CenterPoint Human Services
Page 1 of 63
CONTENTS
Executive Summary ......................................................................................................................................................................... 5
I.
II.
Demographics ................................................................................................................................................................................ 6
Population ................................................................................................................................................................................................. 6
Race and Language Demographics ................................................................................................................................................ 7
Poverty, Homelessness, Unemployment ....................................................................................................................................... 8
III.
Provider Capacity and Service Utilization Data ............................................................................................................. 9
Medicaid Eligibility in Catchment Area ...................................................................................................................................... 9
State Enrollees in Catchment Area ............................................................................................................................................. 10
Service Utilization............................................................................................................................................................................... 10
Assertive Community Treatment (ACTT) ..................................................................................................... 10
Community Support Team (CST) ................................................................................................................... 11
Psychosocial Rehabilitation (PSR) .................................................................................................................. 11
Multi-Systemic Therapy (MST)....................................................................................................................... 12
Intensive In-Home (IIH) ................................................................................................................................... 12
Child and Adolescent Day Treatment ............................................................................................................. 12
Substance Abuse Comprehensive Outpatient Treatment Program (SACOT) ........................................... 13
Substance Abuse Intensive Outpatient Program (SAIOP) ........................................................................... 13
Opioid Treatment ............................................................................................................................................. 14
Mobile Crisis Management Team (MCM) ..................................................................................................... 14
IV.
Access and Choice ..................................................................................................................................................................... 15
US OMB Metropolitan (Urban) and Non-Metropolitan (Rural) Counties................................................................ 15
Analysis of Choice............................................................................................................................................................................... 15
Waivers of Access and Choice Requirements ......................................................................................................................... 17
Specialized Services ........................................................................................................................................................................... 17
Partial Hospital ................................................................................................................................................. 17
Mental Health Group Homes........................................................................................................................... 17
Traumatic Brain Injury Services – Residential ............................................................................................. 18
Psychiatric Residential Treatment Facility .................................................................................................... 19
Residential Treatment Levels 1 – 4 ................................................................................................................. 19
Child Mental Health Out of Home Respite .................................................................................................... 20
CenterPoint Human Services
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Substance Abuse Non-Medical Community Residential Treatment ............................................................ 20
Substance Abuse Medically Monitored Community Residential Treatment .............................................. 20
Intellectual / Developmental Disabilities (IDD) Group Homes and Alternative Family Living (AFL) .... 21
Intellectual / Developmental Disabilities Out of Home Respite .................................................................... 23
Intellectual / Developmental Disabilities Facility Based Respite .................................................................. 23
Intermediate Care Facility / IDD..................................................................................................................... 23
Needs Identified by Clients, Families, Providers and Stakeholders ......................................................................... 25
V.
Survey Data ........................................................................................................................................................................................... 25
Clients ................................................................................................................................................................ 25
Family Members/Caregivers ........................................................................................................................... 26
Providers ............................................................................................................................................................ 26
Community Stakeholders ................................................................................................................................. 27
Focus Group.......................................................................................................................................................................................... 28
Analysis.......................................................................................................................................................................................... 30
VI.
Needs Analysis...................................................................................................................................................................................... 30
Progress on State Initiatives ........................................................................................................................................................... 30
Progress on Integration of Physical and Behavioral Health ............................................................................................ 32
Successes since the last needs assessment ................................................................................................................................. 32
FY15 Quarter 1 – Providers / Services Added / Enhancements ................................................................... 32
FY15 Quarter 2 – Providers / Services Added / Service Enhancements ...................................................... 34
FY15 Quarter 3 – Providers / Services Added / Service Enhancements ...................................................... 34
Priorities and Strategies ......................................................................................................................................................... 37
VII.
VIII.
Appendices .............................................................................................................................................................................. 39
Appendix A – Maps ........................................................................................................................................................................... 40
Outpatient Services - Medicaid........................................................................................................................ 40
Outpatient Services – State* ............................................................................................................................ 41
Psychosocial Rehabilitation - Medicaid .......................................................................................................... 42
Psychosocial Rehabilitation – State ................................................................................................................. 42
Child and Adolescent Day Treatment - Medicaid.......................................................................................... 43
Substance Abuse Comprehensive Outpatient Treatment Program – Medicaid ......................................... 44
Substance Abuse Comprehensive Outpatient Treatment Program - State ................................................. 44
Substance Abuse Intensive Outpatient Program - Medicaid ........................................................................ 45
Substance Abuse Intensive Outpatient Program - State ............................................................................... 45
CenterPoint Human Services
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Opioid Treatment – Medicaid ......................................................................................................................... 46
Opioid Treatment - State ................................................................................................................................. 46
Day Supports - Medicaid .................................................................................................................................. 47
Adult Developmental Vocational Program - State......................................................................................... 48
Assertive Community Treatment Team - Medicaid ...................................................................................... 49
Assertive Community Treatment Team - State ............................................................................................. 49
Community Support Team – Medicaid .......................................................................................................... 50
Community Support Team – State.................................................................................................................. 50
MH / SA Supported Employment – Medicaid ............................................................................................... 51
MH / SA Supported Employment – State ....................................................................................................... 51
Intensive In-Home – Medicaid......................................................................................................................... 52
Intensive In-Home – State ................................................................................................................................ 52
Multi-Systemic Therapy – Medicaid ............................................................................................................... 53
Multi-Systemic Therapy – State ...................................................................................................................... 53
(b) (3) Peer Support - Medicaid ....................................................................................................................... 54
Traumatic Brain Injury Services (non-residential) - State ........................................................................... 54
Mobile Crisis – Medicaid ................................................................................................................................. 55
Mobile Crisis - State ......................................................................................................................................... 55
(b) (3) Waiver Respite – Medicaid................................................................................................................... 56
I / DD Home Based Services – Medicaid......................................................................................................... 57
I / DD Home Based Services – State ................................................................................................................ 57
I/DD Supported Employment Services – Medicaid ....................................................................................... 58
I/DD Supported Employment Services – State .............................................................................................. 58
(b) (3) Waiver Community Guide – Medicaid ............................................................................................... 59
Inpatient Hospital (Adult / Geriatric) – Medicaid ......................................................................................... 60
Inpatient Hospital (Adult / Geriatric) – State ................................................................................................ 60
Inpatient Hospital (Adolescent) – Medicaid ................................................................................................... 61
Inpatient Hospital (Adolescent) – State .......................................................................................................... 61
Inpatient Hospital (Child) - Medicaid ............................................................................................................. 62
Inpatient Hospital (Child) - State .................................................................................................................... 62
Crisis Respite - State ......................................................................................................................................... 63
CenterPoint Human Services
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I.
EXECUTIVE SUMMARY
The CenterPoint Human Services (CenterPoint) “April 2015 Provider Capacity, Community Needs Assessment and
Gaps Analyses” (Needs Assessment) and the resulting Network Development Plan describes identified behavioral
health needs within Forsyth, Stokes, Davie and Rockingham Counties. As the LME/MCO responsible for publiclyfunded services, CenterPoint’s goal is to align LME/MCO actions with service needs identified through data
analysis and community input, mindful of the possibilities available within the scope of its mission, mandates and
funding.
Needs assessment is crucial for setting priorities, making funding and programmatic decisions and taking action.
CenterPoint is committed to an ongoing process to identify and address service gaps and track progress towards
meeting priority needs.
This Needs Assessment incorporates data, reports and input from the following sources:
 Feedback from Consumer and Family Advisory Committee (CFAC) and multiple other advisory groups
 Provider focus group
 Survey data from clients, family members, providers and stakeholders
 NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS)
 NC Division of Medical Assistance (DMA)
 U. S. Census Bureau
 Medicaid and State and other non-Medicaid funded paid claims data
Needs are identified based on review, trending and analysis of benchmarks and progress indicators established by
the North Carolina Department of Health and Human Services (DMA, DMHDDSAS) and/or by CenterPoint;
analysis of data from the other identified sources; and analysis of feedback from stakeholders and the provider
focus group. Revised state criteria categorize all four CenterPoint counties as urban, rather than rural, making
access requirements more stringent.
While each county and disability group has unique needs, higher priority areas identified are listed below (not in
priority order).
 Behavioral Health Urgent Care and Facility-Based Crisis Centers with co-located medical and recoveryfocused services
 Psychiatric services in all counties, increasing capacity and timely access
 Timely access to inpatient care – reduced emergency department wait time; increased number of beds
 Increased availability of providers with expertise in specific clinical specialties [autism spectrum disorders;
eating disorders; dual diagnosis, especially including Intellectual and Developmental Disabilities (I/DD)]
 Additional evidence based practices
 Respite services
 Increased access to enhanced benefit services (Assertive Community Treatment Team, Community Support
Team and Intensive In-Home services) for clients without Medicaid (state funding required)
 Increased numbers of bilingual (Spanish-speaking) therapists
 Increased client/community education regarding access to available services and supports
 Housing and supports that decrease homelessness
 Employment services including Supported Employment for MH and SA populations
 Transportation to access services
 SA residential services
 Integrated/collaborative healthcare
 Partial Hospitalization
 Alternative service definitions to meet intensive treatment needs of individuals who do not meet medical
necessity criteria for existing enhanced services
CenterPoint Human Services
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II. DEMOGRAPHICS
POPULATION
North Carolina
Population: 9,535,483
County Population
Stokes
47,401
Rockingham
93,643
Forsyth
350,670
Davie
41,240
Forsyth County, which includes a large urban center
(Winston-Salem), comprises almost 66% of the total
population of the CenterPoint catchment area. Stokes,
Davie and Rockingham Counties each contain several
small towns or population centers. CenterPoint is
committed to adequate provision of services within
defined access standards for all residents in the
catchment area.
Age Distribution within Counties
Population
North
Carolina
9,535,483
Forsyth
Stokes
Davie
Rockingham
350,670
47,401
41,240
93,643
Persons under 5 years
6.6%
6.8%
5.3%
5.7%
5.6%
Persons under 18 years
Person 65 years and over
23.9%
12.9%
24%
13.0%
22%
16.0%
23.6%
16.6%
22.2%
16.2%
4/1/13 – 7/1/13; U.S. Census Bureau, Population Division Release Date 2014; 1/29/15
CenterPoint Human Services
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RACE AND LANGUAGE DEMOGRAPHICS
4/1/13 – 7/1/13; U.S. Census Bureau, Population Division Release Date 2014; 1/29/15
.
CenterPoint recognizes the need for additional bi-lingual (Spanish) service providers in Forsyth, Davie and
Rockingham Counties. In counties where the potential for a non-English speaking population is 5% or greater,
CenterPoint provides written materials upon request for clients in both English and the native language.
Translation services (language and deaf/hard of hearing translation) are available to all who communicate with
CenterPoint and its providers, including individuals calling to access services.
4/1/13 – 7/1/13; U.S. Census Bureau, Population Division Release Date 2014; 1/29/15
CenterPoint Human Services
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POVERTY, HOMELESSNESS, UNEMPLOYMENT
2010 Census; http://www.census.gov/hhes/www/poverty/ (Poverty Rates by County: 1960 - 2010); 3/25/15
The N.C Interagency Council for Coordinating
Homeless Programs (ICCHP) sponsors an
annual point in time survey each January.
For the 2014 NC Point-in-Time County,
Forsyth County reported 515 people as
homeless, while Rockingham County reported
210 people as homeless. The Point-in-Time
Count includes people who were residing in
emergency shelter or transitional housing or
who were unsheltered on the night of the
count. Stokes and Davie Counties did not
report any people in these three categories.
Point-In-Time / People Experiencing Homelessness
( Percentage of County Population)
Of the NC total reported as homeless:
• 24% of adults had a serious mental
illness (10% increase from the previous
year)
• 31% of adults had an substance use
disorder
• 13% of adults were veterans
As of 1/31/14; North Carolina Coalition to End Homelessness,
http://www.ncceh.org/pitdata; 3/24/15
Rockingham County has an
unemployment rate that
exceeds both the national and
state averages.
4/1/13 – 7/1/13; U.S. Census Bureau; 1/29/15
CenterPoint Human Services
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III. PROVIDER CAPACITY AND SERVICE UTILIZATION DATA
The following section covers the current provider capacity to provide access to services for Medicaid beneficiaries
and indigent population in the CenterPoint network. The section below additionally reviews children (age 3-11),
adolescents (age 12-17), young adults (age 18-20), adults (21-64), and older adults (65 and older) covered by the
CenterPoint Per Member Per Month (PMPM) payment system and those who received state funded services during
SFY2013-2014.
The CenterPoint provider network is composed of a
total of 1,164 unduplicated licensed practitioners
working in solo and / or group practices and agencies.
Providers are located throughout the state of North
Carolina and beyond, in locations where clients with
Medicaid from Forsyth, Stokes, Davie or Rockingham
Counties live.
Located within the four-county catchment area, the CenterPoint provider network includes 405 licensed
practitioners; 38 agencies; and five hospitals. Fourteen of these provider agencies are certified Critical Access
Behavioral Health Agencies (CABHAs) and maintain offices and deliver services in Forsyth, Stokes, Davie and/or
Rockingham Counties.
MEDICAID ELIGIBILITY IN CATCHMENT AREA
(As Percentage of Population)
3 – 11
12-17
18 - 20
21 - 64
65 +
As % of Total County
Population
Forsyth
6.65%
3.58%
1.27%
5.80%
1.25%
18.54%
Stokes
4.13%
2.72%
1.14%
5.04%
1.44%
14.46%
Davie
4.44%
2.69%
1.06%
4.25%
1.09%
13.53%
Rockingham
5.48%
3.35%
1.36%
7.67%
2.16%
20.02%
Catchment Area
6.05%
3.39%
1.26%
5.94%
1.41%
18.05%
County
As of 3/24/15; N.C. Division of Medical Assistance, Medicaid 834 Report; 3/24/15
CenterPoint Human Services
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Based on percentage of total county population, Davie County, followed by Stokes County, has the lowest
percentage of individuals eligible for Medicaid in the CenterPoint area. Rockingham County, at 20%, has the
highest percentage. Medicaid eligibility is one indicator of the socio-economic level of the county, with
implications for service funding, development and availability.
STATE ENROLLEES IN CATCHMENT AREA
(As Percentage of Population)
3 – 11
12-17
18 - 20
21 - 64
65 +
As % of Total County
Population
Forsyth
0.09%
0.12%
0.04%
0.82%
0.02%
1.09%
Stokes
0.12%
0.14%
0.05%
0.69%
0.01%
1.00%
Davie
0.09%
0.10%
0.02%
0.40%
0.01%
0.62%
Rockingham
0.09%
0.13%
0.04%
0.83%
0.02%
1.12%
Catchment Area
0.09%
0.12%
0.04%
0.78%
0.02%
1.05%
County
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
The percentage of the population determined to be uninsured and in-service is relatively consistent across the four
counties.
SERVICE UTILIZATION
ASSERTIVE COMMUNITY TREATMENT (ACTT)
Medicaid service utilization for ACTT declined during SFY2013-2014. State funded service utilization was fairly
stable and with lower numbers served. The reimbursement rate for ACTT was increased effective 7/1/2014 to
support the additional provider cost and assure sustainability of the service.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CenterPoint Human Services
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COMMUNITY SUPPORT TEAM (CST)
Medicaid service utilization for CST declined during the SFY2013-2014. State funded service utilization saw an
initial rise at the beginning of the last quarter with a return to average by the end of the quarter. The reimbursement
rate for CST was increased effective 7/1/2014 to support the additional provider cost and assure sustainability
of the service.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
PSYCHOSOCIAL REHABILITATION (PSR)
Medicaid service utilization remained fairly stable throughout SFY2013-2014. State funded service utilization was
increasing during the last quarter. The reimbursement rate for PSR was increased effective 2/1/15 to support the
additional provider cost and assure sustainability of the service.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CenterPoint Human Services
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MULTI-SYSTEMIC THERAPY (MST)
Medicaid service utilization for MST dropped significantly during the first two quarters of the fiscal year. During
the third quarter utilization trended upward and then dropped slightly during the fourth quarter. No clients accessed
State funded MST services during the year.
No clients accessed State funded service
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
INTENSIVE IN-HOME (IIH)
Medicaid and State funded IIH service utilization declined during SFY2013-2014.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CHILD AND ADOLESCENT DAY TREATMENT
Medicaid child and adolescent day treatment service utilization was fairly stable during most of the year.
Not included in State Benefit Plan
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CenterPoint Human Services
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SUBSTANCE ABUSE COMPREHENSIVE OUTPATIENT TREATMENT PROGRAM (SACOT)
Medicaid SACOT service utilization steadily declined throughout the year. State funded SACOT service increased
sharply in the last quarter.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
SUBSTANCE ABUSE INTENSIVE OUTPATIENT PROGRAM (SAIOP)
SAIOP service utilization for both funding sources had a slight downward trend. More clients were served with
state dollars than with Medicaid dollars.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CenterPoint Human Services
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OPIOID TREATMENT
Opioid treatment service utilization rates for both funding sources were fairly stable with a slight upward
trend.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
MOBILE CRISIS MANAGEMENT TEAM (MCM)
MCM service utilization rates were variable throughout the year with a slightly upward trend. MCM
utilization for this time period includes service delivered at Emergency Departments.
7/1/13 – 6/30/14; CareWorks (claims); 2/23/15
CenterPoint Human Services
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IV. ACCESS AND CHOICE
US OMB METROPOLITAN (URBAN) AND NON-METROPOLITAN (RURAL)
COUNTIES



