Behavioral Health Urgent Care Clinic Bridges Crisis Care Gap

(Durham, NC) – Six months after opening, a behavioral health urgent care clinic operated by Carolina Outreach with funding from Alliance Behavioral Healthcare is filling a gap in services for those with mental health needs and substance use disorders.

The goal of the urgent care is to connect people with behavioral health care and services before urgent situations become crises. Without the urgent care center, someone suffering from depression, acute anxiety or substance abuse problems, or who has a child with behavioral issues in school, might have to wait weeks for an appointment or go to a hospital emergency department, which is not the best place for them to get help.

Alliance Director of Hospital Relations Margaret Brunson said the urgent care clinic is part of Alliance’s vision of creating more accessible behavioral health services. “We were ready to expand the continuum of care for our community and looking at open access, and an urgent care facility was a logical step,” Brunson said. “We decided to work with Carolina Outreach because they were already operating a walk-in clinic in Durham, so this was a natural extension of that model.”

Clinic staff see people in a variety of situations, including people who need a medication refill to remain stable but face a wait to see their regular provider, people in acute psychological distress, and people seeking urgent assistance with a substance use disorder. The clinic has also been used by school staff to get quick help for youths in distress, and by parents who are required to get psychiatric assessments for children before they are allowed back in school but face a long wait for an appointment at a traditional mental health practice.

A visit to the urgent care averages about two hours, and begins with a nursing assessment and a drug and alcohol screening to assess whether an individual is physically stable, followed by a crisis assessment to determine what services are appropriate. Clinic staff also do an assessment of social determinants, such as housing, food security and social support, to determine whether an individual needs to be connected with other services to maintain stability.

On average, 89 percent of the individuals assessed are seen by a physician on the same day and 72 percent are discharged with a prescription. Before discharge all individuals are either referred back to their primary care and/or existing behavioral health provider or linked to a new behavioral health provider with a scheduled appointment.

“We are filling a gap in the crisis continuum that has existed for far too long in our community,” said Marissa Holsten, the clinic and urgent care manager for Carolina Outreach. “We can help people receive the right care before or as they go into crisis to prevent them from reaching that edge where they need a higher level of care.”

Holsten said the clinic served on average almost 100 people a month during its first six months. She said that at current staffing levels the clinic could serve 70 to 75 people a week and with increased staffing they could serve up to 100 per week.

The clinic is designed to serve individuals with Medicaid or those uninsured within Alliance’s service area of Durham, Wake, Cumberland, and Johnston counties. The facility is not currently able to accept private insurance, however individuals who are privately insured can pay an out-of-pocket fee for services.

The clinic is located at 2670 Durham-Chapel Hill Blvd. in Durham. Service hours are 8 am to 7 pm Monday through Thursday, 8 am to 3 pm Friday and 9 am to noon Saturday.
Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2,200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

Alliance supports Cumberland County Homeless Count

Alliance Behavioral Healthcare staff recently supported the Annual Point in Time Count (PIT) for individuals facing homelessness in Cumberland County.

The PIT documents year-over-year change in homelessness both regionally and nationally to identify trends and allocate resources. While Cumberland County has seen an overall reduction in homelessness due to the US Department of Veterans Affairs focus on assisting veterans facing homelessness, there was a 30 percent increase in non-veterans who are chronically homeless in the 2017 count.

“Chronically homeless” people are those who have lived 12 continuous months in a place not meant for habitation or have had four episodes of homelessness in three years, and have a disabling condition such a mental illness or a substance use disorder.

Alliance Community Education Specialist Laressa Witt said the issue warrants increased resources. “More funding is needed to address non-veteran homelessness in Cumberland County, prioritizing those who are chronically homeless,” she said.

Hope4NC Wraps Up in Cumberland County

The Crisis Counseling Assistance and Training Program, also known as Hope4NC, wrapped up at the end of 2017, having touched the lives of more than 14,000 Cumberland County residents affected by the destruction and flooding of Hurricane Matthew.

