Alliance Grants Target Social Determinants of Health

Through special one-time grants, Alliance Behavioral Healthcare has been able support organizations that address the social determinants of health, which are the conditions in which people are born, grow, work, live and age and the wider set of forces and systems shaping the conditions of daily life. Studies have shown that while clinical care interventions are essential, a broad range of social, economic, and environmental factors shape individuals’ opportunities and barriers to receiving care and engaging in healthy behaviors.

One grant recipient, the Lighthouse Foundation of Wake County (LFWC), serves low-income, adult residents who are navigating a significant chronic or mental health crisis. LFWC’s mission is to promote the overall wellness of underserved people by assisting with such things as housing, basic daily needs, transportation, healthcare appointments and the like.

Recipients of LFWC’s assistance include Garfield, a 59-year-old man living with Stage 3 colon cancer. Despite his fragile health condition, Garfield continues to work a full time job to make ends meet. However, his primary medical diagnosis was not the issue that brought him to the Lighthouse Foundation of Wake County.

“I needed glasses real bad and could not see real good,” Garfield said. ”This stopped me from driving and getting to work or my appointments. I don’t make much and can’t afford glasses. Lighthouse helped me get an exam and new glasses right away so now I can see and drive again. They were very quick in helping me get an appointment and I am happy my social worker reached out to them for me”.

Another person served by LFWC is Ella, 42, who suffers from brittle diabetes and hypertension. The conditions have created hardships that have had major implications in her daily life and overall wellness. Like Garfield, Ella has received temporary relief and compassionate support from LFWC as she works toward medical stability.

“The Lighthouse Foundation has helped me immensely by covering my doctor appointments at the Open Door Clinic while I am out of work,” Ella said. “I am actively looking for a job, but my diabetes has been out of control and requires me to go back for frequent follow-up appointments to avoid going to the ER. Covering my co-pays helps me see my doctor and get my diabetes back on track.”

The Alliance grant funds support LFWC’s Closing the Gap for the Underserved and Food & Fuel Assistance programs. The Closing the Gap program helps cover co-pays for doctor visits and necessary prescription medications and/or medical supplies for chronically and mentally ill clients. The Food & Fuel Assistance provides LFCW clients with additional food supplements and fuel for transportation to and from medical appointments.

“I am both touched and grateful of this wonderful designation of funds to help out our Food & Fuel and Closing the Gap programs,” said Lighthouse Executive Director Regina Heroux. “It is a pleasure to work with outstanding agencies like Alliance Behavioral Healthcare, who are so committed to the care of those who are sick and less fortunate. Our work is a reflection of great partnerships (which we value and appreciate) that collectively makes an impact in our community.”

“In reflection of the Alliance Complete Care model, Community Relations is thrilled to have an opportunity to support the wonderful work of partners throughout our catchment area that embrace the Social Determinants of Health,” said James Osborn, Alliance’s Director of Community Outreach and Engagement. “The Lighthouse Foundation of Wake County, along with all SDOH funding recipients, inspire us by addressing issues of food security, housing, transportation, and healthcare funding assistance that directly impact and benefit a person’s overall health and wellness.”

Alliance Celebrates 100th Transitions to Community Living Initiative move of FY18

(Durham, NC) –Alliance Behavioral Healthcare’s Transitions to Community Living Initiative (TCLI) recently completed its 100th move of FY2018. This milestone significantly exceeds the state annual performance target for Alliance of 88 individuals transitioned into supportive housing as required by the 2012 Olmstead Settlement Agreement between the United States and North Carolina.

The Olmstead agreement mandates that the state provide community-based supported housing to people who currently reside in, or are at risk of entry into, adult care homes. It also ensures that thousands of people with mental illness have access to critical community-based mental health services and expands their employment opportunities by providing supported employment services.

Alliance is the agency charged with implementing the settlement agreement provisions in Durham, Wake, Johnston, and Cumberland counties. Over the past year Alliance has strengthened its efforts to exceed program goals by adding new employees specifically for the program and securing additional housing inventory to meet demand.

