Welcome to Smoky Mountain Center SMC is a URAC Accredited Agency. Click here to learn more!   Clinical Decision Tools Used by SMC Care Managers Service Definitions Enhanced Services Division Of Medical Assistance Enhanced Mental Health and Substance Abuse Services Revised August 1, 2011 Inpatient Aftercare Follow Up (MH/DD/SA) Inpatient Aftercare Follow Up (MH/DD/SA) MH/DD/SAS - 1/15/03 North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services MH/DD/SAS Service Definitions, January 1, 2003 (with revisions January 15, 2003) Recovery Education Center - Meridian Behavioral Healthcare Meridian's Recovery Education Center - Program Description Safety Supervision Smoky Mountain Center LME, Utilization Management Department "Safety Supervision" Service Definition SMC Level of Care Guidelines MH/SA State Benefit Plan Combined SMC Mental Health and Substance Abuse UM Plan and Level of Care Guidelines Revised Effective October 1,2011 - UPDATED 09/26/2011 IDD State Benefit Plan Smoky Mountain Center LME Intellectual / Developmental Disabilities State-Benefit Plan and Level of Care Guidelines Revised Effective October 1,2011 - UPDATED 09/26/2011 Medicaid Benefit Plan SMC Medicaid Utilization Review Guidelines - Additional Information SMC Medicaid MH/SA/IDD Acute Service Utilization Review Guidelines SMC Medicaid Adult MH/SA Utilization Review Guidelines - UPDATED 1/24/2013 SMC Medicaid Child MH/SA Utilization Review Guidelines - UPDATED 1/25/2013 SMC Medicaid Child Residential L2 Utilization Review Guidelines - UPDATED 5/10/2013 SMC Medicaid Child Residential L3 & L4 Utilization Review Guidelines - UPDATED 4/30/2013 PRTF Admissions and Continued Stay SMC Medicaid Child and Adult Non-Innovations I/DD Utilization Review Guidelines - UPDATED 1/25/2013 SMC Medicaid Substance Abuse Specific Services Utilization Review Guidelines Review Information for Providers UM Medical Necessity PRTF Checklist for Providers UM Recommended Documentation for PRTF Guidelines for Comprehensive Clinical Assessment PCP Manual North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Person-Centered Planning Instruction Manual (2010 version) SMC-Developed Review Tools and Internal Flow Charts Access Access Center Flow Chart Updated Care Manager Workflow for Access Center Calls Standards for Determining Clinical Urgency Authorization Requests SMC Continued Acute Stay Review Tool   Special Processes Documents State Funded Residential Referral Profile Form State Funded Residential Referral Profile Form Undocumented Citizens Undocumented Citizens Information for Providers in the Western Region TRACK (Therapeutic Respite Addressing Crisis for Kids) for Children with I/DD SMC Procedures for TRACK - UPDATED 11/29/2011 Statewide TRACK Fact Sheet - revised March 2012 - UPDATED 03/22/2012 TRACK application 4-29 screening Decision Tool for Developmental Disabilities Plans Decision Tool for Developmental Disabilities Plans Submitted Without Psychological Evaluations SMC Policy 600.06 SMC Policy 600.06 Prohibition of the Use of LME Funds for Services Provided by Family Members or Relatives   Authorization Request Information SMC Routine Authorization Request Review Tool - UPDATED 7/5/2011 Medical/Clinical Necessity Criteria Medical/Clinical Necessity Criteria adopted from the Division of Medical Assistance document, "LME UM Requirements and Procedures", issued 11/14/08, section VII A and B SMC Service Authorization Request Form Please use the links below to download a copy of the Service Authorization Request form in Microsoft Word format. Please only use this form if you are having difficulty with our electronic Managed Care System, AlphaMCS. This document will need to be printed, filled out, and faxed into our Care Management department for entry into our electronic Managed Care System. Service Authorization Request - Paper Form - [ Word DOC ] UPDATED 12/11/2012 Service Authorization Request - Electronic Form - [ Word 2007 DOCX ] UPDATED 12/11/2012   Inpatient and FBC Enrollment, Admission and Continued Stay Procedures Attached are Smoky Mountain Center’s procedures for enrollment, admission and continued stays for Inpatient and Facility Based Crisis Services. As you will see, there is a pass-through provision for these services before authorization review is required. However, notification and enrollment of consumers is required at the time of admission or soon thereafter. For facilities that have been working with SMC for management of state-funded services, you will see that approval by SMC’s Mobile Crisis provider is no longer required for admission, although you will still work closely with MCM providers in many situations. MEMO - Changes to SMC Inpatient Utilization Review Procedures - Adobe PDF UPDATED 7/30/2012 SMC Inpatient Utilization Review Procedures - Adobe PDF UPDATED 7/30/2012 Regional Assessment and Referral Form (RARF) [Electronic Version] - Word DOC UPDATED 8/2/2012 SMC Supplemental Enrollment Form - Word 2007 DOCX UPDATED 7/9/2012 SMC Inpatient Concurrent Review Form - Word 2007 DOCX UPDATED 7/30/2012 MEMO - Changes to SMC Facility Based Crisis Utilization Review Procedures - Adobe PDF UPDATED 7/30/2012 SMC Facility Based Crisis Utilization Review Procedures - Adobe PDF UPDATED 7/30/2012 We recognize that these procedures are new for you and for us; we will work collaboratively with you to learn, implement and improve these procedures. Please feel free to contact any of the following individuals for assistance with these procedures: Fanny Gosselin, LCSW, LCAS, Care Manager - 828-586-5501 ext. 1220 Judith Collins, PA, MH/SA Care Management Supervisor - 828-586-5501 ext. 1260 Toni Shelow, Psy.D., Care Management Director - 828-586-5501 ext. 1223 Steve Puckett, Ph.D., Senior Director, Clinical/UM - 828-586-5501 ext. 1232   Psychological Testing Psychological testing is the use of formal procedures employing reliable and valid instruments to measure intellectual, cognitive, emotional and behavioral functioning. Psychological testing may be used to identify psychopathology, personality style, interpersonal processes, and adaptive skills. Neuropsychological testing is a specialized area of psychological testing that can identify the presence of brain damage, injury or dysfunction and associated functional deficits. Both types of testing require the application of appropriate normative data for interpretation or classification. Testing may be used to guide differential diagnosis in the treatment of psychiatric disorders and disabilities or to provide an assessment of cognitive and intellectual abilities, personality and emotional characteristics and neuropsychological functioning. Smoky Mountain Center (SMC) recognizes the importance and value of psychological testing to address specific diagnostic questions necessary for an individual's treatment that cannot be answered through diagnostic interview and psychiatric evaluation. Before conducting psychological testing, it is important to obtain current clinical information through a Comprehensive Clinical Assessment and/or Psychiatric Evaluation. It is also important to inquire about other psychological testing that may have been conducted with the individual and to obtain copies of such evaluations before conducting psychological testing. SMC Psychological Testing - Guidelines - [Adobe PDF] UPDATED: 3/26/2013 SMC Psychological Testing - Request Form - [Word 2007 DOCX] UPDATED: 3/26/2013 SMC Psychological Testing - Q&A - [Adobe PDF] UPDATED: 3/26/2013

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