Urban includes Metropolitan counties (46 counties).
Rural is anything other than Metropolitan counties (54 counties).
Central County – at least 50 percent of the population resides within urban areas of 10,000 or more population
or contains at least 5,000 people residing within a single urban area of 10,000 or more population.
 Outlying County – included in the Metro/Micro Statistical Area if they meet specified requirements of
commuting to or from the central counties.
As of March 2013; U.S. Census Bureau, Population Division; 3/23/15
As of October 2014; U.S. Department of Health and Human Services (Definition of Rural); 3/23/15
*Office of Management and Budget
Historically, CenterPoint has evaluated network access standards using an “urban” designation for Forsyth County
and a “rural” designation for the other three counties in the catchment area (Stokes, Davie, Rockingham). State
guidelines provided earlier this year require that all CenterPoint counties be categorized as urban, a change that
significantly impacts the gaps analysis process. Access and choice must now be provided within urban guidelines
(access within 30 miles/30 minutes’ drive time), rather than the rural standard (45 miles/45 minutes).
This new standard affects particular services and will be a prompt for development in the coming year.
ANALYSIS OF CHOICE
Service
Outpatient Services
(Medicaid)
Medicaid
Eligibles /
State
Enrollees
Choice of 0 providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
Choice of 1 provider
within the applicable
access distance time
standard (30 mile / 30
minutes)
Choice of 2+ providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
96,215
<0.001%
<0.001%
99.9%
CenterPoint Human Services
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Service
Medicaid
Eligibles /
State
Enrollees
Choice of 0 providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
Choice of 1 provider
within the applicable
access distance time
standard (30 mile / 30
minutes)
Choice of 2+ providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
5,596
0.19%
0.09%
99.72%
Outpatient Services
(State)
Service
Maximum Distance (miles) to Maximum Distance (miles) to
Travel (Medicaid)
Travel (State)
Location Based Services
Psychosocial Rehabilitation
29.5
29.5
Child and Adolescent Day Treatment
27.8
N/A
SA Comprehensive Outpatient Treatment Program
52.4
52.4
SA Intensive Outpatient Program
29.5
30.5
Opioid Treatment
35.8
52.6
Day Supports
20.2
N/A
Adult Developmental Vocational Program
N/A
23.5
Assertive Community Treatment Team
28.9
28.9
Community Support Team
29.6
31.6
MH/SA Supported Employment
31.6
37.7
Intensive In-Home
26.7
26.7
Multi-Systemic Therapy
45.9
71.5
(b)(3) Peer Support
Traumatic Brain Injury Services (non-residential)
Mobile Crisis
(b)(3) Waiver Individual Support (Personal Care)
(b)(3) Waiver Respite
I/DD Home Based Services
I/DD Supported Employment Services
(b)(3) Waiver Community Guide
Crisis and Inpatient Services
Inpatient Hospital – Adult
Inpatient Hospital – Adolescent
Inpatient Hospital – Child
Facility Based Crisis
Crisis Respite
Detoxification (non-hospital)
32.3
N/A
N/A
18.9
51.5
51.5
Contracts Pending
Contracts Pending
19.6
N/A
19.6
44.7
29.6
16.6
24.5
N/A
36.4
36.4
36.4
36.4
52.7
52.7
In Development
In Development
N/A
29.8
Pending Licensure
Pending Licensure
Community Mobile Services
CenterPoint Human Services
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WAIVERS OF ACCESS AND CHOICE REQUIREMENTS
Waiver Time Period
Decision
Service
3/20/15 – 9/20/15
Approved
Mobile Crisis
10/10/14 – 4/20/15
Approved
Ambulatory Detox
10/10/14 – 4/20/15
Approved
10/10/14 – 4/20/15
Approved
10/10/14 – 4/20/15
Approved
9/26/13 – 9/2014
Approved
Action Taken to Date
Non-Hospital Medical
Detox
SA Medically Monitored
Community Residential
Treatment
SA Non-Medically
Monitored Community
Residential Treatment
MH/SA Supported
Employment/LTVS
Wavier requested to
operate with one provider
Provider contract effective
2/16/2015
Provider selected, contract
pending licensure
Provider selected, contract
pending CON process and
licensure
Provider selected, contract
pending licensure
Provider contract effective
10/1/2014
SPECIALIZED SERVICES
PARTIAL HOSPITAL
Parent Provider
Old Vineyard
Parent
Company
Location
Forsyth
Funding
Catchment Site Location
Medicaid
State
Forsyth



