Three ‘provider-led’ groups receive approval for ‘organized care’ of special needs patients

Three “provider-led” entities that provide care to around 35,000 special needs patients in Arkansas using Medicaid funds have been granted the first licenses under a new state law designed to provide improved care and outcomes using “wrap around services.”

Act 775 of 2017, the Medicaid Provider-Led Organized Care Act, was sponsored by Rep. Aaron Pilkington, R-Clarksville, and signed into law by Gov. Asa Hutchinson. The law is designed to allow providers to create a type of insurance network targeted solely for those in Arkansas with severe intellectual and physical medical needs.

That vehicle is known as the “Provider-led Arkansas Shared Savings Entity” (PASSE).

“It is a new model of organized care that will address the needs of certain Medicaid beneficiaries who have complex behavioral health and intellectual and developmental disabilities service needs,” according to the Arkansas Insurance Department (AID).

Brandi Hinkle, deputy chief of communications for the Arkansas Department of Human Services, said the process creates a network of therapists, counselors, doctors and other providers who develop “care coordination” for the patients. The coordination reduces duplication of services, seeks to put all caregivers on the same page and “ideally addresses issues” before they become a more serious problem for the patient and a more expensive solution for the providers, Hinkle said.

Arkansas Insurance Department Commissioner Alan Kerr on Monday (Oct. 23) granted PASSE authority to three of five groups who have applied.

“I am proud to issue the first licenses to provider-led organizations under Act 775 and welcome them as domestic insurance companies. These companies have demonstrated initial financial resources and organizational structure as well as adequate network coverage as deemed by the Department of Human Services. This is an important step for Arkansas in establishing a unique system to serve Medicaid beneficiaries,” Kerr said in the statement.

Following are the three entities who received a license:

• Arkansas Total Care, Inc. (ATC)
ATC is a wholly owned subsidiary of Arkansas Total Care Holding Company, LLC. The ownership of the holding company is held by Mercy Health System, LifeShare Management Group, and Arkansas Health & Wellness Health Plan Inc. LifeShare and AHWHP are owned by Centene Corp. Mercy’s system includes 44 acute care and specialty hospitals, more than 700 physician practices and outpatient facilities and more than 2,000 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. LifeShare develops and delivers person-centered solutions for people with intellectual and developmental disabilities through manage care, state, and health organizations across multiple states. AHWHP is an Arkansas domestic health maintenance organization.

• Arkansas Advanced Care, Inc. (AAC)
AAC will be owned and operated by Baptist Health, Bost, Inc., the University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, and USAble Corporation.

“The members of AAC advocate the goal to ensure that Arkansas’s residents receive the high quality, efficient care with innovative delivery and payment arrangements and population health programs to help transform Arkansas to an organized system of care,” noted the insurance department statement.

• Empower Healthcare Solutions, LLC (EHS)
EHS is comprised of Beacon Health Options, Inc., Woodruff Health Group, LLC, Independent Case Management, Inc., Preferred Family Healthcare, Inc., Arkansas Community Health Network, LLC, The Arkansas Healthcare Alliance, LLC, and Statera, LLC. Beacon is an independent privately-owned company and one of the nation’s largest organizations that assesses and address the clinical needs of individuals who are experiencing mental illness, addiction, and developmental disabilities.

Hinkle said the three groups will cover around 35,000 patients.

“(W)e are currently spending $1 billion annually on this group of beneficiaries. We don’t have an estimate of savings, but we hope to see that care coordination helps this group better utilize preventative treatment, medication adherence and a decrease in unnecessary emergency department usage. DHS has not determined the actuarially-sound global payment amount but will begin that process in the spring,” Hinkle told Talk Business & Politics.

According to DHS, the goals of PASSE are:

• To improve the health of Arkansans who have need of intensive levels of specialized care due to mental health, intellectual or developmental disabilities;
• To link providers of physical health care with providers of behavioral health care and services for individuals with developmental disabilities;
• To coordinate care for all community-based services for individuals with intensive levels of specialized care needs;
• To reduce excess cost of care due to under-utilization and over-utilization of services;
• To allow flexibility in the array of services offered to the population served; and
• To increase the number of service providers available in the community to the population covered.

The state agency also says the program should reduce costs by organizing care, and “not just by managing finances.” To that point, Hinkle said the agency conducts annual reviews to make sure patient care is not reduced in order to simply improve finances.

