Responsible for planning and implementation of multi-million dollar contract with NC DHHS. Duties include: negotiating contracts, educating stakeholders, developing and managing project plan, and serving as Liaison with the State.  Experience overseeing large projects is a must. Understanding of behavioral health or managed care in today’s economy is highly preferred.  

Master’s degree in Human Services, Business, or Project Management is preferred. A bachelor’s degree in the areas noted above and seven (7) years of experience in management of complex human services or business initiatives is eligible for consideration.  The employee must have at least two years of experience working in a LME, Health Care, Managed Care or Business setting that requires administrative, project oversight and leadership responsibility.

Please fill out application and as many continuation sheets as needed to capture work experience and send to Susan Knox

FAX:919-560-7250

E-mail: .(JavaScript must be enabled to view this email address)

Address: The Durham Center, 414 E. Main St. Durham, NC 27701

Click here

rfp test link - ie8

The NC Innovations Waiver is a Home and Community Based Waiver for people with intellectual developmental disabilities and is part of the NC MH/DD/SAS Health Plan.

The NC Innovations Waiver is designed for significantly disabled individuals with intellectual and developmental disabilities or a closely-related condition, and can serve individuals regardless of their age.

NC Innovations offers flexible services for individuals who live in private homes and residential facilities to promote access to their communities. The goal of the waiver is to provide services that allow individuals to learn and maintain skills that promote more independence.

This waiver offers three levels of control and responsibility for services from which the individual and his or her family choose. They are:

• Provider Directed
• Individual Family Directed, which includes Employer of Record, and
• Agency with Choice

A unique option of the NC Innovations Waiver is self-direction known as Individual and Family Directed Supports. Under this option, individuals or families have greater control of all or part of the supports in their Person Centered Plan. The individual/legally responsible person or family becomes the employer in the Employer of Record model. Under this model they can, with the assistance of a Community Guide, hire, train or arrange for training, schedule work, evaluate and even terminate the direct service worker.

The Durham Center additionally offers a second model of self-direction through Individual and Family Directed Supports: Agency with Choice. In this model, the individual/legally responsible person or family works closely with an agency to hire, train or arrange for training, schedule work and evaluate their direct services staff.

This 1915(b) Waiver called the NC MH/DD/SAS Health Plan provides services to individuals in Durham, Guilford, Cumberland and Johnston Counties. All individuals with Medicaid coverage from one of these four counties will be eligible and enrolled into this plan for their mental health, intellectual/developmental disability and substance use/addiction service needs. The services that are available include current North Carolina State Medicaid services, plus some additional services identified through review of evidence-based practices (what works best) and requests by consumers and families. The NC MH/DD/SAS Health Plan puts importance on treatment in the most inclusive setting, attention to the whole person, concentrating on each individual’s strengths instead of weaknesses.

The Medicaid Managed Care Waiver for mental health, intellectual/ developmental disabilities and substance use/addictions is called the NC MH/DD/SAS Health Plan. This plan allows for a waiver of freedom of choice of providers so that The Durham Center can determine the size and scope of the provider network. This Health Plan allows for use of Medicaid funds for alternative services.

The definitions of the services in the NC MH/DD/SAS waiver are the same as those in the current North Carolina Division of Mental Health/Developmental Disabilities/Substance Abuse Service Definitions Manual (APSM 1026).

If you have questions about services and your eligibility for them, do not hesitate to call The Durham Center at (919) 560-7100 or toll-free at (800) 510-9132 24 hours a day, seven days a week. A specially-trained customer service representative will answer your questions or explain more about what services might best fit your needs.

The Durham Center will manage Medicaid costs for its citizens. Medicaid costs are one of the most significant line items in the state’s budget. One way to manage Medicaid costs is with a Freedom of Choice Waiver. This is called a 1915(b)  Waiver because the rules are under 1915(b) in federal regulations.

• It creates a “carve-out” delivery system, a Closed Provider Network, of carefully selected credentialed providers who meet numerous Quality measurements.
• It provides an enhanced service package.

The 1915(c) Waiver is a Home and Community Based Services Waiver:

• The State may offer a variety of services to consumers under a 1915(c) Waiver.
• The number of services that can be provided is not limited. Medical (skilled nursing) and non-Medical (respite, case management, environmental modifications) services can be covered.
• Family   members and friends may be providers of waiver services if qualified, except for parents of minor children.
• States have the discretion to choose the number of consumers to serve in a Home and Community Based Services Waiver.

What is a 1915(b)(c) waiver?

A waiver is an agreement between the state and Center for Medicaid Services in Washington to be exempted from certain Medicaid rules. A waiver is necessary for the state to enter into managed care contracts because of the transfer of risk (of losing money) from the state to a Managed Care Organization. It requires the MCO to have an adequate risk reserve. It requires the Managed Care Organization to provide organizational functions found in a typical health insurance plan such Management of the Provider Network, Quality Management and Utilization Management.

What benefits should a Waiver provide to Consumers?

• Choice
• Voice
• Medically-necessary needs being met
• A process for complaint/grievance solution
• Second opinions

What must Waiver LMEs/MCOs offer to consumers?

• Provide telephone contact7 days a week, 24 hours per day
• Provide emergency referrals 24/7 within one hour
• Provide emergency care within 2 hours
• Provide urgent care within 48 house, usually an assessment
• Provide routine care within 10 working days
• Appointment wait times:
  • Scheduled appointments: 60 minutes
  • Walk-in appointments: 2 hours
  • Emergencies: face to face within 2 hours; if life threatening, immediate attention
• Must offer all medically necessary services in the benefit plan regardless of whether or not there is a provider in the network for that service; a client-specific contract might be needed or a search for a provider with specific expertise
• Qualified staff to evaluate service requested by service providers
• A qualified provider network, with the consumer given a choice between at least two providers
• A choice of providers within 30 miles or 30 minutes in an urban area
• Provide written material within 14 days of receiving the first service; this material will explain the benefit plan, how to access services and consumer rights
• Better communication with access to local decision makers
• Better use of savings
• The Managed Care Organization can change reimbursement rates to incentivize best practices or to better serve a target group of consumers
• Keep funding in the public system
• Adjust existing services to meet changing needs
• Give Consumer and Family feedback in an annual Consumer Satisfaction Survey

$36,472 - $62,791

(Cultural and Linguistic Competency Coordinator-BECOMING Project)

Leads and coordinates efforts to develop and ensure multicultural and linguistic competencies for the federally funded BECOMING (Building Every Chance OF Making IT Now and Grown-up) Project, which aims to enhance and expand the local System of Care (SOC) to better address the needs of disconnected transition-age youth (TAY; 16 to 21 years old).  The Cultural and Linguistic Competence (CLC) Coordinator will work immediately under the Project Coordinator and side-by-side with other project directors to develop, implement, and monitor the Cultural and Linguistic Competence Plan, a component of the larger Strategic Plan for Durham’s SOC.  The CLC Coordinator will be a  key liaison with cultural communities, resources, families, and youth, providers, community agencies and other stakeholders, identifying and attending to unique needs and assisting the Project team in developing implementation strategies with sensitivities to unique cultural and linguistic needs within the Durham community.  The CLC Coordinator will also work closely with the project’s Social Marketing, Technical Assistance, and Youth Coordinators to appropriately adapt all introductory, marketing, assessment, and training materials to best meet the needs of the cultural community, which includes sensitivities toward race and ethnicity, gender, age, and developmental considerations.  Qualified individuals will have strong communication skills and demonstrate knowledge of cultural and linguistic principles and concepts, as well as, organizational change principles and concepts.  An understanding of the SOC and issues directly impacting the target population of TAY and their families is important.  Qualified individuals should have demonstrated ability to work effectively with a broad array of cultures and be bi/multilingual in at least English and Spanish.   Requires any combination of education and experience equivalent to a bachelor’s degree from an accredited college or university with a major in psychology, counseling, social work or public administration and six months experience in a community, business or governmental program that delivers mental health support.

To apply please visit the Durham County website.

PRIOR APPROVAL REQUIRED ON FIRST DAY OF SERVICE (CABHA Agencies only)

Service Definition

• Clinical Policy 8L
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 87
  
• Implementation Update 86
  
• Implementation Update 83
• Implementation Update 78
• Implementation Update 77
• September 2010 Medicaid Bulletin

Initial Request(s): Pass through of eight hours. Prior authorization required for an additional eight hours (before 9th hour of service). Concurrent Request(s): Prior authorization for final eight hours of service (before 17th hour of service).

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)
• Service Order

Items Required for a Concurrent Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)
• Service Order

Policy Update(s)

• Implementation Update 83
• Implementation Update 58
• Implementation Update 54

PRIOR APPROVAL REQUIRED ON FIRST DAY OF SERVICE

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 11

PRIOR APPROVAL REQUIRED AFTER 8 HOURS OF ADMISSION

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 11

PRIOR APPROVAL REQUIRED AFTER FIRST 60 DAYS (AVAILABLE ONE TIME PER CONSUMER PER CALENDAR YEAR)

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• Include Evidence Base Model On Request For Service
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 68
• Implementation Update 65
• Implementation Update 11

PRIOR APPROVAL REQUIRED AFTER FIRST 30 DAYS (AVAILABLE ONE TIME PER CONSUMER PER CALENDAR YEAR)

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• Include Evidence Base Model On Request For Service
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 68
• Implementation Update 65
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items Required for an Initial Request

• Child And Family Team Recommendation
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• Out of State Placement Packet
  Required for residential placements greater than 40 miles from NC state line.
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Items Required for a Concurrent Request

• Child And Family Team Recommendation
• Comprehensive Clinical Assessment
  A new comprehensive clinical assessment (that addresses cooccurring disorders as appropriate) by a psychiatrist (independent of the residential provider and its provider organization) that includes clinical justification for continued stay at this level of care.
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Policy Update(s)

• Medicaid Bulletin September 2011
• Implementation Update 90
• Implementation Update 87
• Implementation Update 85
• Implementation Update 68
• Implementation Update 63
• Implementation Update 60
• Implementation Update 43
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items Required for an Initial Request

• Child And Family Team Recommendation
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• Out of State Placement Packet
  Required for residential placement greater than 40 miles from NC state line.
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Items Required for a Concurrent Request

• Child And Family Team Recommendation
• Comprehensive Clinical Assessment
  A new comprehensive clinical assessment (that addresses cooccurring disorders as appropriate) by a psychiatrist (independent of the residential provider and its provider organization) that includes clinical justification for continued stay at this level of care.
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Policy Update(s)

• Medicaid Bulletin September 2011
• Implementation Update 90
• Implementation Update 87
• Implementation Update 85
• Implementation Update 68
• Implementation Update 63
• Implementation Update 60
• Implementation Update 43
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items required for an Initial Request

• Child And Family Team Recommendation
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• Out of State Placement Packet
  Required for residential placements greater than 40 miles from NC state line.
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Items required for a Concurrent Request

• Child And Family Team Recommendation
• Comprehensive Clinical Assessment
  A new comprehensive clinical assessment (that addresses cooccurring disorders as appropriate) by a psychiatrist (independent of the residential provider and its provider organization) that includes clinical justification for continued stay at this level of care.
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Policy Update(s)

• Medicaid Bulletin September 2011
• Implementation Update 90
• Implementation Update 87
• Implementation Update 85
• Implementation Update 68
• Implementation Update 63
• Implementation Update 60
• Implementation Update 43
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP including all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP including all required signatures.

Policy Update(s)

• Implementation Update 67
• Implementation Update 66
• Implementation Update 63
• Implementation Update 60

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items Required for an Initial Request

• Child And Family Team Recommendation
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• Out of State Placement Packet
  Required for residential placement greater than 40 miles from NC state line.
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Items Required for a Concurrent Request

• Child And Family Team Recommendation
• Comprehensive Clinical Assessment
  A new comprehensive clinical assessment (that addresses cooccurring disorders as appropriate) by a psychiatrist (independent of the residential provider and its provider organization) that includes clinical justification for continued stay at this level of care.
• Discharge Plan
• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.
• Psychiatric Evaluation
  Required for initial requests if clinically indicated. Required for concurrent requests if clinically indicated and for all authorizations past 120 days.

Policy Update(s)

• Medicaid Bulletin September 2011
• Implementation Update 90
• Implementation Update 87
• Implementation Update 85
• Implementation Update 68
• Implementation Update 63
• Implementation Update 60
• Implementation Update 43
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-1

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Policy Update(s)

• Implementation Update 87
• Implementation Update 82
• Implementation Update 63
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Policy Update(s)

• Implementation Update 66
• Implementation Update 60

Intial Request(s): Pass through of 7 days, prior authorization required before 8th day of service.

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Include all required signatures.
• Service Order
  Include required signatures for Crisis Admission

Items required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Include all required signatures.

Policy Update(s)

• Implementation Update 71
• Implementation Update 62
• Implementation Update 58
• Implementation Update 54

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  A signed service order is required for initial requests. Be sure to include all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  A signed service order is required for initial requests. Be sure to include all required signatures.

Policy Update(s)

• PCP
  A signed service order is required for initial requests. Be sure to include all required signatures.
• Implementation Update 83
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Required for regular admission, be sure to include all required signatures. Service order required for Crisis Admission.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Required for regular admission, be sure to include all required signatures. Service order required for Crisis Admission.