Stokes
Davie
Rockingham
MENTAL HEALTH GROUP HOMES
Parent Provider
A Better Path
A Brighter Tomorrow
Group
A Sure House
Alberta Professional
Services
Barium Springs Home for
Children
Black and Associates
Global
Carter’s Circle of Care
CenterPoint Human Services
Parent
Company
Location
Guilford
Funding
Medicaid
Guilford

Forsyth

Guilford

Iredell

Guilford

Forsyth

State
Catchment Site Location
Forsyth
Stokes
Davie
Rockingham



Page 17 of 63
Parent Provider
Central Care Division
Envisions of Life
Ethel’s Footprint
Grandfather Home for
Children
Inspirationz
JMJ Enterprises
Lydia’s Home
New Leaf Adolescent Care
Realistic Change by
Choice
Successful Transitions
Timber Ridge
Turning Point Homes
Wescare Professional
Services
Wilson’s Constant Care
Youth Enrichment Group
Home
Youth Haven Services
Youth Unlimited
Parent
Company
Location
Rockingham
Guilford
Alamance
Funding
Medicaid
Catchment Site Location
State
Forsyth
Stokes
Davie
Rockingham




Avery

Forsyth
Guilford
Guilford
Mecklenburg




Iredell

Guilford
Rowan
Iredell



Guilford


Forsyth


Guilford

Rockingham
Randolph





TRAUMATIC BRAIN INJURY SERVICES – RESIDENTIAL
Parent
Company
Location
Vance
Davie
Wake
Parent Provider
D.D. Residential Services
Davie County Group
Easter Seals UCP NC
Edwards Community
Support Service
Group Homes of Forsyth
Home Care Solutions of
North Carolina
Independent Living Group
Home
Lutheran Family Services
Milling Manor
Monarch
Remmsco
Residential Treatment
Services of Alamance
RHA Health Services
Rouses Group Home II
Therapeutic Alternatives
Funding
Medicaid
Catchment Site Location
State
Forsyth