“We are focused on getting as many people into housing as we possibly can,” said Alliance Olmstead Settlement Project manager Larry Swabe. “Our mission in doing this is to make sure that individuals with severe and persistent mental illness have the same opportunities to live a life just like you and I do”

For the people served by TCLI the transition from restrictive institutional settings, where life is regulated and residents do very little for themselves, can be transforming. “This program opens a whole new life to these folks – one many of them never dreamed was possible.” said TJ Hayes, an Alliance transition supervisor.

“Going through the process makes me feel a sense of accomplishment. I am proud of myself and there’s still so much more I want do in my life,” said Rakshanda (who asked to be identified by first name only), a community member who transitioned into her own apartment in 2016. “Having this apartment is a major stepping stone.”

Alliance’s TCLI efforts are aligned with the organization’s commitment to housing as a healthcare strategy. “We believe that housing is a platform that improves an individual’s quality of life, allows them to pursue their own goals and dreams, and serves as a foundation for their recovery,” said Ann Oshel, senior vice president of community relations at Alliance.

“On multiple levels, this is the right thing to do for these individuals,” said Alliance CEO Rob Robinson. “We shouldn’t underestimate the value this initiative provides to help us meet our goals as a managed care organization – to tangibly improve the quality of life of the people we serve, and in the process to make more efficient use of the public funds we are entrusted with.”

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 to Host Community Forum in Johnston County

Johnston County Mental Health, the Local Management Entity for public mental health, substance use, and intellectual/developmental disability care for the citizens of Johnston County, will merge with Alliance Behavioral Healthcare effective July 1, 2018. Please join us to discuss the merger:

Wednesday, May 30, 2018, 4–6 pm
Johnston County Agricultural Center
2736 NC Hwy 210, Smithfield 27577

Spanish language interpretation will be available. Please let us know of any other special accommodation requests by emailing AOshel@alliancebhc.org.

Alliance Behavioral Healthcare to Pilot TBI Waiver

(Durham, NC) – Alliance Behavioral Healthcare was selected in 2016 by the NC Department of Health and Human Services to operate a pilot Waiver for Traumatic Brain Injury (TBI) in its four-county service region. The TBI waiver application was recently approved by the Centers for Medicare and Medicaid Services for implementation in late summer 2018.

Alliance is a public behavioral health managed care organization, or MCO, with responsibility for the authorization of services for over 439,000 Medicaid-eligible and uninsured individuals and a population of 1.8 million in Durham, Wake, Cumberland and Johnston counties.

The waiver is designed to provide a variety of community-based rehabilitative services and supports as an alternative to nursing facility care or specialty rehabilitation hospital care for eligible individuals with a traumatic brain injury. It supports rehabilitation and promotes choice and community involvement.

Adults with cognitive, behavioral and or physical support needs, whose injury occurred on or after their 22nd birthday and who need specialty rehabilitation hospital care or skilled nursing care, and who meet financial eligibility requirements, may be eligible to participate in this waiver.

“Alliance joins with the TBI community in welcoming the long-awaited approval of this waiver,” said Alliance CEO Rob Robinson. “It will make available an array of services that provides the potential for people with traumatic brain injury to live independent, satisfying lives. We look forward to collaborating closely with DHHS to create a model that can be successfully replicated across the state.”

People interested in learning more about the waiver and how to apply for participation in the waiver can contact Alliance’s Access and Information line by calling (800) 510-9132. As additional developments in the waiver implementation are finalized over the coming weeks they will be accessible on the Alliance website (AllianceBHC.org) by searching keyword “TBI.”

Johnston County Mental Health to Merge with Alliance Behavioral Healthcare

(Durham, NC) – Johnston County Mental Health, the Local Management Entity for public mental health, substance use, and intellectual/developmental disability care for the citizens of Johnston County, will merge with Alliance Behavioral Healthcare effective July 1.

Alliance is a public behavioral health managed care organization, or MCO, responsible for the authorization of services for over 439,000 Medicaid-eligible and uninsured individuals and a population of 1.8 million in Durham, Wake, Cumberland and Johnston counties.

Alliance has been managing Medicaid services in Johnston, as well as those funded by the State since 2013. Service providers working in Johnston have been part of the Alliance provider network for years as well. Aside from a new name and logo, Alliance officials anticipate that Johnston residents will see minimal change as result of the merger.

