Wednesday, September 17, 2008

This week's difficulties (so far) re: Value Options creation of mental health care BARRIERS to NC CITIZENS

NC DHHS Update # June 2, 2008

"Until a provider receives an authorization from ValueOptions, they are at risk for nopayment for any services delivered."

If there is no authorization from VO----FOR WHATEVER REASON----the client cannot receive Medicaid related services. If they do, the provider company is completely at risk for losing thousands of $$ / client.

Given the terribly slow rate of processing paperwork associated w/ Medicaid authorizations at VO, 'continuity of care' is now no longer possible. Thus, what we have is some care.....some care.....

Progress as associated w/ mental health issues is benefited by a sustained attention to matters.


Dr. Land has stated, in an Editorial piece (fair & balanced!) at the Raleigh News & Observer: (you may need to cut and paste this link:

"...After months of hard work to get on top of the overwhelmed system we inherited, ValueOptions is now on track to help the state save roughly $500 million a year. .."

Let's forget that this money has no meaning in terms of what it refers to, for a

moment. $500 million related to what?

How is it, Dr. Land, that you are going to save this money? Basically, you are going to save it as associated with the creation of barriers to continuation of care as pertaining to a two-level perusal process associated with the admission of ANY paperwork. First the lower level clerical people look it over for mistakes, sending it back again and again and THEN those above them look over the paperwork.

Just think of all the money being expended and being paid for by NC citizens associated with the creation of correct paperwork.

One of the VO NC employees made this post at the News & Observer article site:

"Posted by:
2008-09-15 12:03:42
Rated: 1 by 1 users.
Here we go again

Dr. Lane needs to get her facts correct. The staff at the NC office does work hard and try to do a good job. However, VO puts up barriers, does not give staff resources and does not comply with its contact with the state. All of this leads to a very poor working relationship with providers across the state. The complaints from the providers continue to increase each day.


Item: tonight I sat on my cell phone for about 30 minutes, off the expressway, listening to the mother of a schizophrenic young man who has been placed in a mental health residential home in western NC. She called up the Endorsed Provider company, CNC Access, a large company providing Community Support Service (CSS) in western NC (I have no affiliation w/ them), and they advised her that they were stretched to the breaking point and there were no immediately available CSS workers for her son.

Today she asked the manager of the home if she would know what to look for in terms of psychosis if her son becamse psychotic----entirely possible given that he just spent almost half a year in Broughton associated with trying to get him to a stable place.

The manager stated she had never witnessed a psychotic episode.

VO stands to save NC money re: the non-availability of this large company's Community Support Services as basically the companies are staggering under the barriers that VO has been creating associated with the clerical combing over of the 20 page Person Centered Plans (remember: this has nothing to do w/ the work being is a guide for the work that is to be rendered; the PCP is not reimbursed though it takes hours and hours to develop).

In the case of 3 other clients associated with CSS services which have been in place for months, AFTER the clerical people combed over the documents, rejecting them over and over----COME AUGUST 1----when the number of hours of CSS were reduced-----THEN THE PAPERWORK WAS ACCEPTED AS ASSOCIATED WITH THE DIMINISHMENT OF THE ALLOWABLE NUMBER OF CSS HOURS.


Maintenance of Service for Adults Receiving Community Support Services
"Please note that Maintenance of Service authorizations for adults receiving Community Support Services are limited to 32
units per week as of August 1, 2008. "


Were barriers increased as per a demand from NC DHHS? We wil be finding out over the next few days as associated w/ querying Tara Larson who is purportedly the liason between VO and NC DHHS and by default, the LME's.


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