Davie
Rockingham


Greene

Forsyth


Forsyth


Forsyth


Davidson
Davie
Albemarle
Rockingham




Alamance

Buncombe
Rockingham
Randolph



CenterPoint Human Services
Stokes






Page 18 of 63
PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY
Parent Provider
Alexander Youth Network
Avalonia Group Homes
Barium Springs Home for
Children
Brynn Marr Hospital
Central Regional Hospital
Cornerstone Treatment
Facility
Cornerstone Treatment
Facility Program
Devereaux Georgia
Treatment Network
Eliada Homes
Parent
Company
Location
Mecklenburg
Gaston, SC
Medicaid
Iredell

Onslow
Greenville


Anson

Robeson

Cobb, GA

Buncombe
Greenville,
SC

Avery

Yancey, SC
Lenoir


Florence, SC

Hoke

Greenville,
SC

Brunswick

Mecklenburg

Blount, TN
Guilford


Excalibur Youth Services
Grandfather Home for
Children
New Hope Carolinas
Nova
Palemetto Pee Dee
Behavioral Health
Premier Healthcare
Services
Springbrook Behavioral
Health System
Strategic Behavioral
Center
Thompson Child & Family
Focus
Village Behavioral Health
Youth Focus
Funding
State
Catchment Site Location
Forsyth
Stokes
Davie
Rockingham



RESIDENTIAL TREATMENT LEVELS 1 – 4
Parent Provider
A Better Path
A Brighter Tomorrow
Group
A Sure House
Alberta Professional
Services
CenterPoint Human Services
Parent
Company
Location
Guilford
Funding
Medicaid
Guilford

Forsyth

Guilford

State
Catchment Site Location
Forsyth
Stokes
Davie
Rockingham


Page 19 of 63
Parent
Company
Location
Medicaid
Iredell

Guilford

Forsyth
Rockingham
Guilford
Alamance




Avery

Forsyth
Guilford
Guilford
Mecklenburg




Iredell

Guilford
Forsyth
Rowan
Iredell




Guilford


Forsyth


Guilford

Rockingham
Randolph


Parent Provider
Barium Springs Home for
Children
Black and Associates
Global
Carter’s Circle of Care
Central Care Division
Envisions of Life
Ethel’s Footprint
Grandfather Home for
Children
Inspirationz
JMJ Enterprises
Lydia’s Home
New Leaf Adolescent Care
Realistic Change by
Choice
Successful Transitions
The Children’s Home
Timber Ridge
Turning Point Homes
Wescare Professional
Services
Wilson’s Constant Care
Youth Enrichment Group
Home
Youth Haven Services
Youth Unlimited
Funding
Catchment Site Location
State
Forsyth
Stokes
Davie
Rockingham






CHILD MENTAL HEALTH OUT OF HOME RESPITE
Parent Provider
The Children’s Home
Youth Haven Services
Parent
Company
Location
Forsyth
Rockingham
Funding
Catchment Site Location
Medicaid
State
Forsyth





Stokes
Davie
Rockingham

SUBSTANCE ABUSE NON-MEDICAL COMMUNITY RESIDENTIAL TREATMENT
Parent Provider
Holistic Services (Pending
Licensure)
Parent
Company
Location
Funding
Medicaid
Robeson

State
Catchment Site Location
Forsyth
Stokes
Davie
Rockingham

SUBSTANCE ABUSE MEDICALLY MONITORED COMMUNITY RESIDENTIAL TREATMENT
CenterPoint Human Services
Page 20 of 63
Parent Provider
Holistic Services (Pending
Licensure)
Parent
Company
Location
Funding
Medicaid
Robeson

Catchment Site Location
State
Forsyth
Stokes
Davie
Rockingham

INTELLECTUAL / DEVELOPMENTAL DISABILITIES (IDD) GROUP HOMES AND
ALTERNATIVE FAMILY LIVING (AFL)
Parent Provider
A+ Willamson Care
Network
Ablecare Corporation
Alberta Professional
Services
Autism Society of NC
Baptist Children’s Home
of NC
Carolina Residential
Services
Central Care Division
Charles Hines and Son
Climbing Jacob’s Ladder
CNC Access
Community Assisted
Residential Environment
Community Support
Service
Creative Custom Living
D.D. Residential Services
Davie County Group
Home
Dream Makers Assisted
Living Service
Easter Seal UCP NC
Educare Community
Living Corporation
Edwards Community
Support Service
Family Solutions Center
Foster’s Care Facility
Friendly People That Care
Gentlehands of NC
GHA Autism Supports
Group Homes of Forsyth
Home Care Solutions of
NC
Parent
Company
Location
Funding
Medicaid
Guilford

Guilford

Guilford

Orange

Davidson

Yadkin

Catchment Site Location
State
Forsyth




Forsyth


Guilford

Guilford
Vance

CenterPoint Human Services
Rockingham





Davie

Forsyth

Wake

Guilford









Greene
Forsyth
Davie

Rockingham
Forsyth
Forsyth
Forsyth
Davie
Guilford
Forsyth
Guilford
Stanly
Forsyth
Stokes













Page 21 of 63
Parent
Company
Location
Medicaid
State
Forsyth
Forsyth



Forsyth

Guilford

Mecklenburg
Guilford
Davie
Albemarle




Forsyth


Wake
Davidson
Surry
Rockingham
Wayne
Buncombe
Rockingham









Cumberland


Guilford


Parent Provider
Independent Living Group
Home
J.L. Redford
Lindley Habilitation
Services
Lutheran Family Services
Maxim Health Care
Milling Manor
Monarch
Multi-Therapeutic
Services
NC Mentor
Omni Vision
PQA
Remmsco
Renu Life
RHA Health Services
Rouses Group Home II
Spigner Management
Systems
Sylvanglade Services
The Centers for
Exceptional Children
Therapeutic Alternatives
Top Priority
United Living
United Methodist Agency
for Retarded
United Support Services
Universal Mental Health
Services
Wescare Professional
Services
Zoe Behavioral Health
Services
Funding
Stokes
Davie
Rockingham












Forsyth
Randolph
Forsyth
Guilford



Mecklenburg

Mecklenburg

Mecklenburg

Guilford

Guilford

CenterPoint Human Services
Catchment Site Location






Page 22 of 63
INTELLECTUAL / DEVELOPMENTAL DISABILITIES OUT OF HOME RESPITE
Parent Provider
Dream Makers Assisted
Living
Easter Seals UCP NC
Horizons Residential
Independent Living Group
Home
Monarch
PQA
The Children’s Home
Youth Haven
Parent
Company
Location
Funding
Medicaid
Davidson

Wake
Forsyth


Forsyth


Albemarle
Surry
Forsyth
Rockingham







Catchment Site Location
State
Forsyth
Stokes
Davie
Rockingham











INTELLECTUAL / DEVELOPMENTAL DISABILITIES FACILITY BASED RESPITE
Parent
Company
Location
Wake
Forsyth
Parent Provider
Easter Seals UCP NC
Horizons Residential Care
Funding
Medicaid
State


Catchment Site Location
Forsyth
Stokes
Davie
Rockingham

INTERMEDIATE CARE FACILITY / IDD
Parent
Company
Location
Medicaid
Mecklenburg

Buncombe

Onslow
Lenoir


Forsyth


Forsyth
Forsyth
Burke
Mecklenburg
Mecklenburg
Albemarle
Granville
Wayne
Wayne
Alamance
Mecklenburg













Parent Provider
Autism Services of
Mecklenburg County
Black Mountain
Neuromedical Treatment
Center
Carobell
Caswell Center
Educare Community
Living Corporation
Horizons Residential Care
Howell Support Services
J Iverson Riddle Center
Lifespan
Lutheran Family Services
Monarch
Murdock Center
Nova
O’Berry Center
Ralph Scott Life Services
RHA Howell Care Centers
CenterPoint Human Services
Funding
State
Catchment Site Location
Forsyth


Stokes
Davie
Rockingham

Page 23 of 63
Parent Provider
RHA North Carolina MR
Rouses Group Home
Surry Yadkin Residential
Services
T.L.C. Home
The Keywest Center
UNC TEACCH
Voca Corporation of North
Carolina
Watsons Group Home
Parent
Company
Location
Buncombe
Rockingham
Medicaid
Surry