“Operationally speaking, the staff at Johnston County Mental Health has been a part of Alliance for years now,” said Alliance CEO Rob Robinson. “Our individuals and families, providers and community partners have already become integrated with the Alliance organization, and we anticipate that this will be a seamless transition.”

The merger received approval from the Johnston Board of County Commissioners and the Alliance Board of Directors in March, and is subject to official sign-off from the NC Department of Health and Human Services.

The basic staff structure currently in place in the Johnston office will remain the same. These positions are those that most routinely come in contact with individuals and families, providers and community partners, such as individual and family affairs, community relations and care coordination. The local Alliance office will remain at 521 North Brightleaf Boulevard in Smithfield. Local members of the Johnston Consumer and Family Advisory Committee will continue to function as full participants in the Alliance CFAC Steering Committee.

“We are delighted that the working relationships we have formed with our Johnston LME partners will be officially incorporated under the Alliance banner,” said Cynthia Binanay, Alliance Board Chair. “This makes both organizations stronger going forward and the Alliance commitment remains, as always, to provide clinically-sound, cost-efficient services and supports that make a positive difference in the lives of the citizens we serve.”

New Alliance Newsletter Available

We are pleased to introduce the Alliance InTouch newsletter for Alliance employees, friends and community members. The newsletter is designed to help our stakeholders, internal and external, stay “in touch” with what is going on at Alliance and the important work we do to deliver the best care to the people we serve.

Read and download the Alliance InTouch newsletter.

Alliance Launches Opioid Action Website

Alliance Behavioral Healthcare has launched the Alliance For Action on Opioids website (allianceforaction.org), a resource to help individuals, family members, and professionals take small but important steps in their lives and work to help stem the tide of the opioid epidemic.

Alliance for Action is targeted to individuals and families as well as health care providers, including pharmacists, and focuses on actions people can take against the opioid epidemic at home, or at work in the case of health care professionals.

The website highlights steps that may prevent opioid misuse and overdose deaths, such as locking up prescription drugs and properly disposing of leftover medications, learning how to prevent overdose deaths with naloxone, and recognizing the red flags of opioid misuse and addiction. It also presents resources to help people learn about smart pain management, recovery and treatment options.

For pharmacists and other health care providers Alliance For Action also advises learning to conduct “SBIRT” or “Screening, Brief Intervention And Referral To Treatment,” an early intervention approach to help people with, or at risk of developing, substance use disorders before they need specialized treatment. The website also provides links to opioid-related continuing education and encourages professionals to stay current on prevention, screening and treatment knowledge and learn how to advise patients about naloxone and smart pain management.

“We want pharmacists and providers to understand opioid addiction as a chronic, preventable and treatable disease, and to increase awareness of the risk of opioids and possible drug interactions,” said Alliance Clinical Pharmacist Vera Reinstein. “We also want them to recognize the value of offering naloxone to people identified as high-risk for opioid overdose.”

Opioid overdoses claim nearly four North Carolinians every day and overdose deaths have increased by nearly 400 percent over the past 16 years, according to the NC Department of Justice. The US Centers for Disease Control reports that on average, 115 Americans die from opioid overdoses every day.

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.

In North Carolina, Alliance is at the forefront of efforts to help stem the tide. When data analytics, utilization management and peer case reviews identified a pattern of risky prescribing of benzodiazepines and opioids, Alliance staff worked with providers to design and implement a set of tiered responses that aligns closely with the state’s plan to reduce prescription drug misuse.

Alliance also offers ongoing technical assistance for members of its provider network and provides education on appropriate best practice prescribing guidelines and how to assess and effectively treat opioid use disorders.

In addition, Alliance invested $100,000 to supply naloxone free of charge to community providers as well as consumers with known addictions and their families, along with education on how to use it. Alliance includes instruction in the use of naloxone in its Crisis Intervention Team training for law enforcement officers and other first responders and supplied naloxone to the Wake County Sheriff’s Office and the TASC program in Cumberland County.

Board Audit & Compliance Committee cancelled

​The February 28, 2018, meeting of the Board Audit & Compliance Committee has been cancelled.

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.