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Rapid Response Team

What is RRT

Rapid Response Team is a DHHS cross-divisional team who meet every weekday to facilitate the resolution of immediate needs for children in DSS custody. These children are in need of placement at the identified medically necessary level of care by removing barriers created by systemic issues and by facilitating problem-solving and challenging conversations among county DSS, Local Management Entities, Managed Care Organizations and other stakeholders in the child serving system. The team consists of members from:

  • Division of Child and Family Wellbeing
  • Division of Health Benefits
  • Division of Mental Health Developmental Disabilities and Substance Abuse Services
  • Division of Social Services
  • Division of State Operated Health Care Facilities
  • North Carolina Psychiatric Access Line (NCPAL)

Due to an increase of children residing in the Emergency Departments of hospitals with mental health concerns Senate Bill 693 was created. Creation of new statute under Chapter 7B –Emergency Motion for placement and payment. Allows for a limited appearance to be made and motion to be filed in the underlying juvenile court case by a hospital, LME/MCO or DHHS regarding a juvenile’s continued stay in a hospital. Requires a hearing to be held in district court and directs the court to make written findings as to whether there is medical necessity for the juvenile to remain in the hospital and whether entities have satisfied obligations under new 122C provisions. Court may also order an entity to pay reasonable costs of hospital https://www.ncleg.gov/Sessions/2021/Bills/Senate/PDF/S693v7.pdf

RRT was created because of Senate Bill 693. The RRT process started in December of 2020 to address the number of children residing in Emergency Departments, DSS Offices, and the numerous barriers created by systemic issues of addressing mental health services and supports of children in DSS custody.

Requirements for making a Rapid Response Team Referral

  • Child must be in DSS Custody
  • DSS/MCO Collaboration Implemented (All team members, DSS case worker and MCO Care Coordinator, are responsible for participating in regularly scheduled CFT meetings, identifying barriers that need to be escalated to the state level, history of placement searches).
  • DSS/MCO Leadership Involvement Present
  • Recent CCA/Psychological Evaluation Completed
  • Referrals are made by County DSS’s and MCO’s

RRT Referral and Review Process

  • County DSS submits referrals to response.behavioralhealth@dhhs.nc.gov; https://ncdhhs.servicenowservices.com/gsp
  • Referrals are reviewed to determine current placement, needed level of care, barriers to placement etc.
  • If referral meets criteria for RRT- an invite is sent to county DSS and LME-MCO for an upcoming RRT meeting. If referral is not accepted the referring person will be notified.
  • Action items are tracked during the meeting and sent to participants.
  • LME-MCOs submit regular updates until the child is in the appropriate level of care.
  • While a referral is open with RRT, follow-up meetings may be held for additional updates, planning, or coordination.
  • RRT open cases are closed once the recommended level of care is secured and supports/services are in place for the child.
  • Children can be referred multiple times if meeting the criteria of submitting a referral.

RRT Roles and Responsibilities

  • When RRT receives notification of a juvenile in need of placement from a county DSS, the RRT must evaluate the information and coordinate a response.
  • This may include facilitating and convening a meeting of staff from LME-MCOs & county DSS offices to coordinate a plan for child placement at the medically recommended level of care.
  • RRT strives to remove barriers created by systemic issues, when possible, and to facilitate problem solving and challenging conversations among stakeholders.
  • RRT will work with the team to identify potential alternative service options and/or the potential to wrap services together to meet the unique needs of children/youth.
  • RRT will continue to rely on LME-MCO and county DSS offices to submit referrals to appropriate providers and placements for the children/youth.

ERT: Executive Response Team

Executive Response Team meets weekly and consists of leadership from the following Divisions/Offices: Division of Health Benefits, Division of Mental Health/Developmental Disabilities/Substance Use Services, Office of the Chief Medical Officer for BH/IDD, Division of Social Services, Division of Child and Family Wellbeing, Division of Health Services Regulation, and Office of the General Counsel.

ERT: Executive Response Team

ERT Responsibilities Include:

  • Oversight of RRT
  • Reviewing Escalated RRT Referrals requiring further review, executive engagement with MCO/DSS, legal consultation, expedited processes, support alleviating state process/system barriers.
  • Oversight of Child Welfare Transformation Projects.
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