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Children with Complex Needs

Workforce Development/Training

Children with Complex Needs (CWCN) are ages 5 and under 21, with a developmental and/or intellectual disability and a mental health disorder diagnosis who are Medicaid eligible and at risk of not being able to return to or maintain placement in a community setting.

The CWCN program offers workforce development to educate, train, and support the workforce serving CWCN. Trainings are launched through Behavioral Health Springboard ( bhs.unc.edu). Training modules include live webinars, in person, and asynchronous e-learning.

The Division of Child and Family Wellbeing (DCFW) Partnership

The Children with Complex Needs program has a workforce development and training program sponsored by the North Carolina Division of Child and Family Wellbeing.

The CWCN program specialist works with the CWCN state administrator (through DCFW) to:

  • Review and monitor local management entity/managed care organizations (LME-MCOs) workforce development planning.
  • Collaborate with national subject matter experts regarding supporting CWCN, state service providers, LME-MCOs, provider associations and family advocacy organizations.
  • Provide oversight and updates to CWCN resources website: https://complexmhidd-nc.org.
  • Research evidence-based practices and policy regarding supporting CWCN nationally.
  • Consumers, families, guardians and stakeholders may contact the LME/MCO 24/7 access number overseeing their county for further information regarding services for Children with Complex Needs. If consumers, families and guardians experience any barriers to services please contact Children.ComplexNeeds@dhhs.nc.gov.

External Stakeholder Support and Partnership

The CWCN program works with community stakeholders and agencies that serve CWCN which is not limited to LME-MCOs, national experts on subject matter regarding supporting individuals with dual diagnoses, providers serving CWCN, family advocacy programs, State Developmental Centers, NCSTART, and other organizations.

Local Management Entity/Managed Care Organizations (LME-MCOs):
Manage the care of NC Medicaid beneficiaries who receive mental health, developmental disabilities, or substance use treatment services. These organizations determine a process to identify CWCN within their catchment areas and link them to the appropriate supports and services. DHHS provides an allocation for each LME-MCO to appoint a point of contact for CWCN to collaborate with state and local partners, report out data, create and implement workforce development plans, and ensure linkages to services.

NC DHHS: LME/MCO Directory

  • Alliance Health
  • Partners Health Management
  • Trillium Health Resources
  • Vaya Health

North Carolina Department of Health and Human Services (NCDHHS) State Operated Healthcare Facilities: NC DHHS: State Operated Healthcare Facilities
Oversees and manages state operated healthcare facilities that treat adults and children with mental illness, developmental disabilities, substance use disorders and neuro-medical needs. The developmental centers below provide supports for CWCN.

Murdoch Developmental Center NC DHHS: Murdoch Developmental Center

CWCN Children’s Assessment Clinic #1 located on campus.

Participation in Admission Center Committee meetings to collaborate regarding admission to youth programs and provide recommendations for those supporting youth on the waitlist.

The specialty programs serving youth include:

  • Partners in Autism Treatment and Habilitation (PATH)
  • Specialized Treatment for Adolescents in Residential Setting (STARS)
  • Therapeutic Respite Addressing Crisis for Kids (TRACK)

J Iverson Riddle Developmental Center NC DHHS: J. Iverson Riddle Developmental Center

CWCN Assessment Clinic #2 located on campus

Caswell Developmental Center NC DHHS: Caswell Developmental Center

  • CWCN Children’s Assessment Clinic- Introduces a clinical team (psychiatrist, family physician, registered nurse, social worker, and psychologist) to provide a thorough review and assessment of the clinical needs of those referred.
  • Children are referred through their LME-MCO in partnership with the legal guardian.

Referral process:

  • Children who been identified as having complex needs are eligible.
  • LME-MCO and the child’s guardian will complete the Assessment Clinic prescreening or referral form.
  • Form is submitted to the assessment team referral coordinator via encrypted email or fax.
  • The assessment coordinator will work with the LME-MCO and guardian until the referral information is complete. Once completed the referral coordinator will confirm the acceptance and schedule the assessment.

North Carolina Systemic, Therapeutic, Assessment, Resources and Treatment (NCSTART):
NC START | NCDHHS
provides crisis prevention and intervention services for youth with trauma, intellectual/developmental disabilities ( I/DD), and/or behavioral health needs throughout the state of North Carolina. NCSTART is divided into 3 programs that serve different counties of North Carolina (Central, West, and East). The NCSTART program works with the LME-MCOs for referrals, community consultation/education and linkages to services.