Policy Update(s)

• PCP
  Required for regular admission, be sure to include all required signatures. Service order required for Crisis Admission.
• Implementation Update 11

Initial Request(s): Pass through of 16 visits per calendar year for recipients under 21 years of age. Pass through of 8 visits per calendar year for recipients over 21 years of age. Concurrent Request(s): Prior authorization required for additional visists.

Service Definition

• Clinical Coverage Policy 8C
• Records Management And Documentation Manual

Items Required for an Initial Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)

Items Required for a Concurrent Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)

Other Resources

• Psychological Testing Request Form

Policy Update(s)

• Medicaid Bulletin January 2012
• Medicaid Bulletin December 2011
• Medicaid Bulletin November 2011
• Medicaid Bulletin October 2011
• Medicaid Bulletin September 2011
• Medicaid Bulletin August 2011
• Medicaid Bulletin July 2011
• Medicaid Bulletin June 2011
• Medicaid Bulletin April 2011
• Medicaid Bulletin March 2011
• Medicaid Bulletin June 2010
• Medicaid Bulletin April 2010
• Medicaid Bulletin March 2010
• Medicaid Bulletin July 2009
• Medicaid Bulletin June 2009
• Medicaid Bulletin May 2009
• Medicaid Bulletin March 2009
• Medicaid Bulletin October 2008
• Medicaid Bulletin February 2008
• Special Medicaid Bulletin July 2006
• Medicaid Bulletin August 2005
• Special Medicaid Bulletin May 2005
• Special Medicaid Bulletin January 2005
• Implementation Update 92
• Implementation Update 89
• Implementation Update 87
• Implementation Update 86
• Implementation Update 85
• Implementation Update 77
• Implementation Update 76
• Implementation Update 73
• Implementation Update 71
• Implementation Update 70
• Implementation Update 58
• Implementation Update 57
• Implementation Update 56
• Implementation Update 55
• Implementation Update 51
• Implementation Update 44
• Implementation Update 43

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed with all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed with all required signatures.

Policy Update(s)

• Implementation Update 85

Service Definition

Items required for an Initial Request

Items required for a Concurrent Request

Policy Update(s)

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Policy Update(s)

• Implementation Update 63
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8D-2

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  For an Initial Request, a complete PCP with Signed Service order is required prior to or on the day service is provided. For a Concurrent Request, an updated PCP is required. If the PCP is changed a signed service order is needed.

Policy Update(s)

• Implementation Update 63
• Implementation Update 11

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed/Updated PCP with all required signatures

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed/Updated PCP with all required signatures

Policy Update(s)

• Revised Intensive In-Home Training Requirements
• Intensive In-Home Training Requirements
• Implementation Update 86
• Implementation Update 85
• Implementation Update 83
• Implementation Update 82
• Implementation Update 79
• Implementation Update 75
• Implementation Update 73
• Implementation Update 71
• Implementation Update 68

Initial Request(s): Pass through of 48 hours for emergency admissions after business hours only. Prior authorization required after 48 business hours.

Service Definition

• Clinical Coverage Policy 8B
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON 
  (for recipients under age 21 admitted to a free standing inpatient facility)
• Criterion #5 Service Needs/Discharge Planning Status Form (for recipients through age 17 with no appropriate discharge service available)
• Criterion #5 Instructions

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON 
  (for recipients under age 21 admitted to a free standing inpatient facility)
• Criterion #5 Service Needs/Discharge Planning Status Form (for recipients through age 17 with no appropriate discharge service available)
• Criterion #5 Instructions

Policy Update(s)

• Medicaid Bulletin June 2011
• Special Medicaid Bulletin July 2006
• Special Medicaid Bulletin December 2001
• Medicaid Bulletin September 2001
• Medicaid Bulletin March 2003
• Medicaid Bulletin July 2002
• Medicaid Bulletin February 2009
• Medicaid Bulletin December 2002
• Medicaid Bulletin April 2007
• Implementation Update 87
• Implementation Update 55
• Implementation Update 53

Initial Request(s): Pass through of 48 hours for emergency admissions after business hours. Prior authorization required after 48 business hours.

Service Definition

• Clinical Coverage Policy 8B
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON
  (for recipients under age 21 admitted to a free standing inpatient facility)
• Criterion #5 Service Needs/Discharge Planning Status Form (for recipients through age 17 with no appropriate discharge service available)
• Criterion #5 Instructions

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• CON
  (for recipients under age 21 admitted to a free standing inpatient facility)
• Criterion #5 Service Needs/Discharge Planning Status Form (for recipients through age 17 with no appropriate discharge service available)
• Criterion #5 Instructions

Policy Update(s)

• Special Medicaid Bulletin July 2006
• Special Medicaid Bulletin December 2001
• Medicaid Bulletin September 2001
• Medicaid Bulletin March 2003
• Medicaid Bulletin July 2002
• Medicaid Bulletin February 2009
• Medicaid Bulletin December 2002
• Medicaid Bulletin April 2007
• Medicaid Bulletin April 2007
• Implementation Update 55
• Implementation Update 53

Initial Request(s): Pass through of one event per calendar year. Concurrent Request(s): Prior authorization required if requesting additional event in the same calendar year.

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)

Items Required for a Concurrent Request

• ORF 2 (Electronic Version)
• ORF 2 (Written/Typed Version)

Policy Update(s)

• Implementation Update 51

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Policy Update(s)

• Medicaid Bulletin September 2011
• Revised CST Training Requirements
• Implementation Update 89
• Implementation Update 86
• Implementation Update 85
• Implementation Update 83
• Implementation Update 82
• Implementation Update 75
• Implementation Update 73
• Implementation Update 71
• Implementation Update 68
• Implementation Update 60
• Implementation Update 57

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Policy Update(s)

• Implementation Update 75
• Implementation Update 73
• Implementation Update 68
• Implementation Update 65
• Implementation Update 64
• Implementation Update 63
• Implementation Update 62
• Implementation Update 61
• Implementation Update 60

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Policy Update(s)

• Implementation Update 75
• Implementation Update 73
• Implementation Update 68
• Implementation Update 66
• Implementation Update 65
• Implementation Update 64
• Implementation Update 63
• Implementation Update 62
• Implementation Update 61
• Implementation Update 60
• Adult Discharge and Transition Plan

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures

Policy Update(s)

• Revised Day Treatment Training Requirements
• Implementation Update 86
• Implementation Update 85
• Implementation Update 83
• Implementation Update 82
• Implementation Update 79
• Implementation Update 75
• Implementation Update 73
• Implementation Update 72
• Implementation Update 71
• Implementation Update 70
• Implementation Update 68
• Implementation Update 66
• Implementation Update 63
• Implementation Update 60

PRIOR APPROVAL REQUIRED FOR ALL REQUESTS

Service Definition

• Clinical Coverage Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Completed PCP with all required signatures.

Policy Update(s)

• Implementation Update 68
• Implementation Update 65

PRIOR APPROVAL REQUIRED FIRST DAY OF SERVICE

Service Definition

• Clinical Policy 8A
• Records Management And Documentation Manual

Items Required for an Initial Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Items Required for a Concurrent Request

• ITR (Electronic Version)
• ITR (Written/Typed Version)
• PCP
  Be sure to include all required signatures.

Policy Update(s)

• PCP
  Be sure to include all required signatures.
• Implementation Update 11

• Ambulatory Detoxification
• Assertive Community Treatment Team
• Child and Adolescent Day Treatment
• Community Support Team (CST)
• Diagnostic/Assessment
• Inpatient Hospital Psychiatric Treatment (MH)
• Inpatient Hospital Substance Abuse Treatment
• Intensive In-Home Services
• Level II Group Home
• Level II Therapeutic Foster Care
• Mobile Crisis Management
• Multisystemic Therapy (MST)
• Non-Hospital Medical Detoxification
• Outpatient Behavioral Health Services provided by Direct-Enrolled Providers
• Outpatient OPIOID Treatment
• Partial Hospitalization
• Professional Treatment Services in Facility-Based Crisis Program
• Psychiatric Residential Treatment Facility (PRTF)
• Psychosocial Rehabilitation
• Residential Level III—4 Or Less Beds
• Residential Level III—5 Or More Beds
• Residential Level IV—4 Beds Or Less
• Residential Level IV—5 Beds Or More
• Substance Abuse Comprehensive Outpatient Treatment Program
• Substance Abuse Intensive Outpatient Program
• Substance Abuse Medically Monitored Community Monitored Residential Treatment
• Substance Abuse Non-Medical Community Residential Treatment
• MH/SA Targeted Case Management

Categories

DD

MH/SA

CAP Requests

CAP Revisions

TCM Only Requests

CAP Webinar for TCM Agencies

LME Guide to Viewing CAP UR Decisions in ProviderConnect

Service Provider Guide to Viewing CAP UR Decisions in ProviderConnect

Service Definition

• CAP-MR/DD Comprehensive Manual
• CAP-MR/DD Supports Manual
• Clinical Coverage Policy 8M
• Records Management And Documentation Manual

Items Required for an Initial Request

• Cost Summary
• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• PCP
  If the review results in a new service being added to the PCP, the appropriate medical professional must also sign indicating medical necessity and order of the service. If the review results in a new or revised goal, complete the Action Plan section of the Update/Revision Form with the new goal information. If the review results in no changes to the PCP, document the review on the original Action Plan pages while obtaining new signatures on the Update/Revision Form. It is best practice to note somewhere on the Update/Revision Form that documentation of the review can be found on the original Action Plan pages with dates coinciding with the signatures on the Update/Revision Form.

Policy Update(s)

• Medicaid Bulletin January 2012
• Medicaid Bulletin December 2011
• Implementation Update 92
• Implementation Update 85
• Implementation Update 84
• Implementation Update 82
• Implementation Update 80
• Implementation Update 78
• Implementation Update 59
• Implementation Update 39

Service Definition

• CAP-MR/DD Comprehensive Manual
• CAP-MR/DD Supports Manual
• Clinical Coverage Policy 8M
• Records Management and Documentation Manual

CAP Services

• Adult Day Health
• Augmentative Communication Devices
• Crisis Respite
• Crisis Services (Revised 05/09)
• Day Supports
• Home And Community Supports
• Home Modifications
• Home Supports
• Individual Caregiver Training And Education
• Long Term Vocational Supports
• Personal Emergency Response System (Pers)
• Residential Supports
• Respite Services
• Specialized Consultative Services
• Specialized Equipment And Supplies
• Supported Employment
• Transportation
• Vehicle Adaptations

Items Required for an Initial Request

• Comprehensive Clinical Assessment (CCA)
• Cost Summary
• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• Current Psychological
  For children, must be completed in the past year; for adults, must be completed in the last three years or accompanied by an update.
• MR-2
  MR-2 including the LME Representative signature and the signature of a psychiatrist or MD. Contact EDS (HP Enterprise Services) at 919-851-8888 to obtain blank forms. 
• NC SNAP
  Additional blank NC SNAP forms can be obtained through the LME. This form cannot be copied. You may contact the designated representative at the LME to obtain additional forms.
• PCP
• Risk Identification Tool
  Click here for instructions for the Risk Identification Tool

Items Required for a Continued Needs Review Request

• Cost Summary
• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• MR-2
  MR-2 including the LME Representative signature and the signature of a QP. Contact EDS (HP Enterprise Services) at 919-851-8888 to obtain blank forms. 
• NC SNAP
  Additional blank NC SNAP forms can be obtained through the LME. This form cannot be copied. You may contact the designated representative at the LME to obtain additional forms.
• PCP
• Risk Identification Tool
  Click here for instructions for the Risk Identification Tool

Policy Update(s)

• Transition Protocol
• Supports Waiver CAP-MR/Dd Manual 2008
• Self Direction Update
• Medicaid Bulletin January 2012
• Medicaid Bulletin December 2011
• Medicaid Bulletin September 2011
• Medicaid Bulletin June 2011
• Medicaid Bulletin May 2011
• Implementation Update 92
• Implementation Update 90
• Implementation Update 89
• Implementation Update 85
• Implementation Update 84
• Implementation Update 82
• Implementation Update 80
• Implementation Update 78
• Implementation Update 76
• Implementation Update 60
• Implementation Update 59
• Implementation Update 58
• Implementation Update 56
• Implementation Update 55
• Implementation Update 54
• Implementation Update 52
• Implementation Update 51
• Implementation Update 50
• Implementation Update 48
• Implementation Update 45
• Implementation Update 43
• Implementation Update 42
• Implementation Update 39
• Comprehensive Waiver CAP-MR/DD Manual 2008
• CAP Update 7/22/09
• CAP Update 4/21/09
• CAP Update 12/19/08
• CAP Update 10/29/08
• CAP Update 1/23/09

Service Definition

• TCM Only Draft Service Definition
  This service definition has not been approved.

Items Required for an Initial Request

• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• Current Psychological/CCA
• NC SNAP
  Additional blank NC SNAP forms can be obtained through the LME. This form cannot be copied. You may contact the designated representative at the LME to obtain additional forms.
• PCP
  Be sure to include all required signatures. For concurrent requests, review documented within 90 days.

