H259 - 2023 Appropriations Act. (SL 2023-134)

Overview: Section 9J.12 of S.L. 2023-134 allocates $750,000 in nonrecurring funds for each year of the 2023-2025 fiscal biennium of the funds appropriated to the Division of Social Services (DSS), Department of Health and Human Services (DHHS), for the development of a foster care, trauma-informed, standardized assessment. The purpose of the assessment is to assist children who are at risk of entry into the foster care system or are already in the foster care system and have experienced trauma warranting involvement of the Division and other agencies and who, because of the trauma, are at a higher risk of needing behavioral health, intellectual, or developmental disability services.

The assessment must be developed by the following organizations or individuals:

• Representatives from the following divisions of DHHS:
  • Division of Social Services
  • Division of Health Benefits
  • Division of Mental Health, Developmental Disabilities, and Substance Use Services
  • Division of Family and Child Well-Being
• Prepaid health plans and primary care case management entities that serve children at risk of entry into the foster care system or who are in the foster care system.
• Representatives from county departments of social services.
• Benchmarks.
• Individuals with lived experiences.
• Others identified by the groups above based upon areas of expertise.

This section also includes requirements for the assessment's development which must include a rollout plan with a goal of implementation in all 100 counties. The rollout plan must include:

• Development of the assessment's template by March 31, 2024.
• A finalized template by September 30, 2024, inclusive of training curriculum and methodology, vendor selection to manage and conduct the training and determine the statewide rollout, and coordination with tribal jurisdictions.
• The phased-in approach to begin on October 1, 2024, and have the assessment functional statewide by September 30, 2025.
• Establishment of a base rate for the assessment which supports the oversight, training, and monitoring of the fidelity to the assessment.
• Establishment of standardized workflow of notifications to payers and child welfare agencies.
• Identification of core outcomes.
• Establishment of a statewide training plan.

At a minimum, the assessment must do the following:

• Juveniles between 4 and 17 years of age being placed into foster care receive the assessment within 10 working days of the referral.
• Each juvenile who is included in the Medicaid children and families specialty plan receives an assessment.
• Each assessment can be administered in person or by telehealth.
• A county department of social services must make the referral for an assessment within five working days of a determination the juvenile was abused or neglected in accordance with G.S. 7B-302.
• A juvenile can receive an assessment with parental consent if the county department of social services determines that the juvenile is at imminent risk of entry into foster care.
• If necessary, an individual from 18 to 21 years old can receive an assessment.
• Provide an evidence-informed and standardized template and content for the assessment.
• If the juvenile has an assigned case manager under the Medicaid program, the responsible care management entity is informed of the assessment referral and to whom.

DHHS must do all of the following for implementation and rollout:

• Leverage the expertise and lessons learned from the entities who have successfully implemented these assessments and training venues.
• Complete required documentation and, if applicable, leverage all available federal revenues for such activities.
• Amend existing contracts between DHHS and entities who have the expertise to manage the assessment and rollout plan.
• Create a Division of Social Services Statewide Dashboard with the assessment implementation and rollout plan status which must be updated monthly. The dashboard must contain:
  • Referrals.
  • Case management.
  • Assessments.
  • Lag between referrals, assessments, and service initiation.
  • Youth personal outcomes focused on supporting permanency.
  • Any other elements identified by the partnership.

This section became effective July 1, 2023.