Lee
Durham
Orange



Guilford

Guilford

CenterPoint Human Services
Funding


State
Catchment Site Location
Forsyth

Stokes
Davie
Rockingham


Page 24 of 63
V.
NEEDS IDENTIFIED BY CLIENTS, FAMILIES, PROVIDERS
AND STAKEHOLDERS
SURVEY DATA
CenterPoint conducted a needs assessment survey from February 13 to March 9, 2015. Clients, family members,
providers and community stakeholders were informed about the survey via the CenterPoint “Friday E-mail”,
CenterPoint advisory groups, e-mail distribution lists of other human service organizations, and personal outreach
to community leaders/stakeholders. Providers offered printed survey copies to clients to enhance client awareness
and voluntary participation in the survey. One hundred seventy two individuals (n=172) participated in the
CenterPoint survey. Survey respondents included clients receiving services (36%), providers (28.5%), community
members/ stakeholders (22.7%), and family members/caregivers (12.8%).
CLIENTS
The majority of clients that responded to the survey reported “no barriers” to service. However, of the barriers
identified the following themes emerged:





Medical issues and/or physical disability limiting access to services
Lack of reliable transportation, limited bus passes
Inability to pay for services and/or medication
Lack of support from family/friends; feelings of fear or embarrassment
Lack of employment and/or housing
Clients also were asked to identify what they would most like to see changed about services. Again, the majority of
clients that responded to the survey reported “no changes needed”. While some needed changes overlapped with
identified barriers, the following distinct changes were noted:



Extended service duration for psychiatric appointments
More opportunities for community activities/ socialization
Increased services for clients with I/DD
CenterPoint Human Services
Page 25 of 63
FAMILY MEMBERS/CAREGIVERS
Barriers to service identified by family members/caregivers were very similar to barriers identified by clients.
Identified barriers include:




Medical issues/physical disability
Lack of employment/housing
Lack of support from family/ friends, fear or embarrassment
Reading skill level/education level
Family members and caregivers also were asked to identify needed changes in services. While some needed
changes overlapped with identified barriers, the following distinct changes were noted:







Saturday community activities, increased socialization
More offices with more convenient locations
More one on one service
More time with the psychiatrist
Increased stability with state rules
Care Coordinators have too many cases
Easier approval for add-on services; more timely authorizations from Utilization Management (UM)
PROVIDERS
Providers were given an opportunity to respond to the survey as well. Providers identified the following barriers to
service:







Lack of reliable transportation
Homeless/housing issues
Lack of employment
Cannot pay for services/ medication; no insurance
Do not know what services are available
Medical issues
Lack of support from family/ friends
Providers also identified a list of needed changes that was different from the identified need:









Integration with primary care
Increased peer support services
Case management
Bi-lingual therapists
Increased resources for detox and SA residential
Staff too busy to explain services
Increased services to children with Autism Spectrum Disorder
Improved relationship between hospitals, police and DSS
More adult residential services
CenterPoint Human Services
Page 26 of 63





More flexible office hours
Continuity between MCOs – paperwork and processes
Assistance for folks in jail/homeless
Staff turnover
Length of time between appointments
COMMUNITY STAKEHOLDERS
Stakeholders identified the following identified needs in their community:







Lack of reliable transportation
Lack of employment/housing issues
Cannot pay for services/ medications
Community does not know what services are available
No insurance
Lack of support from family/ friends
Frequency of services provided is not adequate
Additionally, the following distinct needed changes were identified:










Bi-lingual therapists
SA services located in Davie and Stokes
Limited state benefits
Entrance criteria too rigid
Timely appointments
Mental Health Intensive Outpatient
More individual OPT, more residential services
Treatment options for the dually diagnosed (MH or SA with I/DD)
Case management
Training for DSS
Survey responses for clients, family members/caregivers, providers and community stakeholders were
consistent with responses from last year’s survey.
CenterPoint Human Services
Page 27 of 63
FOCUS GROUP
A focus group was held with 12 carefully selected CenterPoint providers on Monday, March 9, 2015. Twenty-six
participants were selected to assure representation from all age/disability groups. All age/disability groups were
represented despite low attendance due to rescheduling as a result of inclement weather. The focus group was
facilitated by an independent consultant to assure confidentiality of individual responses. The following section
describes the themes and recommendations from the CenterPoint focus group.

Themes from CenterPoint Provider Focus Group
State funding - Many concerns were expressed regarding state funded services ranging from the size of the
overall budget available, the rates paid for state service and the more stringent service criteria (relative to
Medicaid).

Lack of service codes for “people in the middle” - Providers felt there are service codes and service
provisions for people with acute needs and those with modest needs but not for people in all target
populations “in the middle”.

Transportation - More accurately the lack of transportation was consistently mentioned as a need for people
to access services.

Case management - Providers believe that the case management services historically provided, but ended
when MCOs took on responsibility for care coordination, continue to be needed. Out of necessity providers
continue to carry out some of those historic case management functions but are not compensated for them.

Rates - Providers believe that the rates they are paid do not incorporate the full range of activities they are
expected to provide.

Service definitions - Providers believe that the service definitions are outdated and need to be updated with
provider input.

CenterPoint as an MCO - Providers believe that CenterPoint is more bureaucratic than other MCOs they
work with. One provider calculated that they spend 38 hours per month more on complying with
CenterPoint’s reporting requirements than they do for other MCOs. Other concerns expressed include that
some Managers/Directors are prejudiced against certain services, like specialized residential, and that
results in those services not being authorized even when needed by the client. Providers believe that service
authorization decisions are often made by staff that does not have a good understanding of the needs of a
specific target population-most often people with I/DD.

Integration with acute primary care - Providers are not aware of activities that CenterPoint may be engaged
in to improve coordination with acute primary providers on behalf of clients.

Continuity of care - Providers report that there is not continuity of care mechanisms in place for effective
service coordination between providers for those clients that are being served by multiple providers.
Providers report they have no way of knowing if clients they are serving are also receiving services from
another provider or providers.
CenterPoint Human Services
Page 28 of 63

Providers believe that CenterPoint staff is committed professionals that truly want to “do the right thing”.

Providers resent that the MCO has higher pay scales and benefits than they do and consistently hires staff
away from them.
CenterPoint Human Services
Page 29 of 63
VI. ANALYSIS
NEEDS ANALYSIS
Based upon analysis of service utilization, survey responses and access data, the following needs have been
identified for further study and planning on best means to meet the identified need, e.g. feasibility study based upon
market share, Request for Proposal (RFP)/ Request for Information (RFI) for additional providers, expansion of
existing providers, reallocation of state funds, alternative service definitions, and community partnerships.


















Behavioral Health Urgent Care and Facility Based Crisis Centers (Implementation in progress)
Substance Abuse Medically Monitored Residential Treatment (Provider identified, licensure pending)
Substance Abuse Non-Medically Monitored Residential Treatment (Provider identified, licensure pending)
Non-Hospital Medical Detox (Provider identified, licensure and Certificate of Need pending)
Substance Abuse Comprehensive Outpatient Treatment – State, Medicaid
Substance Abuse Intensive Outpatient – State
Opioid Treatment – State
MH/SA Supported Employment – State
Multi-Systemic Therapy – Medicaid, State
Partial Hospitalization – Medicaid, State
b(3) Peer Support – Medicaid
Mobile Crisis Management Team
I/DD Home Based Services – State
Housing alternatives
Employment alternatives
Bi-lingual (Spanish speaking) therapists
Increased services for the dually diagnosed (MH or SA with I/DD)
Additional integrated/collaborative healthcare
PROGRESS ON STATE INITIATIVES
To support the State’s initiative of Transition to Community Living, develop the infrastructure within
CenterPoint and the community to provide community-based housing alternatives.

