Behavioral Health Initiatives

NCHA is working to identify, standardize and disseminate evidence-driven practice changes, while concurrently designing policy solutions to support implementation. Our work falls into the three broad objectives of:

  • Preventing unnecessary emergency department visits
  • Improving the flow and care of patients after ED arrival
  • Promoting strong transitions into community-based care

Behavioral health reform is one of NCHA’s legislative priorities. Learn more here.

Behavioral Health Resources

NCHA has created a resource directory for providers with support from the North Carolina Office of Rural Health, a division of the North Carolina Department of Health and Human Services.

NC Hospital Foundation grant-funded program

In 2014, the Kate B. Reynolds Charitable Trust awarded the NC Hospital Foundation, an affiliate of NCHA, a three-year grant to implement the NC Mobile Medication Program in two of the state’s high-need counties. Pilot programs in Nash County by UNC Nash Health Care and in Vance County by Daymark Recovery Services utilize trained peer support specialists, supervised by registered nurses, to meet one-on-one with individuals in their homes to build the skills they need to keep medical appointments and follow medication instructions. After its first year in operation, the program had achieved a 94% reduction in emergency department visits by participants and reduced psychiatric hospitalizations by 83 percent.

The North Carolina Mobile Medication Program is modeled after a project in rural Pennsylvania, which was the winner of the first Kate B. Reynolds Charitable Trust’s Innovations in Rural Health Award in 2013. In its first year, the Pennsylvania program helped reduce hospitalization costs in the area by more than $1.3 million.

In June 2016, the North Carolina Mobile Medication Management Program received the highest honor in the Pioneer Institute’s 25th Annual Better Government Competition. The program was chosen from 100 entries from across the country for its unique approach to reducing the number of psychiatric hospitalizations and repeated emergency department visits by individuals with severe behavioral health disorders. See a video and read the program details.

Learn more about the program:
Rural programs help spread mental health care from door to door

NCHA has convened statewide, multi-sector workgroups to determine how best to support member hospitals/systems through advocacy and programmatic efforts. The workgroups, representing health systems, DHHS, LME-MCOs, patient advocates and stakeholder groups, agreed upon the following priorities to be reflected in proposed comprehensive legislation introduced in the 2017 legislative session:

  1. Revise the NC statute on involuntary commitment (122c Article 5).
  2. Preserve 3-way bed funding.
  3. Support the statewide expansion of case management.

Organizations represented on the NCHA Behavioral Health Work Groups include:

  • Alliance Behavioral Healthcare
  • Appalachian Regional Healthcare System
  • Cardinal Innovations
  • CarolinaEast Health System
  • Carolinas HealthCare – Behavioral Health Charlotte
  • Carolinas HealthCare System
  • Catawba Valley Medical Center
  • Columbus Regional
  • Cone Health
  • Daymark Recovery Services
  • DHHS, Division of Mental Health, Developmental Disabilities and Substance Abuse Services
  • Disability Rights NC
  • DHHS, Division of Medical Assistance
  • DHHS, Division of State Operated Healthcare Facilities
  • Duke University Hospital
  • Duke University School of Medicine
  • Holly Hill Hospital
  • Horizon Health
  • LifePoint Health
  • Margaret Pardee Hospital
  • Mission Health
  • National Alliance of Mental Illness NC
  • NAMI Wake County
  • Nash UNC Health Care
  • NC Psychiatric Association
  • NC Coalition for Emergency Physicians
  • Duke University Health System
  • New Hanover Regional Medical Center
  • North Carolina Sentencing and Policy Advisory Commission
  • Novant Health
  • Novant Health Presbyterian Medical Center
  • Onslow Memorial Hospital
  • Partners Behavioral Health Management
  • Sentara Healthcare
  • Southeastern Health
  • Southern Regional AHEC
  • St. Luke’s Hospital
  • The Sandhills Center
  • Trillium Health Resources
  • UNC Health Care
  • Lenoir UNC Health Care
  • UNC School of Government
  • UNC WakeBrook
  • Vaya Health
  • Vidant Health
  • Wake Emergency Physicians
  • Wake EMS
  • WakeMed Health & Hospitals
  • Wake Forest Baptist Medical Center