“We regularly do quality assurance to make sure that a diagnosis is being treated appropriately based on standards across the country,” she said.

The first phase of PASSE began Oct. 1, 2017. Additional patients are expected to be added in January 2018 based on assessments by the AID and DHS. The second phase begins Jan. 1, 2019. It’s in this phase where the provider-led groups will receive payment “for each enrollee to cover the administration costs and benefits for each patient, while ensuring a level of savings for the state.” Hinkle said one example of a phase 2 cost-savings goal is the reduction of unnecessary medical tests.


Perspectives Becomes A Provider For HealthScope Insurance

Perspectives Behavioral Health Management is pleased to announce that we are now a provider for individuals with HealthScope Insurance.  For appointments for medication management as well as individual and family therapy contact us at 479-783-5353.

For more information about HealthScope click on the link below:



Perspectives announces expansion as a Blue Cross Blue Shield product provider

Personalized Healthcare, Nationwide

Since 1929, Blue Cross Blue Shield (BCBS) companies have provided healthcare coverage to members, allowing them to live free of worry, free of fear. In every ZIP code, Blue Cross Blue Shield offers a personalized approach to healthcare based on the needs of the communities where their members live and work. They work closely with hospitals and doctors in the communities they serve to provide quality, affordable healthcare.

We understand and answer to the needs of local communities, while providing nationwide healthcare coverage that opens doors for more than 106 million members in all 50 states, Washington, D.C., and Puerto Rico. Nationwide, more than 96 percent of hospitals and 93 percent of doctors and specialists contract with Blue Cross Blue Shield companies — more than any other insurer

Perspectives Behavioral Health is extremely proud to be part of the networks throughout the nation that provides services through BCBS.  As we have always done, we are committed to providing timely access, quality services and superior communication that is centered around best practices.  Perspectives is now accepting new patients as a BCBS provider throughout Oklahoma and Arkansas.  For more information or to make an appointment, contact us at 479-783-5353 or 888-505-5040.

Perspectives Behavioral Health Management, LLC Achieves National RE- Accreditation

Perspectives Behavioral Health Management, LLC Achieves National RE- Accreditation

Perspectives Behavioral Health has achieved national re-accreditation through the New York-based Council on Accreditation (COA).  Perspective provides the following services:  outpatient behavioral health services for children, adolescents and adults.  Services provided are as follows: day treatment for children, adolescents and adults, school based services for children and adolescents, intensive outpatient services for all ages and traditional outpatient clinic services for all ages.   Perspectives re accreditation process is an ongoing process. Organizations pursue re-accreditation to demonstrate the implementation of best practice standards in the field of human services. COA evaluated all aspects of Perspectives programs, services, management, and administration.

COA re-accreditation is an objective, independent, and reliable validation of an agency’s performance. The COA re- accreditation process involves a detailed review and analysis of an organization’s administration, management, and service delivery functions against international standards of best practice. The standards driving re- accreditation ensure that services are well-coordinated, culturally competent, evidence-based, outcomes-oriented, and provided by a skilled and supported workforce. COA re-accreditation demonstrates accountability in the management of resources, sets standardized best practice thresholds for service and administration, and increases organizational capacity and accountability by creating a framework for ongoing quality improvement. 

To achieve COA re- accreditation, Perspectives first provided written evidence of compliance with the COA standards.  Thereafter, a group of specially trained volunteer Peer Reviewers confirmed adherence to these standards during a series of on-site interviews with trustees, staff and clients. 

Based on their findings, COA’s volunteer-based Accreditation Commission voted that Perspectives had successfully met the criteria for re-accreditation.

An endorsement of COA and the value of its re-accreditation process is reflected in it being named by the US State Department as the sole national independent accrediting body under the Hague Convention on Intercountry Adoption to accredit intercountry adoption service providers. In addition, COA is the only national accreditor designated by the U.S. Department of Defense to develop accreditation standards and processes for human service programs provided to military personnel and their families.

Founded in 1977, COA is an independent, not-for-profit accreditor of the full continuum of community-based behavioral health care and social service organizations in the United States and Canada. Over 2,000 organizations — voluntary, public, and proprietary; local and statewide; large and small — have either successfully achieved COA accreditation or are currently engaged in the process. Presently, COA has a total of 47 service standards that are applicable to over 125 different types of programs. To learn more about COA, please visit

Perspectives Behavioral Health offers outpatient behavioral health services to children and adolescents in Fort Smith and surrounding areas. Perspectives has been providing services to children, adolescents and adults since 2003.