Items Required for a Continued Needs Review Request

• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• PCP
  Be sure to include all required signatures. For concurrent requests, review documented within 90 days.

Policy Update(s)

• Medicaid Bulletin January 2012
• Medicaid Bulletin December 2011
• Medicaid Bulletin July 2011
• Implementation Update 87
• Implementation Update 78
• Implementation Update 77
• Implementation Update 76
• Implementation Update 73
• Implementation Update 71
• Implementation Update 68
• Implementation Update 62
• Implementation Update 59
• Implementation Update 55
• Guide For Transition Planning
• Bulletin Correction

$23,152 - $39,862

(Mental Health - The Durham Center)

Performs a range of clerical tasks, resolving problems, and may require coordination of several processes in the Customer Service Department that require knowledge of program operations, policies, and processes.  Public contact with recipients of services, representatives of other agencies, and other institutions.  Performs a variety of office tasks in support of administrative, program, and technical operations.  This position will have general assignments in a variety of on-going office functions.  Must work independently and with other office support in resolving problems.  Requires graduation from high school and one year of clerical experience; or an equivalent combination of training and experience.

To apply please visit the Durham County website.

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The Durham Center

Address:
414 East Main Street, Second Floor
Durham, NC 27701

Customer Service Telephone Number:
(919) 560-7200
(877) 839-0301
Customer Service is available Monday-Friday, 8:30am-5:00pm.

24 Hour Help and Crisis Number:
(800) 510-9132
(919) 560-7100

The Utilization Management Department is available Monday-Friday, 8:00am-5:30pm.  It can be reached at (919) 560-7200 or (877) 839-0301.

The Durham Center maintains several fax numbers.  If you do not know the appropriate number for the person you are faxing, you may call Customer Services at (919) 560-7200.

Full Staff Contact Listing

Staff Contact Listing by Need

Visit our directions page for driving directions.

August 2011

June 2011

May 2011

April 2011

March 2011

February 2011

December 2010

November 2010

October 2010

September 2010

August 2010

July 2010

June 2010

May 2010

April 2010

January 2010

December 2009

November 2009

October 2009

September 2009

August 2009

July 2009

June 2009

May 2009

April 2009

February 2009

January 2009

December 2008

November 2008

October 2008

September 2008

August 2008

July 2008

June 2008

May 2008

April 2008

March 2008

February 2008

Older minutes can be obtained by emailing .(JavaScript must be enabled to view this email address)

Register online for provider trainings sponsored by The Durham Center

View a Provider Training Schedule
View an Alcoholics Anonymous Schedule
View a Narcotics Anonymous Schedule

April

CFAC Meeting
TROSA (1820 James Street)
April 4, 5:30pm

Provider Advisory Council
Durham Center Access
April 7, 10:30am

Area Board Finance Committee
Durham Center Access
April 7, 3:00pm

Area Board Meeting
Durham Center Access
April 7, 4:00pm

Area Board Executive Committee
The Durham Center
April 12, 8:15am

Independent Living Initiative Training
The Durham Center
April 12, 12:30pm

Motivational Interviewing Practicum for Beginners
The Durham Center
April 13, 9:00am

Advanced Motivational Interviewing Practicum
The Durham Center
April 13, 10:30am

Adopting Best Practices in Substance Abuse Treatment
The Durham Center
April 13, 1:00pm

Note that all events after April 19 located at The Durham Center will occur at its new offices at 414 East Main Street.

Making a Difference for Durham Families Breakfast
Durham Armory
April 21, 8:30am

Area Board Quality Management Committee
The Durham Center
April 21, 4:00pm

Independent Living Intitative Training
The Durham Center
April 26, 12:30pm

Quality Improvement Planning and Reporting Training
Durham Center Access
April 29, 9:00am

May

Note that all events located at The Durham Center will occur at its new offices at 414 East Main Street.

CFAC Meeting
TROSA (1820 James Street)
May 2, 5:30pm

Provider Advisory Council
The Durham Center
May 5, 10:30am

Area Board Finance Committee
The Durham Center
May 5, 3:00pm

Area Board Meeting
The Durham Center
May 5, 4:00pm

Trauma Informed Agency Training
The Durham Center
May 6, 9:00am

Area Board Executive Committee
The Durham Center
May 10, 8:15am

Independent Living Initiative Training
The Durham Center
May 10, 12:30pm

Motivational Interviewing Practicum for Beginners
The Durham Center
May 11, 9:00am

Advanced Motivational Interviewing Practicum
The Durham Center
May 11, 10:30am

Adopting Best Practices in Substance Abuse Treatment
The Durham Center
May 11, 1:00

Area Board Quality Management Committee
The Durham Center
May 19, 4:00pm

Durham Community Collaborative
The Durham Center
May 26, 10:00am

Area Board Human Rights Committee
The Durham Center
May 31, 4:00pm

Request for Proposals for Auditing Services

To access services, call Durham Center Access at (919) 560-7100 or toll-free (800) 510-9132.

If you have a complaint, call Customer Service at (919) 560-7200 or toll-free (877) 839-0301.

If you have a general informational question about The Durham Center, call (919) 560-7200.

To speak to The Durham Center about displaying or speaking at your event, call (919) 560-7256 or email .(JavaScript must be enabled to view this email address).

If you are a media representative with a question or have a question about this website, call (919) 560-7206 or email .(JavaScript must be enabled to view this email address).

If you have a non-Medicaid (IPRS) provider billing question, call (919) 560-7360 or email .(JavaScript must be enabled to view this email address) or call (919) 560-7372 or email .(JavaScript must be enabled to view this email address).

If you have a Medicaid provider billing question, call HP at (800) 688-6696.

If you have a question about contracts or endorsement, call (919) 560-7366 or email .(JavaScript must be enabled to view this email address).

If you have a question about becoming an independent provider, call (919) 560-7359 or email .(JavaScript must be enabled to view this email address).

If you have a question about provider monitoring, call (919) 560-7370 or email .(JavaScript must be enabled to view this email address). (Note: a toll-free Compliance Hotline is available at (800) 826-6762 for reporting issues such as suspected fraud or abuse. Callers may remain anonymous.)

If you have a question about consumer authorization, call (919) 560-7109 or email .(JavaScript must be enabled to view this email address).

If you have a question about the screening, triage and referral process, call (919) 560-8947 or email .(JavaScript must be enabled to view this email address).

If you have a question about quality improvement, management or reports, call (919) 560-7487 or email .(JavaScript must be enabled to view this email address).

If you have a question about provider incident reporting, call (919) 560-8938 or email .(JavaScript must be enabled to view this email address).

For information about housing assistance, call (919) 560-7144 or email .(JavaScript must be enabled to view this email address).

To reach our Mental Health Program Specialist, call (919) 560-7364 or email .(JavaScript must be enabled to view this email address).

To reach our Substance Abuse Program Specialist, call (919) 560-7471 or email .(JavaScript must be enabled to view this email address).

To reach our Developmental Disabilities Program Specialist, call (919) 560-7511 or email .(JavaScript must be enabled to view this email address).

Merger and Medicaid Waiver FAQs

Updates on the proposed merger of The Durham Center and Wake LME and The Durham Center's transition to operating as a Managed Care Organization are found in these FAQs.

Mandatory Electronic Submission of Authorization Requests

State law requires that providers submit authorization requests electronically

Changes in Developmental Therapy

Due to funding, changes are being made to how Developmental Therapy is authorized 

Toll-Free Customer Service Line

To call Customer Service at The Durham Center toll-free, dial   1-877-839-0301

FY11 Highlights

Review The Durham Center's FY11 highlights and accomplishments

Consumer Newsletter

Access the latest Consumer Newsletter from The Durham Center

Consumer Handbook Available

Access a Consumer Handbook published by the NC Division of MH/DD/SA Services English/Spanish

Implementation Updates

Access the latest Implementation Updates from the Divsions of MH/DD/SAS and Medical Assistance

ED Report

Access The Durham Center's report on mental health admissions to local hospital emergency departments

Online Training Registration

Providers can now register online for trainings sponsored by The Durham Center

Anti-Stigma Campaign

Bring Change 2 Mind is a campaign working to reduce misconceptions about mental illness and provide easy access to information and support

Suicide Warning Signs

It is important to recognize the warning signs for suicide

Durham Mobile Crisis Team

The Mobile Crisis Team is housed at Durham Center Access and is an important part of our community's crisis response system

February 2, 2012

January 27, 2012

January 20, 2012

January 12, 2012

January 6, 2012

December 22, 2011

December 16, 2011

December 9, 2011

December 2, 2011

November 23, 2011

November 18, 2011

November 11, 2011

November 4, 2011

October 28, 2011

October 21, 2011

October 14, 2011

October 7, 2011

September 30, 2011

September 23, 2011

September 16, 2011

September 9, 2011

September 2, 2011

August 26, 2011

August 12, 2011

August 5, 2011

July 29, 2011

July 22, 2011

July 15, 2011

July 8, 2011

June 23, 2011

June 17, 2011

June 10, 2011

June 3, 2011

May 27, 2011

May 20, 2011

May 13, 2011

May 6, 2011

April 29, 2011

April 21, 2011

April 15, 2011

April 8, 2011

April 1, 2011

March 25, 2011

March 18, 2011

March 11, 2011

March 4, 2011

February 25, 2011

February 18, 2011

February 11, 2011

February 4, 2011

January 28, 2011

January 21, 2011

January 14, 2011

January 7, 2011

December 23, 2010

December 17, 2010

December 10, 2010

December 3, 2010

November 24, 2010

November 19, 2010

November 12, 2010

November 5, 2010

October 29, 2010

October 22, 2010

October 15, 2010

October 8, 2010

October 1, 2010

September 24, 2010

September 17, 2010

September 9, 2010

September 3, 2010

August 27, 2010

August 20, 2010

August 13, 2010

August 6, 2010

July 30, 2010

July 23, 2010

July 9, 2010

July 2, 2010

June 25, 2010

June 11, 2010

June 4, 2010

May 28, 2010

May 21, 2010

May 14, 2010

May 7, 2010

April 30, 2010

April 23, 2010

April 16, 2010

April 9, 2010

April 1, 2010

March 26, 2010

March 19, 2010

March 12, 2010

March 5, 2010

February 26, 2010

February 18, 2010

February 12, 2010

February 5, 2010

January 29, 2010

January 22, 2010

January 15, 2010

January 8, 2010

Full Staff Listing

Staff Listing by Need

Organizational Chart

• Online Provider Training Registration (faxes no longer accepted)
• Auto Attestation Form
• Care Coordination Referral Form
• County Vendor Application
• Customer Grievance Form
• Division Appeal Request Form
• ECS Agreement
• Notice of Change Form
• Record Destruction Log (Sample)
• Record Storage Log (Sample)
• Request for MOA Form
• State Claim Form
• Technical Assistance/Training Request Form
• Three Year Re-Endorsement Attestation Letter
• W-9 Form

• Consumer Sliding Fee Scale
• Contracting with New and Existing Providers Policy
• DMH Memo on Referral and Client Recruitment Practices
• Durham County Resource Guide
• Guidelines for Evaluating Human Services Degrees
• Guidelines for Implementing Core Rules
• How to Become an Endorsed Provider
• How to File a Wage Complaint
• Insurance Certificate Sample
• Licensed Facility Rule Waiver Request Protocol
• Residential Services Letter of Support Protocol
• Provider Emergency Numbers
• Quality Management Department Orientation
• Request for Recoupment 2005
• Therapeutic Leave for Medicaid Clients
• Verifying Foreign Degrees

• ProviderConnect Users Manual
• Finance Billing Manual for FY12
• The Durham Center Operations Manual

• Agency Benchmarks Template (Logic Model)
• FAQs About NC-TOPPS
• FAQs About IRIS
• Incident Response and Reporting Manual
• IRIS Website
• IRIS Technical Manual
• NC-TOPPS Enrollment Instructions FY09
• Provider Quarterly Incidents Report (Form QM11)
• QM Dashboard FY11
• QA-QI Checklist
• QM Plan FY11
• QM Plan Instructions
• QM Plan Template
• QM Training PowerPoint (4/29/11 Training)
• The Durham Center Strategic Plan
  

QM Committee Minutes
January 2011
February 2011
April 2011
May 2011
June 2011
August 2011
October 2011
December 2011

UM Staff Fax Numbers
Initial Screening and Registration
ProviderConnect
Opening Paperwork
Ongoing Authorization for IPRS
Current IPRS Benefit Plan
PCP Review of Medicaid and Non-Medicaid
Discharge/Transfer of Consumers
Presentations
Memos

Initial Screening and Registration

• Consumer Missed Appointment Follow Up Form
• Registration Management Memo-Process
• UM Changes-Introductory PCP

ProviderConnect

• ProviderConnect
• ProviderConnect Users Manual
• ProviderConnect Webinar
  

Opening Paperwork

• Fee For Service Plan
• LME Consumer Admission and Discharge Form
• Start Dates For IPRS Service Authorizations
• UM Fax Cover Sheet

Ongoing Authorization for IPRS

• 6-Month Provider Reauthorization Aggregate Spreadsheet
• Hours to Units Conversion Table
• IRPS Codes for LME Authorization Request Form

Current IPRS Benefit Plan

• IPRS Memo
• DD Adult–Child LOC Grid
• MH Adult LOC Grid
• MH/SA Child LOC Grid
• SA LOC Grid

PCP Review of Medicaid and Non-Medicaid

• PCP Review Tool

Discharge/Transfer of Consumers

• Transfer/Discharge Procedures

Presentations

• Utilization Review Update PowerPoint

 Memos

• Authorization of Medicaid Services June 1, 2006
• Community Support Changes
• Community Support High-Cost Review Announcement
• Developmental Therapies and Personal Assistance
• Medicaid DMH TCM Residential Treatment
• Medicaid Transition to Value Options
• Service Authorization Update
• The Durham Center Clinical Review Plan
• UM Authorization Update 8/28/06

Based on the volume of applications for financial assistance through the Independent Living Initiative and the limited funds for this fiscal year, The Durham Center must temporarily stop accepting program applications. Since July 1 we have helped over 275 households avoid homelessness or acquire new housing after becoming homeless. Over 30% of these households consisted of families with children. We know that economic hardship requires many households to continue to seek assistance and we will work to refer these households to the most appropriate partnering agency. The Durham Center hopes to resume accepting applications in the near future and will make the community aware when it is able to do so.