Under the state of North Carolina’s settlement agreement with the federal Department of Justice (the “DOJ
Settlement”), a total of 30 individuals have been transitioned to community–based housing with appropriate
services and supports
To support the State’s initiative for Assertive Community Treatment Team/Supported Employment, develop
and/or enhance community-based wrap around supports including Assertive Community Treatment Teams
and Supported Employment with fidelity to evidence-based models.
CenterPoint Human Services
Page 30 of 63



ACTT Learning Collaborative met monthly for training, technical assistance and sharing of knowledge,
while enhanced ACTT rates support fidelity to evidence-based protocols
Five major ACTT providers successfully achieved scores substantiating fidelity to evidence-based
protocols, i.e. the providers are delivering the service consistent with evidence-based standards
An additional Supported Employment provider was added by a RFP process to assure capacity and choice
for individuals with mental health and/or substance use needs
To support the State’s initiative for addressing Crisis Services/Emergency Department Wait Times, align
programs to emphasize the importance of recovery, self-determination and least restrictive level of care.




Identified Forsyth County site for Facility-Based Crisis Center with Behavioral Health Urgent Care in area
of targeted need, near supportive community resources; received DHHS grant funding
Collaborated with Forsyth Technical Community College to develop a Peer Support and recovery-focused
career track program with options leading to an Associate Degree in Human Services Technology
Provided Peer Support
Collaborated with rural hospital Emergency Department staff and Mobile Crisis Management providers to
discuss first responder protocols
To support the State’s Closer to Home initiative, encourage the appropriate use of residential treatment
services for children.

Eight children admitted to Intensive Alternative Family Treatment, an evidence-based, home-like
residential “alternative to facility-based institutional care”
For the local Performance-Based Contracts initiative, ready the provider network for performance-based
contracts with incentives based on client outcomes focused on quality and recovery.

Established client-related clinical outcomes in contracts for a large comprehensive adult mental health
provider (Daymark: evidence-based Dialectical Behavior Therapy group outcomes); for a substance abuse
provider (Partnership: client satisfaction); and for a child mental health provider (NC Mentor: sustained inhome residence of children following completion of Intensive In-Home Services)
For the local initiative Enhancing Lives, focus the I/DD system on delivering meaningful day activities in the
least restrictive settings.



Much publicized Rockingham County arts-based program “Art on Scales” opened in Reidsville December
2014
Initiate vendor contract to develop veteran community and emerging I/DD vocational micro-enterprise
partnership to target interested clients who are unserved/underserved by legacy day programs
Community stakeholder meetings are underway on transition of “sheltered workshop” service models to
alternative meaningful day activities
For the local Rural Service Enhancement initiative, implement service enhancements designed to improve
service quality, access and provider choice in rural communities.
CenterPoint Human Services
Page 31 of 63



With significant stakeholder input, finalized Davie County Work Plan to address MH and SA service
access, quality and provider choice
Supported Rockingham County Emergency Medical Services “alternative destination” grant application to
fund transport for individuals’ needing behavioral health assessment/intervention to locations other than
hospital emergency departments.
Identified funding for new position to staff Wellness Centers in Stokes and Davie Counties and, when a site
is identified, in Rockingham County as well
PROGRESS ON INTEGRATION OF PHYSICAL AND BEHAVIORAL HEALTH




Integrated Care clinician co-located at the Community Care Clinic
Health Improvement Peer Program (HIPP) grant support for additional trainings and for state funded
clients
RFI issued for a medical service provider to be co-located with the planned Behavioral Health Urgent
Care/Facility Based Crisis Center
Continuation as a Screening, Brief Intervention, Referral to Treatment (SBIRT) participation
SUCCESSES SINCE THE LAST NEEDS ASSESSMENT
FY15 QUARTER 1 – PROVIDERS / SERVICES ADDED / ENHANCEMENTS
(July – September 2014)
Service Added /
Enhancement
“Open Access” to Care
Forsyth
Counties Served
Stokes Davie Rockingham
Age
Served
Disability
Served
Adult, Child MH, I/DD, SA








Child
MH




Child
MH




Adult
MH, SA
Increased rates for
psychiatric / prescriber




Adult;
Child
MH, I/DD, SA
Increased rate ACTT




Adult
MH, SA
Increased rate for CST




Adult
MH, SA
(located in Winston Salem)
Enhanced School-Based
Day Treatment
Program
Enhanced School-Based
Outpatient Therapy
Community Support
Team (expanded capacity
and choice)
CenterPoint Human Services
Page 32 of 63
Service Added /
Enhancement
Increased rate for rural
child psychiatric
services









Forsyth

Counties Served
Stokes Davie Rockingham



Age
Served
Disability
Served
Child
MH, SA
“Open Access” to Care
o Urban Service Model (Forsyth)
 Established 9/1/14 in Forsyth County (Winston Salem) a fully operational “open access” to
care model offering same day walk-in access to assessment and, if needed, to
psychiatric/prescriber services; available to all catchment area residents. (Monarch)
o Rural Service Model (Stokes, Davie, Rockingham)
 Established in Stokes (RHA Health Services), Davie (RHA Health Services) and
Rockingham (Youth Haven), a rural “modified open access” service model offering
specific days of the week/times when individuals may walk in without an appointment for
assessment; psychiatric/prescriber services are provided, if needed, within three business
days through addition of increased on-site and tele-psychiatric prescriber services.
Enhanced School-Based Rural Day Treatment Program
o Implemented 8/18/14 an enhanced quality Day Treatment program for middle and high school
students in Stokes County with new provider; enhanced reimbursement rate supports rural service
delivery. (Youth Haven)
Enhanced School-Based Outpatient Therapy
o Implemented 8/18/14 enhanced quality outpatient therapies for middle and high school students in
Stokes County schools with new provider. (Youth Haven)
o Added two grant-funded licensed practitioners serving middle school students at the school-based
Rockingham. (School Health Alliance)
Community Support Team
o Expanded CST capacity and provider options/choice in Forsyth, Davie and Rockingham Counties
via a RFP. (Daymark Recovery Services)
MH/SA Supported Employment / Long Term Vocational Supports
o Expanded capacity and provider options/choice for the service via RFP, with access available to
residents of all counties. (PQA Health Services)
Increased Rates for Psychiatric/Prescriber Services
o Increased psychiatric services rates effective 7/1/14 to support the service by more appropriately
reflecting provider costs.
Increased Rates for ACTT Service
o Increased ACTT service rates effective 7/1/14 to support the service by more appropriately
reflecting provider costs.
Increased Rates for CST Service
o Increased CST service rates effective 7/1/14 to support the service by more appropriately reflecting
provider costs.
Increased Rates for Rural Child Psychiatric Services
o Increased rates for rural child psychiatric services in Rockingham based on specified additional
hours of MD/prescriber availability; will increase access and support provider cost of delivering the
service. (Youth Haven)
CenterPoint Human Services
Page 33 of 63
FY15 QUARTER 2 – PROVIDERS / SERVICES ADDED / SERVICE ENHANCEMENTS
(October – December 2014)
Service Added /
Enhancement
Counties Served
Forsyth Stokes Davie Rockingham
Psychological services





Age
Served
Disability
Served
Adult, Child
MH, I/DD
Psychological Services
o Added additional psychologist offering outpatient therapy and psychological evaluations in rural
Rockingham County.
FY15 QUARTER 3 – PROVIDERS / SERVICES ADDED / SERVICE ENHANCEMENTS
(January – March 2015)
Service Added /
Enhancement
Elementary SchoolBased Day Treatment
Ambulatory Detox
Counties Served
Forsyth Stokes Davie Rockingham
(located in Winston Salem)
Fidelity-Based
Dialectical Behavior
Therapy (DBT)
30-Day Comprehensive
Assessment program
Psychosocial
Rehabilitation rate
increase
myStrength.com (web
based recovery tool)
Pay for Performance
Initiative – Partnership
for a Drug Free NC
Pay for Performance
Initiative – NC Mentor
Child Psychiatry in
Rural County







Age
Served
Disability
Served
Child
MH

Adult
SA





Adult
MH/SA




Child
MH/SA/I-DD




Adult
MH/SA




Adult
MH/SA




Adult
SA




Child
MH




Child
MH/SA
Elementary School-Based Day Treatment Program
CenterPoint Human Services
Page 34 of 63
o



