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APPROVED RULES

the standardized forms and processes provided by the Secretary for system management functions including:
(1)person-centered plan;
(2)screening/triage/referral interview;
(3)claims processing;
(4)contract;
(5)memorandum of agreement;
(6)quality improvement plan;
(7)strategic plan;
(8)local business plan;
(9)authorization of state funded services;
(10)endorsement of a provider of service; and
(11)letter of support for residential facilities.
(b)  All standardized forms and processes shall be implemented on a statewide basis.
(c)  No standardized form or process shall require more information than is necessary to comply with state or federal reporting requirements.
(d)  A standardized form or process shall not be altered by a LME or provider.
(e)  An LME shall not add any additional requirements upon providers that are not included in a standardized process.  

History Note:Authority G.S. 122C-112.1(a)(32); S.L. 2006-142, Section 4(m);

Eff. May 1, 2008.

10A NCAC 26C .0601SCOPE

The requirements of this Section govern the removal of a local management entity (LME) function as set forth in G.S. 122C-115.4(d).

History Note:Authority G.S. 122C-115.4(f)(3);

Eff. May 1, 2008.

10A NCAC 26C .0602DEFINITIONS

As used in the rules in this Section, the following terms have the meanings specified:
(1)"Critical performance indicator" means any of the measures as set out in these rules developed and implemented pursuant to G.S. 122C-112.1(a)(33).
(2)"Focused technical assistance" means the process of advising, providing consultation and evaluation related to a specific function, activity or performance indicator designed to improve the quality of performance of the targeted operation.
(3)"Local management entity (LME)" means the same as defined in G.S. 122C-3(20b).
(4)"Material breach" means an LME has failed to maintain for a period of two consecutive months, the required outcome expectations, as outlined in the DHHS/LME contract, on a critical performance indicator after the LME has received focused technical assistance.
(5)"Monitor" or "Monitoring" means the same as defined in 10A NCAC 27G .0602(9).

History Note:Authority G.S. 122C-115.4(f)(3);

Eff. May 1, 2008.

10A NCAC 26C .0603NOTICE OF DEFICIENT

PERFORMANCE

The Secretary shall issue a notice of deficient performance in writing to an LME when the LME fails to achieve the required outcome for a critical performance indicator established for one of the primary functions of LMEs as set forth in G.S. 122C-115.4(b).  The written notice shall:
(1)identify the critical performance indicator outcome the LME failed to achieve including a statement of the findings that support a conclusion of deficient performance;
(2)identify the LME function related to the critical performance indicator outcome;
(3)identify the required outcome expectation(s); and
(4)state the timeframe for meeting the required outcome expectation(s).

History Note:Authority G.S. 122C-115.4(f)(3);

Eff. May 1, 2008.

10A NCAC 26C .0604PLAN OF CORRECTION

REQUIREMENTS

(a)  The LME shall respond to the notice of deficient performance by submitting to the DMH/DD/SAS a written Plan of Correction (POC) within 15 working days of receipt.
(b)  The DMH/DD/SAS shall review the POC and approve it as written or communicate in writing with the LME regarding required corrections.  The LME shall have a period of five additional working days to submit a revised POC.  
(c)  Failure to submit or revise the POC may result in a suspension of funding for the LME function.

History Note:Authority G.S. 122C-115.4(f)(3);

Eff. May 1, 2008.

10A NCAC 26C .0605FOCUSED TECHNICAL

ASSISTANCE

Within 15 working days of the approval of the POC, the DMH/DD/SAS shall initiate focused technical assistance and monitoring of the LME.  The DMH/DD/SAS shall continue to provide focused technical assistance and monitoring until:

(1)the LME achieves and maintains the required outcome on the designated performance indicator(s) for a period of two consecutive months; or

(2)the end of six months, whichever occurs first.

History Note:Authority G.S. 122C-115.4(f)(3);

Eff. May 1, 2008.

22:23                                                               NORTH CAROLINA REGISTER                                           JUNE 2, 2008

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