Frequently Asked Questions

Below are a number of questions routinely asked regarding licensure and the provision of mental health services.

1. Where do my client referrals come from?
There are a variety of referral sources in the community (i.e. families, hospitals, periodic providers, group homes, etc.). As a new provider, you must market your agency to the community by having open houses, sending fliers/brochures, etc., to the various community partners. For state funded services, the Local Management Entity-Managed Care Organization (LME-MCO) is the source of referrals and the provider must have a state funded contract with the LME-MCO to receive this type of referral.

2. Do I have to have a qualified professional or "Q"?
Twenty four-hour, day treatment, and outpatient treatment facilities are required to have a qualified professional assist in the development of client treatment/habilitation plans to ensure treatment outcomes. The type of service you are licensed to provide and the type of clients you serve will dictate the type of qualified professional you must have. Rules 10A NCAC 27G Section .0103 (PDF, 23 KB) and .0104 (PDF, 19 KB) include definitions, education and experience requirements of qualified professionals.

3. Do I have to pay the qualified professional or "Q"?
There is no licensure rule requiring a mental health provider to pay for the services of a qualified professional, however "Q"s are professionals who generally charge a fee for their services. Payment for the services of a qualified professional is governed by a variety of factors including hours worked, the specific services provided, and years of experience.

4. Do I have to be licensed before I can serve clients?
Yes. Serving most clients without first obtaining a license is a violation of the law. Specifically, North Carolina General Statute 122C-28 (PDF, 10 KB) states: "Operating a licensable facility without a license is a Class 3 misdemeanor and is punishable by a fine not to exceed fifty dollars ($50.00), for the first offense and a fine, not to exceed five hundred dollars ($500.00), for each subsequent offense. Each day's operation of a licensable facility without a license is a separate offense."

5. Do all staff need training to work in the facility or to provide services?
Yes. All staff must be trained and competent to provide services to mental health clients. Failing to have trained and competent staff may result in poor care for clients, may place clients' health and safety at risk, may place the health and safety of the staff at risk, and may increase provider liability.

6. How do I get people trained? Where can I send them?
Staff training should be provided by a person who is competent in the area in which staff need training. Training in medication administration, for example, must be conducted by a licensed registered nurse, pharmacist, or other legally qualified person as per 10A NCAC 27G .0209(c)(3) (PDF, 18 KB). Training in client rights, including restrictive interventions must be conducted by a person trained in these areas and is qualified to train others. Training resource information is available from the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. It is recommended to use your qualified professional as a resource for assisting, developing or performing some of the required training. Your LME-MCO may also be a resource for training resources.

7. Do I need my staff in place for the initial licensure survey?
Yes. DHSR will not issue a license to a provider who does not have staff in place.

8. How much money will I get for keeping clients?
Reimbursement of mental health services varies according to the population served (i.e. adults, minors), the disability for which services are provided (i.e. mental illness, developmental disabilities or substance abuse problems), and the funding source used for reimbursement (i.e. Medicaid, Special Assistance). DHSR does not handle billing, funding, or client placement. Reimbursement information is available from the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.

9. Do you know of any consultants who can write policies?
DHSR does not maintain information on consultants who write policies and procedures for mental health providers. To recommend consultants would be a conflict of interest for DHSR as a regulatory agency. Policies and procedures must be individualized to reflect the care and services you will provide.

10. What are the fee's charged to open a facility?
Please see the fee portion of the application packet (PDF, 323 KB) for this information.

11. Can facilities be licensed in mobile/manufactured homes?
Yes, but there are restrictions. These restrictions include: (1) rules 10A NCAC 27G .5600 and .5100 (PDF, 383 KB) are the only two licensure categories that allow mobile/manufactured homes, and (2) the maximum number of clients is three. In addition, a waiver is required for this setting by contacting our Construction Section.

12. How do I clarify to the local authorities the type of facility I am proposing to operate?
Take the completed service categories section in the licensure application to your zoning, building and/or fire officials. Providers of day, outpatient and residential need zoning approval. 24-hour residential services must present completed application to their LME-MCO to request a letter of support.

13. Do I have to upgrade the facility to meet handicap accessibility?
If you provide residential services for handicapped clients, you need to provide proper accommodations. Contact your local building official for information.

14. Can someone from Construction come to look at a facility prior to my renting or leasing it?
No. You need to review the physical plant requirements in 10A NCAC 27G--Section .0300 (PDF, 365 KB) to verify the facility meets the construction, space and other physical plant requirements for the clients to be served. You may, however, contact the DHSR Construction Section for specific questions.

15. Can we use a rope ladder for a second escape?
No. A facility required to provide a second remote exit from any story must be a door with stairs meeting the North Carolina State Building Code.

16. What are the requirements for a day facility?
Physical plant requirements are on page three of the application packet. No fees are required at this time.

17. How do I get a letter of support?
Twenty-four hour residential applicants must contact the LME-MCO in the catchment area to verify/review if there is a need for the particular twenty-four hour residential service (see 10A NCAC 27G .0406). The LME-MCO will issue the letter of support which needs to be enclosed with the initial licensure application or a change application if changing service category.

18. When do I need to renew my license?
All licenses expire at the end of the calendar year. Renewal applications for child residential services are sent out in July. Providers should complete these renewals and return them by October 15th to allow time for endorsement. All other renewal applications will be sent in October to be returned before the end of that year with the annual fee and appropriate inspections.