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Implemented 2/18/15 a new Day Treatment program for elementary school students in Stokes
County (King Elementary); enhanced funding supports rural service delivery. (Youth Haven)
Ambulatory Detox
o Expanded the SA service continuum with the 2/15 addition of this Medicaid-funded SA service not
previously available within the catchment area. (Partnership for a Drug-Free NC)
Dialectical Behavior Therapy (DBT) Groups
o CenterPoint has incentivized fidelity-based DBT groups, with clinical outcomes, in Forsyth and
Rockingham. (Daymark)
Comprehensive 30-Day Assessment (for children referred for PRTF)
o Contracted for a specialized comprehensive assessment for children referred for Psychiatric
Residential Treatment Facility (PRTF placement); will assure selection of most appropriate level of
care and type of treatment (New Hope).
Psychosocial Rehabilitation (PSR) Rate Increase
o PSR rate enhancement to increase service utilization and to more appropriately support provider
costs of delivering the service.
myStrength.com (Web-based recovery tools)
o Web-based recovery tools offered to all clients served by Daymark Recovery Services through
collaboration between myStrength, Daymark and four LME/MCOs (CenterPoint, Partners
Behavioral Health Management, Smoky Mountain LME/MCO, Cardinal Innovations Healthcare
Solutions). The on-line tools will be offered to over 39,000 Daymark clients residing in 50 of the
state’s 100 counties. Performance measures and clinical outcomes are included in the contract.
Pay for Performance Initiatives
o Pay for Performance bonus incentives will be offered to two providers who achieve specified
clinical outcomes in the following areas:
 Client satisfaction and improved quality of life with substance abuse treatment services.
(Partnership for a Drug-Free NC)
 Intensive In-Home (IIH) services outcomes i.e. client remains in home within one year of
IIH treatment implementation. (NC Mentor)
Rural Child Psychiatric Rate Increase
o Increased rates for rural child psychiatric services in Rockingham County based on specified
additional hours of MD/prescriber availability; will increase access and support provider cost of
delivering the service. (Youth Haven)
CenterPoint Human Services
Page 35 of 63
Pending Services and Support Initiatives
The following initiatives are under development:


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


Medicaid-Funded Substance Abuse Services
o The following substance abuse services are being developed for access by individuals from all
catchment area counties. Providers have been identified via the RFP process. All services are
pending state licensure and Non-Hospital Medical Detoxification is also subject to a Certificate of
Need issuance.
 Non-Hospital Medical Detox (Holistic Services)
 Medically Monitored Community Residential Treatment (Holistic Services)
 Non-Medically Monitored Community Residential Treatment (Holistic Services)
Wellness & Recovery Centers
o Enhancements to staffing and curriculum in Stokes county are pending
o Space in Davie and Rockingham Counties are being explored; funding and new positions have
been approved.
Rural Area Child Psychiatric / Prescriber Service Rate Increase
o Planning is underway with existing primary child service providers in rural counties (Stokes and
Davie – RHA Health Services; Rockingham – Youth Haven) to offer enhanced
psychiatrist/prescriber rates if a specified level of additional prescriber hours are made available.
Short-Term Transitional Housing
o Three short-term transitional housing slots are being developed for use by individuals transitioning
to community living under the Department of Justice (DOJ) Settlement Agreement and others who
can benefit from a short-term stay (up to 90 days).
Behavioral Health Co-located with Health Department
o Establish a behavioral health provider on-site at Stokes County Public Health Department two halfdays per week to provide assessment and treatment (RHA). Anticipated start date for this initiative
is 5/4/2015.
Behavioral Health Urgent Care and Facility Based Crisis Center
o CenterPoint will receive $998,458 each year for the 2014-15 fiscal year and 2015-16 fiscal year.
CenterPoint, with Monarch, will develop a 24-hour Behavioral Health Urgent Care Center for
Adults and Children, and a co-located 16-bed Facility Based Crisis unit for adults. A RFI has been
issued for a co-located medical clinic serving adults and children.
CenterPoint Human Services
Page 36 of 63
VII. PRIORITIES AND STRATEGIES
Access and choice



Conduct feasibility study to determine sustainability of additional provider(s) of services not meeting
current access standards (specific services listed in Needs section)
Initiate RFPs where needed
Request Waivers to operate with a single provider of a service if capacity is sufficient and expansion is not
feasible
Needs of each age-disability group in the Medicaid and indigent population





Increase utilization of (b)(3) services
Alternative service definitions to meet intensive treatment needs of individuals who do not meet medical
necessity criteria for existing enhanced services
Expand local capacity for Intensive Alternative Family Treatment
Focus the I/DD service system on delivering meaningful day activities and least restrictive residential
settings
Increase capacity of psychologist follow-along for Specialized Consultative Services.
Priorities of community stakeholders


Further develop the infrastructure within CenterPoint and the community to provide community-based
housing alternatives
Increase the number of MH/SA Supported Employment providers and the number of clients
served/employed
Underserved and special populations




Establish group homes for sexually aggressive adults
Develop services and supports for individuals waiting for Innovations services
Increase community awareness of the need for bi-lingual practitioners partnering with universities and local
Hispanic newspapers/organizations
Research and data analysis to develop a plan to serve veterans and military families
Sustain statewide standards on DHHS contract measures

With input from and support of community stakeholders, CenterPoint will implement Behavioral Health
Urgent Care and Facility-Based Crisis Centers

Establish/monitor provider performance measures included in provider contracts that track initiation and
engagement of services

Improve client engagement in the treatment process, thereby improving appointment compliance (initial,
follow-up and post-hospitalization) and decreasing the use of crisis services as well as decreasing
readmission rates to hospitals and other treatment facilities
CenterPoint Human Services
Page 37 of 63


Continue collaborative Integrated Health Care project with CCNC partners to improve the medical
monitoring and health outcomes for high-risk Medicaid clients based on national monitoring guidelines
Enhance local options for diversion from PRTF and step-down from more intensive services
Transition to Community Living


Implement additional client transition to community housing with clinical services and supports as needed
Develop additional community-based housing alternatives
Crisis Solutions Initiative

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
With funding secured, implement the Behavioral Health Urgent Care and Facility-Based Crisis Centers
Wellness Recovery Centers
New technology initiatives
Integration of Physical and Behavioral Health Care

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RFI issued for a medical service provider to be co-located with the planned Behavioral Health Urgent
Care/Facility Based Crisis Center
Artemis Project integration into behavioral health clinics workflow
Add integrated/collaborative care clinician co-located at the Forsyth County Community Care Clinic
Health Improvement Peer Program (HIPP) grant support for additional trainings and for state funded
clients
Integrated/collaborative care clinicians and Peer Support Specialists on-site at Downtown Health Plaza
Antipsychotic medication monitoring project (health screening for co-morbid medical conditions)
Coordination of physical health needs for clients accessing Emergency Department or inpatient psychiatric
services
Naloxone kit funding/distribution/education
Increasing the Use of Enabling Technologies



