Target Population Changes Serving Durham, Wake, Cumberland and - - PowerPoint PPT Presentation

Target Population Changes

Serving Durham, Wake, Cumberland and Johnston Counties

Important Changes

• Reduces Number of Target Populations to ten
• Allows for automation/auto-assignment of certain

target populations (GAP, AMI, ASTER, CMSED, CSSAD)

• Generic Assessment Payment target population

replaces or collapses the six AO target populations

• All important information regarding Target

Population changes can be found under NC Tracks on the NC DHHS website.

Serving Durham, Wake, Cumberland and Johnston Counties

Important Changes

Serving Durham, Wake, Cumberland and Johnston Counties

Target Population Links

• http://www.ncdhhs.gov/mhddsas/communicationbulletins/2

014/commbulletin142/6-20- 14%20Latest/cb142benefitplanstreamlining6-11-14-3.pdf

• http://www.ncdhhs.gov/mhddsas/communicationbulletins/2

014/commbulletin142/6-20- 14%20Latest/benefitplaneligibilitycriteria06-17-14-3.pdf

• http://www.ncdhhs.gov/mhddsas/communicationbulletins/2

014/commbulletin142/6-20- 14%20Latest/benefitplanstreamliningovrview6-11-14-3.pdf

Serving Durham, Wake, Cumberland and Johnston Counties

Implementation Plan

• Alliance is working with Alpha to update all

target populations based on State provided crosswalk.

• Alliance is not requiring the submission of

diagnostic updates in Alpha on 8/1/2014 related to DSM 5 for existing consumers.

• When enrolling new consumers in Alpha, begin

using DSM 5 diagnoses on and after 8/1/2014

Serving Durham, Wake, Cumberland and Johnston Counties

Reminders

• Adult Target Populations can be open ended
• Child Target Populations must have an end

date prior to an individuals 18th birthday

• GAP Target Population can be open for 60

consecutive days

• Prior to receiving state funded IDD services,

individuals most be deemed eligible through the Alliance Eligibility Committee

Serving Durham, Wake, Cumberland and Johnston Counties

IDD Eligibility

Developmental disability" means a severe, chronic disability of a person which:

• a. Is attributable to a mental or physical impairment or combination of

mental and physical impairments;

• b. Is manifested before the person attains age 22, unless the disability

is caused by a traumatic head injury and is manifested after age 22;

• c. Is likely to continue indefinitely;
• d. Results in substantial functional limitations in three or more of the

following areas of major life activity: self-care, receptive and expressive language, capacity for independent living, learning, mobility, self- direction and economic self-sufficiency; and

• e. Reflects the person's need for a combination and sequence of special

interdisciplinary, or generic care, treatment, or other services which are

• f a lifelong or extended duration and are individually planned and

coordinated; or

• f. When applied to children from birth through four years of age, may

be evidenced as a developmental delay

Serving Durham, Wake, Cumberland and Johnston Counties