Effective June 15, 2022, qualifying Medicaid Standard Plan members in Healthy Opportunities Pilot regions may receive additional services that address toxic stress and multiple non-medical needs.
The following new services are:
- Evidence-Based Parenting Classes (addresses toxic stress), including the Incredible Years curriculum, which provide group and one-on-one instruction, often in a classroom setting, over 18-20 sessions by a trained facilitator
- Home Visiting Services (addresses toxic stress), including the Parents as Teachers curriculum, which provide one-on-one observation, instruction, and support from a trained case manager who may be a licensed clinician, and typically involve at least 12-24 home visits annually depending on the family’s need.
- Medical Respite (addresses multiple non-medical needs) is a short-term, specialized program focused on individuals who are homeless or imminently homeless, have recently been discharged from a hospital setting and require continuous access to medical care.
Toxic stress is prolonged, severe, or chronic stress that can cause significant problems with health, development, and functioning. Some stressors that are likely to cause adverse reactions are potentially traumatic events like exposure to violence (especially recurring violence such as child abuse or domestic violence, or threats of violence in neighborhoods with high rates of violent crime), experiences of war, terrorism, or natural disasters, or chronic stressors like low-income families’ insecurity about basic needs.
Evidence-based parenting classes and home visiting services are offered to families that may be at risk of disruption due to parental stress or difficulty coping with parenting challenges, or child behavioral or health issues. These services are also appropriate for newly reunited families following foster care/out of home placement or parental incarceration.
Medical Respite services include comprehensive residential care that provides the enrollee the opportunity to rest in a stable setting while enabling access to hospital, medical, and non-medical services that assist in completing their recuperation. Medical respite services should include, at a minimum, short-term post-hospitalization housing, medically-tailored meals and transportation services.
The new Healthy Opportunities Pilot services listed above are available in three regions of the state on the following timelines, overseen by the following Network Lead organizations:
- Access East Inc.: Beaufort, Bertie, Chowan, Edgecombe, Halifax, Hertford, Martin, Northampton, Pitt
- All services available by July 26.
- Community Care of the Lower Cape Fear: Bladen, Brunswick, Columbus, New Hanover, Onslow, Pender
- Evidence-Based Parenting Classes and Home Visiting Services will be available by June 20.
- Medical Respite will be available by July 11.
- Impact Health/Dogwood Health Trust: Avery, Buncombe, Burke, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
- All services are available as of June 15.
Qualified members are already eligible to receive food, housing and transportation services . To be eligible for and receive Pilot services, NC Medicaid Managed Care members must live in a Pilot region and have at least one qualifying physical or behavioral health condition and one qualifying social risk factor, as defined by the Department. For more information, please see frequently asked questions.
Those interested in pilot services should contact their health plan or care manager. For more information, please visit the Healthy Opportunities Pilots webpage.
Contact
NC Medicaid Contact Center, 888-245-0179