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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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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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Asthma
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This service strives to reduce the impact of asthma upon state residents by:
-Collecting and maintaining data on asthma statewide
-Putting a state asthma plan into action to include all age groups, ethnic groups, backgrounds and settings
-Making the general public more aware of asthma and how to prevent and control it
-Advocating for policies such as smoke-free restaurants and state vehicles
-Providing technical assistance and resources (funding and materials) to local asthma groups, also
-Providing leadership and administration for the statewide asthma coalition, the Asthma Alliance of North Carolina.
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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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Community Capacity Building to Eliminate Health Disparities
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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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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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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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Food/Nutrition Education
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TBD
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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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Outreach and Education
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The Division of Services for the Deaf and the Hard of Hearing conducts outreach and education activities such as, but not limited to:
-Division website
-Educational and informational mailings
-Public Service Announcements (PSAs)
-OPEN/net programming
-Ads and articles in publications
-Exhibit booths at target venues
-Presentations at conferences
-Presentations and training for community members
These activities are designed to:
- Promote available services and resources to help people with hearing loss
- Link people with hearing loss to the services they need
- Make agencies and organizations aware of services and resources available to them to help facilitate necessary connections with deaf, hard of hearing, deaf-blind and speech-impairedNorth Carolinians
-Provide deaf, hard of hearing and deaf-blind people the information and skills they need to function independently in the community where they live.
The Division of Services for the Deaf and the Hard of Hearing serves a diverse population. Outreach and education activities targets:
-Deaf
-Hard of Hearing
-Speech Impaired
-Deaf-Blind
-Service Providers
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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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