Press Release


Symptoms, Treatment, and Recovery

Emotional and Psychological Trauma In This Article

If you’ve experienced trauma, you may be struggling with upsetting emotions, frightening memories, or a sense of constant danger. Or you may feel numb, disconnected, and unable to trust other people. When bad things happen, it can take a while to get over the pain and feel safe again. But with the right self-help strategies and support, you can speed your recovery. Whether the trauma happened years ago or yesterday, you can heal and move on.

What is emotional and psychological trauma?

Emotional and psychological trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless in a dangerous world.

  • Traumatic experiences often involve a threat to life but any situation that leaves you feeling overwhelmed can be traumatic, even if it doesn’t involve physical harm. 
  • It’s not the objective facts that determine whether an event is traumatic, but your subjective emotional experience.
  • The more frightened and helpless you feel, the more likely you are to be traumatized.

Causes of emotional or psychological trauma

Emotional and psychological trauma can be caused by:

  • One-time events, such as an accident, injury, natural disaster, or violent attack
  • Ongoing, relentless stress, such as living in a crime-ridden neighborhood or battling a life-threatening illness
  • Commonly overlooked causes, such as surgery (especially in the first 3 years of life), the sudden death of someone close, the breakup of a significant relationship, or a humiliating or deeply disappointing experience

An event will most likely lead to emotional or psychological trauma if:

  • It happened unexpectedly.
  • You were unprepared for it.
  • You felt powerless to prevent it.
  • It happened repeatedly.
  • Someone was intentionally cruel.
  • It happened in childhood.

Risk factors that increase your vulnerability to trauma

A number of risk factors make people more susceptible to emotional and psychological trauma. You’re more likely to be traumatized by a stressful experience if:

  • You’re already under a heavy stress load or have recently suffered a series of losses
  • You’ve been traumatized before—especially if the earlier trauma occurred in childhood

Childhood trauma increases the risk of future trauma

Experiencing trauma in childhood can have a severe and long-lasting effect. When childhood trauma is not resolved, a sense of fear and helplessness carries over into adulthood, setting the stage for further trauma.

Childhood trauma results from anything that disrupts a child’s sense of safety, including:

  • An unstable or unsafe environment
  • Separation from a parent
  • Serious illness
  • Intrusive medical procedures

Symptoms of emotional and psychological trauma

People react in different ways to trauma, experiencing a wide range of physical and emotional reactions. There is no “right” or “wrong” way to think, feel, or respond, so don’t judge your own reactions or those of other people. Your responses are NORMAL reactions to ABNORMAL events.

Emotional and psychological symptoms of trauma:

  • Shock, denial, or disbelief
  • Anger, irritability, mood swings
  • Guilt, shame, self-blame
  • Feeling sad or hopeless
  • Confusion, difficulty concentrating
  • Anxiety and fear
  • Withdrawing from others
  • Feeling disconnected or numb

Physical symptoms of trauma:

  • Insomnia or nightmares
  • Being startled easily
  • Racing heartbeat
  • Aches and pains
  • Fatigue
  • Difficulty concentrating
  • Edginess and agitation
  • Muscle tension

Symptoms typically last from a few days to a few months, gradually fading as you process the trauma. But even when you’re feeling better, you may be troubled from time to time by painful memories or emotions—especially in response to triggers such as an anniversary of the event or something that reminds you of the trauma.

Grieving is normal following trauma

Whether or not a traumatic event involves death, survivors must cope with the loss, at least temporarily, of their sense of safety. The natural reaction to this loss is grief. Like people who have lost a loved one, trauma survivors go through a grieving process, which is easier if you turn to others for support and take care of yourself.

Trauma recovery tip 1: Get moving

Trauma disrupts the body’s natural equilibrium, freezing you in a state of hyperarousal and fear. In essence, your nervous system gets “stuck.” As well as burning off adrenaline and releasing endorphins, exercise and movement can actually help your nervous system become unstuck.