PLEASE READ THIS FIRST FOR IMPORTANT HOUSING INFORMATION

• Durham County Resource Guide
• Durham Housing Resource List
• ILI Housing Application (ILI Risk/Barrier Factor Checklist must also be submitted as part of the ILI application packet)
  
• ILI Information and Instructions
• ILI Risk/Barrier Factor Checklist
• Rapid Response Referral Form
• Supportive Housing Program Application
• Supportive Housing Program Requirements
• Targeting Program Information Sheet
• The Durham Center Housing Services and Programs

Child Mental Health
Adult Mental Health
Substance Abuse
Developmental Disabilities

Child Mental Health (Care Review)

• Care Review Contract with families
• Care Review Core Values
• Care Review Levels of Care
• Care Review Priority Populations
• Care Review Referral Form and Instructions (Adult, Hispanic, Youth and Transition)
  
• Child Care Room and Board Letter-Families
• Child Care Room and Board Letter-Providers
• Care Review Unified Plan
• Out-of-Home Placements Policies and Procedures
• State Child/Adolescent Discharge Plan

Child Mental Health (Flex Funds)

• Flex Funds Request Form
• Flex Funds Request Protocol
• IPRS Target Pop Cat CMH 

Child Mental Health (PRTF/Whitaker)

• Whitaker School Referral Form
• Wright School Referral Form
• Wright School Referral Form Signature Page

Child Mental Health (Working with Durham Public Schools)

• Community Support in Schools Procedures
• Criminal Background Check
• Memorandum of Understanding for CSS Workers
• School Administrator Agreement Form
• Standards for CSS

Adult Mental Health

• Care Coordination Referral Form
• Care Review Referral Form and Instructions (Adult, Hispanic, Youth and Transition)
• Person-Centered Planning Tool  
• What to Expect at Care Review (for consumers)

Substance Abuse

• Adult Substance Abuse Services
• Care Coordination Referral Form
• SA Plan
• SA Training – Getting Started (PowerPoint)
• The Durham Center Substance Abuse Services

Developmental Disabilities

• Brain Injury Association of NC Resource Book
• DD Services Prioritization Tool
• NC SNAP Examiner Training Registration Form
• NC SNAP Instructions
• NC Traumatic Brain Injury Resources
• NC SNAP Supplemental Information Coversheet
• NC START Access FAQs
• NC START Brochure
• NC START Items Needed for Intake
• NC START Referral and Screening Form
• Quality Elements for DD Services

The Durham Center Operations Manual
 

The Durham Center Finance Billing Manual

The Durham Center Strategic Plan FY2011-2013

FY2010 Annual Report

Obtaining Services Handbook

The Durham Center Brochure

Client Rights Handbook

Notice of Privacy Practices (English)

Aviso de Normas de Privacidad (Espanol)

Mental Health Informational Publication 2011
Mental Health Informational Publication 2008

Developmental Disabilities Informational Publication

Alcohol Awareness Month Informational Publication 2011
Alcohol Awareness Month Informational Publication 2008

Recovery Month Informational Publication 2010
Recovery Month Informational Publication 2007

Substance Abuse/Addiction PowerPoint Presentation

CFAC Brochure

Evidence Based Practices Brochure

State/Local
Federal

State/Local:

• 10-Year Results Plan to End Homelessness in Durham – www.endhomelessnessindurham.org
• Action for Children-NC – www.ncchild.org
• Alcohol/Drug Council of NC – www.alcoholdrughelp.org
• The Arc of NC – www.arcnc.org
• Autism Society of NC – www.autismsociety-nc.org
• BECOMING Durham - www.becomingdurham.org
• Brain Injury Association of NC - www.bianc.net
• Disability Rights North Carolina – www.gacpd.com
• Durham County Government - www.co.durham.nc.us 
• Durham County Resource Guide
• Durham Health Innovations - www.dtmi.duke.edu/dccr/dhi
• Durham Mobile Crisis Team - access a flyer
• Durham Network of Care – www.durhamnetworkofcare.org
• Durham System of Care – www.durhamsystemofcare.org
• Family Support Network of NC – www.fsnnc.org
• National Alliance for the Mentally Ill-NC (NAMI-NC) – www.naminc.org
• North Carolina Area Health Education Centers (AHEC) Program – www.ncahec.net
• NC Collaborative for Children, Youth and Families - www.nccollaborative.org
• NC Council of Community Programs – www.nc-council.org
• NC Council on Developmental Disabilities – www.nc-ddc.org
• NC Department of Health and Human Services – www.ncdhhs.gov
• NC Division of Health Service Regulation - www.ncdhhs.gov/dhsr
• NC Division of Medical Assistance (North Carolina's Medicaid program) – www.ncdhhs.gov/dma
• NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services – www.ncdhhs.gov/mhddsas
• NC Division of MH/DD/SA Services Consumer Handbook - English or Spanish
• NC Division of MH/DD/SA Services Traumatic Brain Injury Website - www.dhhs.state.nc.us/mhddsas/tbi/index.htm
• NC Evidence-Based Practices Center – www.ncebpcenter.org
• NC Exceptional Children's Assistance Center – www.ecac-parentcenter.org
• Supports Intensity Scale Website - www.unc.edu/depts/ddti/sis.html
• Value Options – www.valueoptions.com

Federal:

• Association for Persons in Supported Employment – www.apse.org
• Centers for Medicare and Medicaid Services (CMS) – (provider side only) www.cms.hhs.gov
• National Alliance on Mental Illness (NAMI) – www.nami.org
• National Center on Secondary Education and Transition - www.ncset.org
• National Institute of Mental Health (NIMH) – www.nimh.nih.gov
• National Suicide Prevention Lifeline – www.suicidepreventionlifeline.org
• Substance Abuse & Mental Health Services Administration (SAMHSA) – www.samhsa.gov
• URAC – www.urac.org 

State/Local
Federal

State/Local:

• 10-Year Results Plan to End Homelessness in Durham – www.endhomelessnessindurham.org
• Action for Children-NC – www.ncchild.org
• Alcohol/Drug Council of NC – www.alcoholdrughelp.org
• The Arc of NC – www.arcnc.org
• Autism Society of NC – www.autismsociety-nc.org
• BECOMING Durham - www.becomingdurham.org
• Brain Injury Association of NC – www.bianc.net 
• Disability Rights North Carolina – www.gacpd.com
• Durham County Government - www.co.durham.nc.us
• Durham County Resource Guide
• Durham Health Innovations - www.dtmi.duke.edu/dccr/dhi
• Durham Mobile Crisis Team - access a flyer
• Durham Network of Care – www.durhamnetworkofcare.org 
• Durham System of Care – www.durhamsystemofcare.org
• Family Support Network of NC – www.fsnnc.org
• First in Families of North Carolina - www.fifnc.org
• National Alliance for the Mentally Ill-NC (NAMI-NC) – www.naminc.org
• North Carolina Area Health Education Centers (AHEC) Program – www.ncahec.net
• NC Collaborative for Children, Youth and Families - www.nccollaborative.org
• NC Council of Community Programs – www.nc-council.org
• NC Council on Developmental Disabilities – www.nc-ddc.org
• NC Department of Health and Human Services – www.ncdhhs.gov
• NC Division of Medical Assistance (North Carolina's Medicaid program) – www.ncdhhs.gov/dma
• NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services – www.ncdhhs.gov/mhddsas
• NC Division of MH/DD/SA Services Consumer Handbook - English or Spanish
• NC Evidence-Based Practices Center – www.ncebpcenter.org
• NC Exceptional Children's Assistance Center – www.ecac-parentcenter.org

Federal:

• Association for Persons in Supported Employment – www.apse.org
• National Alliance on Mental Illness (NAMI) – www.nami.org
• National Center on Secondary Education and Transition - www.ncset.org
• National Institute of Mental Health (NIMH) – www.nimh.nih.gov
• National Suicide Prevention Lifeline – www.suicidepreventionlifeline.org
• Substance Abuse & Mental Health Services Administration (SAMHSA) – www.samhsa.gov
• URAC – www.urac.org

Durham’s Consumer and Family Advisory Committee was formed as an advisory committee to The Durham Center as part of the State’s mental health reform. Its members are individuals who directly experience mental health, developmental disability and/or substance abuse issues   or who have family members who do.

CFAC works to identify gaps in services and to offer suggestions for long-term organizational planning and reviews and approves certain operating documents produced by The Durham Center.

About Durham CFAC:

• It has identified housing, employment and reduction of stigma as three important areas for our community. The group addresses these issues and others through committee work.
• It helps educate elected officials and the broad public on issues related to the work of The Durham Center.
• It meets monthly on the first Monday of the month from 5:30-7:15pm. Meetings are usually held at TROSA at 1820 James Street, Durham, and are open to all consumers and family members.
• A stipend is offered for member attendance at meetings.

For more information or to apply for membership, you may email Durham CFAC.

Archived Meeting Minutes

Access the State CFAC website.

Register online for trainings sponsored by The Durham Center
View an Alcoholics Anonymous Schedule
View a Narcotics Anonymous Schedule

April

CFAC Meeting
TROSA (1820 James Street)
April 4, 5:30pm

Area Board Finance Committee
Durham Center Access
April 7, 3:00pm

Area Board Meeting
Durham Center Access
April 7, 4:00pm

CFAC Meeting
TROSA (1820 James Street)
February 7, 5:30pm

Area Board Executive Committee
The Durham Center
April 12, 8:15am

Note that all events after April 19 located at The Durham Center will occur at its new offices at 414 East Main Street.

Making a Difference for Durham Families Breakfast
Durham Armory
April 21, 8:30am

Area Board Quality Management Committee
The Durham Center
April 21, 4:00pm

May

Note that all events located at The Durham Center will occur at its new offices at 414 East Main Street.

CFAC Meeting
TROSA (1820 James Street)
May 2, 5:30pm

Area Board Finance Committee
The Durham Center
May 5, 3:00pm

Area Board Meeting
The Durham Center
May 5, 4:00pm

Area Board Executive Committee
The Durham Center
May 10, 8:15am

Area Board Quality Management Committee
The Durham Center
May 19, 4:00pm

Durham Community Collaborative
The Durham Center
May 26, 10:00am

Area Board Human Rights Committee
The Durham Center
May 31, 4:00pm

FY2010 Annual Report

The Durham Center Strategic Plan FY2011-2013

Obtaining Services Handbook

The Durham Center Brochure

Client Rights Handbook

Notice of Privacy Practices (English)

Aviso de Normas de Privacidad (Espanol)

The Durham Center Strategic Plan FY 2011-2013

Mental Health Informational Publication 2011
Mental Health Informational Publication 2008

Developmental Disabilities Informational Publication

Alcohol Awareness Month Informational Publication 2011
Alcohol Awareness Month Informational Publication 2008

Recovery Month Informational Publication 2010
Recovery Month Informational Publication 2007

Substance Abuse/Addiction PowerPoint Presentation

CFAC Brochure

Evidence Based Practices Brochure

When you request or receive services, your rights are protected by North Carolina law. The Customer Services Department at The Durham Center can provide information about rights to people seeking or receiving services.

Client Rights Handbook

You have the right to: Be treated with respect, self-determination, dignity, privacy and humane care, and to be free from physical punishment, abuse, neglect or exploitation An individualized, Person-Centered or Child and Family Plan and to participate in the development and review of that plan Be informed about medications Refuse treatment Be informed about the expectations and requirements of your treatment service Know the cost of services Confidentiality

If you are connected to a provider, you will discuss payment arrangements for services. You will need to provide insurance information and proof of your income. Some services are covered by insurance and you will not be billed for those, except for any co-payments your insurance requires. If you do not have insurance you will be billed for services on a sliding-fee scale based on your income.

If you need help understanding and/or applying for financial assistance, such as Food Stamps, Medicaid or Supplemental Security Income, your provider will help connect you to the right people and support you in the application process through your Child and Family or Support Team.

Housing is a critical part of the comprehensive System of Care approach utilized by The Durham Center. For an individual without secure housing, it can be difficult to focus on and succeed in the other parts of a treatment plan.

