, use of, and sales at participating farmers’ markets statewide. The FMNP increases participants’ access to healthy local produce, encourages consumption of locally grown fruits and vegetables, and expands awareness of and sales at participating farmers’ markets.
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Maternal Health
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This service provides a wide range of maternal health services to ensure that low-income pregnant women have access to early and continuous prenatal and interconception care and follow recommended perinatal care guidelines before, during and after pregnancy. Services include: - Prenatal care - Pregnancy care management - Childbirth education - Skilled nurse home visits - Behavioral Health Screening - Tobacco Cessation Counseling - Reproductive Life Planning - Risk appropriate levels of care - Care Management Services - Maternal Mental and Behavioral Health This is accomplished by funding local health departments, community based organizations, health care facilities and universities to improve the health of expectant mothers and increase healthy births.
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NC Pre-K
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NC Pre-K (formerly More at Four) funds high quality pre-kindergarten services in approved sites statewide for at-risk four year olds and supports the requirement that NC Pre-K classroom teachers attain a NC Birth-Kindergarten or Preschool Add-on Continuing License.
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WIC
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TBD
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Service Name
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Oral Health Preventive Services
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Oral Health service efforts focus on reducing tooth decay by providing: preventive services to at-risk groups; dental screening, referral and follow-up of children needing care; and dental health education. Specific activities provided by Oral Health staff include:
-Providing dental screenings for school children, referring children for dental care, and working with families to help them obtain care
-Encouraging and helping communities seeking to install or upgrade fluoridation systems
-Providing dental sealants for elementary schoolchildren at high risk for developing tooth decay
-Offering a weekly fluoride mouthrinse to children in targeted high risk elementary schools
-Preventing tooth decay in very young children by training and supporting physicians and local health department to provide dental preventive care
-Providing education about tooth decay and oral health in elementary schools and community settings
-Providing consultation and technical assistance to local public and private health care providers
-Providing American Dental Association-accredited specialty training to masters level dentists seeking experience or certification in dental public health
-Tracking changes in child oral health status over time, compiling annual screening findings into a database, which is made available to the public each year
Services are provided directly in the communities. The general population of North Carolina benefits from this service. The emphasis is on children at high risk of tooth decay. No other public or private group provides these services across the state.
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School Telehealth
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The goal of School Telehealth services is to increase access to behavioral health services to public school youth in high need areas and alleviate barriers for students and families to access behavioral health assessments and treatment. The service provides public school Districts in high-need low resource areas funding to offer tele-behavioral health services, treatment, and assessments to students. Funding is non-recurring State funds provided directly to school districts and as well as the North Carolina tele-health collaborative to fund projects that would expand services to high-need low-resource districts.
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Service Name
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HIV/STD Prevention Activities
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This service conducts activities to prevent the spread of HIV and STDs. Major activities include:
Conduct HIV/STD surveillance for collection of data for program planning and targeted intervention.
Refer clients to medical care and initial appointment.
In partnership with community partners, provide HIV and STD testing in both local health departments and non-traditional settings.
This service benefits both clients and the general public. Increased HIV testing allows HIV-positive individuals to be identified and cared for; this results in improved health for them as well as significantly less risk of transmission to others. By altering and reducing risky behaviors and assuring that individuals are in care, the transmission of HIV and other STDs is reduced.
Services are provided by Disease Intervention Specialists (DIS) and by local health departments, colleges and universities and community-based organizations.
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Medical Evaluation and Risk Assessment
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This service assesses the risks of exposure to air, water and soil contaminants in the workplace and in the environment.
- It evaluates exposures to hazardous substances.
- It designs, conducts and reviews studies of diseases and their causes.
- It medically evaluates health effects of environmental contamination.
- It informs local health departments, health care providers, other state agencies and the general public about these hazards.
The service benefits industry, employees and the general public.
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WISEWOMAN
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WISEWOMAN provides medical screenings, referrals, and health education to North Carolina women who are:
-Low-income (250 percent of the federal poverty level or below)
-Uninsured or underinsured
-Between the ages of 40 and 64
The focus is on reducing the risk of cardiovascular disease and improving their overall health. The service pays for blood pressure, cholesterol, and diabetes screening/testing, dietary, physical activity, and smoking cessation interventions/classes as well as medical referral and follow-up as appropriate. Services are provided by local health departments and community health centers in 41 sites across the state.
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Service Name
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Breast and Cervical Cancer Control
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Breast and Cervical Cancer Control (BCCCP) pays for screening to detect breast and cervical cancer in North Carolina women who are:
-Low -income (250 percent of the federal poverty level or below).
-Uninsured or underinsured.
-Between the ages of 40 and 64.
The service pays for clinical breast examinations, mammograms and pap tests as well as diagnostic services and medical referral and follow-up as appropriate. There is an increased emphasis on reaching African American, American Indian and Latina women because of increased rates of breast and cervical cancer in these minority groups.
Services are provided by local health departments, community health centers and hospitals in 82 sites across the state.
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Medication Assistance
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The Medication Assistance Program (MAP) provides access to free prescription drugs available through pharmaceutical manufacturers to patients who cannot afford them as a safety net for uninsured, low-income individuals in the state.
This service, currently offered through 122 sites in rural health centers, federally qualified health centers and community and faith based organizations, uses special software called Medication Access and Review Program (MARP). MARP was created in partnership through private foundations and supported by ORHCC. This software matches patients' eligibility with available free medications. ORHCC provides training and technical support to users of this software, as well as assisting prescription assistance coordinators in each site to develop best practices in their medication assistance programs.
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Service Name
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Children with Multiple Needs
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TBD This is one of 4 funds across DHHS that assures that children with health and safety needs that could result in out-of-home placement receive treatment services to enable them to continue to live at home and/or the community. Activities will target and address acute system and individual need; and build and enhance sustainable community supports through LME/MCOs and statewide providers for long-term advancement of behavioral health of children
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Family Support Program Services
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Family Support services are designed and developed locally to provide family-focused and community- based interventions targeting families with children at risk of neglect, abuse, or dysfunction in the home or community, and to enhance families’ and children’s ability to attain, increase, or improve educational achievement leading to greater self-sufficiency.
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Genetics and Newborn Screening
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Genetics and Newborn Screening provides follow-up for newborns screened for problems that are not apparent at birth so that they can receive early diagnosis, treatment and follow-up. This includes inherited diseases, metabolic disorders (caused by the accumulation of chemicals produced naturally in the body) and hearing loss. Services are also available to children whose hearing loss is detected later in life. Speech and hearing staffs provide training to health departments, Head Starts and other agencies so they can identify more children with hearing problems. A statewide Web-based data system, WCSWeb, ensures that children with hearing loss are referred to medical specialists and appropriate care. Staff also manage contracts supporting cochlear implants and teleaudiolgy evaluations for children. State genetic counselors work in partnership with medical centers with a focus on genetic screening, diagnosis and counseling through contracts and direct services. The counselors also provide training and consultation to health departments, private health care providers, educators, care coordinators, families and public agencies across the state. A partnership with the N.C. State Center for Health Statistics Birth Defects Registry enables staff to counsel and educate parents of affected children on the risk of their later children inheriting the same disorder.Staff also manage a contract to provide maternal serum alpha feta protein testing (a blood test) for pregnant women who do not have another source of payment for this testing.
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HIV Case Management
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HIV case management includes referral, coordination, assessment, and linkage services provided for people who have Human Immunodeficiency Virus.
Persons are eligible to receive HIV case management services if they:
(1) have a medical diagnosis of HIV disease or HIV seropositivity;
(2) are eligible for regular Medicaid services;
(3) are not institutionalized; and
(4) are not recipients of other Medicaid-reimbursed case management services provide through the State's home and community-based waivers or the State Plan.
Types of HIV case management services include: evaluation of need, development of an individual plan of care, coordination of services included in the plan of care and monitoring of services for quality and effectiveness.
HIV case management services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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School Health Services
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School Health works to promote good health and school success of children and adolescents.The service offers schools expertise in:-Nutrition,-Behavioral health,-School nursing and clinical coordination and-Assistance for school health centers School Health staff members manage and monitor approximately 130 contracts for school nurses (School Nurse Funding Initiative) and school health centers who receive state appropriated funds. The staff also provide:-Direct services-Program development-Health education-Consultation and technical assistance to strengthen and support community school nurses and school health centers The service benefits students and their families as well as educational staff who require support of health personnel with students who have health care needs.
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Targeted Substance Abuse Prevention
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Substance Abuse Prevention services are provided to targeted individuals at risk of using and abusing alcohol, tobacco and other drugs. Services focus on prevention, intervention, and support for individuals, families and communities at risk for substance use and abuse. Services are delivered through the six prevention strategies that include: Information dissemination -Education -Alternatives -Problem identification and referral -Community based (that is, addressing access and social norms through policy, media, education and advocacy) and Environmental Strategies Targeted groups may include but not limited to LGBTQ youth, Children of substance abusers, youth affected by trauma, African American youth and parents. Strategies for these populations tend to be more selective and indicated according to the Institute of Medicine (IOM) model.
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Teen Pregnancy Prevention Initiatives (TPPI)
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The Teen Pregnancy Prevention Initiatives (TPPI) works to prevent teen pregnancies by funding projects in local health departments and community-based organizations. It supports educational and health care services to:
-Reduce pregnancies among teenage girls
-Help teenage parents prevent another unintended pregnancy
Services are in a limited number of communities and serve male and female teens, regardless of income, who are considered to be at risk of being or causing a pregnancy. Services are provided through contracts with local health departments and community-based organizations, schools; and local departments of social services.
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Vaccine Distribution and Administration
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Vaccine Distribution and Administration promotes a core public health function in North Carolina through partnership and collaboration with local partners, and strives to eliminate the transmission of vaccine preventable disease through effective immunization programs and outbreak control measures. Utilizing best practice strategies and evidence-based programming activities achieves this mission. Basic statewide core activities include: Vaccine Delivery -- Ordering federal vaccines and distributing them to Vaccines for Children (VFC) enrolled providers.Accountability and Management -- Monitoring proper vaccine storage, handling, safety and usage. Assuring compliance with federal requirements of the Vaccines for Children (VFC) and Section 317 programs. Visiting providers to conduct VFC Site Visits and IQIP (Immunization Quality Improvement for Providers) visits. Ensuring federal requirements are met and enforcing state immunization laws and compliance requirements.Program Support -- Providing training and education to health professionals. Informing providers and the public about vaccination schedules and CDC’s Standards for Pediatric Immunization Practices. Ensuring that children, birth through age 18, are appropriately immunized. Providers must administer vaccines according to the schedule recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, unless in the provider's medical judgment (subject to accepted medical practice) such compliance is medically inappropriate.Outbreak Control -- Monitoring and protecting the public from the occurrence of vaccine-preventable diseases. Preparing for and responding to public health emergencies.Monitoring Effectiveness -- Monitoring vaccine coverage and compliance with state requirements. Collecting and analyzing immunization data to ensure the service is effective and in compliance with state and federal requirements.Immunization Information Systems -- Maintaining the North Carolina Immunization Registry (NCIR), delivering a secure, confidential web based statewide computerized immunization information system. Activities related to Vaccine Distribution and Administration provides a link between the federal Vaccines for Children (VFC) and Section 317 Programs, which helps families by providing vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay. CDC buys vaccines at a discount and distributes them to grantees — i.e., state health departments and certain local public health agencies — which in turn distribute them at no charge to those private physicians' offices and public health clinics registered as VFC providers. The VFC program is administered at the national level by the U.S. Centers for Disease Control and Prevention (CDC) and at the local level by the North Carolina Immunization Program (NCIP). Enrolled VFC providers are able to order VFC vaccine through the NCIP and receive ACIP routinely recommended vaccines at no cost. This allows them to provide routine immunizations to eligible children without high out-of-pocket costs.
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Service Name
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340B Drug Pricing Program
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The 340B drug pricing program provides low-cost medications and assistance with prescription co-payments. Eligible patients are served by the North Carolina Farmworker Health Program and do not participate in other prescription assistance programs.
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Ambulance
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Ambulance includes transportation provided for emergency situations. Ground and air transportation are both covered services. Air transportation refers to fixed wing crafts and helicopters.
Under some conditions, a patient will be provided with non-emergency ambulance transportation. Situations when this is a covered service include when a recipient is bed-confined and has debilitating physical condition(s) that require travel by stretcher only and require ground transportation to receive medical services. The recipient’s condition must meet the definition of medical necessity and he/she must require medical services that cannot be provided in the place of residence.
Most Medicaid recipients are eligible for ambulance services, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Ambulance services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Ambulatory Surgery Center
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An ambulatory surgery center provides surgical procedures in an outpatient setting. A person receiving care in this type of facility has “same-day” procedures. The settings can be in centers connected to hospitals, physicians’ office or free-standing. Some birthing centers are also in this service group.
Most Medicaid recipients are eligible to receive services in ambulatory surgery centers, but there may be restrictions depending on the person’s type of Medicaid eligibility. A person’s physician decides if a surgical procedure can be safely performed in an ambulatory setting.
Ambulatory Surgical services are optional services.
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Case Management
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Case management services include referral, coordination, assessment, and linkage services provided for people who are at risk for neglect, exploitation or abuse. The services assist people
in gaining access to needed medical, social, educational, and other services and encourages the use of cost-effective medical care by referrals to appropriate providers.
Eligible recipient include adults who are at risk or show evidence of abuse, neglect, or exploitation as defined in G.S. 108A-101 or children who are at risk or show evidence of abuse or neglect as defined in G.S. 7A-517.
County departments of social services provide these services.
Representative activities include: evaluation of need, development of an individual plan of care, coordination of services included in the plan of care and monitoring of services for quality and effectiveness.
Case management services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Child Support Enforcement
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Child Support Enforcement (CSE) services help families collect child support payments to ensure that both parents financially support their children. Services are provided through county departments of social services or other agencies in conjunction with others such as clerks of court, the judiciary, sheriff departments, municipal law enforcement and employers. CSE offers the following services:
- Locating non custodial parents. CSE searches to find where the non custodial parent lives and or works and the location of assets the parents may use to provide support.
- Establishing paternity for children born outside of marriage. CSE establishes the legal father of the child to define a legal responsibility necessary to pursue a support obligation.
- Establishing support obligations Support obligations are entered as legally binding court orders.
- Collecting and distributing support. CSE collects support and distributes payments to the family. Records are kept of all court-ordered child support payments that are paid and that are past due.
- Enforcement. CSE works to ensure the non custodial parent's compliance with the court-ordered support.
Access and Visitation Services
Access and Visitation activities funded through a federal grant provides fatherhood initiatives to improve relationships between non custodial parents and their children. The goal is to increase collections for children and families and to help develop access and visitation by non custodial parents with their children. The services available through this include:
- Mediation and counseling
- Education
- Development of parenting plans
- Supervised visitation and development of guidelines for visitation, and neutral pick up and drop off.
The services provided may vary. Services are based on an assessment of need.
NC has awarded these funds to five (5) Family Court Districts who have hired Access and Visitation Coordinators to oversee and/or provide services; a smaller portion of the funds is also allocated to the Wake Co. Human Ser vice's Working for Kids program for utilization towards program services.
These services benefit children and families in North Carolina.
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Chiropractic
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Chiropractic services include diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system. The main chiropractic treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues. Services often include exercises and health and lifestyle counseling.
