Behavioral Health I/DD Tailored Plan

North Carolina will launch the Behavioral Health and Intellectual/Developmental Disability Tailored Plan in 2021. This plan is designed for individuals with significant behavioral health needs and intellectual/developmental disabilities (I/DDs). The Behavioral Health I/DD Tailored Plan will also serve other special populations, including Innovations and Traumatic Brain Injury (TBI) waiver enrollees and waitlist members.

 

State-funded Services Design Under Behavioral Health I/DD Tailored Plans Webinar 

Friday, Jan. 24, 2020 from 10 a.m. to 11 a.m. 

This webinar will walk stakeholders through aspects of State-funded Services design under Behavioral Health I/DD Tailored Plans detailed in the recently released “North Carolina’s Design for State-funded Services Under Behavioral Health and Intellectual/Developmental Disability Tailored Plans,” including the delivery of State-funded behavioral health, I/DD, and TBI services, as well as the continuation of critical “local health functions” (functions focused on health prevention and promotion) under Behavioral Health I/DD Tailored Plans. 

Registration is required and can be completed on this registration page

 

Draft Provider Manual for Tailored Care Management

Dec. 11, 2019 - We are pleased to share for comment the draft provider manual and application process for care management for people with Behavioral Health and I/DDs who will be served by Tailored Plans. While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department continues to work on the design of Tailored Plans.   

As you know from our conversations throughout this year, one of the Department’s key areas of focus in Medicaid Transformation is building robust and effective models for managing beneficiaries’ comprehensive needs through local care management. Provider-based care management will promote whole-person care, foster high-functioning integrated care teams, and drive towards better health outcomes.  

We recognize that it will take time to build up a delivery system to support Tailored Care Management that is fully integrated with primary care and other providers. This manual supports providers by describing the model requirements and initiating the certification application process for Advanced Medical Homes and Care Management Agencies. As described in the manual, we will have a schedule for reviewing applications throughout 2020 in four “batches.” The first deadline for providers to apply will be Feb. 7, 2020.  

For more information on the provider webinar and application process, see the webinar "Tailored Care Management: What Providers Need to Know" below.

For now, North Carolina’s move to Medicaid Managed Care has been suspended. All health providers enrolled in Medicaid are still part of the program and will continue to submit claims through NCTracks as they do today. Beneficiaries will continue to access Behavioral Health and I/DD services through LME-MCOs. These services will continue to be provided as they are today.
 

Previous Meetings

2019

2019

Tailored Care Management: What Providers Need to Know - Dec. 18, 2019

Presentation. Recording.

How Beneficiaries Move Between the Standard Plan and Behavioral Health I/DD Tailored Plan - Nov. 6, 2019

Presentation. Recording will be added when available.


Care Management under the Behavioral Health I/DD Tailored Plan - August 30, 2019

Behavioral Health I/DD Tailored Plan Care Management - August 20, 2019

Behavioral Health I/DD Tailored Plan Care Management - May 30, 2019

Behavioral Health I/DD Tailored Plan Eligibility and Enrollment - March 26, 2019
Note: Eligibility and enrollment policy was updated July 16, 2019. Please refer to the update documents for accurate information.

MCAC Behavioral Health I/DD Tailored Plan Design Subcommittee - March 6, 2019

MCAC Behavioral Health I/DD Tailored Plan Design Subcommittee - Feb. 4, 2019

Integration of Behavioral and Physical Health Care in Tailored Plan - Jan. 24, 2019

2018

2018

Stakeholder Update on Tailored Plan Design - Nov. 28, 2018