NC Hospital Foundation grant-funded program

NCHA is actively engaged with state agencies, member hospitals and community leaders in addressing the growing opioid epidemic in North Carolina. NCHA is working with our partners to improve care pathways and to identify and disseminate model opioid practices for providers. Our opioid-related initiatives include:

    • Coalition for Model Opioid Practices
      The Coalition for Model Opioids Practices in Health Systems is a partnership between the North Carolina Healthcare Association and the North Carolina Department of Health and Human Services. Within the coalition, there are three working groups: Prevention and Safe Pain Management, Health System Response, and Healthcare Worker Diversion Efforts. This collaborative work helps frame the areas of focus our health systems should be prioritizing as they move to develop best practices and tools to combat the ongoing opioid crisis in our state. Coalition members include representatives from all 130 hospitals in North Carolina, professional societies, and government agencies who are working to address the opioid crisis at a health system level.
    • Peer Support
      The Peer Support program seeks to improve connections to ongoing treatment, recovery, and harm reduction supports for patients presenting to emergency departments with non-fatal opioid overdose. Peer support specialists or similar staff are embedded into the emergency department to connect patients presenting with opioid overdose to treatment, recovery, and harm reduction supports. Find out more about the Peer Support initiative.
    • Mobile Crisis
      Historically, North Carolina has lacked a standard emergency response, triage, and documentation process for overdose events – unlike clear protocols for medical, fire, or other emergencies. In partnership with the Injury and Violence Prevention Branch (IVPB), the North Carolina Hospital Foundation is developing a coordinated crisis response plan between Emergency Departments and County EMS departments to ensure proper management and improved outcomes for Opioid Use Disorder patients.

Critical Access Hospital Behavioral Health Learning Action Network

The North Carolina Office of Rural Health initiated a Behavioral Health Learning and Action Network (LAN) consisting of representatives from CAH administrative teams, nursing, emergency departments and behavioral health programs. The LAN provides education and networking opportunities for the CAHs to address their most critical behavioral health needs.

Mental Health Literacy

Mental health literacy is defined as “knowledge and beliefs about mental disorders which aid their recognition, management or prevention.” These resources focus on helping people develop a working knowledge of mental health.

Hospital Staff Development

Hospitals and health systems provide essential behavioral health care services to millions of Americans every day. These resources help better equip frontline health care workers treating patients with mental health conditions.

Hospital Safety and Security

Violence is a public health problem of epidemic proportion. The danger to health care providers in professional settings escalates as violence moves off the streets and into the medical setting. The key to violence reduction is the early recognition of potential violence by a calm and prepared health care provider. These resources provide guidelines and training to support a safe and secure environment.

Suicide Prevention

Suicide is a major public health concern. Over 40,000 people die by suicide each year in the United States; it is the 10th leading cause of death overall. Suicide is complicated and tragic but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives. These resources provide education, tools and contacts to support suicide prevention.

Care Transitions

For individuals with behavioral health conditions – mental illness and substance abuse – transitions from points of care pose substantial obstacles to successful treatment outcomes. Significant risks include hospital readmissions, care disengagement and symptom exacerbation. These resources provide support for these critical transitions.

Crisis Services

People often don’t get the mental health services they need because they don’t know where to start. Use these resources to find help for yourself, your friends, your family or others seeking mental health services.

Opioid Stewardship

The opioid epidemic in North Carolina is a crisis that makes no distinction between age, race, sex, wealth, or any other demographic factor. As a result, the problem is affecting our state at every level of care delivery. NCHA has been working to improve care pathways at a hospital and health system level for those suffering with Opiate Use Disorder. The following are a starting place for your hospital to begin aligning your opioid plans with NCHA and the State of North Carolina.

State Resources

The state of North Carolina has a wide variety of resources available to healthcare providers. Some of these resources include an LME/MCO Directory, a listing of state crisis services programs, and NAMI resources.

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North Carolina Healthcare Association

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Cary, NC 27513
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