Most Medicaid recipients are eligible to receive chiropractic services, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Chiropractic services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Clinics
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Clinic services include screening, diagnosis and treatment services provided in free standing clinics, dialysis centers, health departments, Federally Qualified Health Centers and Rural Health Centers. This includes a wide array of services such as physician visits, diagnostic tests, screening tests, medical procedures, injectable drugs, vaccinations, renal dialysis, prevention services, family planning, rehabilitative services, etc.
Clinic services are optional in all settings except for Federally Qualified Health Centers and Rural Health Centers. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Clinics - Mental Health
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Mental Health Clinics, also referred to as Local Management Entities (LMEs), serve as managers of the local public mental health, developmental disabilities and substance abuse services system. They provide screening and referral services, provide day to day operations for Community Alternatives Programs for Mental Retardation & Developmental Disabilities waivers; develop, endorse and monitor the local provider network for MH/DD/SA services, provide care coordination for the most vulnerable recipients with disabilities and provide some direct services.
They may serve as a managed care organization for the catchment area, as does the Piedmont Cardinal Health Plan.
LMEs address the needs of persons with severe mental illness, developmental disabilities and/or substance abuse disorders in order to access and coordinate treatment services. LMEs contract with and monitor providers to promote timely access to quality services. The services that Medicaid funds serve as a safety net for local communities.
Medicaid recipients who have medically necessity for the types of services provided or managed by LMEs can access services by contacting the LME responsible for services in their county.
Mental Health Clinics are optional services. Some services provided by MHC may be considered mandatory, if medically necessary, for children up to age 21 under Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program.
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Community Services Block Grant Case Management
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The purpose of the Community Services Block Grant is to reduce poverty, revitalize low-income communities and empower low-income families and individuals to become self-sufficient/economically independent by (1) providing services in communities where poverty is an acute problem; (2) providing activities such as education, employment, income management, basic life skills, family supports, housing, child care, transportation, etc. designed to assist low-income participants, including the elderly poor, (3) providing emergency assistance inclusive of but not limited to rent/mortgage, utilities, medical/healthcare supports, etc. such as supplies and services, nutrition supports and related services to counteract conditions of starvation and malnutrition among the poor; and (4) coordinating and establishing linkages between governmental and other human services programs to assure the effective delivery of such services to low-income individuals.
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Congregate Nutrition
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Congregate Nutrition, that is, meals served in a group setting, such as a senior center or church, is funded under the Home and Community Care Block Grant (HCCBG) to help older adults stay in their homes. The meal (typically lunch) must meet 1/3 of the Recommended Daily Allowance (RDA) for nutrition.Services are available through HCCBG providers in counties, such as county departments of aging and social services and private nonprofit councils on aging. The service benefits adults age 60 and over, with an emphasis on minorities and socially and economically needy seniors.
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County Transportation
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County transportation services are provided in all counties of North Carolina to Medicaid recipients who need transportation to their medical appointments. Counties may have their own van and other transport vehicles, may contract with a local transportation system, may reimburse the recipient directly for transportation or may provide gas vouchers to the recipient. When a recipient has to travel out of county, other traveling expenses may be provided, such as meal reimbursement and lodging accommodations.
Counties may schedule the transportation themselves or may delegate that activity to a transportation vendor. Medicaid only pays for transportation if the recipient receives a Medicaid covered service provided by a qualified Medicaid provider (enrolled as a NC Medicaid provider) and only pays for the least expensive means suitable to the recipient’s needs.
Medicaid recipients arrange for transportation by contacting their local department of social services.
County transportation services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21. The State Plan must specify that the Medicaid agency will ensure necessary transportation for recipients to and from their medical providers.
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Dental
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NC Medicaid covers most diagnostic and preventive dental services such as exams, radiographs, dental cleanings, fluoride treatments and sealants for adults and children. These covered services are important in the detection and prevention of oral health problems. Fillings, root canals, periodontal services, oral surgery procedures and partial and full dentures are also covered.
These dental treatment services result in the restoration and/or maintenance of function and oral health. Orthodontic services are covered for children under age 21 with functionally impairing malocclusions. Poor oral health is often linked to many chronic and acute diseases in research studies. The services covered by the DMA Dental Program are designed to promote not only a healthy mouth and dentition, but also better overall systemic health.
Dental services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Durable Medical Equipment
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Durable Medical Equipment (DME) includes rented and purchased medical equipment and supplies that are provided for a person to use in their home. Examples of these types of equipment and supplies are: wheelchairs and other mobility devices, orthotics and prosthetics, enteral nutrition, oxygen and related supplies, urological supplies, etc. Repair and maintenance of equipment is also included in this service group.
A person’s physician must prescribe the equipment or supply and provide evidence of medical necessity. DME providers may bring the equipment and supplies to the person’s home or in some cases the items can be picked up in pharmacies and medical supply businesses.
Most Medicaid recipients are eligible to receive DME, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Durable Medical Equipment services are mandatory, however Orthotics and Prosthetics are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Family Planning
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Provides family planning services and other preventive care to low-income women and men by funding clinics in local health departments and other community-based providers. The aim is to:
- Decrease the number of unplanned pregnancies
- Decrease the health problems associated with unplanned pregnancies
The service benefits the general population with an emphasis on low-income North Carolinians. Services are provided through local health departments and some community-based organizations.
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Farmworker Health Medical and Outreach Services
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Farmworker medical and outreach services support agencies across the state that provide and link migrant and seasonal farmworkers with primary and preventive health services. Rural health centers, public health departments, community health centers, and local nonprofits provide a range of medical, nursing, case management, and education services at clinics, farmworker camps, and farmworker residences. This service benefits migrant and seasonal farmworkers and their families in North Carolina.
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Financing
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North Carolina Medicaid pays premiums for Part A and Part B Medicare for some Medicaid recipients who are eligible for both Medicare and Medicaid (also called dually eligible). The premiums are monthly and assure that Medicare is the primary healthcare payor for these dually eligible people. Part A Medicare covers services such as inpatient care in hospitals, nursing home care, skilled nursing facility care, home health and hospice care.
Part B Medicare covers services like doctors' services, outpatient care, home health services, and other medical services. Part B also covers some preventive services.
The local department of social services helps eligible people apply for Part A and Part B Medicare premium payments by Medicaid.
Part A and Part B Medicare premium payments are mandatory for states.
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Financing - Group Health Plans
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Medicaid pays premiums to some private insurance companies for some people who are also eligible for Medicaid. The people for whom Medicaid makes premium payments have diseases or conditions which are serious, complex and have a high treatment cost. By paying these claims, the person retains the third party insurance as the primary payor and Medicaid is the secondary payor.
This program is administered by Medicaid’s Program Integrity section, which helps enroll the people who are qualified for these premium payments.
Group Health Plan premium payments are optional for states
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Food and Nutrition Services
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TBD This is one of 11 funds across DHHS that assures that families at risk of economic challenges receive health and safety benefits. Food and Nutrition Services issues eligible applicants an EBT (Electronic Benefits Transfer) card to purchase food.
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Food and Nutrition Services
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Food and Nutrition Services provides cash-like benefits for eligible low- income individuals and families to buy nutritious food for good health. Benefits are based on family size and income. Food and Nutrition Services is North Carolina's name for the federal Supplemental Nutrition Assistance Program or SNAP.
In North Carolina, monthly benefits are issued via Electronic Benefit Transfer (EBT) cards. Benefits may be used to purchase food at participating stores. Workers at each local county department of social services/human services agencies determine who is eligible.
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Health Check
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The Health Check program includes regular preventive medical care and the diagnosis and treatment of any health problem found during a screening. There is no separate enrollment in Health Check. If someone is eligible for Medicaid and is under the age of 21, they automatically receive Health Check services. These services are also called Early Periodic Screening, Diagnosis and Treatment (EPSDT) services.
These services are important because they identify treatments that are medically necessary to correct or ameliorate a defect, physical or mental illness or a condition that is identified through a screening examination.
Health Check services are mandatory.
Services must be ordered by the Medicaid child's physician or another licensed clinician. Prior approval from the Division of Medical Assistance may be required to verify medical necessity for some services.
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Health Choice Program
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North Carolina Health Choice (NCHC) for Children is a free or reduced price comprehensive health care program for children. The goal of the NCHC Program is to reduce the number of uninsured children in the State to ensure that the population served will be healthy and ready to learn and work.
NCHC covers hospitalization and outpatient care including the following:
- Physician and clinic services
- Laboratory and radiology services
- Surgical services
- Prescription drugs
- Dental services
- Vision
- Hearing
- Durable medical equipment and supplies such as wheelchairs
- Physical therapy, occupational therapy and therapy for individuals with speech, hearing and language disorders
- Hospice care
- Home health care (limited)
- Inpatient mental health services (requires precertification)
- Outpatient mental health services (requires precertification after 26 outpatient visits per year)
- Inpatient substance abuse treatment and outpatient substance abuse treatment (requires precertification)
- Special needs children with chronic mental or physical conditions or illness may receive services beyond those listed above if the services are medically necessary (requires precertification)
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Hearing Aids
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Hearing aids are provided for Medicaid recipients who are less than 21 years of age. The person must receive medical clearance from a physician. Hearing aids must be prior approved; an audiogram evaluation report and hearing aid manufacturer’s warranty information is required as a part of the prior approval process. There are no copayments for hearing aids, hearing aid accessories or hearing aid services.
Hearing Aid services are optional services. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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HMO Premiums
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Health Maintenance Organization (HMO) premiums are payments made to contractors or other entities for eligible Medicaid recipients for:
1) Prior authorization of high resolution imaging procedures (Med Solutions),
2) Behavioral health services in a five-county area (Piedmont Cardinal Health Plan), and
3) Program for All Inclusive Care for the Elderly.
All requests for high resolution imaging procedures for Medicaid recipients must be prior approved, except for procedures in emergency rooms and inpatient hospital settings. A per member per month payment is made to Med Solutions to manage this function. High resolution procedures include PET scans, MRIs, CAT scans and ultrasounds.
Piedmont Cardinal Health Plan is a managed behavioral health care program that authorizes and coordinates all the behavioral health services in the five county area of Cabarrus, Davidson, Rowan, Stanley and Union. A per member per month payment is paid to Piedmont Behavioral for all the Medicaid recipients in these counties. The services include all psychiatric inpatient care, outpatient services, CAP/MR/DD and ICF/MR services.
PACE is a national model for a capitated managed care program for the frail elderly. The PACE model is regulated by the Centers for Medicare and Medicaid and combines Medicaid and Medicare funding to serve persons who meet the nursing facility level of care. PACE offers a comprehensive array of services to those persons enrolled in the program. Additionally, the enrollees receive oversight and intervention from professional staff and frequent and detailed medical reviews. The overall goal is to manage all the health and medical needs of this
frail population in order to avoid hospitalization and long term care placement.
Providing services under capitated payment arrangements is an optional service delivery.
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Home Health
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Home Health services include medically necessary skilled nursing care, specialized therapies (physical therapy, occupational therapy, speech therapy), home health aide services and medical supplies in a person’s home setting. The services must be provided by a Medicare-certified home health agency. Home health services are considered part-time and intermittent. A person’s physician must prescribe the service and authorize a patient specific plan of care.
Most Medicaid recipients are eligible to receive Home Health services, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Home Health services for persons over age 21 eligible for nursing facility services are mandatory services. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
Private Duty Nursing (PDN) is included in this category of service. PDN is an optional service.
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Home Infusion Therapy
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Home Infusion Therapy (HIT) services include infusion nursing services, pharmacy services, medical equipment, supplies and training for self-administration of a drug or nutrition therapy. The route of administration may be intravenous, enteral, parenteral or epidural. Antibiotic therapy, pain management and total parenteral nutrition are examples of HIT.
HIT services are available for recipients who live in a private residence or an adult care home.
Home Infusion Therapy services are optional.
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Hospice
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Hospice is a benefit, which a Medicaid recipient elects himself/herself due to having a terminal illness. An individual is considered terminally ill if he or she has a medical prognosis of six months or less life expectancy as certified by a physician.
Hospice services include nursing care, medical social services, counseling, the professional care of a physician, in-home aide services, home management services, physical and occupational therapy, speech/language pathology, medical appliances and supplies, drugs and biologicals and short-term inpatient care when related to the terminal illness.
Hospice services can be delivered in a private residence, an adult care home, a hospice residential care facility or a hospice inpatient unit. The services also may be provided in a hospital or nursing facility under arrangement with the hospice agency.
Hospice services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Hospital Services
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Hospital services include inpatient, outpatient and emergency room services provided in a hospital setting. The types of hospitals which provide services include general, critical access, rehabilitation and specialty.
Generally, all people eligible for Medicaid may receive services within the hospital setting, but there may be some restrictions depending on the person’s type of Medicaid eligibility.
Hospital services are mandatory.
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Integrated Health Care Delivery Systems
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Integrated Health Care Delivery Systems (IHCDS) funds creative local solutions to difficulties encountered in the financing and delivery of health care services for Medicaid recipients, the uninsured, and other vulnerable populations. IHCDS leverages existing infrastructure, including DHHS divisions, Community Care of North Carolina (CCNC), physicians, hospitals, health departments, community and rural health centers, communities, private philanthropies, and academia, to build and strengthen health systems that improve access and coverage; enhance quality, cost-effectiveness, and coordination of care; and contain unnecessary growth in healthcare expenditures through integration with the DHHS multi payer platform.
NC HealthNet initiative supports community efforts to provide organized and coordinated health care services to uninsured North Carolinians. Through HealthNet funding, patients get help with:
-Finding a primary care provider-Getting access to specialty care and prescription medications-Care for chronic medical conditions.
Effective SFY 2008, the HealthNet initiative supports the ongoing maintenance of community-based systems of care for the uninsured. This initiative links the volunteer spirit of community physicians, hospitals, health departments, rural and community health centers, and other safety net organizations with the administrative infrastructure of CCNC to provide low-income uninsured adults access to integrated health care services. HealthNet gains strengthen and help sustain communities' efforts to work collaboratively, share and conserve scarce resources, and find medical homes for the uninsured.
The Children's Health Insurance Program Reauthorization (CHIPRA)is a quality demonstration grant from the Centers for Medicare and Medicaid (CMS) that has been available since 1998. This grant seeks to develop, evaluate, and inform a national perspective on child healthcare quality that includes care provided through Medicaid and CHIP as a well as a provider-based models project and an electronic health records (EHR) format project. Long term outcomes of this grant are:
-Improve data collection for children’s healthcare quality measures-Incorporate new pediatric healthcare quality measures and assess their effect on accessibility and quality of Medical and CHIP services as well as transparency and consumer choice-Evaluate effectiveness of new or expanded provider-based models to improve healthcare quality for children covered by Medicaid and CHIP, support collaboration across multiple payers and stakeholder groups, become cost-effective, and identify changes to improve healthcare delivery to children-Implement and evaluate the pediatric HER format and assess its effect on the quality and cost of children’s healthcare.
The Chronic Pain Initiative/Project Lazarus (CPl) is another project of the ORHCC. Funding from the Kate B. Reynolds Charitable Trust, with Medicaid matching funds, addresses the rise in deaths by unintentional poisonings resulting from the use of opioid medications in the treatment of pain. Based on Project Lazarus, a successful pilot project in Wilkes County, CPI is a combined statewide effort of the state level partners, the CCNC networks, and Project Lazarus, Inc., as well as local coalitions of primary care and behavioral health providers, hospitals, education system personnel, law enforcement, and public health. CPI provides strategies and a series of toolkits to assist local medical providers address opioid misuse and abuse. The initiative addresses both the clinical issues related to prescribing opioid medications and the need for active community engagement. During SFY 2015, ORHCC secured funding from The Duke Endowment, along with Medicaid matching funds, to build upon the foundation of the CHIPRA initiative and support the statewide expansion of a successful local initiative. Fostering Health NC leverages the CCNC patient-centered medical home model of care and existing technology platforms to improve continuity of health information and coordination of care for the state’s foster children.
