N.C. Child and Family Improvement Initiative Extends Open Enrollment for Statewide Child Treatment Provider Network

What is happening?

North Carolina’s six Local Management Entities/Managed Care Organizations (LME/MCOs) launched the NC Child and Family Improvement Initiative on May 1, 2022, to create a statewide solution to the current pressing challenges of the service delivery system for youth in foster care.

Building on the early successes of the NC Child and Family Improvement Initiative, the LME/MCOs are moving forward to formalize a statewide network of child treatment providers to ensure that youth in the foster care system have continuity of care without delay when moving from one area of North Carolina to another.

The LME/MCOs are offering an open enrollment period for all child treatment providers. The open enrollment period has now been extended through December 31, 2022, to ensure that children and adolescents have access to the services they need statewide.

When is this happening?

Open Enrollment for child treatment providers will be extended until December 31, 2022.

How is this affecting providers?

From August 1, 2022 through December 31, 2022, all LME/MCOs are offering an open enrollment period for child Psychiatric Residential Treatment Facility (PRTF), Level IV, Level III, Level II group and family, and Facility-Based Crisis (FBC) providers to ensure that children and adolescents have access to the services they need statewide.

Provider Action Required: 

If you are a child PRTF, Level IV, Level III, Level II group and family, or FBC provider and want to join Alliance’s network, please submit the Provider Application Request on or before December 31, 2022. Please note that your enrollment with NCTracks is a pre-requisite. Data for the provider agency, including NPI, taxonomy, sites, and affiliated clinicians, must all be in NCTracks to continue to contract with Alliance or to make changes to your contract with Alliance.

We encourage you to contract with each LME/MCO to maximize statewide resources and service access for children and adolescents. For more information about becoming an in-network provider, please use the following links:

Alliance Health (Cumberland, Durham, Johnston, Mecklenburg, Orange, and Wake counties)

Eastpointe (Duplin, Edgecombe, Greene, Lenoir, Robeson, Sampson, Scotland, Warren, Wayne, and Wilson counties)

Partners Health Management (Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union, and Yadkin counties)

Sandhills Center (Anson, Davidson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph, Richmond, and Rockingham counties)

Trillium Health Resources (Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Currituck, Dare, Gates, Halifax, Hertford, Hyde, Jones, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Tyrrell, and Washington counties)

Vaya Health (Alamance, Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Caswell, Chatham, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rowan, Stokes, Swain, Transylvania, Vance, Watauga, Wilkes, and Yancey counties)

What if a provider does not want to join an LME/MCO network at this time?

For providers who do not want to join an LME/MCO network, all LME/MCOs are offering out-of-network agreements for community-based and non-hospital services. While the NC DHHS directs reimbursement for these services to be 90% of the Medicaid rate, the LME/MCOs have agreed to pay at least 100% of the Medicaid rate for these services to strengthen statewide network and service capacity.

Who should providers contact with questions?

If you have questions, please contact our Provider Help Desk at [email protected].

 To learn more about the NC Child and Family Improvement Initiative, click here.