Alliance Behavioral Healthcare managed the project and, working with private, non-profit human services agency Action Pathways, deployed five outreach teams who canvassed neighborhoods, hotels, rentals and shelters to provide disaster crisis counseling to those affected by the flood.

The project, a partnership with the Substance Abuse and Mental Health Services Administration (SAMSHA) and the Federal Emergency Management Agency (FEMA), offered short-term interventions that included coping strategies and emotional support to help disaster survivors manage the stress of their situations.

Outreach teams made 14,045 contacts in Cumberland County through presentations and group encounters, neighborhood canvassing, telephone, email and other means, providing crisis counseling to 715 individuals and providing 484 referrals for further care.

“Without the support of the teams and community education most people would not have known where to go for help,” said Alliance Senior Vice President for Community Relations Ann Oshel. “Hope4NC also offered technical assistance to help providers and community organizations better understand how to access mental health services, which will provide ongoing referrals now that grant funds have ended.”

While the program did not provide home repairs, outreach counselors referred citizens to a variety of community resources that could assist people in putting their lives and homes back together. Many residents were also referred to organizations that could provide assistance with behavioral or mental health care, affordable housing, legal assistance, furniture and clothing.

In many cases, residents struggling with hardships were just happy to have someone listen to and empathize with them. “It can be devastating to lose everything and still have the daily struggle of living outside your home many months later,” says Disaster Recovery Coordinator Laressa Witt. “Added to the financial burden of starting all over, it can be very stressful for families.”

According to FEMA there are four emotional stages of disaster, moving from the heroic phase to the honeymoon phase to the disillusionment phase and finally to the reconstruction phase. Witt said that many of the people contacted were in the disillusionment phase. “Many folks said they had no idea it would take this long to return to their homes, and this has added to their emotional fatigue.”

Individuals who still need assistance can call Alliance’s toll-free, 24-hour Access and Information Center at 800-735-2962.

Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2,200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

Alliance Participates in NC Lock Your Meds Campaign

As part of its commitment to stemming the tide of opiate addiction and misuse of prescription pain medications, Alliance Behavioral Healthcare is participating in the NC Lock Your Meds educational campaign.

NC Lock Your Meds is part of a national multi-media campaign produced by National Family Partnership designed to reduce prescription drug abuse by making adults aware that they may be the “unwitting suppliers” of prescription medications being used in unintended ways, especially by young people.

Many people who misuse prescription medications get them from family and friends. Only five percent of children who misuse prescription medications say they get them from a stranger or a drug dealer.

The Lock Your Meds campaign aims to educate people about the importance of securing medications to prevent them from being accessed by children, family members or visitors. The project involves distributing promotional materials and information, as well as a limited number of medicine lockboxes, to raise awareness of the issue.

“She gets her hair from her mom. Her eyes from her dad. And her drugs from her grandma’s purse,” reads one poster depicting a teen girl. Another features a teen boy and reads “He gets his music online. His t-shirts at the mall. And his drugs from his uncle’s medicine cabinet. All feature the “Lock Your Meds” tagline and direct people to the website www.lockyourmeds.org/nc.

The materials, which include posters, rack cards and magnets, are being distributed by Alliance’s Community Relations/Community Engagement staff. The Alliance Care Coordination team is distributing the lockboxes to individuals being discharged from facilities who are prescribed opioids and may be transient or have children. Alliance is also disseminating other information via its robust online and social media channels.

“Locking up medications is a very effective deterrent to medicine theft and misuse that may lead to prescription drug addiction,” said Alliance Clinical Pharmacist Dr. Vera Reinstein. “Securing the medications you are currently taking and properly disposing of the ones you no longer need can keep you from becoming an accidental dealer.”

Surveys have found that every day more than 1,700 children and young adults begin experimenting with prescription drugs, ranging from pain relievers and depressants to stimulants and over-the-counter medicine. Legally prescribed painkillers are often a precursor to drug use disorders, addiction and overdoses.