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Lab and X-Ray
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Lab and X-ray services include diagnostic lab tests in independent laboratories and lab tests and portable x-rays and ultrasounds in independent diagnostic testing facilities. These types of tests are ordered by physicians. These services do not include lab and x-ray services performed in hospitals and physician offices.
Most Medicaid recipients are eligible for lab and x-ray services provided in these settings, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Lab and X-ray services are mandatory services.
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Local Education Agencies
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Medicaid pays for certain health-related services provided by local education agencies (LEAs) within the public schools and other settings identified in the Individualized Education Plan (IEP).
Direct medical services that are currently available within the LEA setting are audiology, speech/language therapy, occupational therapy, physical therapy, psychological and counseling services and nursing services.
The covered services are performed by school staff or contracted personnel.
LEA services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Low Income Energy Assistance Program (LIEAP)
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LIEAP is a one-time vendor payment to help eligible households pay heating bills. The amount of the benefit is dependent on household size and income. Applications are taken December 1st through March 31st of every year through county departments of social services; however, priority in eligibility is given to households containing an elderly person age 60 and above or a disabled person receiving services through the Division of Aging and Adult Services (DAAS) from December 1st through January 1st or until funds are exhausted. Disabled persons are defined as receiving SSI, SSA, or VA disability. Net income must be at or below 130% of the Federal Poverty Level.
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Operation Fan-Heat Relief - OFHR
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Operation Fan Heat Relief (OFHR) has provided free fans during the summer for those 60 and older whose health, safety and comfort is at risk from extended heat in their home. Recently, contributors have allowed fans to be given to adults with disabilities under the age of 60 as well as air conditioners to adults with more severe health issues, as noted by their doctor. OFHR has no federal, state or local funding. The private contributors (Dominion NC Power, Duke Energy, Progress Energy and Valassis Corp.) provide policies and designate eligibility criteria for adults living in their service area. Money is not used for direct cash assistance, payment of utility bills or administrative costs. Adults living in the service area of one of the private contributors may apply for this assistance through local aging offices.
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Optical
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Optical services include routine eye exams and visual aids (eyeglasses, medically necessary contact lenses and other visual aids) for adults and children. Prior approval is required for all visual aids. There are limitations regarding the frequency of eye examinations and the number of dispensed visual aids. Providers are required to obtain Medicaid eyeglasses through a single contractor unless there are extenuating circumstances.
Most Medicaid recipients are eligible for optical services, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Optical services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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PART D
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North Carolina Medicaid pays a monthly ‘premium’ to the Federal government for Part D services for some Medicaid recipients who are eligible for both Medicare and Medicaid (also called dually eligible). The premiums are for drug costs Medicaid would have been responsible for before the Part D legislation in 2006. These payments are also referred to as "clawback" payments.
Eligibility staff in the local departments of social services assists Medicare eligible recipients with Part D enrollment. Medicaid recipients, entitled to/or enrolled in Medicare, can opt to not be covered by Medicare Part D. This is called affirmatively declining. Medicaid recipients who affirmatively decline Medicare Part D coverage will not be auto-enrolled into a prescription drug plan. Therefore, they will not have prescription drug coverage, unless they have other prescription drug insurance coverage.
Part D payments are mandatory for states.
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Partial Payments
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Partial payments are not services, per se, but are financial transactions for Medicaid services which will be allocated to specific accounts at a later time. These financial transactions are purely for accounting purposes.
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Personal Care Services
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Personal Care Services (PCS) include a range of hands-on human assistance provided to persons of all ages with disabilities and chronic conditions to enable them to accomplish tasks that they would ordinarily do for themselves if they were not disabled. The services are primarily provided by a paraprofessional aide in a person’s home and include assistance with common activities of daily living (ADLs) such as eating, dressing, bathing, toileting, and mobility. Services are provided on a scheduled and intermittent basis to supplement other community services and the care, assistance, and support provided by the recipient’s family and other informal caregivers.
Medicaid in-home PCS does not require the recipient to meet Medicaid nursing facility level of care requirements to participate and are generally not adequate in scope and amount to replace facility-based services for recipients who require ongoing care, supervision, or monitoring by a nurse or other health care professional. This program is appropriate for recipients whose needs for assistance can be safely met in the home by family members and other informal caregivers supported by scheduled visits by specially trained PCS aides.
Personal Care Services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Physician
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Physician services include assessment, diagnosis, treatment, consultation and surgical services provided in inpatient and outpatient settings by licensed physicians and other licensed practitioners. The providers in this service category include all physician specialties such as general practitioners, surgeons, pediatricians, oncologists, anesthesiologists and radiologists. It also includes practitioners such as nurse practitioners, and certified nurse anesthetists who practice under the supervision of a licensed physician or independently within the scope of their professional licensure and certification.
Generally, all people eligible for Medicaid may receive physician services, but there may be restrictions for certain types of physician services depending on the person’s type of Medicaid eligibility.
Over 80 percent of people eligible for Medicaid have a primary care physician who helps them access other types of specialty physicians and practitioners when needed. Primary care physicians provide care and case management so that a Medicaid recipient has the benefit of a coordinated approach to management of their health care needs.
Physician services are mandatory services.
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Podiatry
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Podiatry is the surgical, medical, or mechanical treatment of ailments of the human foot and ankle, and their related soft tissues. Podiatry is considered an optional service and therefore included in the annual limitation of eight total optional services. Generally speaking, routine foot care is not covered except as determined to be medically necessary.
Most Medicaid recipients are eligible for podiatric services, but there may be restrictions depending on the person’s type of Medicaid eligibility.
Podiatry Services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Practitioner Non Physician
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Practitioner Non-Physician services include two types of services:
1) outpatient and enhanced behavioral health services for adults and children, and
2) specialized therapies (physical, speech, occupational and respiratory therapy) for children provided by Independent Practitioners.
Outpatient and enhanced behavioral health services include services such as outpatient psychotherapy, substance abuse treatment, intensive in-home services, crisis services, community support, psychosocial rehabilitation, etc. Some provider types must be endorsed by the Local Management Entities (mental health agencies), while some providers who provide outpatient behavioral health services can be independently enrolled.
Adults and children who have medical necessity for behavioral health services are eligible to receive these services, although most of them have to be prior approved by a Medicaid designated contractor.
Specialized therapies (PT/OT/ST/RT) provided by Independent Practitioners (IPP) may be delivered in the IPP office, at the Medicaid recipient’s home, school, through the Head Start program, and at child care settings (i.e., regular and developmental day care) settings. The services must be prior approved after a certain number of limited visits.
Practitioner Non-Physician Services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Refugee
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The North Carolina Refugee Medical Assistance Program (RMA) provides health care to needy refugees who do not meet qualifications for any other health care program. RMA is a short-term transitional program available for the first eight months a refugee resides in the United States.
Local departments of social services (DSS) determine eligibility for RMA. In providing RMA to refugees, providers must provide at least the same services in the same manner and to the same extent as provided under the North Carolina Medicaid program. Refugee Medical Assistance (RMA/MRF) is the program of last resort. Therefore, DSSs must first assess each individual refugee applicant for Family and Children’s Medicaid, Aged, Blind, and Disabled (Adult) Medicaid and NC Health Choice for Children (NCHC).
Refugee Services are funded entirely by Federal funds.
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Refugee Health Assessments
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The purpose of the Refugee Health Assessment is to quickly detect and treat any communicable diseases in newly arriving refugees. The health assessment also identifies and treats health problems that could keep the refugee from finding a job and independence. Newly arrived refugees are screened primarily in local health departments, where they also receive follow-up treatment or referrals for identified health conditions. Service offerings in local health departments vary slightly from county to county. Refugees may come to live in any county in North Carolina although there are several counties that receive the majority of new arrivals. Parts of the refugee health assessment should be available to any refugee living in any county.
Key service activities include:
Provide funding to affected local health departments for implementation of appropriate refugee health screenings to newly arrived refugees
Consultation and technical assistance, monitoring, data collection, and training provided by the state Refugee Health Coordinator to affected local health departments
Persons eligible for this service are refugees and some other immigration statuses (certain Cuban and Haitian entrants, certain Amerasians, asylees, adult victims of severe forms of trafficking, Iraqi/Afghan Special Immigrants and Lawful Permanent Residents who held one of the previously listed statuses prior to adjusting to Lawful Permanent Resident) that are eligible for refugee benefits and services. The Refugee Health office contracts with the top seven local health departments each year (funding is based on previous year arrival numbers, numbers of refugees reported to be screened, and projected future year arrivals). Local health departments may be able to bill Medicaid or Refugee Medical Assistance for the cost of the health assessment. The funding for this service is 100% federal from the Office of Refugee Resettlement.
The service benefits newly arrived refugees and the general population ofNorth Carolina.
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Refugee Medical Assistance (RMA)
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The North Carolina Refugee Medical Assistance Program (RMA) provides health care to needy refugees who do not meet qualifications for any other health care program. RMA is a short-term transitional program available for the first twelve (12) months a refugee resides in the United States.
Local departments of social services (DSS) determine eligibility for RMA. In providing RMA to refugees, providers must provide at least the same services in the same manner and to the same extent as provided under the North Carolina Medicaid program. Refugee Medical Assistance (RMA/MRF) is the program of last resort.
Refugees must
FIRST be evaluated for all Medicaid program for any of the mainstream Medicaid programs {Family and Children’s Medicaid (MAF) i.e. Medicaid Pregnant Women (MPW), Aged, Blind, and Disabled (Adult) Medicaid, NC Health Choice for Children (NCHC) and Children’s Health Insurance Program (NC CHIP)} and determined ineligible PRIOR to being placed on RMA.
RMA provides health care coverage for the first 12 months a refugee resides in the USA and has eligibility status, such as:
Refugee
s
Asylees
Cuban and Haitian Entrants
Certain
Amerasians
XE "Amerasians"
(from Vietnam)
Victims of Human Trafficking
Special Immigrant Visa (SIV)
XE "Special Immigrant Visa (SIV)"
Holders from Iraq and Afghanistan
NOTE
: SIV holders and potentially transition to Lawful
Permanent Residents
(LPR)
status within the first ninety (90) days, after date of entry
XE "Date of Entry"
into the United States.
Afghan Special Immigrant Parole (SI/SQ)
Afghan individuals with Special Immigrant (SI) Conditional Permanent Residence (CPR)
Afghan Humanitarian Parolees (AHP)
Ukrainian Humanitarian Parolees (UHP)
Non-Ukrainian Individuals
XE "Non-Ukrainian Individuals"
displaced from Ukraine
displaced from Ukraine-->
displaced from Ukraine-->
NOTE: Current, Lawful Permanent Residents (LPR) XE "Lawful Permanent Residents (LPR)" status holders may have held one of the above statuses prior to adjusting to LPR status. Refugee Services are funded entirely by Federal funds.
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Senior Farmers' Market Nutrition Program Participant Vouchers
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Senior Farmers' Market Nutrition Program Participant Vouchers provide low income seniors access to fresh locally grown produce. This services lessens the risk of malnutrition and enhances seniors' independence. Seniors who attend congregate (group) meal sites may receive vouchers through the US Department of Agriculture for the purchase of locally grown produce at state-certified farmers markets. Market vendors deposit the vouchers through their bank, and the program is paid through the State Treasurer's Office.
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Service Name
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Refugee Cash Assistance (RCA)
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The North Carolina Refugee Cash Assistance (RCA) Program was established to provide income to refugees who do not meet qualifications for Work First Cash Assistance (WFCA), Supplemental Security Income (SSI) or Matching Grant (MG). RCA is a short-term transitional program available for the first twelve months from their arrival date or the date the eligible is granted in the United States. RCA is for eligible people who do not have dependent minor children. In determining eligibility for RCA, the county DSS must comply with the policies and procedures described in this chapter of the NC Refugee Assistance Manual. Matching Grant (MG) is a separate federal program designed to help refugees attain economic self-sufficiency within eight months (240 days) after date of arrival in the United States, without accessing public cash assistance. Participating NC refugee resettlement agencies agree to match the Office of Refugee Resettlement (ORR) grant with cash and in-kind contributions for refugees who qualify. If individuals, couples and/or families with refugee status receive Matching Grant then the individual, couple and/or family member will not be eligible for any another public cash assistance benefit such as Refugee Cash, Work First Cash Assistance, or Supplemental Security Income (SSI) while receiving MG. This is referred to as dual enrollment of a public assistance benefit, which is not acceptable. Refugee families with dependent minor children must apply for, and if eligible, participate in the state Temporary Assistance for Needy Families (TANF) program, known in North Carolina as Work First. See Work First Manual XE "Work First Manual" to determine eligibility for WFCA. Refugees sixty-five (65) years of age or older, or refugees who are blind or disabled, would meet criteria for the SSI. DSS is responsible for referring eligible individuals to the Social Security Administration for SSI benefits. NOTE: The term “refugee” will refer to all populations/groups listed below, who are ORR-eligible with a qualified status, exempt from the 5-year ban time frames and potentially eligible for RCA. RefugeesAsyleesCuban and Haitian EntrantsCertain Amerasians (from Vietnam)Victims of Human TraffickingSpecial Immigrant Visa (SIV) XE "Special Immigrant Visa (SIV)" Holders from Iraq and Afghanistan. NOTE: SIV holders and potentially transition to Lawful Permanent Residents (LPR) XE "Lawful Permanent Residents (LPR)" status within the first ninety (90) days, after date of entry into the United States. Afghan Special Immigrant Parole (SI/SQ)Afghan individuals with Special Immigrant (SI) XE "Afghan individuals with Special Immigrant (SI)" Conditional Permanent Residence (CPR)Afghan Humanitarian Parolees (AHP)Ukrainian Humanitarian Parolees (UHP)Non-Ukrainian Individuals XE "Non-Ukrainian Individuals" displaced from Ukraine XE "Victims of Human Trafficking" XE "Afghan Special Immigrant Parole (SI/SQ)" XE "Conditional Permanent Residence (CPR)" XE "Afghan Humanitarian Parolees (AHP)" XE "Ukrainian Humanitarian Parolees (UHP)" NOTE: References will be made to the NC Work First Manual XE "Work First Manual" whenever the WFCA and RCA programs have policies and procedures in common. Exceptions or special rules for RCA will be noted. RCA recipients must be referred and participate in employability services within thirty (30) calendar days of receipt of approval RCA disposition. If a refugee service provider is not available within the county AND they individual is receiving Refugee Cash Assistance, then employment services are provided by the local Department of Social Services.