  • Instead of focusing on your thoughts or distracting yourself while you exercise, really focus on your body and how it feels as you move.
  • Exercise that is rhythmic and engages both your arms and legs—such as walking, running, swimming, basketball, or even dancing—works best.
  • Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of wind on your skin.
  • Rock climbing, boxing, weight training, or martial arts can make it easier to focus on your body movements—after all, if you don’t, you could get hurt.
  • Try to exercise for 30 minutes or more—or if it’s easier, three 10-minute spurts of exercise per day are just as good. Move as often as you can throughout the day.

Trauma recovery tip 2: Don't isolate

Following a trauma, you may want to withdraw from others, but isolation makes things worse. Connecting to others face to face will help you heal, so make an effort to maintain your relationships and avoid spending too much time alone.

  • You don’t have to talk about the trauma. Connecting with others doesn’t have to mean talking about the trauma. In fact, for some people, that can just make things worse. Comfort comes from feeling engaged and accepted by others.
  • Ask for support. While you don’t have to talk about the trauma itself, it is important you have someone to share your feelings with face to face, someone who will listen attentively without judging you. Turn to a trusted family member, friend, counselor, or clergyman.
  • Participate in social activities, even if you don’t feel like it. Do “normal” things with other people, things that have nothing to do with the traumatic experience.
  • Reconnect with old friends. If you’ve retreated from relationships that were once important to you, make the effort to reconnect.
  • Join a support group for trauma survivors. Being with others who are facing the same problems can help reduce your sense of isolation and hearing how others cope can help inspire you.
  • Volunteer. As well as helping others, volunteering can be a great way to challenge the sense of helplessness that often accompanies trauma. Remind yourself of your strengths and reclaim your sense of power by comforting or helping others.
  • Make new friends. If you live alone or far from family and friends, it’s important to reach out and make new friends. Take a class or join a club to meet people with similar interests, connect to an alumni association, or reach out to neighbors or work colleagues.

If connecting to others is difficult

Many people who have experienced trauma feel disconnected, withdrawn and find it difficult to connect with other people. If that describes you, there are some things you can do before you next sit down with a friend:

  • Exercise or move. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.
  • Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Sit straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.

Trauma recovery tip 3: Self-regulate your nervous system

No matter how agitated, anxious, or out of control you feel, it’s important to know that you can change your arousal system and calm yourself.

  • Mindful breathing.  If you are feeling disoriented, confused, or upset, a quick way to calm yourself is through mindful breathing. Simply take 60 breaths, focusing your attention on each out breath.
  • Sensory input. Does a specific sight, smell or taste quickly make you feel calm? Or maybe petting an animal or listening to music works to quickly soothe you? Everyone responds to sensory input a little differently, so experiment to find what works best for you. See Stress Relief in the Moment.
  • Staying grounded. To feel in the present and more grounded sit on a chair, feel your feet on the ground and your back against the chair. Look around you and pick six objects that have red or blue in them. Notice how your breathing gets deeper and calmer.
  • Allow yourself to feel what you feel when you feel it. Acknowledge your feelings about the trauma as they arise and accept them. Our emotional intelligence toolkit can help.

Trauma recovery tip 4: Take care of your health

A healthy body increases your ability to cope with stress from a trauma.

  • Get plenty of sleep. After a traumatic experience, worry or fear may disturb your sleep patterns. A lack of sleep can make your trauma symptoms worse and make it harder to maintain your emotional balance. Go to sleep and get up at the same time each day and aim for 7 to 9 hours of sleep each night.
  • Avoid alcohol and drugs as their use can worsen your trauma symptoms and exacerbate feelings of depression, anxiety, and isolation.
  • Eat a well-balanced diet. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. Avoid sugary and fried  and eat plenty of omega-3 fats—such as salmon, walnuts, soybeans, and flaxseeds—to give your mood a boost.
  • Reduce stress. Try relaxation techniques such as meditation, yoga, or deep breathing exercises. Schedule time for activities that bring you joy such as favorite hobbies.

When to seek professional help for emotional or psychological trauma

Recovering from a traumatic event takes time, and everyone heals at his or her own pace. But if months have passed and your symptoms aren’t letting up, you may need professional help from a trauma expert.

Seek help for emotional or psychological trauma if you're:

  • Having trouble functioning at home or work
  • Suffering from severe fear, anxiety, or depression
  • Unable to form close, satisfying relationships
  • Experiencing terrifying memories, nightmares, or flashbacks
  • Avoiding more and more things that remind you of the trauma
  • Emotionally numb and disconnected from others
  • Using alcohol or drugs to feel better

Finding a trauma specialist

Working through trauma can be scary, painful, and potentially retraumatizing. Therefore, this healing work is best done with the help of an experienced trauma specialist.

