NC DHHS COVID-19 Update: April 24, 2020
Extension of the Stay-at-Home Order
Governor Cooper extended North Carolina’s Stay At Home order through May 8. The Governor shared details about North Carolina’s plan to lift restrictions in three phases once the data show that key metrics are headed in the right direction.
Our state has taken aggressive action to slow the spread of COVID-19 and save lives. Those actions combined with North Carolinians’ resolve to stay home to protect their loved ones have put our state on the right path. If we stick to these efforts now, we will continue to see a slowing of virus spread and we can slowly begin easing restrictions.
Secretary Mandy Cohen provided a detailed look at where North Carolina stands on metrics on testing, tracing and trends and outlined the progress needed to begin lifting restrictions
- Sustained Leveling or Decreased Trajectory in COVID-Like Illness (CLI) Surveillance Over 14 Days. Currently, North Carolina’s syndromic surveillance trend for COVID-like illness is decreasing over the last 14 days.
- Sustained Leveling or Decreased Trajectory of Lab-Confirmed Cases Over 14 Days. Currently, North Carolina’s trajectory of lab-confirmed cases over the last 14 days cases is still increasing, although at a slower rate.
- Sustained Leveling or Decreased Trajectory in Percent of Tests Returning Positive Over 14 Days. Currently, North Carolina’s trajectory in percent of tests returning positive over the last 14 days is increasing at a slow rate.
- Sustained Leveling or Decreased Trajectory in Hospitalizations Over 14 Days. Currently, North Carolina’s trajectory of hospitalizations over the last 14 days is largely level with a slight trend upward.
In addition to these metrics, the state will continue building capacity to be able to adequately respond to an increase in virus spread. These include:
- Increase in Laboratory Testing. Currently, North Carolina is testing approximately 2,500 to 3,000 people per day and is working to increase to at least 5,000 to 7,000 per day.
- Increase in Tracing Capability. Currently, North Carolina has approximately 250 people doing contact tracing across its local health departments and is working to double this workforce to 500.
- Availability of Personal Protective Equipment. The state is working to ensure there are adequate supplies to fulfill requests for critical PPE for at least 30 days. This includes face shields, gloves, gowns, N95 masks, and surgical and procedural masks. Currently the state has less than 30 days supply of gowns and N95 masks. Availability of PPE is calculated based on the average number of requests for the last 14 days compared to the supply that the state has on hand.
Telehealth Clinical Policy Modifications: Outpatient Behavioral Health Services
Effective April 20, 2020, NC Medicaid in partnership with the DHHS Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability Clinical Coverage Policy 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic.
In addition to previous flexibilities published in COVID-19 Special Medicaid Bulletins #9, #19, and #46, the Department is issuing guidance on allowing telephonic outpatient psychotherapy, in addition to the telehealth flexibilities previously added. As clinically appropriate, services may still be offered via HIPAA-compliant, real-time, two-way interactive audio and video telehealth appointment to proceed with the behavioral health intervention(s). (Note: please see OCR guidance relaxing technology requirements). If that option is not available, services may be offered via non-HIPAA compliant audio and video telehealth appointment with documented beneficiary or legal guardian consent. If two-way audio-visual options are not accessible to the beneficiary, the following services may be offered via telephonic modality.
These temporary changes are retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when the policy modification is rescinded. When the temporary modifications end, all prior service requirements will resume.
For more information, please see SPECIAL BULLETIN COVID-19 #59: Telehealth Clinical Policy Modifications - Outpatient Behavioral Health Services.