NCPA Blog: What's On Our Mind

September 17, 2018  How to Talk to Your Kids About Natural Disasters


From hurricanes and tornadoes to earthquakes, mudslides and even extreme blizzards and flooding, families around the world have faced the trauma of natural disasters.

As Hurricane Florence batters the Carolinas, parents living in and outside the storm’s path are facing questions about it from their children. HuffPost spoke to experts in child and adolescent psychiatry about the best ways to talk to kids about natural disasters.

Here are 10 things to keep in mind when discussing natural disasters with children at different developmental stages. While the advice is geared toward families directly affected by a particular disaster, many of these guidelines can apply to children outside the disaster zone, as well as those who have faced disasters in the past and may be feeling triggered by the latest news...

Find Out What They Want To Know

“Don’t assume you know what your child is thinking about and what their concerns are,” said Allan Chrisman, a Duke University associate professor emeritus of psychiatry and behavioral sciences and AACAP disaster and trauma program co-chair. “There’s always a tendency for parents to over-explain or bring in information that is at a higher level than the child is at, so try to understand what exactly the child’s questions are really about in terms of their own thinking and feelings.”

Kids may not be forthright with their concerns, so parents should ask them open-ended questions first, like “How are you feeling?” “What have you seen or heard?” or “What are you worried about?”

“Kids need the reassurance that they’re going to be safe, but you want to address their specific fears. And you can’t know what their fears are without asking them,” Beresin said. “They might ask, ‘Is our dog going to be OK? What about our goldfish? Can we take our goldfish?’” Even if they aren’t in the direct storm path, kids might be worried about family members who are, and children who have lived through natural disasters in the past might be worried for other little kids.

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September 14,  Hurricane Florence Special Bulletin

Reimbursement for Medically Necessary Services During Hurricane Florence
NC Medicaid and Health Choice will reimburse providers for medically necessary drugs and services and equipment and supplies provided during the Hurricane Florence emergency without prior approval (PA) starting September 14, 2018 through September 21, 2018. Medical documentation must support medical necessity.

In addition, beneficiaries who have been evacuated out-of-state (OOS), voluntarily or involuntarily, can receive medical care if needed and NC Medicaid and Health Choice will reimburse the OOS provider without prior approval. OOS providers must enroll as NC Medicaid providers in an abbreviated, expedited process here.

Providers are encouraged to obtain a prior approval if it is possible to do so (and normally required for the service). All claims are subject to audit.

Expediting Nursing Home Admissions for Individual Displaced Due to Hurricane Florence
Providers should upload the signed Physician Signature form with their portal submissions to NC Tracks. NC Tracks is designed to receive long term care PA information in the FL2 format. NC Medicaid has temporarily suspended the requirement of a Pre-Admission Screening and Annual Resident Review (PASSR) number on the PA. Providers should note on their portal submissions stating that the PASRR is unavailable due to Hurricane Florence emergency placement. In addition, providers should add all the pertinent information about the recipient’s levels of care needs in their portal submission.

Lastly, the Medicare requirements of 3-day qualifying hospital stay is waived for Medicaid beneficiaries who require a short-term stay in a Nursing Facility due to care needs or shelter needs related to Hurricane Florence for the period September 12 through September 26, 2018.

Critical Access Hospital (CAH) Bed Limit Lifted During Hurricane Florence
As outlined in 42 CFR 485.620(a), Condition of Participation: Number of Beds and Length of Stay, ‘Except as permitted for CAH having distinct part units under 42 CFR 485.647, the CAH maintains no more than 25 inpatient beds. Inpatient bed may be used for either inpatient or swing-bed services’.

For dates September 14, 2018 through September 21, 2018, NC Medicaid is lifting the limit of 25 beds to accommodate the needs of our beneficiaries and providers due to the anticipated impact of Hurricane Florence.

Unless otherwise noted, these exceptions are in effect for dates of service from September 14 through September 21, 2018. After the storm has passed, the State will evaluate the need to extend the exceptions and will publish any changes.

Providers needing further information should call the NC Tracks Contact Center 1-800-688-6696.

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July 31, 2018  Shortage of psychiatrists drives new mental health care model

By LIV OSBY, The Greenville News (Greenville, SC)

Psychiatrists are in increasingly short supply just as the number of people who need their care is growing.

Mental health providers have been struggling to find a way to treat them all.

Now Bon Secours St. Francis Health System psychiatrists are teaming up with primary care doctors through a new program called Collaborative Care that reduces the need for psychiatric visits, officials say.

Advocates say it increases access to care, results in better outcomes and saves money as well.

Under the program, St. Francis uses consulting psychiatrists behind the scenes to review diagnoses, medications and therapy to ensure patients are getting the right care, said Dr. Carson Felkel, a Bon Secours psychiatrist.

“The key to this model is having the consulting psychiatrist talking weekly with the primary care provider,” he said. “So patients don’t have to see a psychiatrist so often.”

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