WellCare of North Carolina is Increasing Access to Trauma-Informed Services

This month, for our partner spotlight, Benchmarks’ Center for Quality Integration (CQi) is highlighting our partners at WellCare of North Carolina, one of the five Managed Care Organizations selected to provide statewide healthcare coverage to NC Medicaid recipients through Standard Plans. Standard Plans offer physical and mental/behavioral health coverage to individuals experiencing mild to moderate behavioral health concerns.

WellCare works to provide its beneficiaries with access to quality whole-person healthcare ensuring those with behavioral health concerns have access to evidence-based and evidence-informed services. While Standard Plan beneficiaries’ mental and behavioral health needs are generally mild to moderate, research from studies like the adverse childhood experiences (ACEs) study and others like it indicate that over 60% of people experience at least one adverse experience before age 18 and nearly 17% experience at least four,(CDC, 2022). These are experiences, which if remained unaddressed may have lasting and potentially detrimental effects on health later in life, even leading to early death (Merrick MT, et al, 2019). In fact, ACEs are associated with five of the top ten leading causes of death in the US (CDC, 2021).

By understanding the impact and the scope that mental health issues, especially those stemming from trauma, can have on individual’s overall health, WellCare works to increase the availability and accessibility of trauma-informed services to families. By reducing administrative burdens, such as pre-authorizations, evidence-based models like Trauma-Focused Cognitive Behavioral Therapy (TFCBT) and Parent-Child Interaction Therapy (PCIT) are more accessible when timeliness is of the essence.

In addition, to help at risk children stay healthy at lower levels of care, WellCare is partnering with Benchmarks CQi to allow certified clinicians the ability to offer Trauma-intensive Comprehensive Clinical Assessments (TiCCAs) to children involved in child welfare. Benchmarks’ outcomes data on the TiCCA shows that a holistic approach to these assessments and early identification of trauma related needs result in more accurate diagnosis, more appropriate recommendations for treatment, and added cost savings. To accompany these efforts, WellCare also engages in early partnership and collaboration with County DSS offices by extending care management services to children and families involved in In-Home Family Services who receive TiCCAs. These care management services can be used to assist County DSS offices in wrapping the family in services that cover the entire gamut of health including any social determinants of health needs identified in the assessment. WellCare understands that failure to adequately assess and provide supports for children and families impacted by trauma, especially those involved in child welfare, can result in children being displaced from family and community settings which can be costly and have proven to slow progress towards desirable outcomes (Rubin et al, 2007; Atwool, 2006).

Benchmarks appreciates our partnership with WellCare and their dedication to ensuring children and families in North Carolina have access to quality and evidence-informed whole person care. We commend their efforts to provide trauma-informed care and services to families through engaging in innovative approaches to address the needs of some of our most vulnerable populations.

We are glad to be able to highlight the wonderful work being done around the state by our members and partners. And we continue to encourage and support them as they lead North Carolina to being a trauma-informed, trauma-aware, and trauma-responsive community for all!

References

1. Centers for Disease Control and Prevention. (2021, August 23). Adverse childhood experiences (aces). Centers for Disease Control and Prevention. Retrieved October 13, 2022, from https://www.cdc.gov/vitalsigns/aces/index.html
2. Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1external icon.
3. Centers for Disease Control and Prevention. (2022, April 6). Fast facts: Preventing adverse childhood experiences |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved October 13, 2022, from https://www.cdc.gov/violencepr...n/aces/fastfact.html
4. Rubin, D. M., O'Reilly, A. L., Luan, X., & Localio, A. R. (2007). The impact of placement stability on behavioral well-being for children in foster care. Pediatrics, 119(2), 336–344. https://doi.org/10.1542/peds.2006-1995
5. Atwool, Nicola. (2006). Attachment and Resilience: Implications for Children in Care. Child Care in Practice. 12. 10.1080/13575270600863226.