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The Mecklenburg County Local Management Entity (LME) has the responsibility of monitoring all providers of Mental Health, Developmental Disabilities and Substance Abuse services in accordance with rules, regulations and procedures set forth by the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services (MH/DD/SAS). 

One monitoring tool that was developed by the State and is required of all LMEs to use is the Frequency and Extent of Monitoring (FEM).  The FEM assesses the level of confidence and determines the frequency in which providers will receive routine monitoring.

The FEM is conducted on all service providers who have a service contract or a Medicaid Memorandum of Agreement with the LME; provider scores are reported to the NC Division of MH/DD/SAS. 

The FEM is organized in four sections or domains as follows:

• Provider Performance
• Status with other agencies that have oversight responsibilities
• Incident Reporting
• Complaints

The FEM scores rate providers in high, moderate, and low categories.  Providers that score a "High" will require routine monitoring once every 3 years, providers that receive a "Moderate" rating will require routine monitoring every 12 to 18 months, and providers that receive a "Low" rating will require routine monitoring semi-annually.  

FEM scores are updated based on the receipt of new information or when significant changes occur that may affect the frequency and/or extent of scheduled monitoring.

Also note that the FEM rating only determines the frequency of "routine monitoring", additional monitoring of providers may occur related to endorsements, complaints or a focused monitoring related to a specific incident or event. 

When is the Frequency & Extent of Monitoring Tool (FEM) Completed or Updated?

• Initially completed following the LME's endorsement review or upon obtaining a contract with the LME.
• Updated minimally every 3 years.
• Updates may occur more often than the minimally required 3 years in order to reflect a provider's current status based on the receipt of new information or when significant changes occur that may affect the frequency and/or extent of scheduled monitoring. For example:
• After the completion of the Provider Monitoring Tool
  When a new service is added through endorsement or a contract
  When the provider's status with an oversight agency changes i.e. accrediting body, DMH, DMA, DHSR

After a Complaint Review when a provider fails to make themselves available to the LME; implement corrections, or have substantiated an egregious incident
Rating Reports