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Refugee Social Services
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North Carolina’s Refugee Services Programs (RSP) provide transitional assistance to help refugees and other eligible populations become economically self-sufficient and to assist them in becoming integrated members of their communities. RSPs were established via federal funding from the U.S. Office of Refugee Resettlement (ORR) to provide refugee-specific services defined and designated by federal regulation as being allowable for eligible populations, which include: RefugeesNorth Carolina’s Refugee Services Programs (RSP) provide transitional assistance to help refugees and other eligible populations become economically self-sufficient and to assist them in becoming integrated members of their communities. RSPs were established via federal funding from the U.S. Office of Refugee Resettlement (ORR) to provide refugee-specific services defined and designated by federal regulation as being allowable for eligible populations, which include:RefugeesAsyleesCuban and Haitian Entrants XE "Cuban and Haitian Entrants" Certain Amerasians XE "Amerasians" (from Vietnam)Victims of Human TraffickingSpecial Immigrant Visa (SIV) XE "Special Immigrant Visa (SIV)" Holders from Iraq and Afghanistan NOTE: SIV holders and potentially transition to Lawful Permanent Residents (LPR) status within the first ninety (90) days, after date of entry XE "Date of Entry" into the United States. Afghan Special Immigrant Parole (SI/SQ)Afghan individuals with Special Immigrant (SI) Conditional Permanent Residence (CPR)Afghan Humanitarian Parolees (AHP)Ukrainian Humanitarian Parolees (UHP)Non-Ukrainian Individuals XE "Non-Ukrainian Individuals" displaced from Ukraine XE "Refugees" XE "Victims of Human Trafficking" XE "Conditional Permanent Residence (CPR)" XE "Afghan Humanitarian Parolees (AHP)" XE "Ukrainian Humanitarian Parolees (UHP)" NOTE: Current, Lawful Permanent Residents (LPR) status holders may have held one of the above statuses prior to adjusting to LPR status. These eligible populations may receive services up to 5 years. A person is no longer eligible for services once they become a U.S. citizen (are naturalized.) Direct refugee services are provided via pass-through funds for programs delivered by local agencies. These include programs such as:- Refugee Support Services Refugee School Impact Refugee Early School Impact Services to Older Refugees Refugee Youth Mentoring Refugee Health Promotion Refugee Mental Health Initiative. The Refugee Social Services program provides intensive, refugee-specific services to eligible "refugees" in such areas as employment, English language training, case management, social adjustment, Interpretation, and immigration assistance (among others). All services are provided in conjunction with a family self-sufficiency, employability, and services plan. The goal of the program is to provide the necessary support services to enable the client to become an integrated, participating member of the community where they live. The program stresses employment for adults as early as possible. Clients access the program by enrolling with a local refugee service provider in their area.
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Smart Start-Subsidized Child Care Services
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Smart Start Subsidized Child Care Services help eligible families in need pay for child care. The assistance is provided under the Smart Start program, which serves children from birth to age 5. Smart Start services are provided statewide through 75 local partnership organizations.
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Subsidized Child Care Services
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Subsidized Child Care provides financial assistance to eligible families through county departments of social services to help pay for child care. Families may apply through their county social services department (DSS). The DSS may contract with a local agency to provide vouchers and issue payments for child care. The service benefits children from low-income families. Assistance is available to support parents' employment or education, child developmental needs, child protective services and child welfare services.
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Work First Family Assistance
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Work First Family Assistance provides monthly financial assistance to meet the basic needs of families with children, such as food and shelter. The local department of social services/human services agencies processes applications for cash assistance within 45 days. Cash assistance is limited to 24 months for cases including adults. Families also receive intensive employment services to help them become self-supporting. The service benefits low-income families with children.
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Service Name
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Sickle Cell Syndrome - Services for Children
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The NC Sickle Cell Syndrome Program provides clinical care, care coordination and educational services to the pediatric population across the state who are living with sickle cell disease and other related blood disorders. Services included are: - Education about sickle cell disease and sickle cell trait is provided to individuals and families affected by sickle cell trait and to the general population. - Ongoing care coordination and counseling services in addition to medical services are provided to patients Pediatric services to sickle cell clients are offered to reduce death and illness from sickle cell disease by supporting one community-based organization, medical centers and regional sickle cell educator counselors. This service contracts with one community based organization and six medical centers throughout the state.
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Smart Start Health Related Activities
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Health-related activities are one of the services provided under the Smart Start program, which serves children from birth to age 5. This service is for children with special needs or at risk of developmental delay. It is provided in addition to services supported by mental health or early intervention or special education funds. It includes:
-Neonatal intensive care unit support
-Speech, physical or other therapists
-Behavior intervention specialists
-Parent-to-parent activities
-Coordination of services
Services are provided statewide through 75 local Smart Start partnership organizations.
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Service Name
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Client Services
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The following support activities are provided to all deaf, hard of hearing, deaf-blind North Caroliniansand their families, in all 100 counties, through the Regional Centers:
-Advocacy
-Counseling
-Consultation
-Technology training
-Information and referral
-Consumer skills development
-Telecommunications and emergency alerting equipment distribution
Eligible North Carolinians who are Deaf, Hard of Hearing or Deaf-Blind may apply to receive telecommunications and emergency alerting equipment. To ensure effective communications, regional centers help clients with the following:
-Selection of telecommunications and emergency alerting equipment
-Installations of telecommunications and emergency alerting equipment
-Appropriate use of adaptive equipment
-Knowledge and awareness of other types of equipment
The deaf, hard of hearing and deaf-blind have different needs and regional centers assist with:
-Self-advocacy skills development
-Understanding individual rights under the Americans with Disabilities Act of 1990, Section 504 of Rehabilitation Act of 1973 and other related statutes
-Effective use of sign language interpreters
-Selecting and using effectively appropriate assistive technology
-Dealing with grief over losing hearing
-Training family members how to effectively communicate with an older adult with hearing loss
-Advocacy in accessing housing, transportation, healthcare services, emergency alert and response services, law enforcement, judicial system and so forth
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Service Name
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Intellectual and Developmental Disability Services for Adults
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Community
Based Intellectual and Developmental Disability services are provided to adults
aged 18 and older with intellectual and/or developmental disabilities so they can remain in
the communities of their choice. Services include:
-Personal care: assistance with activity of daily living
skills;
-Habilitation: services
to assist the individual in retaining, acquiring, and
improving the self-help, socialization, and adaptive
skills necessary to reside and participate successfully in the
community;
-Supported
employment: supporting
people to seek and gain work and providing the support they need
maintain employment in a competitive and integrated setting;
-Residential
services: supporting individuals living in licensed homes and supported living settings;
-Respite
services: a
short-term/periodic relief or break for caregivers; and
-Education
and supportive services for families.
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The services are accessed through Local Management Entities -Managed Care Organizations (LME-MCOs), which are local agencies responsible for overseeing and managing publicly funded mental health, developmental disability and substance abuse services; and through providers that contract with LME-MCOs throughout the state.
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Medical Eye Care Services
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Medical Eye Care provides one-on-one care which may include eye exams, surgery, purchase of eyeglasses, low-vision evaluations and eye care education to prevent blindness and restore vision. Services are provided by eye care professionals.
Services are available to low-income North Carolina residents who do not qualify for Medicare. The social worker for the blind in each county determines eligibility.
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Mental Health Hospital - Adults
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Inpatient behavioral health services provide treatment for people 65 years and older in a hospital setting 24 hours a day. Supportive counseling, therapeutic interventions, nursing and medical care are provided under the supervision of a psychiatrist or a physician. This service is designed to provide continuous treatment for Medicaid recipients with acute psychiatric or substance abuse problems.
Inpatient behavioral health services are provided both in private psychiatric hospitals, general hospitals and state operated hospitals. Inpatient services have to be authorized by a Medicaid contractor.
Inpatient Behavioral Health Services for adults are optional.
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Mental Health Services for Adults
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Community Based Mental Health Services for adults age 18 and up includes an array of evidence based practices and services that treat, empower and support North Carolina residents with mental illness and their families. These include: Assertive Community Treatment, Community Support Team , Individual Placement Support-Supported Employment, Psychosocial Rehabilitation programs, Mobile Crisis Management, Peer Support Services, Outpatient Therapy, and Medication Management
The services are provided through local management entities-managed care organizations (LME-MCOs), which are local agencies responsible for overseeing and managing publicly funded mental health, developmental disability, and substance abuse services; and through providers that contract with LME-MCOs throughout the state. The services benefit North Carolina residents with a diagnosis of mental illness and their families.
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Sickle Cell Syndrome - Services for Adults
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The North Carolina Sickle Cell Syndrome Program provides clinical treatment, care coordination and educational services to the adult sickle cell population in our state. The DPH-Sickle Cell Benefit Plan (DPH-SC; formerly known as Purchase of Medical Care Services or POMC) is available to eligible adult sickle cell clients with low or no income and/or health insurance coverage and are in need of coverage for clinical care. Adult services include: Education to sickle cell clients about the disease and how to reduce death and illnessCare coordination, counseling and support is available from regional sickle cell educator counselors and contracted community based sickle cell staffClinical care is provided by hematologists and other clinical staff at six contracted medical centers This service contracts with one community based organization and six medical centers throughout the state.
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Single Stream Funded Services
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Single stream funding is a way of paying for services for individuals who have a diagnosis of mental illness, a developmental disability or a substance abuse issue, or a combination of these. Services are delivered by providers contracted with local management entities/ managed care organizations (LME/MCOs) that are paid via a non-Unit Cost Reimbursement(non-UCR) fee structure.State service funds are allocated to the LMEs once state General Assembly approves an annual budget, and these allocation are communicated to the LMEs via the continuation allocation letter and subsequent allocation letters. The majority of these state funds are allocated into the single stream funds account. Single stream funds are allocated as non-UCR funds, but LME/MCOs are required to submit claims for services rendered and the value of these claims will be considered in settlement of the single stream funding account. Since the single stream funds are flexible in nature, LME/MCOs do not have to request a realignment of these funds.
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Substance Abuse Services for Adults
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Substance Use Disorder services for adults are designed for individuals age 18 and older with identified substance use related disorders. Services and Supports include:
-Recovery Supports such Recovery Centers and Support Services, Screening Brief Intervention and Referral to Treatment (SBIRT)-Outpatient treatment such as individual therapy, group therapy, family therapy, community support team
-Other Enhanced Services (outpatient):
-Substance Abuse Intensive Outpatient Program (SAIOP)
-Substance Abuse Comprehensive Outpatient Treatment (SACOT)
-Community Support Team (CST)
-Opioid Treatment Program (OTP)
-Residential Services such as halfway house, residential treatment, and other group living services-Detoxification Services-Inpatient Hospital
-Substance abuse services for pregnant women and women with children.These services provide comprehensive gender-specific substance abuse services that may include, but are not limited to the following: assessment, case management, individual, group and family therapy, substance abuse intensive and/or comprehensive out-patient services, parenting training, residential services, coordination with primary and preventative health care, ancillary services and referrals for appropriate interventions for the children.
-Work First is a statewide initiative to provide early identification of Work First applicants and recipients that have substance use problems that impact their ability to become self-sufficient, Class H or I controlled substance felons that have substance use problems who are applying for Work First and/or Food and Nutrition Services to access substance use services, and to assist parents who are involved with Child Protective Services, who have substance use problems, to engage in appropriate treatment.
-Treatment Accountability for Safer Communities (TASC) services are designed to address addiction, mental illness and criminal behavior among the criminal offender population with the aim of reducing criminal activity and drug use among this population.
Services are delivered by contracted providers of Local Management Entities. Local Management Entities manage and oversee publicly funded mental health, substance abuse, and intellectual and developmental disability services to North Carolinians.
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Service Name
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Child Protective Services
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Child Protective Services (CPS) helps prevent further harm to children from abuse, exploitation or neglect by a parent or caretaker. CPS workers in county departments of social services (DSS) accomplish this through:
Assessing suspected cases of abuse and neglect.
Assisting the family in diagnosing the problem.
Providing in-home counseling and supportive services to help children stay at home with their families.
Coordinating community and agency services for the family.
Petitioning the court for removal of the child, if necessary.
Providing public information about child abuse and neglect.
There are three phases to CPS: Intake, CPS Assessments and CPS In-Home Services. Social workers at the county DSS receive reports of alleged abuse or neglect, determine whether the allegations meet the legal definitions (CPS Intake), and if so, initiate a CPS Assessment. If the family needs services, CPS provides them (CPS In-Home Services) until the conditions that led to the maltreatment are resolved. When the safety of the child cannot be assured, DSS takes the child into legal custody.
Child Protective Services are available 24 hours a day, seven days a week, through all 100 county departments of social services in North Carolina. The program serves all infants, children and adolescents in North Carolina who need protection.
When a CPS report is accepted for assessment, one of two approaches is used. For abuse and severe neglect cases, the Investigative Assessment approach is used. For cases involving neglect or dependency, a more family-centered approach (the Family Assessment) may be used. There are specified steps that must be taken by the CPS social worker in order to determine whether or not involuntary CPS services are needed by the family. If services are needed, these are provided during the CPS In-Home Services (formerly known as Case Planning and Case Management) phase.
At the conclusion of a CPS Assessment (Investigative Assessment or Family Assessment), a case decision must be made whether there are safety issues for children in the home that require involuntary CPS services, the CPS social worker arranges or provides services to alleviate the conditions that led to the maltreatment of the child and to resolve the safety issues.
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Emergency Respite for Caregivers
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Emergency Respite for Caregivers provides respite to caregivers (parents, foster parents, or any other adults responsible for children) who are caring for children with behavioral health needs. Respite can be planned or unplanned, facility or home-based, for short durations or longer periods of time consistent with 1915i Medicaid Policy. The goal is to support families so that children can remain in their homes, reducing the likelihood for higher end services, minimizing placement disruptions, and reducing incidences of crises. Services include paying for reserved capacity, technical assistance and workforce development, and building new provider capacity. Funding is non-recurring State funds which are distributed via allocation with Tailored Plans.
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Family Behavioral Health Peer Supports
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Family Behavioral Health Peer Supports deliver support services via Family Partners/Peers through face-to-face support groups, phone calls, or individual meetings. They bring expertise based on their own experience parenting children or youth with social, emotional, behavioral, or other challenges. Family Partners/Peers guide caretakers through a complex behavioral health system and empower families to advocate for themselves and their children. This service is only available when a child is experiencing behavioral health challenges. The program is also expanding the capacity of our university partner to provide training, implementation support, and capacity building to expand Family Partner/Peer services. Current funding is non-recurring State funds dispersed through a contract with the University of North Carolina-Greensboro who subcontracts with provider agencies to employ Family Partners/Peers. The goal is to engage 30-40 new peers serving an estimated 900 families by the end of FY 26 and the development of a new child Medicaid clinical coverage policy to support sustainability and continued growth of service.
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Service Name
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CAP-Children
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The Community Alternatives Program for Children (CAP/C) is a 1915 (c) home and community based waiver authorized by the Centers for Medicare and Medicaid Services. It is for children less than 21 who have nursing facility or hospital level of care needs. It allows children needing long-term medical care to return to or remain in the community and live as independently as possible in their homes. The program provides in-home nurse or nurse aide care, respite care, case management, home and vehicle modifications, waiver supplies and other services.
Local case management providers provide case management, assessments, care plans, education and training for family members and maintain waiting lists for families who desire a CAP/C slot for their child. The Division of Medical Assistance serves as the lead agency and provides overall management of the program.
CAP- Children services are waiver programs and as such are optional services.
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Early Intervention
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Early Intervention serves children birth to age 3 who have diagnosed conditions or developmental delays and their families.- Determines whether children are eligible for the program;- Ensures the development of an Individualized Family Service Plan for eligible children;- Provides Service Coordination through the 12 state-operated and four contractor-operated Children's Developmental Services Agencies (CDSAs);- Ensures the provision of services through a network of Community Providers and the CDSAs Monitoring of the service system is provided through the Division of Public Health. The desired result is that children receiving the service reach their highest developmental potential.