Eligibility criteria:

  • Documented IDD or Traumatic Brain Injury diagnosis prior to age 22
  • Co-occurring mental health diagnosis and/or complex behavioral needs
  • Services are available to children ages 6-20 years of age

Referral information:

  • Referrals for children that are not in active crisis are made through the LME-MCO directly to the NCSTART teams.

Resources

DCFW/DHHS Resources

Consumers, families, guardians and stakeholders may contact the LME/MCO 24/7 access number overseeing their county for further information regarding services for Children with Complex Needs. If consumers, families and guardians experience any barriers to services please contact Children.ComplexNeeds@dhhs.nc.gov.

Education/School Based Resources

Consumers, families, guardians and stakeholders may contact the LME/MCO 24/7 access number overseeing their county for further information regarding services for Children with Complex Needs. If consumers, families and guardians experience any barriers to services please contact Children.ComplexNeeds@dhhs.nc.gov.

American Psychiatric Association
(2013). Diagnostic and Statistical Manual of Mental Disorders (DSM– https://www.psychiatry.org/psychiatrists/practice/dsm

American Speech-Language Hearing Association
Scope of Practice in Speech-Language Pathology.
https://www.asha.org/policy/SP2016-00343/

Autism Society, NC
https://www.autismsociety-nc.org/

Division of Integrated Academic and Behavior Systems, NC Department of Public Instruction
NC MTSS Implementation Guide. https://www.dpi.nc.gov/students-families/parents-corner/multi-tiered-systems-support-mtss-families

Exceptional Children’s Assistance Center (ECAC)
IEP [Resources for parents.]
https://www.ecac-parentcenter.org/

Individuals with Disabilities Education Act
https://sites.ed.gov/idea/

Public Schools of North Carolina
Integrated academic and behavior systems.
http://www.ncpublicschools.org/integratedsystems/

North Carolina Department of Public Instruction (NC-DPI)
https://www.dpi.nc.gov/

Parent resources
https://ec.ncpublicschools.gov/parent-resources

Policies Governing Services for Children with Disabilities (Amended March 2018)
https://ec.ncpublicschools.gov/policies/nc-policies-governing-services-for-children-with-disabilities

PBISWorld
Information on behavior intervention plans.
https://www.pbisworld.com/

Wright, Pete
(2010). The history of special education law.
https://www.wrightslaw.com/law/art/history.spec.ed.law.htm

U.S. Department of Education
Student Placement in Elementary and Secondary Schools and Section 504 of the Rehabilitation Act and Title II of the Americans with Disabilities Act.
https://www2.ed.gov/about/offices/list/ocr/docs/placpub.html

Behavioral Health/Crisis Resources

ARCH National Respite Network
(2018). 9 steps to respite care for family caregivers of children and adults with intellectual and developmental disabilities.
https://disabilitynavigator.org/article/68325/9-steps-respite-family-caregivers-children-and-adults-intellectual-and-developmental

Carolina Consultation Center
1-800-862-6264 (toll free). For practitioners anywhere in North Carolina.

Crisis Solutions North Carolina
https://crisissolutionsnc.org/ Mobile crisis units and crisis centers.

Deb, S., Clarke, D., & Unwin, D
(2006). Using medication to manage behaviour problems among adults with a learning disability: Quick reference guide. https://www.birmingham.ac.uk/documents/college-les/psych/ld/ldquickreferenceguide.pdf

Summary of NC’s Current Law on Involuntary Commitment
https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-abuse/involuntary-commitments

NC County Departments of Social Services
https://www.ncdhhs.gov/divisions/social-services/local-dss-directory

NC Developmental Centers
https://www.ncdhhs.gov/divisions/dsohf/facilities

NC Local Management Entities/Managed Care Organizations (LME/MCOs)
https://www.ncdhhs.gov/landing-page/clone-lmemco-directory, or download the reference sheet.

NC Pediatric Access Line (NC-PAL)
919-681-2909 [For practitioners in Person, Granville, Vance, Warren, Franklin, and Halifax counties.
For details, see https://ipmh.duke.edu/content/ncpal.]

NC Systemic, Therapeutic, Assessment, Resources, and Treatment (NC-START)
https://www.centerforstartservices.org/locations/north-Carolina [Services for adults.]

Vanderbilt Kennedy Center (Nashville, TN)
Health care for adults with intellectual and developmental disabilities: Toolkit for primary care providers.
https://iddtoolkit.vkcsites.org/. [This toolkit provides a number of assessment tools for managing behavioral crises.]

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