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North Carolina

8  Coordination of services of TANF/Work First with Workforce Development partners through a formalized appraisal / referral processes.

SUBSTANCE USE AND MENTAL HEALTH INITIATIVE

North Carolina law (NCGS 108A-29.1) requires substance use screening and testing for the illegal use of controlled substances, if there is reasonable suspicion, for each Work First program adult applicant or recipient as a condition of eligibility to receive assistance. Adult applicants or recipients will complete a substance use questionnaire designed to determine if an adult applicant or recipient is at risk for alcohol and/or substance use disorders. If the results indicate reasonable suspicion of substance use, a drug test is required within a period of time as specified by the Department. The results of drug tests will remain confidential and will not be released to law enforcement.

A voluntary mental health screening is offered to all adult Work First applicants and recipients as part of the interview process. If the screening indicates the adult is at risk for mental health issues, the applicant/recipient may be referred to a Qualified Professional in Substance Abuse (QPSA) for further assessment. If appropriate, a substance use referral is made through the Local Management Entity – Managed Care Organization (LME-MCO) to identify a provider for treatment and then a treatment plan is developed. The QPSA serves as the care coordinator to track the adult's engagement in treatment. The QPSA and the Work First caseworker jointly develop a plan for the family to ensure success. If an adult refuses to be screened initially for substance use, the adult is ineligible for Work First Cash Assistance but may still apply for Medicaid. If otherwise eligible, the remaining household members can receive cash assistance.

If the adult fails to comply with the treatment plan without good cause; the adult is ineligible for cash assistance. The QPSA will assist the Work First worker in determining good cause. The family’s payment is recalculated with the adult excluded from the needs unit, and the payment is made to a protective payee. Participants in treatment programs are expected to combine treatment with other appropriate work activities.

WORK FIRST STAFF TRAINING

The Division of Social Services Work First Program in collaboration with NC FAST and the Division of Mental Health/Developmental Disabilities and Substance Abuse Services provided the Work First Substance Use and Mental Health Initiative Training Webinar. This training was to assist counties in preparing for Substance Use Testing implementation on August 3, 2015. All 100 NC counties participated in the training webinar.

The Work First Program will collaborate with the appropriate partners and develop additional training for County TANF/Work First staff on “motivational interviewing”, two-generational approaches and child development evidenced-based practice (impact of poverty on cognitive development and executive functioning.

FRAUD AND ABUSE

The Department of Health and Human Services enforces standards and procedures to detect and prevent fraud and abuse by recipients and employees of the program. An administrative hearing process enables county departments of social services/agencies to identify cases of intentional