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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
 

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1915 b/c Medicaid Waiver Expansion Plans for MH, DD and SA Services

News Alerts

Additional News Alerts

News Alert June 1, 2011

On May 20th, DHHS received seven RFA applications from the following LMEs:CenterPoint Human Services (solo application)

  • The Durham Center - with Guilford, Johnston, and Cumberland Counties
  • Eastpointe - with The Beacon Center, and Southeastern Regional
  • Pathways - with Mental Health Partners and Crossroads Behavioral Health
  • Smoky Mountain Center (solo application)
  • Southeastern Center - with Onslow-Carteret Behavioral Healthcare
  • Wake County (solo application)

Existing LME - MCO and already selected LMEs proceeding forward by previous RFA Application process:

  • (existing MCO) PBH partnering with OPC, Alamance Caswell, and Five County
  • Western Highland Network
  • Mecklenburg County
  • East Carolina Behavioral Health
  • Sandhills Center 

News Alert April 1, 2011

DHHS is soliciting additional applications from LMEs to participate in the State’s 1915 b/c Medicaid waiver and to operate Medicaid-funded services through a prepaid inpatient health plan (PIHP).  This is the final RFA that will be issued for statewide expansion.  Full expansion is expected to be completed by January 1, 2013.  Click here for additional information.

In April 2005, the N.C. Department of Health and Human Services (DHHS) began the “Piedmont Cardinal Health Plan” a pilot project where Medicaid-funded services for mental health, substance abuse, and development disabilities are provided on a capitation basis in a five-county area through a prepaid inpatient health plan (PIHP). PBH, formerly know as Piedmont Behavioral Healthcare, a local management entity (LME), operates the PIHP and manages state-funded mental health, substance abuse, and developmental disabilities services.

In May of 2009, DHHS elected to expand this pilot project beyond PBH to be phased-in statewide. Toward this goal, The Division of Mental Health Developmental Disabilities and Substance Abuse Services ( DMH/DD/SAS) and the Division of Medical Assistance (DMA) worked in partnership, to submit on behalf of DHHS waiver amendment requests to Centers for Medicare and Medicaid Services (CMS) in December 2009 to expand the pilot project through the modification of the existing Piedmont Cardinal Health Plan 1915(b) Freedom of Choice waiver and the modification of the 1915(c) Innovations Home and Community Based Services (HCBS) waiver. The links to the CMS Waiver Amendments are listed below which are posted on DMA’s website for review.

DMHDDSAS and DMA are collaborating together in the leadership of this initiative. Four LMEs responded to the first request for applications (RFA) posted in 2010 and submitted applications to participate in the State's 1915 (b)/(c) Medicaid Waiver in April 2010. DMHDDSAS and DMA issued a Special Implementation Update #74 and Special Implementation Update #80 announcing the selections of Mecklenburg County Area MH/DD/SAS and Western Highlands Network as the next LMEs to participate in the 1915b/c Medicaid Waiver.

Using the RFA process, DHHS will solicit applications from LMEs to operate Medicaid-funded services through capitated PIHPs. DHHS will select and contract with qualified LME applicant(s) that meet the CMS and DHHS regulatory and technical criteria, as well as industry standards for the administrative, clinical, and financial operations of PIHP. The other two LMEs (East Carolina Behavioral Health and Sandhills Center) that originally applied in 2010 do not need to reapply for participation.

 


We invite consumers, families and other stakeholders to send general questions/comments about this initiative to: 1915BC.Waiver.Contact@dhhs.nc.gov.

 

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