The Durham Center’s Independent Living Initiative is a referral-based program that provides short-term rental assistance for people with severe and persistent mental illness and persistent mental illness, a developmental disability or a substance abuse issue. The program’s goal is to increase the self-sufficiency of its participants.

This rental assistance includes:

• Monthly rental subsidies for a period of 3-6 months depending on the type of illness
• Housing startup funds to help cover one-time expenses including security and utility deposits, moving expenses and purchase of furniture
• Emergency assistance funds on a one-time basis to help with unexpected emergencies.

If you are interested in participating in this program, please talk with your provider, who has access to the proper forms and will know how to help you through the process.

The Durham Center promotes the use of evidence-based practices by its contracted providers. These practices have been consistently shown in several research studies to assist consumers in achieving their desired goals of health and wellness.

Evidence-based practices provided by The Durham Center include:

Assertive Community Treatment (ACT)
Integrated Dual-Disorder Treatment (IDDT)
Family Psychoeducation
Wellness Management and Recovery (WMR)
Supported Employment
Housing
Multi-Systemic Therapy (MST)
Intensive In-Home Therapy

Assertive Community Treatment (ACT) is a comprehensive community-based model for delivering treatment, support and rehabilitation services for adults with severe and persistent mental illness. A team of professionals provides the specific mix of services needed by a consumer 24/7 for as long as they are needed. Rather than teaching skills or providing services in clinical settings and expecting them to be generalized to "real-life" situations, services are provided in the settings and context where problems arise and support or skills are needed.

Integrated Dual-Disorder Treatment (IDDT) improves the quality of life for persons with dual disorders by integrating substance abuse services with mental health services. It combines pharmacological, psychological, educational and social interventions to address the needs of consumers and their families, promoting consumer and family involvement in service delivery.

Family Psychoeducation works in partnership with families of individuals with schizophrenia and related disorders to help the individual and family members develop coping skills for handling the problems posed by these illnesses. Over a period of at least nine months, family psychoeducation teaches crisis intervention and problem solving accompanied by skills training, ongoing guidance about the management of mental illness and emotional support for family members.

Wellness Management and Recovery (WMR) is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover – or rediscover – their abilities to pursue personal goals and develop a sense of identity that allows them to grow beyond their mental illness.

Supported Employment helps people with disabilities participate in the labor market in jobs they prefer with the level of professional help they need, typically providing individual placements in competitive employment paying at least minimum wage without requiring extended pre-vocational training. These jobs promote social integration, productivity and maximum use of the worker’s skills and abilities.

Housing for individuals with disabilities should respond to their right to live in communities of their choosing and to be fully included with non-disabled people. They should be empowered to live in accessible, affordable housing and individualized supports and adaptations should be of their choosing and under their control. Today large congregate facilities are considered unnecessary and inappropriate regardless of the type or severity of the disability.

Multi-Systemic Therapy (MST) is considered an evidence-based practice in child mental health and is designed to enhance the skills of youth and their families who have anti-social or aggressive/violent behaviors or delinquency issues. These children are often involved with the juvenile justice system. MST provides an intensive model of treatment based on empirical data and evidence-based interventions that target specific behaviors with individualized in-home behavioral interventions.

Intensive In-Home Therapy allows for high levels of services for children and youth exhibiting anti-social, aggressive/violent or other inappropriate behaviors resulting in a risk for out-of-home placement. It utilizes a team approach which includes families to provide counseling, self-help and living skills training, and linkage to community services, as well as parenting skills training. It is proven to diffuse current crises, to decrease the likelihood of reoccurrence and to dramatically reduce the chance of out-of-home placement.

The Durham Center supports individuals with mental illness in their recovery process as a means to achieve their personal goals, and we recognize that recovery is a unique and personal process that involves changing attitudes, values, feelings, goals, skills, and roles in order to live a satisfying, hopeful and contributing life.

Providers who work with The Durham Center can explain how a Person-Centered or Family-Centered Plan might assist you in meeting your goals, and you and your provider will create this plan together. For children up to age 19 who have emotional disturbances and need services from other agencies as well as mental health services, your child and family will have the opportunity to identify people that can join you as part of a Child and Family Team. The Team will help coordinate the services and supports needed to implement your Plan and meet the goals of your child and family.

If you are an adult, you can identify people to help you work through a Support Team to coordinate the services and supports needed to implement your Plan.

Our Personal Life Planning Kit can help individuals and families who need multiple services and supports identify and describe what they want and need to meet their own goals and priorities.

We offer mental health, developmental disability and substance abuse services to children and adults in Durham County through a large network of private providers. These services include:

Services marked with an asterisk (*) are considered Best or Evidence-Based Practices, meaning that significant research has shown them to be effective.

Assertive Community Treatment* A program for adults with severe mental illness who work with a team of professionals to achieve their goals

Clubhouse A place for adults with mental illness and substance use issues to receive support, learn new skills and be encouraged to reach their goals

Cognitive Behavioral Therapy* A form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do

Community Support* The process of working with adults or children and their families to develop a plan and to coordinate services and supports to help them to reach their life goals

Crisis Stabilization and Crisis Residential Offered at Durham Center Access, an alternative to a hospital where individuals in crisis can go to receive help; the goal is for individuals to return home as quickly as possible

Evaluation and Testing Collecting of information about an adult’s or a child’s and family’s life, strengths, needs and abilities in order to better develop a plan of services and supports

Housing and Residential Services* Once you are receiving services, your provider can help you decide which residential supports you will need to achieve your goals; this can include various kinds of assistance, like rent subsidies and help with start-up expenses, to help ensure safe, stable housing (visit Housing Services to learn more.)

General Information The Durham Center has a Customer Services Department which can provide information and address any complaint you may have about your services.

Integrated Dual-Diagnosis Treatment* Improves the quality of life for persons with dual disorders by integrating substance abuse services with mental health services, combining medicines with psychological, educational and social interventions to address the needs of consumers and their families

Intensive In-Home Services* A team and family approach to provide intensive services for children who have serious emotional disturbances, complex family challenges or serious
behavioral problems likely to result in out-of-home placement

Medication Management Evaluation of medication options by an approved provider to determine which medicine is best, how it should be taken and whether it is working

Multi-Systemic Therapy* A team and family-based intervention designed to enhance the skills of youth and their families who have anti-social, aggressive/violent behaviors or delinquency issues, including involvement with the juvenile justice system

Outpatient Therapy (individual, family, group)* Professionals teach new skills or ways to cope with problems

Peer Run Drop-in Center* A place, like the Triangle Empowerment Center, where individuals with mental illness can go to relax, participate in meaningful activity and socialize in a safe environment

Rapid Response Homes A safe and therapeutic short-term residential option for children dealing with serious behavioral or emotional disturbances or family crises

Respite Care* Care for an individual with a disability in the home or other safe place so the family or loved ones can take a “break” from their caregiving responsibilities

Substance Abuse Detoxification A monitored process involving abstinence to clear the drug from the body, accompanied by support during the physical and psychological changes that result

Substance Abuse Intensive Outpatient Treatment* A program that provides the patient multiple sessions per week to learn new behaviors, to participate in self-help groups and to practice relapse prevention strategies

Substance Abuse Residential Services Provide structured, communal living (such as halfway houses) serving as step-down or transition from more restrictive environments

Supported Employment* Helps people with disabilities participate in the labor market in jobs they prefer with the level of professional help they need

Wellness Management and Recovery* Helps individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, cope effectively with their symptoms and grow beyond their mental illness

The Area Board is the governing body of The Durham Center. It engages   in comprehensive planning, budgeting and approval of all budget amendments and oversees the provision and monitoring of community-based mental health, developmental disabilities and substance abuse services for eligible Durham County citizens.

The Area Board meets on the first Thursday of every month at 4:00pm at   The Durham Center. Visit our directions page.

Current Members of the Area Board

Lascel Webley, Jr., Chair
Nancy S. Henley, M.D., Vice-Chair
John Barry
Amir Berhannu
Monique Holsey-Hyman
Phillip Golden
Betsy MacMichael
Commissioner Michael Page
George Quick
Amelia Thorpe

Area Board Committee Meetings (all open to the public)

Executive Committee
Second Tuesday of every month, 8:15am
414 East Main Street

Finance Committee
First Thursday of every month, 3:00pm
414 East Main Street

Human Rights Committee
Last Tuesday of every other month, 4:00pm
414 East Main Street

Quality Management Committee
Third Thursday of every month, 4:00pm
414 East Main Street

Agenda for upcoming meeting
Archived meeting minutes and Board Reports

Durham Center Access is the gateway to all of the local mental health, developmental disability and substance abuse services managed by The Durham Center.

If you or a family member needs help for a mental health, developmental disability or substance abuse issue you can call Durham Center Access at 919-560-7100 24 hours a day, 7 days a week. Walk-in crisis help is also available for emergency situations 24 hours a day at 309 Crutchfield Street, near Durham Regional Hospital in Durham.

Durham System of Care has developed a Life Planning Kit to help you identify your needs. If you have completed one and wish to share that information, please bring it with you. This should decrease the number of questions you have to answer. To learn more about the Life Planning Kit you can visit www.durhamsystemofcare.org or call 919-560-3706.

When you call you can receive information or a referral to an appropriate provider. Based on the information that you provide, DCA will give you information on providers that may be able to help you meet your needs. Once you select a provider, they will help you connect to that provider for further assessment or help you get immediate assistance in an emergency situation.

Administration

Oversees all organizational program activity, ensuring continuity of services and developing community partnerships. The communications component within Administration handles media and public relations and other internal and external communications functions.

Contracts Management/Provider Relations

Develops and monitors contracts that support quality care for consumers according to County, State and Federal regulations.

Customer Service

Creates, promotes and sustains an organizational focus on the needs of internal and external customers and consumers with an eye on improving quality of treatment and efficiency of services.

Finance

Provides strong financial accountability relating to budgeting, billing, auditing and financial analysis of revenue and expenditures.

Quality, Research & Development and Information Technology

Develops and implements a quality management system including data management and reporting that is integrated philosophically throughout the organization to ensures a quality experience for each consumer.

System of Care

Oversees a comprehensive spectrum of mental health and other services and supports to form a coordinated network of care in the community for adults and children.

Care Management

Ensures that services are medically necessary and that client services are delivered based on clinical standards according to State and Federal guidelines.

The Durham Center manages mental health, developmental disability and substance abuse services in Durham County. Although we do not actually provide services, our job is to ensure that local citizens who seek help receive the quality services and supports they are eligible for to help them achieve their goals and live as independently as possible. These services are delivered by a network of private providers who contract with The Durham Center.

Services that respect and support you:
They build on your strengths, promote your recovery, respect your culture, are flexible to respond to your unique and changing needs.

Services that respond to real life needs:
An array of community services provided by your choice of provider, and active connections to housing, social support, legal assistance and other everyday needs.

Services that are effective:
Based in research about what works and measured by best-practice quality standards.

Services that are linked and coordinated:
Using teamwork to help connect your services and supports, providing a “no wrong door” approach so you can get the services and supports you need from multiple community agencies.

The Durham Center has been certified as a Quality Improvement Organization-like entity by the Centers for Medicare and Medicaid Services and has been awarded a CARF Three-Year Accreditation for its Services Management Network.

View The Durham Center's FY11 Highlights and Accomplishments.

English
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English

SKIP TO MERGER/MEDICAID WAIVER FAQs

Q. What is The Durham Center?
A. The Durham Center is the Local Management Entity (LME) for Durham County. It manages a network of private providers who supply care for Durham County citizens with mental illness, developmental disability and substance abuse diagnoses who have limited or no ability to pay for services.

Q. What is Durham Center Access?
A. Durham Center Access (DCA) is the gateway to all of the local mental health, developmental disability and substance abuse services managed by The Durham Center. You can call Durham Center Access at 800-510-9132 or 919-560-7100 24 hours a day, 7 days a week. Walk-in crisis help is also available for emergency situations 24 hours a day at 309 Crutchfield Street, near Durham Regional Hospital.

Q. What is Durham System of Care?
A. System of Care is an integrated network of community services and resources supported by a partnership between families, professionals and the community in all aspects of service planning and delivery. The goal of System of Care is to establish a seamless array of comprehensive, flexible and effective supports for individuals and families to make the Durham community a better place to live for all.

Q. What number should I call for general information about The Durham Center?
A. (919) 560-7200

Q. How do I get help for myself or someone else?
A. Call Durham Center Access at 800-510-9132 or 919-560-7100 24 hours a day, 7 days a week. Based on the information provided, DCA will give a referral to an agency contracted with The Durham Center for further assessment or will provide immediate assistance in an emergency situation.

Q. How can I file an anonymous complaint?
A. The Durham Center has a Customer Services Department that you can call or visit when you have a question or complaint or want to provide some positive feedback. You can reach Customer Services at (919) 560-7200 or visit our offices at 501 Willard Street in Durham. We are open Monday through Friday from 8:30am to 5:00pm.

Q. How do I report suspected fraud or abuse?
A. A toll-free Compliance Hotline is available at (800) 826-6762 for reporting issues such as suspected fraud or abuse. Callers may remain anonymous.

Q. Where can I get contact information for staff of The Durham Center?
A. You can access a general staff list by clicking on the Contact Us button on the website. You can also access a guide to the right person to contact based on your particular need.

