North Carolina Department of Health and Human Services
Division of Health Benefits
August 2024

Background
In an effort to improve delivery and access to behavioral health services for children and youth in North Carolina, the State’s General Assembly allocated $22 million in recurring funding to enhance Medicaid services available to children and youth in foster care. To inform how this funding is allocated, NC Medicaid, in coordination with the Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMH/DD/SUS), the Division of Child and Family Well-Being (DCFW), and the Division of Social Services (DSS), seeks stakeholder input to help identify: 1) critical service gaps for children and youth in foster care, and 2) innovative NC Medicaid services that can help to address these gaps.

The legislation requires that:
  • The allocated funding benefit children/youth in foster care (it may also benefit other children/youth);
  • Services identified must be:
    • Evidence-based or evidence-informed practices that promote safe and timely permanency for children in foster care (e.g., reunification, adoption), prioritizing family connections (e.g., kinship), as available, and divert from higher level foster care placements (e.g., Therapeutic Foster Care, Intensive Alternative Family Treatment (IAFT)), or
    • Community-based or short term residential treatment options, including stepdown options from higher levels of care, that divert children with more complex behavioral health needs from higher level placements (e.g., Psychiatric Residential Treatment Facilities (PRTF), other residential treatment services, inpatient hospital admissions).
  • Funding must be distributed through capitated contracts with the State’s Medicaid Managed Care plans (i.e., Standard Plans, Tailored Plans, and/or Children and Families Specialty Plan (CFSP)).
In addition, NC Medicaid is especially interested in stakeholder feedback related to how the available funding can be used to promote the following goals:
  1. Geographic standardization of behavioral health services across North Carolina;
  2. Timely access to behavioral health services consistent with urgency of an individual’s need;
  3. Sustainability of the Department of Health and Human Services (DHHS) investments through the $80M in Special Funding to strengthen NC’s behavioral health services continuum for all children/youth.
Responses from stakeholders will assist NC Medicaid with decisions regarding use of the funds. No funding awards will be made directly to health plans or providers because of this solicitation. As directed by the legislature and noted above, funding must be distributed through capitated contracts and as such, limits the State’s ability to use this funding for provider-level capacity building. This is not a grant opportunity.

Following the selection of services, NC Medicaid will work to secure the needed authorities needed to effectuate funding through capitation.
 
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