State upgrades Community Support program
for mental health and substance abuse patients
RALEIGH — Proposed new guidelines will strengthen the effectiveness of a widely used mental health service in North Carolina.
New definitions for the Community Support program have been posted to the Internet. After a 45-day public comment period, the N.C. Department of Health and Human Services could adopt the new rules and make them effective as early as Jan. 1.
Community Support is a key service in North Carolina’s new community mental health and substance abuse service array, which aims to serve consumers in their home communities and avoid the need for disruptive and costly inpatient care. Launched in March 2006, Community Support provides assistance in living skills with an objective of helping recipients achieve autonomy and stability.
Earlier this year, internal reviews indicated problems with the new program — ranging from widespread paperwork errors to overuse of the program and underqualification of many service providers. DHHS has addressed many of these issues through training sessions and in-depth audits of providers, even as the Department and the General Assembly sought to tighten and clarify the regulatory language behind the program.
DHHS staff from the Divison of Medical Assistance and the Division of Mental Health, Developmental Disabilites and Substance Abuse Services modified program definitions to limit the program to what is clinically necessary and to improve the overall quality.
Dr.William Lawrence, acting director of the Division of Medical Assistance, the state’s Medicaid agency, compared the revamping of service definitions to the recent resetting of rates paid to Community Support providers.
“When you establish a new service with no precedent for rates or for provision of the service itself, as we have done with Community Support, it is essential that you periodically evaluate the service and enact the necessary corrections. That was part of the original plan,” Dr. Lawrence said.
A volunteer Physicians Advisory Group, which meets monthly to review DHHS Medicaid policies and proposed changes, approved the new Community Support service definitions last week.
Among many changes, highlights of the new definitions include:
- An emphatic statement that Community Support is a rehabilitative treatment service and not a social support, recreational or mentoring program.
- Establishment of “hard limits” for adults and “soft limits” for children on how much of the service is allowed.
- Clarification as to which activities are covered by the program.
- Clarification of the role and functions of a “Qualified Professional” and a lesser-trained “Associate/Paraprofessional.”
- Requirements of minimum percentages of the service that must be provided by the “Qualified Professional.”
For the full list of new Community Support service definitions, log onto http://www.ncdhhs.gov/dma/mp/proposedmp.htm.