Q. What are good sources of general information about mental illness?
A. Resources include the National Alliance on Mental Illness (www.nami.org) and the state affiliate of that organization (www.naminc.org). Click Other Resources for more information.

Q. What are good sources of general information about developmental disability?
A. Resources include the NC Council on Developmental Disabilities (www.nc-ddc.org) and The Arc of NC (www.arcnc.org). Click Other Resources for more information.

Q. What are good sources of general information about substance abuse/dependence?
A. Resources include the Substance Abuse & Mental Health Services Administration (www.samhsa.gov) and Alcohol/Drug Council of NC (www.alcoholdrughelp.org). Click Other Resources for more information.

Q. What are evidence-based practices?
A. Evidence-based practices are treatments that have been consistently shown in several research studies to assist consumers in achieving their desired goals of health and wellness. The Durham Center focuses on the implementation of these services.

Q. How do you determine what services I need?
A. When you call Durham Center Access, a brief telephone interview will begin to determine which services will most likely to be helpful to you. Then you may be referred to your choice of provider for a formal assessment. A good assessment is the beginning of a good plan for treatment. Based on the information gathered during the assessment, your provider will work with you to make decisions about your treatment needs.

Q. How do you determine what services I am eligible for?
A. Eligibility for services is based on the funding sources available to pay for a service. All basic services and most specialty services are available to individuals with Medicaid coverage or Health Choice for children, and also to those without any insurance. Some specialty services may not be available depending on your coverage.  In those cases, we will work with providers to come up with alternatives which will be helpful in your recovery.

Q. What if I don’t have health insurance?
A. When you call Durham Center Access, the representative you talk with can help determine if you are eligible for a variety of publicly-funded services.

Q. How can I learn about and compare local providers?
A. Click the “Provider Search” button on the website to search for providers using your choice of search criteria. The results of your search will provide valuable information which will be useful in comparing providers.

Q. How do I know which provider is best for me?
A. Durham Center Access may refer you to a choice of providers appropriate for your situation. You can compare them using the searchable database by clicking the “Provider Search” button on the website. Also, you can access a booklet that provides tips for choosing a provider.  Click Obtaining Services Handbook to view the booklet.

Q. What is a QP, a PP and an AP?
A. “QP” stands for Qualified Professional, “PP” for Paraprofessional, and “AP” for Associate Professional. These designations are determined by the amount of education and supervised training an individual has received.

Q. What are Person-Centered and Family-Centered Planning?
A. Treatment planning that supports individuals with mental illness and their families in their recovery process as a means to achieve their personal goals. It recognizes that recovery is a unique and personal process that involves changing attitudes, values, feelings, goals, skills and roles to live a satisfying, hopeful and contributing life. Providers who work with The Durham Center can explain how a Person-Centered or Family-Centered Plan might assist you in meeting your goals, and you and your provider will create this plan together.

Q. What are Child and Family Teams?
A. Child and Family Teams (for children up to age 19) are made up of healthcare professionals as well as family members, friends, advocates and other people important to the child and family they support. They pool their knowledge and resources to help coordinate the services and supports needed to implement the Family-Centered Plan.

Q. What is Care Review?
A. Care Review is an inter-agency, community-based process that helps adults as well as Child and Family Teams plan services and supports with the adults or the children and families they serve. Care Review can include brainstorming creative best-practice treatment options, ensuring that current services are a good fit, and working to break through barriers that may be keeping the adult or the child and family from reaching their goals.

Q. What are clubhouses and where are they located?
A. Clubhouses are places for adults with mental illness and substance use issues to receive support, learn new skills and be encouraged to reach their goals. In Durham, Wellness City (401 East Lakewood Avenue) is a clubhouse for adults with mental illnesses. A substance abuse clubhouse is located at 307 Corporation Street.

Q. Will The Durham Center come to my church/youth group/community/school to educate us about mental health, developmental disabilities and substance abuse issues?
A. The Durham Center receives many requests for presentations but unfortunately, staff resources for this purpose are limited. To determine availability you may call (919) 560-7256 or email .(JavaScript must be enabled to view this email address).

Q. What is Durham’s Consumer and Family Advisory Committee (CFAC)?
A. CFAC is an advisory committee to The Durham Center that points out gaps in services, offers suggestions for long-term planning, and reviews certain organizational documents. Members are individuals who experience or have family members who experience mental health, developmental disability and/or substance abuse issues.

Q. How can I join CFAC?
A. If you experience or have family members who experience mental health, developmental disability and/or substance abuse issues, email .(JavaScript must be enabled to view this email address) or click CFAC for more information.

MERGER/MEDICAID WAIVER FAQs

Q. What are Medicaid waivers?
A. In a Medicaid waiver certain standard Medicaid requirements are "waived." The provider network can be "right sized" to help ensure high-quality, financially-stable providers chosen by their ability to meet the needs of the community. Savings in the system can be reinvested in additional services. There is greater control of reimbursement rates for services to respond to local needs and the opportunity to create fiscal incentives to providers that can generate improved consumer outcomes.

Q. What is the status of the proposed merger between The Durham Center and the Wake County LME?
A. Leaders of the two LMEs have engaged in informal discussions over the past year or more about possible logical ways for them to work together. When The Durham Center was designated in October 2011 to begin operating as an MCO beginning in January 2013, these discussions accelerated and became focused on merger. A proposed merger agreement is being crafted by the Durham and Wake LMEs in collaboration with their respective county leadership and governing bodies. When finalized, this agreement will spell out the plan for how the new organization will be governed and staffed, what it will be named and where it will be located, how it will handle State and local funding, and so on.

Q. What is the proposed timeline for merger?
A. The proposed merger agreement calls for the two LMEs to begin operating as a merged Area Authority on July 1, 2012. It is hoped that a merger agreement can be finalized early in 2012 to allow ample time for the new organization to prepare for the July 1 merger.

Q. How will The Durham Center operate differently starting January 1, 2013?
A. At that time The Durham Center will begin to operate as a Managed Care Organization (MCO) for mental health, intellectual/developmental disability (IDD) and substance abuse services. As an MCO, The Durham Center will have greater flexibillity to shape the service delivery system to ensure access to quality care that results in better consumer outcomes. Assuming that the Durham-Wake merger becomes reality, staff of The Durham Center will increase from about 75 now to around 380 to accommodate new geographical and MCO responsibilities. 

Q. Who will manage State and local dollars?
A. The Durham Center will manage those dollars as well, creating uniform authorization management of Medicaid and State-funded services and a single point of accountability for all public funding.

Q. What is an LME and will The Durham Center still be an LME?
A. LME stands for Local Management Entity, which is an agency of local government - area authorities or county programs - responsible for managing, coordinating, facilitating and monitoring the provision of mental health, intellectual/development disability and substance abuse services. Some North Carolina LMEs have responsibility for a single county while others serve multiple counties. The Durham Center will continue to operate as an LME under contract with the NC Department of Human Services in addition to its MCO operations.

Q. What will The Durham Center's relationship with Cumberland and Johnston counties be?
A. The Durham Center will work with Cumberland and Johnston Area Authorities to manage the behavioral health and IDD services for citizens of these counties. Cumberland and Johnston will have a contract with The Durham Center to perform certain functions of the Managed Care Organization.

Q. What are the advantages to the State and local communities (and taxpayers) of the waivers?
A. The waivers result in stable and predictable Medicaid costs. MCOs are paid a determined amount of money each month for each Medicaid consumer and have the responsibility to manage care with that pool of money. A goal of managed care is to improve the quality of care while controlling the rate of Medicaid growth and managing care for high-risk/high-cost individuals.

Q. Why are the waivers good for consumers?
A. Goals of the Medicaid waiver are to:
-Provide consumers with consistent access to high-quality services in the community
-Use resources in a fair and consistent manner to achieve positive outcomes for consumers
-Provide all services that are in the Medicaid benefit plan available to consumers, so their medically-necessary needs can be met.

Waivers will help enable The Durham Center to "right size" the provider network to better ensure high-quality, financially-stable providers chosen by their ability to meet the needs of the community. Provider credentials will be carefully verified and they will be closely monitored for quality and consumer satisfaction.

The utilization management function of the MCO will provide a powerful tool to help ensure that consumers receive the right service at the right level, and Care Managers will be available to provide direct support to high-cost/high-risk consumers. The Durham Center will have the resources to enhance its focus on consumer-driven care through the expansion of best practices such as recovery, self-direction, System of Care and person-centered planning that use peer support and consumer-led models of care. Waivers provide a strong mandate for The Durham Center to continue its ongoing efforts to integrate behavioral health and intellectual/developmental disability care with the primary health care system, ensuring more comprehensive care for consumers.

As always, The Durham Center will work to ensure consumer choice, to provide local responsiveness to individualized consumer needs and direct relationship with care providers, to give voice to consumers, family members and advocates, to provide 24/7 phone access and crisis services, and to support local CFAC activities.

Q. What about the special concerns of parents and guardians of IDD consumers?
A. Care Coordination through the Managed Care Organization is designed to provide more consistent and effective supports for individuals with intellectual/developmental disabilities. The Innovations Medicaid Waiver under the MCO is designed to allow for more self-directed supports and services for individuals with intellectual/developmental disabilities. Savings that result from effective management of services for these individuals will be reinvested to support more services. 

The Durham Center is committed to addressing the unique concerns that caregivers have and will do this through internal workgroups, community forums, and the development of a variety of informational  materials.

Q. How will local providers be affected?
A. Over time the MCO will most likely have a smaller network, which adheres to all access standards and better allows for provider collaboration, ensures the health of the provider network, and allows for increased oversight and fiscal management by the MCO. In this way, enrollees are assured of appropriate provider choice while providers in the network have an enhanced opportunity for economic viability in the marketplace.

Initially, all providers with existing contracts with The Durham Center and those providing services to Medicaid-funded clients with Medicaid based in the TDC coverage area will be entitled to apply for membership to the network. They will go through a credentialing process, with full details to be communicated in the coming weeks and months. The MCO will conduct an annual capacity and geo-access study to evaluate the capacity of the enrolled and credentialed provider network to meet the needs of the coverage area and to measure geographic access to provider locations. These studies will help the MCO know when to add or limit capacity.

Q. What is The Durham Center's plan for sharing additional information with consumers and families, providers and other stakeholders?
A. The Durham Center understands that there are concerns and questions throughout the community during this period of transition. Compounding the anxiety is that answers to all of the questions that people have simply have not been finalized yet. The Durham Center is committed to the ongoing sharing of information with all affected stakeholders as it become available. This will be accomplished through various means, including keeping these FAQs up-to-date, by use of the Provider Newsletter and regular provider meetings, by holding public forums throughout the MCO region over the coming months, and by creating a revised website and appropriate print materials.

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Preguntas más frecuentes – ciudadanos hispanos

P. ¿Qué es el Centro Durham?
R. El Centro Durham es la Entidad de Gerencia Local (LME) para el condado de Durham. Maneja una red de proveedores privados que pueden proporcionar cuidados a los ciudadanos de Durham County con enfermedades mentales, discapacidades de desarrollo y diagnósticos de abuso de sustancias o drogadicción, que tienen una capacidad limitada, o una falta de capacidad para pagar por los servicios.

P. ¿Cuál es el Acceso de Durham Center?
R. El Acceso del Centro Durham (DCA) Es la puerta de entrada para todos los servicios de salud mental local, discapacidad de desarrollo y servicios de abuso de sustancias dirigidos por el Centro Durham. Puede llamar al Acceso de Durham Center al 800-510-9132 ó 919-560-7100 24 horas al día, 7 días a la semana. También hay ayuda de crisis disponibles para aquellos que tengan situaciones de emergencia, 24 horas al día en 309 Crutchfield Street, en el campus del Durham Regional Hospital.

P. ¿Pueden hablarme en español en el Durham Center y en el Acceso a Durham Center?
R. Sí, pueden. Cuando usted llame será puesto en espera por un momento mientras un traductor se une a la conversación.

P. ¿Cómo puedo encontrar a un proveedor que hable español?
R. Cuando usted llama al Acceso al Durham Center, el representante con el que hable le dirá acerca de los proveedores de servicios que hablan español que son apropiados para su situación.

P. ¿Qué es el Sistema de Cuidados de Durham Center?
R. El sistema de cuidados es una red integrada de nuestros servicios comunitarios y recursos apoyado por una asociación entre familias, profesionales y la comunidad en todos los aspectos de la planeación y entrega de servicios. El objetivo del Sistema de Cuidados es establecer un sistema sin fisuras de apoyo extensos, flexibles y efectivos para individuos y sus familias que hacen que la comunidad de Durham sea un sitio mejor para vivir para todos.

P. ¿A qué número debo llamar para obtener información general acerca del Centro Durham?
R. (919) 560-7200

P. ¿Cómo obtengo ayuda para mí o para alguien más?
R. Llame al Acceso al Durham Center al 800-510-9132 o 919-560-7100 24 horas al día, 7 días a la semana. Basándonos en la información que nos proporcione, el DCA le dará una referencia para una agencia contratada por el Durham Center para hacer más valoraciones o para proporcionarle asistencia inmediata en una situación de emergencia.