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Intellectual and Developmental Disability Services for Children/Adolescents
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Community Based Intellectual and Developmental Disabilities services
support North Carolina children and adolescents ages 3-17 with
intellectual and/or developmental disabilities in order to remain in the
communities of their choice. Services provided include: -Personal care: assistance with activity of daily living skills; -Habilitation: services
to assist the individual in retaining, acquiring, and improving the
self-help, socialization, and adaptive skills necessary to reside and
participate successfully in the community; -Supported employment: supporting people to seek and gain work and providing the support they need maintain employment in a competitive and integrated setting,; -Residential services: supporting
individuals living in licensed homes and
supported living settings; -Respite services: a short-term/periodic relief or break for caregivers; and -Education and supportive services for families. The services are accessed through Local Management Entities -Managed
Care Organizations (LME-MCOs), which are local agencies responsible for
overseeing and managing publicly funded mental health, developmental
disability and substance abuse services; and through providers that
contract with LME-MCOs throughout the state.
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J. Iverson Riddle - Child (Family, Infant, and Preschool Program / FIPP)
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The Family Infant Preschool Program (FIPP) of the J. Iverson Riddle Developmental Centerprovides supports and resources towomen who are pregnant, children from birth through five years of age with identified intellectual and developmental disabilities and their families in western North Carolina. Resources and services include:
-Child developmental evaluation and assessment
-Child psychological services
-Early childhood health and development screening
-Early childhood education or special education
-Family support
-Medical supports including nursing services; therapies such as physical, occupational, and speech; Infant and child mental health services
-Assistive technology supports and services
-Neonatal follow-up care
-Parenting Education
FIPP provides early intervention services in Alexander, Burke,Caldwell, Catawba, and McDowell Counties through a contract with the Morganton/Hickory Children’s Developmental Service Agency. FIPP also operates an Early Head Start program in Alexander, Burke, andCaldwellCountieswith 6 infant-toddler classrooms, 3 Family Resource Centers, and home visiting supports for 200 children and families.
FIPP works in partnership with families using family-centered practices, based on respect for families' beliefs and values, as well as their cultural and ethnic backgrounds. FIPP research is conducted as part of the Center for the Advanced Study of Excellence in Early Childhood and Family Support Practices.
FIPP is recognized as one of ten National Centers of Excellence in Early Childhood by the Office of Head Start.
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Mental Health Services for Children/Adolescents
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Community Based Mental Health Services for children and adolescents aged 3-18 includes an array of evidence based practices and services that treat, empower and support North Carolina children and adolescents with mental illness and their families. These services include:
Individual, family, and group counselingMedication ManagementDay treatment servicesIntensive treatment services provided at home and across community settingsMobile Crisis ManagementMultisystemic Therapy Residential services when in-home treatment services have not been able to reduce symptoms and help functioning.
The services are provided through local management entities-managed care organizations (LME-MCOs), which are local agencies responsible for overseeing and managing publicly funded mental health, developmental disability, and substance use services; and through providers that contract with LME-MCOs throughout the state.
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Substance Abuse Services for Adolescents
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Adolescent treatment is comprehensive and may involve multiagency collaboration, wrap around services and System of Care Principles. Substance abuse Services for Adolescent are age and gender appropriate evidence based treatment modalities designed for individuals age 18 and under identified with a substance use disorder. Services include: screening/referral; assessment; engagement; evidence based treatment; beyond treatment/Recovery Oriented Systems of Care. These services involve a joint planning effort of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services and the Department of Public Safety, Division of Adult Corrections and Juvenile Justice. The Juvenile Justice Behavioral Health Partnership (JJBH) serves youth with co-occurring diagnoses who are involved in the juvenile justice system.
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Service Name
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Adjustment Services
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This service provides counseling and training in independent living skills to blind, deaf/blind and visually impaired North Carolina residents. Counseling related to blindness, deaf/blindness, loss of vision and coordinating services with other providers are vital components. This service also focuses on developing skills in:
-Alternate communication methods
-Orientation and mobility
-Safe travel, such as using a sighted guide, using a white cane, taking public transportation and using environmental cues and directions
-Personal care skills
-Home management, such as learning to mark or label and organize items
-Leisure and recreation activities
-Use of technology, purchase of small adaptive devices (such as talking clocks or adapted cooking utensils) and instruction in how to use them
Social workers for the blind, located in all 100 North Carolina counties, provide these services.
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Adult Care Homes
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Adult Care Homes (ACH) are licensed assisted living and mental health facilities that provide room and board and personal care services to adults who need assistance with activities of daily living such as eating, toileting and ambulation. An income supplement called State and County Special Assistance (SA) is provided to persons in the aged, blind and disabled categories who are below a certain income level. This supplement is regarded as payment for room and board while Medicaid reimburses the ACH provider for the personal care services and transportation that is provided to the Medicaid recipient residing in the home.
Some ACH providers have Special Care Unit (SCU) beds which are targeted to people who have Alzheimer’s disease.
The local departments of social services provide the case management and assessments to determine what level of personal care services an Adult Care Home resident needs. Transportation services provided by the Adult Care Home provider and reimbursed by Medicaid are for accessing medical appointments only.
ACH services are optional services.
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Alzheimer's and Dementia Support Services
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The Alzheimers and Dementia Support Services provides outreach, information and referral, training and supportive services to individuals and families living with Alzheimer's disease and related disorders. The Duke Aging Center Family Support Program provide a variety of services to family and professional caregivers
The services aim to help families provide quality long-term care in the home. This is done through community support services and by education about dementia.
The services also provide consultation, technical assistance and research support to Aging and Adult Services staff to help them develop and manage programs and services that support dementia families and professionals throughout the state. The Project C.A.R.E. (Caregiver Alternatives to Running on Empty) component employs family consultants with expertise in dementia. The consultants visit the homes of referred dementia caregivers in crisis and offer assessment, guidance, counseling, support, advocacy, coaching and education. Their aim is to match families with the most appropriate and preferred local respite and community services tailored to their unique situation and needs.
Through Project C.A.R.E., dementia caregivers may spend up to $1,800 a year toward respite services. Families are able to choose among a range of options, including adult day services, group respite, private or agency in-home care, and overnight residential respite. These services benefit adults with Alzheimers disease and other types of dementia as well as their families and professional caregivers.
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At Risk Case Management/Out of Home Placement
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At Risk Case Management is a service that can improve or manage harmful situations and prevent further harm from occurring. Services are provided to disabled adults and families with children who have been abused, neglected or exploited and are in need of protection and include Adult Placement Services to find substitute homes or residential care facilities when they are unable to remain in their current home.Professional case managers, working through each North Carolina county department of social service,provide this service. Their role is to:Assess individual needs and then plan for, arrange, coordinate and monitor services for the person and familyPromote improved family functioningMake use of home- and community-based services in an effort to prevent the need for an acute care or long term care setting
At Risk Case Management also serves adults who are at risk of further mistreatment because the conditions leading to a prior episode continue to exist. When requested, social workers also can help individuals return to more independent settings in the community or relocate in more appropriate settings when new levels of care are needed. These services benefit aging or disabled adults, and their families, who need help with placement and is provided without regard to income.
The Adult Home Specialist Fund also a part of this service, assists county social services departments with financial support for monitoring adult care homes. The funding supports the salaries of adult care homes specialists, who ensure that licensed adult care and family care facilities meet state licensing standards and provide care that meets the needs of the resident.
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CAP-Choice
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The Community Alternatives Program Choice is a 1915 (c) home and community based waiver authorized by the Centers for Medicare and Medicaid Services. It is for adults 18 and over who have a nursing facility level of care need. The “Choice” option allows the person to employ his/her choice of caregivers and to self-direct all aspects of his/her care.
The types of services available to a person in CAP Choice include; in-home aides, medical supplies, home mobility aids, nursing visits, incontinent supplies, personal emergency response systems, etc. The goal of the program is to allow people to stay in their homes as opposed to receiving care in a long term care facility.
Local lead agencies provide the assessment, case management and ongoing oversight of the CAP Choice client’s care. They also manage a waiting list for the slots available for the program.
CAP-Choice services are waiver programs and as such are optional services.
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CAP-Disabled
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The Community Alternatives Program for Disabled Adults (CAP DA) is a 1915 (c) home and community based waiver authorized by the Centers for Medicare and Medicaid Services. It is for adults 18 and over who have a nursing facility level of care need.
The types of services available to a person in CAP DA include; in-home aides, medical supplies, home mobility aids, nursing visits, incontinent supplies, personal emergency response systems, etc. The goal of the program is to allow people to stay in their homes as opposed to receiving care in a long term care facility.
Local lead agencies provide the assessment, case management and ongoing oversight of the CAP Choice client’s care. They also manage a waiting list for the slots available for the program.
CAP-Disabled services are waiver programs and as such are optional services.
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CAP-Mentally Retarded
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CAP MR/DD is a home and community based waiver program for people with mental retardation or developmental disabilities. It offers services in the community for individuals of all ages who require an ICF-MR level of care and provides an alternative to care in an ICF-MR facility. Currently there are two waivers; the Supports waiver and the Comprehensive waiver. The Supports waiver is for people who need less services; the Comprehensive waiver is for people who have more complex needs and need a greater array or more services. The CAP MR/DD waiver provides services to individuals either residing with their family or in their own homes.
The CAP MR/DD program has a limited number of slots which are allocated to counties based on the need within the county and the capacity of the local management entities (mental health agencies) to provide the required case management.
The Division of Mental Health, Developmental Disabilities and Substance Abuse Services manage the daily operation of the program under an agreement with the Division of Medical Assistance.
CAP-Mentally Retarded Developmentally Disabled services are waiver programs and as such are optional services.
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Chore Services for the Blind
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Chore Services for the Blind provides paraprofessionals (qualified aides) to help blind, deaf/blind and visually impaired North Carolina residents with basic home management tasks such as housekeeping, cooking, and laundry which assists consumers with basic home management task.
This service enables North Carolina residents or consumers who are blind, deaf/blind and visually impaired to remain independent and continue living in their own homes and communities. Consumers must be medically stable and have at least one impediment to managing their activities of daily living. People may apply by contacting the social worker for the blind in their county. The social worker authorizes services to qualified applicants if funds are available.
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Family Caregiver Support Services
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Family Caregiver Support Services are administered by providers which include: county departments of social services, county departments on aging, home-delivered meals providers, transportation providers, and local aging agencies; and nonprofit and for-profit home health agencies.
-Providing information to family caregivers, area agencies on aging, county departments of social services, cooperative extension and other local nonprofit agencies that provide outreach and public information through the media, health fairs and other activities
-Respite care which is brief period of relief or rest from caregiving responsibilities. It may be provided in a variety of ways, including in-home aides, adult day care services and group respite, depending on the needs and preferences of the caregivers and their care receivers
-Assistance with Access provides one-on-one contact with caregivers who are seeking information about caregiver resources. Contact can be in person or by phone and usually involves follow-up contacts
-Supplemental Services for family caregivers that help provide for a short-term or one-time need, such as financial assistance for a specific need, providing accessibility equipment or dealing with an emergency.
-Support and Counseling which helps caregivers understand disease processes and helps caregivers to take care of themselves as well as their loved one. It may include individual counseling, support groups and caregiver training.
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Home and Community Based Services
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Home and Community Care Block Grant (HCCBG) services are provided through funding allocated to counties through Area Agencies on Aging to provide a variety of services to older adults and their caregivers. These services may include:
-Access services, that is, information, assistance in getting services, and transportation to doctor appointments.
-In-home services such as in-home aid, adult day services, home repair and home health care.
-Home-delivered meals for those unable to leave their homes. Through the HCCBG, counties set their own priorities and determine which services will be provided.
The services are provided to adults age 60 and over, with an emphasis on serving minorities and socially and economically needy seniors.
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Independent Living Consumer-Managed Personal Care Services
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Consumer-Managed Personal Care Services are an option under the Independent Living (IL) Rehabilitation Program.
Consumers, in partnership with their independent living counselors, plan for part-time personal assistance to facilitate activities of daily living, including access to the community. The consumer hires, fires, pays and performs all duties of the employer, including paying required state and federal taxes. The consumer is reimbursed for the service provided by the personal assistant worker.
Before this service is provided, a qualified professional (such as a registered nurse, occupational therapist or physical therapist) evaluates the independent living skills and needs of the consumer. The counselor and consumer discuss the recommendations and agree upon a total number of personal assistance hours to be provided.
This service benefits individuals with significant disabilities who are working toward independent living goals.
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Independent Living Diagnostic and Assessment Services
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Diagnostic and Assessment Services are provided to people applying for the Independent Living (IL) Rehabilitation Program. Applicants receive an evaluation, counseling, guidance on eligibility requirements and referral to community agencies. This includes:
· Medical, physical and psychological exams and evaluations.
· Interpreter services.
· Driver evaluation.
· Visual and hearing exams.
This service benefits individuals with significant disabilities who are working toward independent living goals.
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Independent Living Guidance and Counseling
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These services cover an array of counseling and guidance issues for eligible individuals with disabilitiesthat could be general or specific and substantive in scope. Guidance, counseling and associated coordination of services, as provided by trained independent living counselors and support staff, are an integral component of the independent living rehabilitation process that enables individuals to live and interact within their community of choice.
The following are examples of guidance and counseling interventions:
-Helping the individual understand their diagnosis, impairment and functional limitations
-Assisting the individual in dealing with and adjusting to the emotional issues surrounding their disability
-Liaison or interventions with medical providers to facilitate the treatment and meet the medical needs of the individual
-Discussion and exploration of the strengths, interests and abilities of the individual in relation to the recommendations from assessment data and other case information.
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Independent Living Housing and Community Integration
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Housing and Community Integration services help a person with disabilities make a transition back into the home and community. Consumers use these services after completing an individualized plan for independent living and as the final phase in returning to the community. These services include:
· Payment for rent and utilities.
· Rent and utility deposits.
· Basic furniture and small appliances.
· Recreational therapy.
· Moving expenses.
· Transportation and vehicle expenses.
These services benefit individuals with significant disabilities who are working toward independent living goals.
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Independent Living Rehabilitation Assessment
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This service, which benefits blind, deaf/blind and visually impaired North Carolina residents, assesses functional abilities and limitations, interests and service needs of the individual seeking services.
This includes evaluating the support system of the person, access to other services and resources in the community, and reviewing medical reports and other factors that may affect independent living rehabilitation needs. Basic information requested to complete an assessment includes:
-A copy of a recent eye exam report
-Medical reports may also be requested if the individual has functional limitations and restrictions due to medical conditions and/or secondary disabilities
-Background information from individuals, family members, care providers and other service providers
This information is used to conduct a comprehensive assessment of individuals' functional abilities, limitations, service needs, support systems, interests, access to other services and resources in the community and factors that may affect their ability to live and function independently in their home, community and employment. Services are delivered by independent living rehabilitation counselors. Independent living rehabilitation counselors meet with individuals referred for independent living rehabilitation services to share information about services and to gather information to help determine individuals' eligibility for services and independent living needs.
Individuals who live inNorth Carolinaand have significant vision loss can access services by contacting one of the seven district offices of the Division of Services for the Blind. This service is available statewide.
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Independent Living Rehabilitation Guidance & Counseling
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Eligible individuals receive counseling and guidance services related to blindness, deaf/blindness, or vision loss and adjustment in addition to assistance in identifying the goals, services, resources and supports needed to help them independently manage activities of daily living in their homes, communities and employment.
