12.10.25 BOA Agenda Packet - Laserfiche WebLink

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27 Draft 1 services organization as their chief medical officer working to offer access to care across 19 2 clinical sites throughout the state of North Carolina. That led me to become the lead medical 3 director for behavioral health at Blue Cross and Blue Shield of North Carolina during COVID, 4 where I was able to support access to mental health services for our 4 million members in 5 North Carolina. Overtime, I really felt the corporate practice of medicine didn't center patients 6 and put their needs first, and it felt really important to me to create a space that centered what 7 patients needed over profits. So, I left my job at Blue Cross and Blue Shield, and I founded 8 Jubilee in hopes that I could offer a space with high client to staff ratios and connection with 9 nature as a way to support longitudinal healing for particularly young adults whose lives were 10 interrupted by mental illness. Our focus is on mental illness. Some of our clients do have co- II morbid cannabis-use disorder, but we are focused on people with PTSD, anxiety disorders, 12 schizophrenia, and depression, who are not receiving the support they need through 13 traditional pathways. 14 15 Kevin Hornik: I'd like to tender Dr. Dennis as an expert in the field of psychiatry and, and mental health 16 treatment. 17 18 Leon Meyers: Without objection. 19 20 Kevin Hornik: Okay. Nora let's see. We've, we've already established that the farm has been operating as 21 a bona fide farm use. Can you tell us a little bit about why from your perspective it's necessary 22 to apply for the special-use permit? 23 24 Nora Dennis: Yes, I can. From our inception, we've been a bona fide farm. I was advised that we should 25 take on that status some time ago by members of county staff who suggested to me that that 26 was the best way for us to have this type of service in the location where it was. So, I'm sorry, 27 can you repeat the question? I like, I'm so nervous. 28 29 Kevin Hornik: That's all right. What, why is it that you are seeking a special-use permit. 30 31 Nora Dennis: Okay, got it. Yeah, so this is a little bit complicated and technical, but within medical billing, 32 there are two categories of billing. There's office-based billing, which uses a CMS 1500 form, 33 and there's facility-based building which use a UB 04 form. For most payers, there's a really 34 big differential in contracting between facility based, the,for facility-based services and office- 35 based services and most prefer to work for people who are providing intensive outpatient care, 36 which is what we do. We're with people multiple hours a day, multiple days a week. They 37 prefer to contract as a facility. And in particular Medicaid plans and Alliance,which is our local 38 Medicaid plan, strongly prefers, in fact won't contract with an office-based service. In order to 39 have a facility-based service, you have to have a license. But I want to be really clear, 40 intensive outpatient services do not require a license in the state of North Carolina. And in 41 fact, there is no mental health intensive outpatient license. There's only a day program 42 license. So, so, because if people said we're operating without a license and, or that it's true, 43 that was because the license is not required. But in any case, I want to take care of Medicaid 44 patients. I've talked repeatedly to Sean Schreiber, who's the COO at Alliance about our wish 45 to take care of Medicaid patients. And he's basically like, call me back when you have a 46 license. So, if we're a bona fide farm, we can't get a fire inspection and if we are not a bona 47 fide farm, then we can. We would give up bona fide farm status where we awarded the 48 special-use permit. I'm asking for more regulation of my facility in order to be able to take 49 care of Medicaid patients in Orange County. 50 27