P. ¿Cómo puedo presentar una queja anónima?
R. El Centro Durham tiene un Departamento de Servicios al Cliente al que puede llamar o visitar cuando tenga una pregunta o una queja y quiera proporcionar sugerencias positivas. Puede llamar al Servicio de Atención al Cliente al (919) 560-7200 o visitar nuestras oficinas en el 501 Willard Street en Durham. Estamos abiertos de lunes a viernes de 8:30am a 5:00pm.

P. ¿Cómo puedo denunciar una sospecha de fraude o abuso?
R. Un teléfono gratuito Compliance Hotline está disponible en (800) 826-6762 para informar sobre asuntos tales como la sospecha de fraude o abuso. Las personas que llaman pueden permanecer en el anonimato.

P. ¿Dónde puedo obtener información de contacto para el personal del Durham Center?
R. Puede obtener acceso a una lista general del personal haciendo clic en el botón de Contáctenos en nuestra página Web. También puede acceder a una guía para encontrar a la persona adecuada, basándose en su necesidad particular.

P. ¿Cuáles son buenas fuentes de información general acerca de enfermedades mentales?
R. Los recursos incluyen la Alianza Nacional para Enfermedades mentales (www.nami.org) y la afiliada estatal de esa organización (www.naminc.org). Haga clic en Otros Recursos para obtener más información.

P. ¿Cuáles son buenas fuentes de información general acerca de las discapacidades en el desarrollo?
R. Los recursos incluyen en Consejo de NC en Discapacidades del Desarrollo (www.nc-ddc.org) y el Arc de NC (www.arcnc.org). Haga clic en Otros Recursos para más información.

P. ¿Cuáles son buenas fuentes de información general acerca del abuso/dependencia de sustancias?
R. Los recursos incluyen la Administración de Servicios para Abuso de Sustancias y Salud Mental (www.samhsa.gov) y el Consejo de Alcohol y Drogas de NC (www.alcoholdrughelp.org). Haga clic en Otros Recursos para obtener más información.

P. ¿Qué son prácticas basadas en la evidencia?
R. Las prácticas basadas en la evidencia son tratamientos para los que se ha mostrado de forma consistente, en varios estudios de investigación, que ayudan al cliente a alcanzar los objetivos de salud y bienestar deseados. El Centro Durham se enfoca en la implementación de estos servicios.

P. ¿Cómo determina usted qué servicios necesito?
R. Cuando usted llama al Acceso al Durham Center, una breve entrevista telefónica le ayuda a determinar qué servicios son los que probablemente le sean más útiles a usted. Luego se le puede dar una referencia de las opciones que tiene de proveedores para una evaluación formal. Una buena evaluación es el comienzo de un buen plan de tratamiento. Basándose en la información reunida durante esta evaluación, su proveedor trabajará con usted para tomar decisiones acerca de las necesidades de tratamiento.

P. ¿Cómo determinan ustedes para qué servicios soy elegible?
R. La elegibilidad a los servicios está basada en las fuentes de financiación disponibles para pagar por un servicio. Todos los servicios básicos y los servicios más especializados están disponibles para individuos con cobertura de Medicaid o con Health Choice para niños y también para aquellos que no tienen ningún seguro médico. Algunos servicios especializados pueden no estar disponibles, dependiendo de su cobertura. En esos casos, trabajaremos con los proveedores para buscar alternativas que le puedan ayudar en su recuperación.

P. ¿Qué puede ocurrir si no tengo seguro de salud?
R. Cuando usted llama al Acceso al Centro Durham, el representante con el que habla le puede ayudar a determinar si es usted elegible para una serie de servicios que reciben fondos públicos.

P. ¿Cómo puedo conocer y comparar a los proveedores locales?
R. Haga clic en el botón de “Búsqueda de proveedores” o en la página Web para buscar proveedores utilizando el criterio de búsqueda de su elección. Los resultados de su búsqueda le proporcionarán información valiosa que será útil para comparar a los proveedores.

P. ¿Cómo puedo saber qué proveedor es mejor para mí?
R. El Acceso al Durham Center puede referirle a una serie de opciones de proveedores apropiados para su situación. Puede compararlos usando la base de datos de búsqueda haciendo clic en el botón de “Búsqueda de proveedor” en al página Web. También puede acceder al cuaderno que proporciona consejos para escoger un proveedor haciendo clic aquí .

P. ¿Qué es un QP, un PP y un AP?
R. “QP” son las siglas de Qualified Professional o profesional cualificado, “PP” significa Paraprofesional y “AP” Associate Professional o profesional asociado. Estas designaciones están determinadas por la cantidad de educación y entrenamiento supervisado que un individuo ha recibido.

P. ¿Qué es planeación centrada en la persona y planeación centrada en la familia?
R. Planeación de tratamiento que soporta individuos con enfermedades mentales y a sus familias en el proceso de recuperación como medio de alcanzar sus objetivos personales. Reconoce que la recuperación es un proceso único y personal que envuelve un cambio de actitudes, valores, sentimientos, objetivos, habilidades y roles para vivir una vida satisfactoria, esperanzadora y que contribuya. Los proveedores que trabajan en el Durham Center, pueden explicar cómo plan centrado en la persona o un plan centrado en la familia puede ayudarle a cumplir con sus objetivos y usted y su proveedor pueden crear este plan juntos.

P. ¿Qué son los equipos de niños y familias?
R. Los equipos para niños y familias (para niños hasta la edad de 19 años) están hechos de profesionales del cuidado de la salud, así como de miembros de la familia, amigos, defensores y otras personas importantes para el niño y la familia a la que apoyan. Unen sus conocimientos y recursos para ayudar a coordinar los servicios y soportan la necesidad de implementar un plan centrado en la familia.

P. ¿Qué es Care Review?
R. La revisión de cuidados es un proceso basado en la comunidad de una inter-agencia que ayuda a los adultos, así como a los niños y a los equipos de niños y familias a planear servicios y apoya a los adultos de los niños y familias que sirven. La revisión del cuidado puede incluir opciones de tratamiento creativas de las mejores prácticas, que aseguran que los servicios que se dan sean los adecuados y que trabajan para romper las barreras que puedan estar impidiendo que el adulto o el niño y su familia, alcancen sus objetivos.

P. ¿Qué son los clubhouses y donde están localizados?
R. Los Clubhouses son lugares para adultos con enfermedades mentales y problemas de drogadicción en los que reciben apoyo, aprenden nuevas habilidades y son alentados a alcanzar sus objetivos. En Durham, Wellness City (401 East Lakewood Avenue) es un clubhouse para adultos con enfermedades mentales. Hay un clubhouse para drogadicción localizado en 307 Corporation Street.

P. ¿Vendrá el Centro Durham a mi iglesia/grupo de juventud/comunidad/escuela, para educarnos acerca de la salud mental, discapacidades del desarrollo y asuntos relacionados con el abuso de sustancias o drogadicción?
R. El Durham Center recibe muchas solicitudes para presentaciones, pero desafortunadamente, los recursos para el personal para este propósito, son limitados. Para determinar si están disponibles puede llamar al (919) 560-7256 o para enviar un correo electrónico haga clic .(JavaScript must be enabled to view this email address)

P. ¿Qué es el Comité de Asesoramiento a la Familia y al Consumidor de Durham (CFAC)?
R. CFAC es un comité de asesoramiento del Centro Durham que muestra vacíos en el desarrollo de servicios, ofrece sugerencias para la planeación a largo plazo y revisa ciertos documentos de la organización. Los miembros son individuos que experimentan, o tienen miembros de la familia que han experimentado, problemas de salud y problemas de discapacidad en el desarrollo y /o problemas de abuso de sustancias o drogadicción.

P. ¿Cómo puedo unirme a la CFAC?
R. Si usted experimenta, o tiene miembros de la familia que experimentan problemas de discapacidad en el desarrollo y/o abuso de sustancias o drogadicción, envíe un correo electrónico a .(JavaScript must be enabled to view this email address) o haga clic en CFAC para obtener más información.

SKIP TO MERGER/MEDICAID WAIVER FAQs

Q. What is The Durham Center?
A. The Durham Center is the Local Management Entity (LME) for Durham County. It manages a network of private providers who supply care for Durham County citizens with mental illness, developmental disability and substance abuse diagnoses who have limited or no ability to pay for services.

Q. What is Durham Center Access?
A. Durham Center Access (DCA) is the gateway to all of the local mental health, developmental disability and substance abuse services managed by The Durham Center. You can call Durham Center Access at 800-510-9132 or 919-560-7100 24 hours a day, 7 days a week. Walk-in crisis help is also available for emergency situations 24 hours a day at 309 Crutchfield Street, near Durham Regional Hospital.

Q. What is Durham System of Care?
A. System of Care is an integrated network of community services and resources supported by a partnership between families, professionals and the community in all aspects of service planning and delivery. The goal of System of Care is to establish a seamless array of comprehensive, flexible and effective supports for individuals and families to make the Durham community a better place to live for all.

Q. What number should I call for general information about The Durham Center?
A. (919) 560-7200

Q. How can my agency become enrolled with The Durham Center?
A. In general, The Durham Center selects providers through a Request for Proposal (RFP) process based on identified community needs for particular services. Other selection methods may also be used, including Requests for Information (RFIs) and Requests for Qualifications (RFQs). The Durham Center offers State and County contracts only to providers who take part in an official RFP/RFI/RFQ process. For complete information, contact (919) 560-7366 or .(JavaScript must be enabled to view this email address).

Q: I am interested in providing Medicaid Enhanced Services (i.e. Community Support Team, Intensive In-Home, Residential, CAP, etc.). Where can I find information and a checklist to confirm that I am in compliance with state/federal laws governing these types of services?
A: Information can be found on the NC Division of MH/DD/SA Services website.

Q. What should my agency know about becoming nationally accredited?
A. All Medicaid Enhanced Benefit Services providers must either be nationally accredited or meet the CARF Standards for unaccredited providers.  These standards are available from The Durham Center’s Compliance Officer. Click for more information on becoming nationally accredited.

Q. Where do I find bulletins, forms and other documents?
A. These are accessed by clicking on the “Documents and Forms” button on the website and are organized by various sub-categories.

Q. What do I do if I have a billing question or issue?
A. Providers can contact their Billing Coordinator or the Finance Director at The Durham Center. For Medicaid related billing questions, provider can contact EDS Provider Services at 1-800-688-6696.

Q. How can I learn about housing resources available to my consumers in the community?
A. Click the “Housing” button on the website. For information about housing assistance, call (919) 560-7144 or .(JavaScript must be enabled to view this email address).

Q. How do I report an incident involving a consumer?
A. All Level II and Level III incidents must be reported to The Durham Center via the Incident Response Improvement System (IRIS) within 72 hours. Level III incidents also require verbal notification to The Durham Center as soon as possible but within 24 hours. Providers are also required to submit a Provider Quarterly Incident Report (Form Q11) by the tenth of the month following the end of the quarter to report aggregate information on Level I-III incidents. Providers should also track Level I incidents through their own internal processes. For further information, review the Incident Response and Reporting Manual, the IRIS Technical Manual, and IRIS FAQs.

Q. How do I report suspected fraud or abuse?
A. A toll-free Compliance Hotline is available at (800) 826-6762 for reporting issues such as suspected fraud or abuse. Callers may remain anonymous.

Q. What reports do I need to submit to The Durham Center?
A. Please refer to the Operations Manual, Section V – Provider Documentation Submission Requirements.

Q. What needs to be included in a QM Plan?
A. The QM Plan meets NC DHHS requirements if it integrates Quality Assurance and Quality Improvement and includes all of the following:
-composition and activities of a quality assurance and quality improvement committee
-written quality assurance and quality improvement plan
-methods for monitoring and evaluating the quality and appropriateness of client care, including delineation of client outcomes and utilization of services
-professional or clinical supervision, including a requirement that staff who are not qualified professionals and provide direct client services shall be supervised by a qualified professional in that area of service
-strategies for improving client care
-review of staff qualifications and a determination made to grant treatment/habilitation privileges
-review of all fatalities of active clients who were being served in residential programs at the time of death
-adoption of standards that assure operational and programmatic performance meeting applicable standards of practice
-review of incidents and complaints

Q. What is NC-TOPPS?
A. The North Carolina Treatment Outcomes and Program Performance System measures the quality and impact of substance abuse and mental health services. Providers of services to adults and children six and older who receive publicly-funded services complete online surveys about each individual’s service needs and outcomes at the beginning, during and at the end of an episode of care. Data is used by State and local government agencies, provider agencies and consumers and their families in evaluating and improving the quality of care in North Carolina’s public service system. To learn more, visit NC-TOPPS. If you already use NC-TOPPS and are having difficulty, your solution might be available here.

Q. What is the Consumer Satisfaction Survey?
A. An annual survey conducted by providers each year on their adult and child consumers of mental health or substance abuse services. SAMHSA uses data from the survey to evaluate funding to states and in North Carolina, the survey provides data on satisfaction with services to stakeholders in organizations at the State and local levels and to consumers and their families. This data is useful for assessing and improving the quality of mental health and substance abuse services.

Q. Where can I get contact information for staff of The Durham Center?
A. You can access a general staff list by clicking on the Contact Us button on the website. You can also access a guide to the right person to contact based on your particular need.