North Carolina residents who are blind, deaf/blind, or have vision loss can access this service by contacting one of the seven district offices of the Division of Services for the Blind. The service is available statewide and is provided by independent living rehabilitation counselors who are staff members.
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Independent Living Rehabilitation Teaching
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Residents of North Carolina who have blindness, deaf/blindness or vision loss may receive extensive, specialized and individualized instruction the use of adaptive techniques and equipment for performing daily living tasks after on set of these disabilities. Instruction is provided in the homes of eligible individuals and in community-based classes called Mini Centers. Basic skills taught include:-Use of adaptive devices and technology
-Safe travel techniques and use of mobility aids
-Communications and handwriting
-Kitchen safety, cooking and nutrition
-Housekeeping and laundry
-Mending and sewing
-Labeling and identification techniques
-Management of secondary disabilities
-Leisure and recreational activities
-Accessing resources, services and supports in the community
Rehabilitation teaching services are provided by independent living rehabilitation counselors who are staff members. Individuals interested in this service should contact the nearest office of the Division of Services for the Blind. This service is available statewide.
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Independent Living Rehabilitation Technology and Assistive Devices
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Rehabilitation Technology and Assistive Devices are provided under the Independent Living (IL) Rehabilitation Program to help individuals with disabilities live in their homes and get access to services in the community. They include:
· Home modifications (ramps, accessible bathrooms, widening of doors and entrances).
· Wheelchairs.
· Communication devices.
· Vehicle modifications.
The consumer and a counselor plan for these services as part of the individualized plan for independent living. These services are coordinated with other providers and comparable benefits, such as Medicaid, Medicare and private insurance. These services benefit individuals with significant disabilities who are working toward independent living goals.
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Independent Living Restoration Services
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Restoration Services are provided under the Independent Living (IL) Rehabilitation Program to help individuals address the limitations and impairments caused by their disability. Medical restoration services include:
· Durable medical equipment, such as canes, crutches, walkers, wheelchairs, hospital beds and special toilet seats.
· Hospital services.
· Orthoses (braces), glasses and hearing aids.
These services prepare the client to complete an individualized plan for independent living and transition back into the community. Clients plan for these services in partnership with an independent living counselor. Services are coordinated with other providers and comparable benefits, such as Medicaid, Medicare and private insurance. These services benefit individuals with significant disabilities who are working toward independent living goals.
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Key Program Assistance
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Key Program services operate in partnership with the NC Housing Finance Agency with the purpose of making available affordable rental units set aside for extremely low income households headed by adults with disabilities. Key Program services provide operating assistance to properties that do not have another form of rental assistance to assure the units are affordable to persons with incomes as low as Supplemental Security Income(SSI); and pays the difference between what a person on SSI income can afford to pay as rent and a state wide operating standard.
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Projects for Assistance in Transition from Homelessness (PATH)
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Projects for Assistance in Transition from Homelessness (PATH) is a Federal Grant that provides outreach, engagement and services to adults who are living outside and have a serious mental illness or a co-occurring serious mental illness and substance use disorder. PATH targets those individuals who are most in need and are not connected to or provided any services from homeless and mental health provider agencies. There is a program in 6 primary locations throughout the State and DHHS contracts directly with a provider agency in these communities to manage and implement the PATH Programs. The agencies/locations are: Coastal Horizons, Inc. - Wilmington Cumberland County CommuniCare – Cumberland County Interactive Resource Center – Greensboro Fifth Street Ministries – Statesville Ashville Buncombe Christian Community Ministries – Ashville and other areas PATH services include activities such as providing survival needs (blankets, tents, sleeping bags), assist with obtaining benefits and housing, referrals to community mental health and substance use treatment, primary health/dental care, income assistance and medical insurance. The goal of PATH is the individuals enrolled to become permanently housed and receiving community mental health services.
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Traumatic Brain Injury Services (TBI)
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Statewide traumatic brain injury (TBI) state funded services assist individuals with a diagnosed traumatic brain injury and their families to receive the necessary supports and specialized services to live in the communities of their choice. Because each brain injury is unique, services for each individual will be different based on their particular needs. Intellectual and developmental disability services and supports may also be available to individuals with a TBI. Some examples of what TBI state funds are used for include: -Residential support -Day Activity -Therapies -Personal Assistance -Respite -Assistance in Activities of Daily Living (ADLs) -Equipment to regain skills and independence -Transportation -Home modification
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Service Name
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Crisis Services
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Crisis intervention services and supports promote a quick return to recovery and wellness management for individuals experiencing behavioral health crisis. The crisis services continuum is an array of crisis prevention, early intervention, response, and stabilization strategies with an emphasis on avoiding unnecessary visits to hospital emergency departments and involvement with the criminal justice system and are accessible and provided in a timely fashion in each community.
Local Management Entities/Managed Care Organizations (LME/MCOs) are responsible to assure an array of crisis services within available funding and under the requirements of the DMA and DMHDDSAS contracts. Expected services include, but are not limited to: Mobile Crisis Management, NC START and respite, behavioral health urgent care centers and community hospital psychiatric inpatient. When available the NC DMHDDSAS will direct funds for other specialty crisis services and community supports via statewide contracts or via competitive invitations to apply for funding processes resulting in designated allocations to the LME/MCOs.
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HIV/AIDS Care Services
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HIV Care Services fall into three categories: AIDS Drug Assistance Program (ADAP), Medical/Supportive and Housing.
1. ADAP provides pharmaceuticals for treatment of HIV/AIDS to eligible, low-income clients who have no other resources, through a combination of state and federal funds. To be eligible for enrollment in ADAP, the person must be at or below 300% of the federal poverty level (fpl). ADAP is supported by state and federal funds.
2. Ryan White federal funds provide primary medical and supportive services to eligible clients including medical and dental care, transportation, case management (coordination of health care and other services for the client), mental health care and other services authorized by Part B of the federal Ryan White Care Act in support of Persons Living with HIV/AIDS (PLWHA).
3. Housing Opportunities for People with AIDS (HOPWA) federal funds provide housing-related assistance to eligible, low-income clients in both one-time emergency situations and on-going but time-limited supported housing. HOPWA is sponsored by the Department of Housing and Urban Development (HUD).
Service is provided through ten regionally-based networks whose funding is allocated through the use of contracts or, in the case of local health departments, through Agreement Addenda.
Major activities for this service include the allocation of federal funds to provide medical and supportive services to 10 regional networks for HIV care; monitoring, site visits, and technical assistance provided by staff, provision of HIV medication to eligible clients, and the use of surveillance data to track cases into care.
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North Carolina Problem Gambling Services
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The North Carolina Problem Gambling Program (NCPGP) provides and supports effective problem gambling programing and services throughout North Carolina.The North Carolina Problem Gambling Program (NCPGP) within the DHHS Division of MH/DD/SAS recognizes that this addiction lives on a continuum, and we want to help people who are experiencing harm, even if they do not meet the full clinical criteria. We recognize that people are more than their addictions and struggles, therefore we use the terms people experiencing problems related to gambling or people living with a gambling disorder. The program has five major components, our 24/7 helpline, treatment, recovery, prevention and education.
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TB Elimination
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This service provides financial assistance to local health departments to test for and treat tuberculosis (TB). This includes:
-TB testing of people suspected of being infected
-Finding and testing the close contacts (household, work associates, etc.) of people recently diagnosed with TB
-Watching the TB patient take medication to ensure that medications are taken in the right combination and at the correct times
TB patients and their close contacts benefit from this service through detection and treatment of the disease. The general public benefits through limiting the spread of the disease. Physicians, local health departments and other health providers can receive consultation regarding TB treatment from the NC Division of Public Health Communicable Disease Branch, a contract physician at Duke University and four regional public health nurse consultants.
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Service Name
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Prescribed Drugs
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Prescribed drugs include brand, generic and other drugs obtained by Medicaid recipients with a prescription at a dispensing pharmacy. Certain over-the-counter drugs are also provided to eligible Medicaid recipients.
Generally, all people eligible for Medicaid may receive prescribed drugs, but there may be some restrictions depending on the person’s type of Medicaid eligibility.
Prescribed Drugs are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Vocational Rehabilitation Modifications and Assistive Technology
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Modifications and Assistive Technology services are provided under the Vocational Rehabilitation (VR) Services program to help individuals overcome barriers to employment. This area includes:
-Vehicle and home modifications
-Telecommunications, sensory and other technological aids
Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state.Services are planned, provided and coordinated by vocational rehabilitation counselors, related professionals and support staff. Individuals have access to other government entities, private and public organizations for services.
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Service Name
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Employment Opportunities in Food Services and Vending
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This service provides training to legally blind North Carolinians who are interested in working in food service or vending. To qualify, operators must be legally blind and meet other eligibility requirements. Then they must complete a six-week training course and do on-the-job training with an established operator in a Business Enterprise facility.
The operator receives a license and may apply for any vacant Business Enterprise facility.
Operators continue to receive assistance and business counseling from their Business Enterprise counselor. There are six counselors located in five district offices.
Facilities are located across the state on federal, state, county and private property. They range in scope from the vending machines at interstate rest areas to the full-service restaurant at Mount Mitchell State Park. People may apply by contacting a vocational rehabilitation counselor in the nearest Division of Services for the Blind office.
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Food and Nutrition Employment and Training
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TBD This is one of 6 funds across DHHS that assures that families who are experiencing economic jeopardy receive employment services to mitigate health and safety risks. Food Nutrition Employment & Training services are provided to Food and Nutrition Services recipients to support job searches, training, and employment.
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Food and Nutrition Services Employment and Training
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Assist Food and Nutrition Services (FNS) recipients ages 18 through 59 years old, who are physically and mentally fit to obtain education, and/or short-term training to help participants acquire and/or maintain employment. Personal Responsibility and Work Opportunity Reconciliation Act of 1996 added separate work rules and restrictions for Able-Bodied Adults Without Dependents (ABAWDs) to the Food and Nutrition Services Program (US Department of Agriculture). Each component of a State agency’s Employment and Training (E and T) Program must be delivered through its workforce development system. If the component is not available locally, the State agency may use another source. An E and T Program may consist of many different types of components, including but not limited to: independent job search; job search training and support; workfare; educational programs to improve employability; work experience or training to improve employability; other employment-oriented activities (e.g., job placement, supported work experience, Workforce Innovation and Opportunity Act services); and self–employment training. Initially, FNS E and T participation was mandatory for all non-exempt recipients in E and T counties. Effective July 1, 2009, FNS E and T is a voluntary program for recipients and as of July 1, 2011, counties are given the option whether to participate in the program. Currently, County Department of Social Services (DSS) offices are participating in the FNS E and T Program through a partnership with their local DWS office, N.C. Community College System and Community Organizations.
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Pre-Employment Transition Services
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The Rehabilitation Act, as amended by the Workforce Innovation and Opportunity Act of 2014 (WIOA) created pre-employment transition services as a new category of vocational rehabilitation services specifically for students with disabilities. The activities charged to this service include "Required Activities" (34 CFR 361.48(a)(2)), "Authorized Activities" (34 CFR 361.48(a)(3)), and "Coordination Activities" (34 CFR 361.48(a)(4)). Required activities include five categories of direct services provided to students with disabilities: 1. Work-based Learning Experiences; 2. Job Exploration; 3. Workplace Readiness Training; 4. Instruction in Self-Advocacy; and 5. Counseling on Opportunities for Enrollment in Comprehensive Transition or Postsecondary Education Programs. Expenditures for authorized activities include costs associated with: Implementing effective strategies to increase the likelihood of independent living and inclusion in communities and competitive integrated workplaces;Developing and improving strategies for individuals with intellectual disabilities and individuals with significant disabilities to live independently, participate in postsecondary education experiences, and obtain and retain competitive integrated employment;Providing instruction to vocational rehabilitation counselors, school transition personnel, and other persons supporting students with disabilities;Disseminating information about innovative, effective, and efficient approaches to achieve the goals of this section;Coordinating activities with transition services provided by local education agencies under the Individuals with Disabilities Education Act (20 U.S.C. 1400 et seq.);Applying evidence-based findings to improve policy, procedure, practice, and the preparation of personnel, in order to better achieve the goals of pre-employment transition services;Developing model transition demonstration projects;Establishing or supporting multistate or regional partnerships involving States, local education agencies, designated State units, developmental disability agencies, private businesses, or other participants to achieve the goals of pre-employment transition services; andDisseminating information and strategies to improve the transition to postsecondary activities of individuals who are members of traditionally unserved populations. Expenditures for coordination activities include agency costs for:Attending individualized education program meetings for students with disabilities, when invited;Working with the local workforce development boards, one-stop centers, and employers to develop work opportunities for students with disabilities;Working with schools, including those carrying out activities under section 614(d) of the IDEA, to coordinate and ensure the provision of pre-employment transition services; andWhen invited, attending person-center planning meetings for individuals receiving services under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
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Pre-Employment Transition Services
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The Rehabilitation Act, as amended by the Workforce Innovation and Opportunity Act of 2014 (WIOA) created pre-employment transition services as a new category of vocational rehabilitation services specifically for students with disabilities. The activities charged to this service include "Required Activities" (34 CFR 361.48(a)(2)), five categories of direct services provided to students with disabilities: 1. Work-based Learning Experiences; 2. Job Exploration; 3. Workplace Readiness Training; 4. Instruction in Self-Advocacy; and 5. Counseling on Opportunities for Enrollment in Comprehensive Transition or Postsecondary Education Programs.
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Senior Community Service Employment Program
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This service is provided through the Senior Community Service Employment Program (SCSEP), funded through the Older Americans Act and administered by the U.S. Department of Labor. The state service administered by the Division of Aging and Adult Services serves low-income adults, age 55 years and older at or below 125% of the federal poverty level who have poor employment prospects because of multiple factors such as lack of skills or transportation, low literacy or disabilities. The state program oversees six (6) sub-grantees who provide services in 24 counties. National programs also provide services in 98 counties throughout the state. Participants are placed in part-time assignments at locations such as social services agencies, health departments, councils on aging, nutrition sites and senior centers. Once they acquire new skills, they receive support transitioning into the regular work force.
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Vocational Rehabilitation Assistive Technology Services
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Services in assistive technology are provided for assessment of technology skills and needs, the design of an assistive technology program that will meet the requirements of eligible blind, deaf/blind and visually impaired individuals to access a training program and/or a job, job site assessment and modification, the assembly of the system, the initial maintenance of the system, and the instruction in its use. These services are planned and coordinate through the rehabilitation counselor, and they are provided by the Division's Rehabilitation Engineer, Assistive Technology Consultants, and assistive technology teachers and other professional staff as needed.
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Vocational Rehabilitation Auxiliary Services
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Interpreter Services are provided under the Vocational Rehabilitation (VR) Services program to help individuals overcome barriers to employment. These services include:
· Sign language and oral interpreter services for eligible individuals who are deaf or hard of hearing, deaf-blind or late-deafened.
· Foreign language interpreting.
· Reader services.
Personal assistance services are also included in this category. Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state. Services are planned, provided and coordinated by vocational rehabilitation counselors, related professionals and support staff. Individuals have access to other government entities, private and public organizations for services.
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Vocational Rehabilitation Diagnostic and Assessment Services
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Diagnostic and Assessment Services are used to determine whether an individual is eligible for the Vocational Rehabilitation (VR) Services program and to identify the specific set of services the person requires to return to or maintain employment.
Diagnostic and assessment services include medical, psychiatric, psychological, vocational and educational evaluations conducted by qualified personnel. These services are not subject to a financial needs test.
Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state. Services are planned, provided, purchased and coordinated by vocational rehabilitation counselors, related professionals and support staff. Individuals have access to other government entities, private and public organizations for services.
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Vocational Rehabilitation Diagnostic and Assessment Services
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Diagnostic and assessment services are provided to determine the ability to obtain, maintain, or regain employment of a blind, deaf/blind or visually impaired person. A plan of assessment methods is developed and implemented by trained vocational evaluation staff in coordination with the vocational rehabilitation counselor working with the individual.
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Vocational Rehabilitation Employment Services
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Vocational Rehabilitation (VR) Employment Services are designed to assist individuals with disabilities in achieving, maintaining, or advancing in meaningful employment. These services provide a comprehensive approach to support job seekers in overcoming barriers to employment and enhancing their employability. VR Employment Services aim to empower individuals with disabilities to achieve their career goals, enhance their independence, and contribute to their communities through meaningful work.
VR Employment Services are individually planned and may include:
Assessment and Planning:
Each individual receives a personalized assessment to identify their strengths, skills, interests, and potential workplace challenges. Based on this assessment, an individualized plan for employment is developed in partnership with the client.
Vocational Rehabilitation Counseling and Guidance:
VR counselors provide ongoing support and provide valuable insights, helping individuals understand their strengths and explore career options while setting realistic goals.
Job Search and Placement Assistance:
VR specialists provide guidance on job search strategies and assist in identifying job opportunities that align with the individual’s skills and interests. Community rehabilitation programs often assist with job placement for individuals receiving on-the-job supports.
Training and Skill Development:
Services may include access to training programs, workshops, and educational resources to help individuals develop the necessary skills for their desired careers.
Supported Employment:
After securing employment, VR may sponsor continued support through community rehabilitation programs that provide job coaching, additional training, and other resources to help individuals navigate workplace challenges and maintain their employment.
Collaboration with Employers:
VR community employment specialists work closely with employers to promote inclusive hiring practices and educate them about the benefits of employing individuals with disabilities. They also help identify and implement reasonable accommodations in the workplace, ensuring that individuals can perform their job duties effectively.
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Vocational Rehabilitation Guidance and Counseling
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Vocational counseling, guidance and service coordination are provided to eligible individuals with physical and mental disabilities by trained vocational rehabilitation counselors, vocational evaluators and other supporting staff with roles specializing in areas ranging from job development/business relations to rehabilitation technology consultants. These services help individuals with disabilities to select and pursue a vocational goal that best suits their abilities, skills, interests, capabilities, resources, and informed choice.
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Vocational Rehabilitation Guidance and Counseling
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This service provides vocational counseling to eligible North Carolina residents with blindness, deaf/blindness or vision loss. It helps individuals set job goals that best suit their abilities, skills, interests and resources.
Services are provided by trained vocational rehabilitation counselors, staff of the Rehabilitation Center for the Blind in Raleigh, and Evaluation Unit staff. Key areas for counseling include:
-Making an informed choice about a vocational goal
-Understanding the individual eye conditions and adjusting to blindness or low vision
-Developing the skills needed to get, keep or regain a job
-Understanding the training program and job duties
-Managing stress during training and the job search
Vocational counseling is provided to eligible individuals by trained vocational rehabilitation counselors, Rehabilitation Center for the Blind staff, and Evaluation Unit staff, so individuals can select a vocational goal that best suits their abilities, skills, interests, capabilities, resources, and informed choice. Counseling is provided by Rehabilitation Counselors and Rehabilitation Center for the Blind staff about their eye conditions and adjustment to blindness, deaf/blindness or low vision. Counseling and guidance is provided to individuals about compliance with training services and job duties.
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Vocational Rehabilitation Job Development and Job Placement
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Job Development and Job Placement services help blind, deaf/blind or visually impaired eligible North Carolina residents, find employment in the field of their choice. A rehabilitation counselor and support staff may provide:
-Job readiness training
-Help in matching the skills and interests of the individual with jobs located in companies in their area
-Follow-up with the individual and the employer to ensure success on the job
Specialized job development, job placement and follow-up services are provided by the rehabilitation counselor and support staff. These services will assist the blind, deaf/blind and visually impaired eligible individuals to locate employment in the field of their vocational choice. Skills and interests of individuals are used to match them with jobs located in companies in their area. Job readiness training is provided by the rehabilitation counselor, who stays in touch with the individual and with the employer to ensure success on the job.
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Vocational Rehabilitation Job Placement and Job Related Supports
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Job Placement and Job Related Supports are services provided under the Vocational Rehabilitation (VR) Services program to help an individual find appropriate employment after other rehabilitation issues are resolved. Services include:
-Job search assistance
-Job placement
-On-the-job support services (to help an eligible person keep a job)
-Supported employment for eligible individuals with the most significant disabilities.
- Vocational evaluation.
These services are not subject to a financial needs test.
The rehabilitation counselor, business relations representatives and other staff members use employer contacts and other methods to carry out these services. Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state. Eligible individuals have access to placement through the Division of Employment Security and other public and private organizations.
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Vocational Rehabilitation Restoration Services
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Restoration Services may be provided under the Vocational Rehabilitation (VR) Services program to remove or ease barriers to employment.
Physical or mental restoration services include medical treatment, therapy, prostheses (artificial limbs) and other medical equipment.
VR provides restoration services when financial support is not readily available from another source, such as private insurance, Medicare or Medicaid.
Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state. Services are planned, provided, purchased and coordinated by vocational rehabilitation counselors, related professionals and support staff. Individuals have access to other government entities, private and public organizations for services.
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Vocational Rehabilitation Restoration Services
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Restoration Services are direct medical services provided to reduce or alleviate barriers to employment. These include medical assessment, treatment, glasses, prostheses (such as an artificial eye) and other medical services as needed.
Rehabilitation counselors and related staff in the seven district offices across the State plan and assess for these services with the blind, deaf/blind and visually impaired individuals. Services are available to North Carolina residents with significant vision loss.
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Vocational Rehabilitation Support Services
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Support Services are provided under the Vocational Rehabilitation (VR) Services program only in direct connection with a required primary service (such as job placement, restoration, training, guidance and counseling, or required diagnostic and assessment services). Support services may include:
· Assistance with transportation, including training in the use of public transportation.
· Travel and related expenses needed to participate in a vocational rehabilitation service leading toward an employment goal.
· Payment for expenses such as food, shelter and clothing (above an individual’s normal expenses) required to participate in an assessment or while receiving planned services.
Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state.
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Vocational Rehabilitation Training Services
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Training Services are provided under the Vocational Rehabilitation (VR) Services program to help eligible individuals develop the knowledge and skills needed to achieve their chosen vocational goal. Training services include:
· Job skill training through a community college, business, vocational, trade or technical school.
· College or university training.
· On-the-job training in a specific job skill by a prospective employer.
· Job readiness training.
· Disability-related training to augment skills.
Community Rehabilitation Program Work Adjustment Training and In-High School Work Adjustment Training services are also included. Training services may be available to individuals who have no transferable work skills and require training to reach a vocational goal.
Services are available through 32 unit offices and two Vocational Rehabilitation facilities throughout the state. Services are planned, provided and coordinated by vocational rehabilitation counselors, related professionals and support staff. Individuals have access to other government entities, private and public organizations for services.
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Vocational Rehabilitation Training Services
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Training services are provided when required, to eligible blind, deaf/blind and visually impaired individuals to obtain the knowledge and the skills required for the achievement of employment, in their choice of a vocational goal. Services include direct training services through the Division's Rehabilitation Center for the Blind. Training for required vocational and academic skills are provided through vocational facilities, trade schools, colleges and universities. Summer school training is offered through the Rehabilitation Center for high school students to acquire the necessary skills to move from high school into the world of work. On-the-job training is provided as necessary. The required training services are planned, provided and coordinated by the rehabilitation counselor.
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Work First Employment Services
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Work First Employment Services is provided to work eligible participants receiving Work First Cash Assistance. Countable income is the same as for Work First Family Assistance (WFFA). WFFA methodology is based on the maximum countable income set by the North Carolina General Assembly. Income is based on Family Size 1 - $312; 2 - $422; 3 - $494; 4 - $544; 5 - $598. Short Term Benefits are provided to any family (that currently does not receive a Work First cash assistance payment) with income at or below 200% of the federal poverty level, provided there is a child in the household who meets the age, kinship, resource limits, citizenship and immigrant rules. The caseworker may accept the family’s statement of the family’s income unless it is questionable. All income available to the family is counted in determining their eligibility for Work First Family Assistance, unless otherwise noted in Work First Policy.
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Service Name
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Emergency Energy Assistance
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Crisis Intervention Program is part of the Low Income Home Energy Assistance Program (LIHEAP) Block Grant and is an important service for all, but especially for families with elderly, disabled or a young children under 6 years old who are especially at risk for life threatening or health related emergency if their home is too cold in the winter or too hot in the summer. Applicants apply for CIP funds to alleviate a heating or cooling related crisis. Benefits may vary based upon the amount needed to alleviate the crisis; however, benefits cannot exceed $600 per State fiscal year. The maximum allowed benefit amount can be up to $600 per application, per crisis situation.
Below are Private Community Funded Energy Assistance Programs that are operated through local departments of social services with funds provided by the customers and employees of Progress Energy, Piedmont Natural Gas Company, Wake Electric Membership Corporation and Haywood Electric Membership Corporation to provide low income energy assistance to their customers. Funding amounts are defined by the energy provider and eligibility guidelines generally follow the Crisis Intervention Program. Help can be for heating or cooling expenses with the exception of Piedmont's program which is just for heating assistance. These programs are administered through the NC FAST:
-Share the Light is 100% funded by Progress Energy customers and employees to provide energy assistance to low income customers in the service area. Applications are taken by the local department of social services. Counties spend the funds until exhausted; any remaining funds are reallocated to the same county for the new SFY.
-Helping Each Member Cope is 100% funded by rounding up the bill to the nearest dollar for participating customers of Haywood Electric Membership Corporation to assist low income customers with energy bills. Counties spend until funds are exhausted; any remaining funds at the end of the SFY are reallocated to the same county.
-Share the Warmth is 100% funded by Piedmont Natural Gas Company employees and customers. Allocations are made to counties with gas company customers to assist with heating bills. Counties spend the funds until exhausted; any funds remaining at the end of the SFY are reallocated to the same county the following year.
-Wake Electric Roundup is 100% funded by Wake Electric Membership Corporation participating customers by rounding up their bills to the next dollar to provide energy assistance to low income customers. Allocations are made to counties based on the number of residential customers in the area. Counties spend until the funds are exhausted; any remaining funds at the end of the SFY are reallocated to the same county in the following SFY.
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Service Name
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Adult Protective Services
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Adults who are elderly or have a disability and who are abused, neglected or exploited or suspected of being abused, neglected or exploited, can get help from Adult Protective Services (APS) from the local county department of social services (DSS). There is no income requirement. County departments of social services receive reports of possible abuse, neglect or exploitation. When a report is received, an evaluation begins. The APS worker looks for signs of mistreatment and identifies problems that might result in abuse, neglect or exploitation. At the end of the evaluation, a case decision is made.
If the APS worker finds a need for protective services, the local DSS must get authorization. If the adult has capacity to consent and agrees to protective services, services are provided. If the adult does not have the capacity to consent, a court order for APS is obtained. Services include working with the individual and the family or caregiver to identify, remedy and prevent problems that may result in abuse, neglect or exploitation. APS also sees that the elderly or disabled person gets needed services. APS reports evidence of mistreatment to the District Attorney and regulatory agencies, and court action is initiated if necessary to protect the adult.
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Guardianship
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Guardianship is a legal relationship in which someone (the guardian) has legal authority to be the substitute decision maker for an adult who cannot manage his or her own affairs or cannot make important legal and medical decisions.
Guardians are often family members, but directors or assistant directors of local human services agencies may serve as guardians when no one else is available or willing. They provide services including:
-Assessing the needs of an individual for a guardian
-Trying to find an appropriate person to serve as guardian
- Petitioning the court or helping the family petition the court to appoint a guardian
-Serving as guardian of last resort; ongoing casework for the individual
-Making required reports to the court Guardianship benefits adults with disabilities and disabled and impairments.
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Service Name
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Adoption Services
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Adoption Services help children whose birth parents cannot care for them to become part of a new family. County departments of social services and private child-placing agencies provide these services, including:
- Recruiting, assessing and selecting adoptive homes.
- Casework services for adoptive families to help sustain the placement.
- Help finalizing the legal adoption.
- Post-adoption services.
These services benefit children in the foster care system and the families who adopt them.
Services are provided by departments of social services and through partnership between public and private agencies that include recruitment, assessment and selection of adoptive homes; casework services to adoptive families to support and sustain the placement and facilitate the finalization of the adoption. After the adoption has been completed, agencies receive payments for placements exceeding an established baseline.
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Foster Care Services
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Foster Care services provide temporary care for infants, children and adolescents who have been removed from their own homes because their families cannot or will not provide protection or care for them adequately. Foster Care Services are designed to strengthen, preserve, and/or reunite families after children have come into agency legal custody or placement responsibility. Foster Care Services:
-Help families strengthen their parenting abilities
-Help children with health, educational, mental health and developmental needs
-Help young adults who are aging out or have already aged out of the foster care system
Services and resources (NC LINKS) for teens and young adults 13 to 21 who have lived or are now living in foster care system; intended to facilitate successful transition to self-sufficiency.
A variety of support services are also available to eligible student recipients of the Postsecondary Education Support Scholarships (NC Reach), based on eligibility. All services are intended to assist the student with successful completion of their academic program.
Grants, Educational Training Vouchers (ETV), provided to students who were in foster care on or after the age of 17, or who were adopted on or after age 16, or were placed in a relative guardianship on or after their 16th birthday to attend postsecondary educational or vocational training programs. For more information on NC LINKS, NC Reach and ETV go tohttp://www.ncdhhs.gov/dss/links/index.html
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Service Name
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Central Regional Hospital / Butner Campus - Child / Adolescent
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Central Regional Hospital (CRH), Child / Adolescent is located in Butner, provides inpatient psychiatric services to children and adolescents who cannot be served in the community because of the severity of their symptoms. Inpatient services include:
-Crisis stabilization (immediate help for a mental health emergency)
-Assessment
-Medical care
-Psychiatric treatment
-Patient advocacy
-Social work services including counseling, discharge planning and links to the community
-Education
CRH operates a child inpatient unit that services children ages 5-12 statewide.
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High Risk Intervention
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Residential Treatment Services (High Risk Intervention) provide a structured, therapeutic and supervised environment to improve the level of functioning for Medicaid funded recipients. People who are less than 21 years old are eligible for these services.
There are four levels of residential treatment:
1. Residential Treatment Level I Service - provides a low to moderate structured and supervised environment in a family setting, excluding room and board.
2. Residential Treatment Level II Service - provides a moderate to highly structured and supervised environment in a family or program setting, excluding room and board.
3. Residential Treatment Level III Service - has a highly structured and supervised environment in a program setting only, excluding room and board.
4. Residential Treatment Level IV Service - has a physically secure, locked environment in a program setting only, excluding room and board.
High Risk Intervention Residential Services are for children who need for intensive, interactive therapeutic interventions and 24 hour supervision.
These services are accessed through Local Management Entities (local mental health clinics) and must be prior approved.
Residential Treatment Services (High Risk Intervention) are optional. Some HRI services may be considered mandatory, if medically necessary, for children up to age 21 under Medicaid's Early Periodic Screening, Diagnosis and Treatment program (EPSDT).