According to the Centers for Disease Control, more than 42,000 Americans died of opioid overdoses in 2016, a 28 percent increase over 2015. Every day nearly four North Carolinians die from a medication or drug overdose. The number of opioid overdose deaths in North Carolina increased from 150 in 1999 to 1,518 in 2016. Opioid deaths across the Alliance region have shown an increase of 526 percent from 1999 to 2016.

Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2,200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

The Lock Your Meds campaign is supported by the NC Department of Health and Human Services, Division of Mental Health, Developmental Disabilities and Substance Abuse Services with funding from Substance Abuse and Mental Health Services Administration and federal grants.

Alliance Partnership with Wake County Schools Wins Award

(Durham, NC) – Alliance Behavioral Healthcare’s School-Based Care Coordination initiative received a “Program of Excellence” award for partnerships to improve services recently from the NC Council of Community Programs.

Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2,200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

The SPCC initiative is an innovative partnership between Alliance and the Wake County Public School System to create safer learning environments and better educational outcomes by addressing the mental health, behavioral and social needs of children attending Wake County schools.

Alliance’s Care Coordinators in the schools use a “wraparound” model to improve student connections with the services they need to reduce the severity of their behavioral health symptoms. In turn, student absences are reduced and academic performance improves. The initiative aims to bridge the gap between families, schools and behavioral health resources and give children and their families a voice in navigating the behavioral and educational systems.

The initiative currently provides care coordination in several areas. One effort promotes continuity of care for children transitioning back into schools from psychiatric residential treatment facilities. Others identify and support children with intellectual and developmental disabilities, identify young children entering school who may need intervention and arrange services for students who need help for existing problems and prevention of more severe problems.

One program unique in North Carolina tailors “diversion plans” for teens accused of minor crimes.  The SBCC teen diversion program has helped 93 teens accused of committing minor offenses at school avoid criminal charges or arrest records, which has allowed some keep their college scholarship offers or retain their eligibility to join the military.

During the 2016-17 fiscal year the SBCC initiative served a total of 414 children across all programs.

“It is critical that parents, school staff and community care providers come together to support all of the students in our care, but especially those students that must have collaborative support to navigate troubling life circumstances,” said Karen Hamilton, Wake County Public School System’s assistant superintendent for special education services. “The WCPSS/Wake County Government and Alliance collaborative allows our community to provide aligned, coherent efforts that strengthen families and the school families of students facing unique struggles. I look forward to the future where we increase the scope and size of our collaboration and reach even more children and families!” Ms. Hamilton said.

“The School-Based Care Coordination initiative is just one example of Alliance’s efforts to reach into our communities to the places where we can be proactive in identifying people who are at risk of the negative impact of behavioral health challenges,” said Dr. Beth Melcher, executive vice president of Alliance’s Care Management Division. “That allows us to intervene with treatment and support to help ensure they can avoid serious consequences and continue living satisfying lives.”

The North Carolina Council of Community MH/DD/SA Programs is the statewide association representing Local Management Entities-Managed Care Organizations (LME/MCOs) in North Carolina. Its “Programs of Excellence” awards recognize the innovation and quality of care that exemplify the public mental health, intellectual/developmental disabilities and substance abuse services in North Carolina.

Alliance Strengthens Services with Care Coordinator Certification

(Durham, NC) – As part of Alliance Behavioral Healthcare’s effort to build an even stronger intellectual and developmental disability care coordination team, 30 Alliance Care Coordinators recently received certification by the National Academy of Certified Care Managers.

The NACCM certification, which requires education, training, supervised work experience and a rigorous exam, demonstrates competency in key work areas including assessment of client strengths, needs and preferences, writing goals and implementing a plan of care and managing and monitoring services and ongoing care needs.

“A national certification in care management for I/DD care coordination enriches the knowledge base of our staff in keeping with Alliance’s mission to address whole person care, said Alliance Director of I/DD Care Coordination Jeff Payne.

“The NACCM curriculum includes both disability-specific and generalized long-term care considerations when managing care for individuals with complex needs, including ethics, social determinant needs and care needs throughout the lifespan of our members. In addition, this certification is recognized by both public and private behavioral and physical health employers to keep Alliance staff contemporary for the ever-changing needs of the members and markets that we are serving now and may serve in the future,” Payne said.

Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2,200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

The NACCM is a nonprofit organization supporting standards of competence in the practice of care management through the administration of a formal certification and recertification program.

IDD Couple

Alliance Unveils New Remote Monitoring Home

(Durham, NC) – Alliance Behavioral Healthcare is offering a special opportunity for people with intellectual and developmental disabilities (IDD) to experience what it is like to live more independently. Working in partnership with a remote monitoring company called Night Owl Support Systems and Resources for Human Development, a member of the Alliance Provider Network, Alliance opened its first Remote Monitoring Home this month.

Alliance is the managed care organization for publicly funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

Alliance’s Remote Monitoring Home is a fully-furnished Durham apartment outfitted with special monitoring technology that allows people to try living for up to two weeks in a safe, secure home, without the need for overnight staff. Many people who receive services managed by Alliance for an intellectual or developmental disability live in group homes with 24-hour staff due to the lack of a safe and affordable alternative. Others live at home but require significant assistance from family or other natural supports. Understandably, some people are hesitant about the prospect of a more self-sufficient living arrangement. By trying Remote Monitoring during a planned stay, individuals will be able to determine if this service can be used to alleviate the need for overnight staff and ultimately, help them to live more independently.

Remote Monitoring also reduces the total cost of an individual’s care, using wireless sensors, two-way communication devices, and professional remote staff to address their needs and monitor their wellbeing during unstaffed hours. If a resident does have the need for in-person staffing support from time to time, they can learn to use the technology to call a trained staff member to come to the apartment to assist them.

The experience of living independently in the Remote Monitoring Home can be the first step to determining that an individual is ready for a level of care known as Supported Living, which is an option for participants in the Medicaid Innovations Waiver. Supported Living provides individualized assistance to enable an individual to live independently in a home they either rent or own.

Individuals who receive intellectual/developmental disability services managed by Alliance and are interested in learning more about the Remote Monitoring Home should contact their Alliance IDD Care Coordinator for more information.

NC Managed Care Organizations Announce Coalition

MCO leaders identify collaboration as key to responding to challenges and opportunities of Medicaid reform Nov. 15, 2017 – Leaders of three North Carolina managed care organizations (MCOs) announced a new partnership to leverage strengths and expertise in response to Medicaid reform. The coalition will unite the efforts of three high-performing MCOs – Vaya Health, Trillium Health Resources and Alliance Behavioral Healthcare – to address significant, statewide health policy issues that impact North Carolinians across the state. The coalition is in full alignment with the Medicaid Reform plan proposed by the NC Department of Health and Human Services.

The joint effort is not a merger or mandated consolidation. Each of the MCOs will continue to operate in their respective counties, keeping their names, board structure and staffing, in addition to working together as part of the coalition to leverage resources, experience and expertise on a statewide level. MCO leaders identify the collaboration as the most effective way to demonstrate to NC DHHS, the General Assembly and potential commercial healthcare partners that MCOs can successfully implement Medicaid Transformation in a way that advances high-quality care, improves population health, engages and supports providers and establishes a sustainable program with predictable costs (a four-prong approach known as the Quadruple Aim).

Through the formation of the coalition, the MCOs seek to have a stronger voice in preserving the role of the public behavioral healthcare system in Medicaid Transformation, helping ensure continued stability and continuity of care for the people they serve. The potential to establish a combined statewide provider network will enhance access to a diverse range of services and supports for people in both urban and rural areas of the state.

“The public MCO system has unique experience and expertise in addressing the behavioral health needs of North Carolinians,” said Brian Ingraham, Vaya Health CEO. “This coalition provides an opportunity to build on our track record of success and expand our contribution to the health of the people we serve.”

“Trillium Health Resources believes that this closer collaboration with our colleagues at Alliance and Vaya will allow us to better serve our members, regardless of where they live in NC, and will promote a stable environment for our provider partners,” said Leza Wainwright, Trillium Health Resources CEO.