Q. What are good sources of general information about mental illness?
A. Resources include the National Alliance on Mental Illness (www.nami.org) and the state affiliate of that organization (www.naminc.org). Click Other Resources for more information.

Q. What are good sources of general information about developmental disability?
A. Resources include the NC Council on Developmental Disabilities (www.nc-ddc.org) and The Arc of NC (www.arcnc.org) . Click Other Resources for more information.

Q. What are good sources of general information about substance abuse/dependence?
A. Resources include the Substance Abuse & Mental Health Services Administration (www.samhsa.gov) and Alcohol/Drug Council of NC (www.alcoholdrughelp.org). Click Other Resources for more information.

Q. What are evidence-based practices?
A. Evidence-based practices are treatments that have been consistently shown in several research studies to assist consumers in achieving their desired goals of health and wellness. The Durham Center focuses on the implementation of these services.

Q. How can I learn about and compare local providers?
A. Click the “Provider Search” button on the website to search for providers using your choice of search criteria. The results of your search will provide valuable information which will be useful in comparing providers.

Q. How do I know which provider is best for me?
A. Durham Center Access may refer you to a choice of providers appropriate for your situation. You can compare them using the searchable database by clicking the “Provider Search” button on the website. Also, you can access a booklet that provides tips for choosing a provider by clicking here. link to Obtaining Services Handbook

Q. What are Person-Centered and Family-Centered Planning?
A. Treatment planning that supports individuals with mental illness and their families in their recovery process as a means to achieve their personal goals. It recognizes that recovery is a unique and personal process that involves changing attitudes, values, feelings, goals, skills and roles to live a satisfying, hopeful and contributing life. Providers who work with The Durham Center can explain how a Person-Centered or Family-Centered Plan might assist you in meeting your goals, and you and your provider will create this plan together.

Q. What are Child and Family Teams?
A. Child and Family Teams (for children up to age 19) are made up of healthcare professionals as well as family members, friends, advocates and other people important to the child and family they support. They pool their knowledge and resources to help coordinate the services and supports needed to implement the Family-Centered Plan.

Q. What is Care Review?
A. Care Review is an inter-agency, community-based process that helps adults as well as Child and Family Teams plan services and supports with the adults or the children and families they serve. Care Review can include brainstorming creative best-practice treatment options, ensuring that current services are a good fit, and working to break through barriers that may be keeping the adult or the child and family from reaching their goals.

Q. What are clubhouses and where are they located?
A. Clubhouses are places for adults with mental illness and substance use issues to receive support, learn new skills and be encouraged to reach their goals. In Durham, Wellness City (401 East Lakewood Avenue) is a clubhouse for adults with mental illnesses. A substance abuse clubhouse is located at 307 Corporation Street.

Q. Will The Durham Center come to my church/youth group/community/school to educate us about mental health, developmental disabilities and substance abuse issues?
A. The Durham Center receives many requests for presentations but unfortunately, staff resources for this purpose are limited. To determine availability you may call (919) 560-7256 or email .(JavaScript must be enabled to view this email address).

Q. What is Durham’s Consumer and Family Advisory Committee (CFAC)?
A. CFAC is an advisory committee to The Durham Center that points out gaps in services, offers suggestions for long-term planning, and reviews certain organizational documents. Members areindividuals who experience or have family members who experience mental health, developmental disability and/or substance abuse issues.

Q. How can I join CFAC?
A. If you experience or have family members who experience mental health, developmental disability and/or substance abuse issues, email .(JavaScript must be enabled to view this email address) or click CFAC for more information.

MERGER/MEDICAID WAIVER FAQs

Q. What are Medicaid waivers?
A. In a Medicaid waiver certain standard Medicaid requirements are "waived." The provider network can be "right sized" to help ensure high-quality, financially-stable providers chosen by their ability to meet the needs of the community. Savings in the system can be reinvested in additional services. There is greater control of reimbursement rates for services to respond to local needs and the opportunity to create fiscal incentives to providers that can generate improved consumer outcomes.

Q. What is the status of the proposed merger between The Durham Center and the Wake County LME?
A. Leaders of the two LMEs have engaged in informal discussions over the past year or more about possible logical ways for them to work together. When The Durham Center was designated in October 2011 to begin operating as an MCO beginning in January 2013, these discussions accelerated and became focused on merger. A proposed merger agreement is being crafted by the Durham and Wake LMEs in collaboration with their respective county leadership and governing bodies. When finalized, this agreement will spell out the plan for how the new organization will be governed and staffed, what it will be named and where it will be located, how it will handle State and local funding, and so on.

Q. What is the proposed timeline for merger?
A. The proposed merger agreement calls for the two LMEs to begin operating as a merged Area Authority on July 1, 2012. It is hoped that a merger agreement can be finalized early in 2012 to allow ample time for the new organization to prepare for the July 1 merger.

Q. How will The Durham Center operate differently starting January 1, 2013?
A. At that time The Durham Center will begin to operate as a Managed Care Organization (MCO) for mental health, intellectual/developmental disability (IDD) and substance abuse services. As an MCO, The Durham Center will have greater flexibillity to shape the service delivery system to ensure access to quality care that results in better consumer outcomes. Assuming that the Durham-Wake merger becomes reality, staff of The Durham Center will increase from about 75 now to around 380 to accommodate new geographical and MCO responsibilities. 

Q. Who will manage State and local dollars?
A. The Durham Center will manage those dollars as well, creating uniform authorization management of Medicaid and State-funded services and a single point of accountability for all public funding.

Q. What is an LME and will The Durham Center still be an LME?
A. LME stands for Local Management Entity, which is an agency of local government - area authorities or county programs - responsible for managing, coordinating, facilitating and monitoring the provision of mental health, intellectual/development disability and substance abuse services. Some North Carolina LMEs have responsibility for a single county while others serve multiple counties. The Durham Center will continue to operate as an LME under contract with the NC Department of Human Services in addition to its MCO operations.

Q. What will The Durham Center's relationship with Cumberland and Johnston counties be?
A. The Durham Center will work with Cumberland and Johnston Area Authorities to manage the behavioral health and IDD services for citizens of these counties. Cumberland and Johnston will have a contract with The Durham Center to perform certain functions of the Managed Care Organization.

Q. What are the advantages to the State and local communities (and taxpayers) of the waivers?
A. The waivers result in stable and predictable Medicaid costs. MCOs are paid a determined amount of money each month for each Medicaid consumer and have the responsibility to manage care with that pool of money. A goal of managed care is to improve the quality of care while controlling the rate of Medicaid growth and managing care for high-risk/high-cost individuals.

Q. Why are the waivers good for consumers?
A. Goals of the Medicaid waiver are to:
-Provide consumers with consistent access to high-quality services in the community
-Use resources in a fair and consistent manner to achieve positive outcomes for consumers
-Provide all services that are in the Medicaid benefit plan available to consumers, so their medically-necessary needs can be met.

Waivers will help enable The Durham Center to "right size" the provider network to better ensure high-quality, financially-stable providers chosen by their ability to meet the needs of the community. Provider credentials will be carefully verified and they will be closely monitored for quality and consumer satisfaction.

The utilization management function of the MCO will provide a powerful tool to help ensure that consumers receive the right service at the right level, and Care Managers will be available to provide direct support to high-cost/high-risk consumers. The Durham Center will have the resources to enhance its focus on consumer-driven care through the expansion of best practices such as recovery, self-direction, System of Care and person-centered planning that use peer support and consumer-led models of care. Waivers provide a strong mandate for The Durham Center to continue its ongoing efforts to integrate behavioral health and intellectual/developmental disability care with the primary health care system, ensuring more comprehensive care for consumers.

As always, The Durham Center will work to ensure consumer choice, to provide local responsiveness to individualized consumer needs and direct relationship with care providers, to give voice to consumers, family members and advocates, to provide 24/7 phone access and crisis services, and to support local CFAC activities.

Q. What about the special concerns of parents and guardians of IDD consumers?
A. Care Coordination through the Managed Care Organization is designed to provide more consistent and effective supports for individuals with intellectual/developmental disabilities. The Innovations Medicaid Waiver under the MCO is designed to allow for more self-directed supports and services for individuals with intellectual/developmental disabilities. Savings that result from effective management of services for these individuals will be reinvested to support more services. 

The Durham Center is committed to addressing the unique concerns that caregivers have and will do this through internal workgroups, community forums, and the development of a variety of informational  materials.

Q. How will local providers be affected?
A. Over time the MCO will most likely have a smaller network, which adheres to all access standards and better allows for provider collaboration, ensures the health of the provider network, and allows for increased oversight and fiscal management by the MCO. In this way, enrollees are assured of appropriate provider choice while providers in the network have an enhanced opportunity for economic viability in the marketplace.

Initially, all providers with existing contracts with The Durham Center and those providing services to Medicaid-funded clients with Medicaid based in the TDC coverage area will be entitled to apply for membership to the network. They will go through a credentialing process, with full details to be communicated in the coming weeks and months. The MCO will conduct an annual capacity and geo-access study to evaluate the capacity of the enrolled and credentialed provider network to meet the needs of the coverage area and to measure geographic access to provider locations. These studies will help the MCO know when to add or limit capacity.

Q. What is The Durham Center's plan for sharing additional information with consumers and families, providers and other stakeholders?
A. The Durham Center understands that there are concerns and questions throughout the community during this period of transition. Compounding the anxiety is that answers to all of the questions that people have simply have not been finalized yet. The Durham Center is committed to the ongoing sharing of information with all affected stakeholders as it become available. This will be accomplished through various means, including keeping these FAQs up-to-date, by use of the Provider Newsletter and regular provider meetings, by holding public forums throughout the MCO region over the coming months, and by creating a revised website and appropriate print materials.

The Durham Center operates on the philosophy of System of Care, an integrated network of community services and resources supported by a partnership between families, professionals and the community in all aspects of service planning and delivery. The goal of System of Care is to establish a seamless array of comprehensive, flexible and effective supports for individuals and families throughout the community and through this assistance, to make the Durham community a better place to live for all individuals and families.

The Core Values of Durham's System of Care:

• Services and supports provided for individuals and families should promote the inherent value of each individual and provide each the opportunity to grow and develop to his or her fullest potential.
• Services and supports should be strength-based, person-centered and family-focused, with the needs of the individual and/or family dictating the types and mix of services and supports provided.
• Services and supports should be neighborhood- and community-based, with the community determining local service needs and how these services are delivered.
• Agencies, programs and services should be responsive to the cultural, linguistic, racial and ethnic strengths and differences of the individuals and families they serve.

As part of System of Care, Network of Care is a comprehensive online source of information about services available to individuals and families and agencies working with them. Visit Network of Care and System of Care to learn more.

The Durham Community Collaborative is a regular open public meeting that brings together family members and representatives of public and private human service agencies to create or help enhance local services and supports. The Collaborative seeks public input and provides a forum to voice community needs. Visit Durham Community Collaborative to learn more.

Durham Center Access (DCA) is the gateway to all of the local mental health, developmental disability and substance abuse services that are part of Durham System of Care.

If you or a family member or friend needs help for a mental health, developmental disability or substance abuse issue you can call Durham Center Access at 800-510-9132 or 919-560-7100 24 hours a day, 7 days a week.

Reach out for help through Durham Center Access. When you call you can receive information or a referral to an appropriate provider. Based on the information that you provide, DCA will give you information on providers that may be able to help you meet your needs. Once you select a provider, they will help you connect to that provider for further assessment or help you get immediate assistance in an emergency situation.

Walk-in crisis help is also available for emergency situations 24 hours a day at 309 Crutchfield Street, near Durham Regional Hospital in Durham. Our staff can assess clients psychiatrically and medically and triage clients for hospitalization, crisis stabilization, residential medical/social detoxification, and residential psychiatric medication stabilization, and they can make outpatient referrals.

A Psychiatric Walk-in Clinic housed at Durham Center Access serves adults and children seeking immediate access to psychiatric clinical services by appointment or on a walk-in basis. Clinic hours are Monday-Friday, 10:00am-6:00pm. To schedule an appointment call (919) 560-7305.

View a Durham Center Access brochure in English or in Spanish.

Get directions to Durham Center Access.

View a Durham Center Access Mobile Crisis Team flyer.

Learn more about the Psychiatric Walk-in Clinic.

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The Durham Center

Address:
414 East Main Street, Second Floor
Durham, NC 27701

Customer Service Telephone Number:
(919) 560-7200
(877) 839-0301
Customer Service is available Monday-Friday, 8:30am-5:00pm.

24 Hour Help and Crisis Number:
(800) 510-9132
(919) 560-7100

The Durham Center maintains several fax numbers.  If you do not know the appropriate number for the person you are faxing, you may call Customer Services at (919) 560-7200.

Full Staff Contact Listing

Staff Contact Listing by Need

Visit our directions page for driving directions.

The Durham Center Offices

The offices of The Durham Center are located at 414 East Main Street, on the second floor of the new Durham County Human Services Building.

Map

Durham Center Access

The 24/hour walk-in crisis facility is located at 309 Crutchfield Street, near Durham Regional Hospital in Durham. Crutchfield Street runs between Roxboro Street and North Duke Street.

Map