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Mental Health Hospital - Children
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Inpatient behavioral health services provide treatment for people less than 21 years old in a hospital setting 24 hours a day. Supportive counseling, therapeutic interventions, nursing and medical care are provided under the supervision of a psychiatrist or a physician. This service is designed to provide continuous treatment for Medicaid recipients with acute psychiatric or substance abuse problems. Services may also include longer term residential treatment services.
Inpatient behavioral health services are provided both in private psychiatric hospitals, general hospitals and state operated hospitals. Inpatient services have to be authorized by a Medicaid contractor.
Inpatient behavioral health services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Non-Community Based Services for Children
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Mental health, substance use, intellectual / developmental disorder, or traumatic brain injury services or treatment provided to youth being cared for in a facility (e.g., youth detention center, youth development center, youth behavioral health residential unit). Facility based services for youth primarily are treatment oriented. Youth may receive treatment such as therapy, counseling, care management, and peer support in a facility.
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Out of Home Treatment Services
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Out of Home Treatment Services reduce use of institutional and congregate-type settings and provide children with an opportunity to live in a family/community setting resulting in less trauma, less disruptions, and more normalcy. Activities include Intensive Alternative Family Treatment (IAFT) and Therapeutic Foster Care (TFC). (IAFT) is a specialized, in-home, family-based foster care. IAFT supports difficult-to-place children/teens by providing a more intense level of care than therapeutic foster care (TFC). IAFT also serves children/teens as they step down from a more restrictive level of care. Service activities include a focus on expanding capacity for IAFT/TFC, paying for reserve capacity for crisis placements in IAFT, and development of specialized placements for high-need youth such as: co-occurring IDD/BH, children with medical needs, LGBTQ+ population, etc. Funding is non-recurring State funds and is distributed to Rapid Resources for Families, a non-profit organization that developed the IAFT model and is the purveyor of the IAFT model.
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Whitaker School
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Whitaker School offers inpatient psychiatric services to children and adolescents aged 13 to 18 whose mental health needs cannot be met in the community. Whitaker School provides integrated, person-centered treatment to children and adolescents with psychiatric disorders with a focus on safety while promoting wellness and offering support to patients and their families consistent with the principles of recovery and trauma informed care.
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Wright School
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The Wright School, located in Durham, North Carolina, serves children with emotional, behavioral, educational, intellectual, social, or neurological needs ages 6 -12 in a non-medical, alternative program which emphasizes the re-educational model of services. Through Wright School, staff members mobilize the home community's resources to build a network of services to meet the student's individual needs and the needs / expectations of their family, school and community. Children receive individual treatment to increase academic, social, and behavioral skills.
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Service Name
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Long Term Care Ombudsman Service
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The Long Term Care Ombudsman Service advocates for residents of long-term care facilities (nursing homes, adult care homes, rest homes, assisted living) throughout North Carolina. Ombudsmen (advocates) respond to, investigate and try to resolve complaints from or on behalf of residents. They also:
-Train and provide technical help to more than 1,000 county-appointed volunteers
-Train long-term care staff about the rights of residents
-Provide elder abuse prevention education for facilities and the public
-Provide information about long-term care to the general public
-Collect and report complaint data to the Administration on Aging
-Promote community involvement with long-term care providers
-Inform public agencies, legislators and others on problems affecting the rights of residents and make recommendations for resolving problemsThe service benefits adults age 60 and over who live in long-term care facilities and their families.
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LTC-ICF MRC
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Intermediate care facilities for people with mental retardation (ICF/MR) are institutional settings which diagnose, treat and/or rehabilitate people with mental retardation. They provide, in a protected residential setting, 24-hour supervision, coordination, and integration of health or rehabilitative services to help each person function at his or her greatest ability. In NC there are two types of ICF/MR facilities that Medicaid reimburses, State operated and non-state operated.
Persons who receive care in these settings have to be prior approved.
ICF/MR services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Non-Community Based Services for Adults
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Mental health, substance use, intellectual / developmental disorder, or traumatic brain injury services or treatment provided to adults being cared for in a facility (e.g., jail or prison). Services are primarily supportive. Supportive services include providing care management, case management, and resource navigation.
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Nursing Facility
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Nursing facilities are licensed long term care facilities which provide round the clock medical, nursing and attendant care. People entering a nursing facility must be prior approved by Medicaid’s fiscal agent. Prior approval is granted only if recipients meet the state’s medical criteria for admission.
The federal Pre-admission Screening and Annual Resident Review (PASARR), which also must be met, screens and evaluates applicants and residents of Medicaid-certified nursing facilities for mental illness, mental retardation, developmental disabilities and related conditions.
Physicians are required to complete a form which establishes medical necessity for the person entering a long term care facility.
Nursing facility services are mandatory for individuals over age 21. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.
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Service Name
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Black Mountain Neuro-Medical Treatment Center
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Black Mountain Center, located in Black Mountain, North Carolina, provides specialized Skilled Nursing Services to adults in the western region of the state with chronic, complex medical conditions that co-exist with neurological conditions often related to a diagnosis of intellectual and/or developmental disability. Black Mountain Center also provides services to adults with Alzheimers disease or other related dementias in the western and central regions of the state. Black Mountain provides specialized medical, mental health, and intellectual and/or developmental disability services to these adults that cannot be served in the community.
Services include:
-Services to adults with developmental disabilities and medical conditions of a serious, chronic nature, requiring 24/7 medical and nursing care
-Services to adults with Alzheimers or related dementia whose assaultive and combative behaviors have resulted in a denial of care in traditional nursing home settings
-Respite services provided to families and other caregivers in the community who need temporary relief from the pressures of caring for a person with Alzheimers disease or other types of dementia.
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Broughton Hospital
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Broughton Hospital, located in Morganton, provides inpatient psychiatric services to North Carolinians who cannot be served in the community because of the severity of their symptoms. Inpatient services include:
-Crisis stabilization (immediate help for a mental health emergency)
-Assessment
-Medical care
-Psychiatric treatment
-Patient advocacy and social work services including counseling, discharge planning and links to the community
Broughton Hospital also operates a Deaf Unit for adults who need inpatient psychiatric or substance abuse services and are deaf/hard of hearing.
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Caswell Center
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Caswell Developmental Center, located in Kinston, is the state-operated developmental center for North Carolina’s eastern region. The center provides services and supports to individuals with intellectual and developmental disabilities (IDD), complex behavioral challenges and/or medical conditions whose clinical treatment needs exceed the level of care available in the community.
Services and supports include:
Residential, medical, habilitation (help in developing functional living skills) and training to promote independence and self-determination. Facility-based therapeutic respite services to provide evaluations and assessments to individuals experiencing specific medical and/or behavioral challenges.Facility-based respite services to provide caregivers temporary relief. A 10-bed program for males with a dual diagnosis of IDD and mental illness. The length of stay is up to 18 months.
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Central Regional Hospital / Butner Campus
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Central Regional Hospital (CRH), located in Butner, provides inpatient psychiatric services to adult North Carolinians who cannot be served in the community because of the severity of their symptoms. Inpatient services include:
-Crisis stabilization (immediate help for a mental health emergency)
-Assessment
-Medical care
-Psychiatric treatment
-Patient advocacy
-Social work services including counseling, discharge planning and links to the community
Central Regional Hospital also operates the statewide Maximum and Medium Security Forensic Units (services for individuals who are involved in both the mental health and criminal justice systems) and the Pre-Trial Evaluation Unit that conducts forensic evaluations to determine if individuals are capable to proceed to trial on the Dorothea Dix campus in Raleigh, NC.
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Cherry Hospital
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Cherry Hospital, located in Goldsboro, provides inpatient psychiatric services to North Carolinians who cannot be served in the community because of the severity of their symptoms. Inpatient services include:
Crisis stabilization (immediate help for a mental health emergency)
Assessment
Medical care
Psychiatric treatment
Patient advocacy
Social work services including counseling, discharge planning, and links to the community
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J. Iverson Riddle Center
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J. Iverson Riddle Developmental Center (JIRDC), located in Morganton, is the state-operated developmental center for North Carolinas western region. The center provides services and supports to individuals with intellectual and developmental disabilities (IDD), complex behavioral challenges and/or medical conditions whose clinical treatment needs exceed the level of care available in the community. Services and supports include:
-Residential, medical, habilitation (help in developing functional living skills) and training to promote independence and self-determination
-Facility-based therapeutic respite services to provide evaluations and assessments to individuals experiencing specific medical and/or behavioral challenges
-Facility-based respite services to provide caregivers temporary relief
-A behavior medicine clinic for community members with a diagnosis of Autism
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Julian F. Keith Alcohol and Drug Abuse Treatment Center
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Julian F. Keith is one of three state-operated North Carolina Alcohol and Drug Abuse Treatment Centers (ADATCs) that provide the following services:
· Medically monitored detoxification
· Psychiatric services
· Nursing services
· Substance abuse treatment and education
· Mental health treatment and education
· Recreational therapy
· Family services
· Discharge planning
Julian F. Keith ADATC is located in Black Mountain, NC and serves primarily the western region of the state. Julian F. Keith has 68 inpatient beds.
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Longleaf Neuro-Medical Treatment Center
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Longleaf, located in Wilson, North Carolina, provides specialized Skilled Nursing services to adults in the western and central regions of the state with chronic, complex medical conditions that co-exist with neurological conditions often related to a diagnosis of severe and persistent mental illness (including but not limited to gero- disorders or dementia, such as Alzheimer's). Services include:
-Services to adults with severe and persistent mental illness that also have long-term medical conditions requiring residential, medical and nursing care. These residents are referred solely from the State psychiatric hospitals; and
-Services to adults with a diagnosis of Alzheimer's or related dementia whose assaultive and combative behavior has resulted in a denial of care in traditional nursing home settings.
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Murdoch Center
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Murdoch Developmental Center, located in Butner, is the state operated developmental center for North Carolina’s central region. The center provides services and supports to individuals with intellectual and developmental disabilities (IDD), complex behavioral challenges and/or medical conditions whose clinical treatment needs exceed the level of care available in the community.
Services and supports include:
Residential, medical, habilitation (help in developing functional living skills), and training to promote independence and self-determination.
Facility-based therapeutic respite services to provide evaluations and assessments to individuals experiencing specific medical and/or behavioral challenges.
Facility-based respite services to provide caregivers temporary relief.
BART (Behaviorally Advanced Residential Treatment), a statewide program that serves young adult males with an IDD diagnosis and extreme behavioral challenges.
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O'Berry Neuro-Medical Treatment Center
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O'Berr y Neuro-Medical Center, located in Goldsboro, North Carolina provides specialized Skilled Nursing services to aging adults in the eastern and central regions of the state with chronic, complex medical conditions that co-exist with neurological conditions often related to a diagnosis of intellectual and/or developmental disability. O'Berry provides specialized medical and intellectual and/or developmental disability services to these adults that cannot be served in the community.
Services include:
Services to adults with developmental disabilities and medical conditions of a serious, chronic nature, requiring 24/7 medical and nursing care; and
Services to adults with intellectual and/or developmental disabilities whose level of need exceeds services available in the community.
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R.J. Blackley Alcohol and Drug Abuse Treatment Center
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R.J. Blackley is one of three state-operated North Carolina Alcohol and Drug Abuse Treatment Centers (ADATCs) that provide the following services: Medically monitored detoxification, Psychiatric services, Nursing services, Substance abuse treatment and education, Mental health treatment and education, Recreational therapy, Family services, Discharge planning
R. J. Blackley ADATC is located in Butner, NC and serves primarily the central region of the state. R.J. Blackley has 62 inpatient beds.
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Walter B. Jones Alcohol and Drug Abuse Treatment Center - Woodside Treatment Center
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Walter B. Jones is one of three state-operated North Carolina Alcohol and Drug Abuse Treatment Centers (ADATCs) that provide the following services:
· Medically monitored detoxification
· Psychiatric services
· Nursing services
· Substance abuse treatment and education
· Mental health treatment and education
· Recreational therapy
· Family services
· Discharge planning
Walter B. Jones ADATC is located in Greenville, NC and serves primarily the eastern region of the state. They offer two statewide programs that serve all 100 NC counties, a hospital inpatient Opioid Treatment Program (OTP) and a perinatal program for pregnant women and their babies. Walter B. Jones Woodside Treatment Center- provides 48 inpatient beds for adults needing inpatient substance use and/or mental health treatment services. WBJ Woodside Treatment Center provides crisis detox and crisis stabilization services for the Eastern region of North Carolina. The Center also provides inpatient perinatal services for women from all 100 North Carolina counties in their 1st, 2nd, and 3rd trimester needing inpatient substance use and/or mental health. Adults seeking services are:(1) Involuntarily admitted for inpatient treatment services; (2) Referred to WBJ Woodside Treatment Center for admission, based on a clinical assessment upon arrival at the Center; or (3) Walk-in to the Center for an assessment. All admissions are based on medical necessity (see admission criteria). The WBJ Woodside Treatment Center is accredited by the Joint Commission as a Behavioral Health Care Facility. If adults who are referred for services or walk-in for an assessment are not admitted, they are provided with a referral to an appropriate level of care
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Service Name
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State-County Special Assistance Adult Care Home/State-County Special Assistance In-Home
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State-County Special Assistance (SA) helps pay the cost of room and board in certain licensed residential care facilities. To be eligible, the applicant must need the type of care provided in the residential facility, must either be age 65 and older, disabled according to Social Security standards, or any age and legally blind. The applicant must also be unable to afford the cost of the facility and must meet financial guidelines. SA checks are sent monthly to eligible individuals living in licensed residential care facilities. These payments to eligible people in facilities are available in all 100 counties. If eligible for SA, the applicant would also receive Medicaid to help cover medical costs. Some adults may be able to receive SA and remain at home.
What is Special Assistance? SA is a state supplement to the federal Supplemental Security Income program (SSI). It provides direct cash payment to help with the cost of care in licensed SA eligible residential care facilities. Limited assistance is available for adults who prefer to remain at home. The cash payments are 50% State and 50% county dollars.
What are residential care facilities? Residential care facilities eligible to receive payments from SA recipients include licensed adult care homes/assisted living facilities, family care homes, mental health supervised living facilities, specialized community residential facilities for children and adolescents and residential hospice facilities. Facilities must agree to abide by the conditions of the Civil Rights Act of 1964. The service pays a higher rate to residents of licensed special care units for persons with dementia. SA recipients in residential care facilities are entitled to Medicaid to help cover their medical costs.
Who qualifies? Eligible recipients are low-income adults (65 and older), adults who are disabled (18 to 65), persons of any age who are legally blind and who qualify for federal SSI payments or who would qualify for SSI but have income higher than SSI limits. SA recipients also must need assistance with their daily living activities in a residential setting, as certified by a licensed physician, physician assistant, or nurse practitioner.
Can a person receive Special Assistance and remain at home? State-County Special Assistance In-Home (SA/IH) provides direct cash payment to enable Medicaid eligible low-income older or disabled adults to remain at home and receive care. Payments are no more than what the payment would be if the person lived in a licensed facility.SA/IH recipients must qualify for Medicaid separately. SA/IH is an alternative to residential care. The number of SA/IH slots statewide may equal 15% of the total number of all SA cases statewide. To receive SA/IH, adults must be in need of the level of care provided in an SA eligible facility and able to remain safely at home with appropriate services.How do people get access to Special Assistance? People may apply through their county department of social services. Someone else may apply on behalf of the recipient.
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