“Alliance has a proven history of effectively serving individuals with multiple and complex needs through evidence-based practices, community partnerships and a focus on the social determinants of health – the environmental factors that impact peoples’ health and quality of life,” said Rob Robinson, Alliance CEO. “We are uniquely positioned to advance innovative, whole-person care as North Carolina transforms its Medicaid program, and this coalition will strengthen our ability to positively impact service delivery on a statewide basis.”

The formation of the coalition does not affect the services and supports of any members of Vaya, Trillium and Alliance Medicaid health plans. Members who have questions should contact their MCO through the respective Access to Care lines.

About the Coalition
Vaya Health, Trillium Health Resources, and Alliance Behavioral Healthcare are local management entity/ managed care organizations (LME/MCOs) responsible for managing publicly-funded behavioral health and IDD services in three catchment areas that collectively span the State of North Carolina from the mountains to the sea. Together, they are responsible for managing more than $1.375 billion in public funds and 610,000 Medicaid covered lives across 52 counties. More information about the coalition can be found at www.AdvancingNCWholeHealth.org.

About Alliance Behavioral Healthcare
Alliance Behavioral Healthcare is the managed care organization for publicly-funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million. Alliance operates an Access and Information Center available 24/7 at (800) 510-9132. Learn more at www.AllianceBHC.org.

About Trillium Health Resources
Trillium Health Resources is a leading specialty care manager (LME/MCO) for individuals with substance use, mental illness and intellectual/developmental disabilities in 25 counties in eastern North Carolina. Trillium’s mission is to transform the lives of people in need by providing them with ready access to quality care. We take a person-centered approach to health and wellbeing, coordinating care across multiple systems to achieve improved health outcomes, quality of care and efficient use of resources. Trillium is investing in innovation to meet the unique needs of the individuals and communities we serve, and remains focused on delivering the right services, in the right amount, at the right time. For more information, visit www.TrilliumHealthResources.org.

About Vaya Health
Based in Asheville, N.C., Vaya Health manages public funds for mental health, substance use disorder and intellectual or developmental disability services in 23 western North Carolina counties: Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Wilkes and Yancey. Access to care and crisis assistance are available 24/7 at 1-800-849-6127. Learn more at www.VayaHealth.com.

Alliance Trains Raleigh PD to Address Behavioral Illness

Alliance Behavioral Healthcare has now trained every employee of the Raleigh Police Department – officers as well as non-sworn employees – in techniques that help them recognize and respond appropriately to people in behavioral health crisis.

Alliance is the managed care organization for publicly-funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.

In total, 407 police officers have received either Crisis Intervention Team (CIT) or Mental Health First Aid (MHFA) training, or both. 319 received CIT training, which provides the skills necessary to recognize and respond appropriately to individuals in behavioral health crisis. They learned to de-escalate dangerous situations and refer individuals, when appropriate, to treatment instead of emergency departments or jail. 28 of those officers received specialized training in how to respond to military veterans in crisis. Almost 100 other Raleigh PD employees have received Mental Health First Aid training, an eight-hour, evidence-based curriculum that teaches a five-step action plan to identify when someone might be struggling with a mental health or substance use problem, and to reach out and offer appropriate support until professional treatment is secured or the crisis resolves.

“CIT is proven to improve the safety of both officers and citizens and to significantly reduce the number of re-arrests of people with a mental illness,” said Ann Oshel, head of Community Relations for Alliance. “And MHFA is for everyone – the skills taught in these trainings have tremendous value for our communities.”

All told, Alliance has provided CIT training to almost 3000 police officers, firefighters, EMS paramedics and other emergency responders and 911 telecommunicators throughout its four-county coverage area, and over 3500 people from all walks of life have received Mental Health First Aid training from Alliance, preparing them to be ready when needed. To register for an MHFA training, use the calendar at AllianceBHC.org or to schedule a training for your office or group, contact the Alliance Access and Information Center at (800) 510-9132.

New Invitation for Bids Issued by Alliance

Invitation for Bids #18-002– Construction Services at Recovery Response Center (RRC), 309 Crutchfield Street in Durham, NC has been posted to the Alliance website.