Track provider performance and clinical outcomes resulting from implementation of myStrength webbased recovery tools
Implement technology to support integrated care (e.g. pedometers “prescribed” by behavioral health
clinicians, point of contact glucose testing for clients taking antipsychotics – incentive for behavioral health
practices, PHQ-9 and other screenings with technology, Sense Health for clients to receive Smart Phone
daily text reminders for medications and appointments)
Technology workgroup will identify, analyze and recommend additional technologies for implementation
CenterPoint Human Services
Page 38 of 63
VIII. APPENDICES
CenterPoint Human Services
Page 39 of 63
APPENDIX A – MAPS
OUTPATIENT SERVICES - MEDICAID
Service
Outpatient Services
Medicaid
Eligibles
Choice of 0 providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
96,215
<0.001%
CenterPoint Human Services
Choice of 1 provider Choice of 2+ providers
within the applicable within the applicable
access distance time
access distance time
standard (30 mile / 30 standard (30 mile / 30
minutes)
minutes)
<0.001%
99.9%
Page 40 of 63
OUTPATIENT SERVICES – STATE*
Service
Outpatient Services
State
Enrollees
Served
Choice of 0 providers
within the applicable
access distance time
standard (30 mile / 30
minutes)
5,596
0.19%
Choice of 1 provider Choice of 2+ providers
within the applicable within the applicable
access distance time
access distance time
standard (30 mile / 30 standard (30 mile / 30
minutes)
minutes)
0.09%
99.72%
*Maximum distance for State served clients is measured by maximum distance from provider to
outermost county line to include all potential clients within catchment counties.
CenterPoint Human Services
Page 41 of 63
PSYCHOSOCIAL REHABILITATION - MEDICAID
Service
Psychosocial Rehabilitation
Maximum Distance to Travel (Individual)
29.5 miles
PSYCHOSOCIAL REHABILITATION – STATE
Service
Psychosocial Rehabilitation
CenterPoint Human Services
Maximum Distance to Travel (Individual)
29.5
Page 42 of 63
CHILD AND ADOLESCENT DAY TREATMENT - MEDICAID
Service
Child and Adolescent Day Treatment
CenterPoint Human Services
Maximum Distance to Travel (Individual)
27.8 miles
Page 43 of 63
SUBSTANCE ABUSE COMPREHENSIVE OUTPATIENT TREATMENT PROGRAM – MEDICAID
Service
SA Comprehensive Outpatient Treatment
Maximum Distance to Travel (Individual)
52.4 miles
SUBSTANCE ABUSE COMPREHENSIVE OUTPATIENT TREATMENT PROGRAM - STATE
Service
SA Comprehensive Outpatient Treatment
CenterPoint Human Services
Maximum Distance to Travel (Individual)
52.4 miles
Page 44 of 63
SUBSTANCE ABUSE INTENSIVE OUTPATIENT PROGRAM - MEDICAID
Service
Maximum Distance to Travel (Individual)
SA Intensive Outpatient Program
29.5 miles
SUBSTANCE ABUSE INTENSIVE OUTPATIENT PROGRAM - STATE
Service
SA Intensive Outpatient Program
CenterPoint Human Services
Maximum Distance to Travel (Individual)
30.5 miles
Page 45 of 63
OPIOID TREATMENT – M EDICAID
Service
Opioid Treatment
Maximum Distance to Travel (Individual)
35.8 miles
OPIOID TREATMENT - STATE
Service
Opioid Treatment
CenterPoint Human Services
Maximum Distance to Travel (Individual)
52.6 miles
Page 46 of 63
DAY SUPPORTS - MEDICAID
Service
Day Supports
CenterPoint Human Services
Maximum Distance to Travel (Individual)
20.2 miles
Page 47 of 63
ADULT DEVELOPMENTAL VOCATIONAL PROGRAM - STATE
Service
Adult Developmental Vocational Program
CenterPoint Human Services
Maximum Distance to Travel (Individual)
23.5 miles
Page 48 of 63
ASSERTIVE COMMUNITY TREATMENT TEAM - MEDICAID
Service
Assertive Community Treatment
Maximum Distance to Travel (Provider)
28.9 miles
ASSERTIVE COMMUNITY TREATMENT TEAM - STATE
Service
Assertive Community Treatment
CenterPoint Human Services
Maximum Distance to Travel (Provider)
28.9 miles
Page 49 of 63
COMMUNITY SUPPORT TEAM – MEDICAID
Service
Community Support Team
Maximum Distance to Travel (Provider)
29.6 miles
COMMUNITY SUPPORT TEAM – STATE
Service
Community Support Team
CenterPoint Human Services
Maximum Distance to Travel (Provider)
31.6 miles
Page 50 of 63
MH / SA SUPPORTED EMPLOYMENT – MEDICAID
Service
MH / SA Supported Employment
Maximum Distance to Travel (Provider)
31.6 miles
MH / SA SUPPORTED EMPLOYMENT – STATE
Service
MH / SA Supported Employment
CenterPoint Human Services
Maximum Distance to Travel (Provider)
37.7 miles
Page 51 of 63
INTENSIVE IN-HOME – MEDICAID
Service
Intensive In-Home
Maximum Distance to Travel (Provider)
26.7 miles
INTENSIVE IN-HOME – STATE
Service
Intensive In-Home
CenterPoint Human Services
Maximum Distance to Travel (Provider)
26.7 miles
Page 52 of 63
MULTI-SYSTEMIC THERAPY – MEDICAID
Service
Multi-Systemic Therapy
Maximum Distance to Travel (Provider)
45.9 miles
MULTI-SYSTEMIC THERAPY – STATE
Service
Multi-Systemic Therapy
CenterPoint Human Services
Maximum Distance to Travel (Provider)
71.5 miles
Page 53 of 63
(B) (3) PEER SUPPORT - MEDICAID
Service
Maximum Distance to Travel (Provider)
Multi-Systemic Therapy
32.3 miles
TRAUMATIC BRAIN INJURY SERVICES (NON-RESIDENTIAL) - STATE
Service
Traumatic Brain Injury (non-residential)
CenterPoint Human Services
Maximum Distance to Travel (Provider)
18.9 miles
Page 54 of 63
MOBILE CRISIS – MEDICAID
Service
Mobile Crisis
Maximum Distance to Travel (Provider)
51.5 miles
MOBILE CRISIS - STATE
Service
Mobile Crisis
CenterPoint Human Services
Maximum Distance to Travel (Provider)
51.5 miles
Page 55 of 63
(B) (3) WAIVER RESPITE – MEDICAID
Service
(b)(3) Waiver Respite
CenterPoint Human Services
Maximum Distance to Travel (Provider)
19.6 miles
Page 56 of 63
I/DD HOME BASED SERVICES – MEDICAID
Service
I/DD Home Based Services
Maximum Distance to Travel (Provider)
19.6 miles
I/DD HOME BASED SERVICES – STATE
Service
I/DD Home Based Services
CenterPoint Human Services
Maximum Distance to Travel (Provider)
44.7 miles
Page 57 of 63
I/DD SUPPORTED EMPLOYMENT SERVICES – MEDICAID
Service
I/DD Supported Employment Services
Maximum Distance to Travel (Provider)
29.6 miles
I/DD SUPPORTED EMPLOYMENT SERVICES – STATE
Service
I/DD Supported Employment Services
CenterPoint Human Services
Maximum Distance to Travel (Provider)
16.6 miles
Page 58 of 63
(B) (3) WAIVER COMMUNITY GUIDE – MEDICAID
Service
(b) (3) Waiver Community Guide
CenterPoint Human Services
Maximum Distance to Travel (Provider)
24.5 miles
Page 59 of 63
INPATIENT HOSPITAL (ADULT / GERIATRIC) – M EDICAID
Service
Inpatient Hospital (Adult / Geriatric)
Maximum Distance to Travel (Provider)
36.4 miles
INPATIENT HOSPITAL (ADULT / GERIATRIC) – STATE
Service
Inpatient Hospital (Adult / Geriatric)
CenterPoint Human Services
Maximum Distance to Travel (Provider)
36.4 miles
Page 60 of 63
INPATIENT HOSPITAL (ADOLESCENT) – MEDICAID
Service
Inpatient Hospital (Adolescent)
Maximum Distance to Travel (Provider)
36.4 miles
INPATIENT HOSPITAL (ADOLESCENT) – STATE
Service
Inpatient Hospital (Adolescent)
CenterPoint Human Services
Maximum Distance to Travel (Provider)
36.4 miles
Page 61 of 63
INPATIENT HOSPITAL (CHILD) - MEDICAID
Service
Inpatient Hospital (Child)
Maximum Distance to Travel (Provider)
52.7 miles
INPATIENT HOSPITAL (CHILD) - STATE
Service
Inpatient Hospital (Child)
CenterPoint Human Services
Maximum Distance to Travel (Provider)
52.7 miles
Page 62 of 63
CRISIS RESPITE - STATE
Service
Crisis Respite
CenterPoint Human Services
Maximum Distance to Travel (Provider)
29.8 miles
Page 63 of 63