  • Finding the right therapist may take some time. It’s very important that the therapist you choose has experience treating trauma.
  • Choose a trauma specialist you feel comfortable with. If you don’t feel safe, respected, or understood, find another therapist. There should be a sense of trust and warmth between you.

After meeting a potential trauma therapist, ask yourself these questions:

  • Did you feel comfortable discussing your problems with the therapist?
  • Did you feel like the therapist understood what you were talking about?
  • Were your concerns taken seriously or were they minimized or dismissed?
  • Were you treated with compassion and respect?
  • Do you believe that you could grow to trust the therapist?

Treatment for psychological and emotional trauma

In order to heal from psychological and emotional trauma, you must face and resolve the unbearable feelings and memories you’ve long avoided. Trauma treatment and healing involves:

  • Processing trauma-related memories and feelings
  • Discharging pent-up “fight-or-flight” energy
  • Learning how to regulate strong emotions
  • Building or rebuilding the ability to trust other people

Trauma therapy treatment approaches

The following therapies are commonly used in the treatment of emotional and psychological trauma:

  • Somatic experiencing  focuses on bodily sensations, rather than thoughts and memories about the traumatic event. By concentrating on what’s happening in your body, you can release pent-up trauma-related energy through shaking, crying, and other forms of physical release.
  • EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation that can “unfreeze” traumatic memories.
  • Cognitive-behavioral therapy helps you process and evaluate your thoughts and feelings about a trauma.

Helping a loved one deal with emotional and psychological trauma

It can be difficult to know how to help a loved one who’s suffered trauma, but your support can be a crucial factor in their recovery.   

  • Be patient and understanding. Healing from trauma takes time. Be patient with the pace of recovery and remember that everyone’s response to trauma is different.  Don’t judge your loved one’s reaction against your own response or anyone else’s.
  • Offer practical support to help your loved one get back into a normal routine. That may mean help with collecting groceries or housework, for example, or simply being available to talk or listen.
  • Don’t pressure your loved one into talking but be available if they want to talk. Some trauma survivors find it difficult to talk about what happened. Don’t force your loved one to open up but let them know you are there to listen if they want to talk, or available to just hang out if they don’t.
  • Help your loved one to socialize and relax. Encourage them to participate in physical exercise, seek out friends, and pursue hobbies and other activities that bring them pleasure. Take a fitness class together or set a regular lunch date with friends.
  • Don’t take the trauma symptoms personally. Your loved one may become angry, irritable, withdrawn, or emotionally distant. Remember that this is a result of the trauma and may not have anything to do with you or your relationship.

Helping a child recover from trauma

It’s important to communicate openly with children following trauma. Let them know that it’s normal to feel scared or upset. Your children may also look to you for cues on how they should respond to trauma so let them see you dealing with symptoms in a positive way.

How children react to emotional and psychological trauma

Some common reactions to trauma and ways to help your child deal with them:

  • Regression. Many children need to return to an earlier stage when they felt safer. Younger children may wet the bed or want a bottle; older children may fear being alone. It's important to be understanding, patient and comforting if your child responds this way.
  • Thinking the event is their fault. Children younger than 8 tend to think that if something goes wrong, it must be their fault. Be sure your child understands that he or she did not cause the event.
  • Sleep disorders. Some children have difficulty falling to sleep; others wake frequently or have troubling dreams. Give your child a stuffed animal, soft blanket, or flashlight to take to bed. Try spending extra time together in the evening, doing quiet activities or reading. Be patient. It may take a while before your child can sleep through the night again.
  • Feeling helpless. Being active in a campaign to prevent an event from happening again, writing thank you letters to people who have helped, and caring for others can bring a sense of hope and control to everyone in the family.

Source: Sidran Institute

If you want to learn skills for connecting to others in ways that reduce stress and anxiety, FEELING LOVED can help.

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Related HelpGuide articles

Resources and references

General information about emotional and psychological trauma

Common Reactions After Trauma – Guide to the common symptoms, effects, and problems that can result from emotional or psychological trauma. (National Center for PTSD)

What is Psychological Trauma? – In-depth introduction to emotional or psychological trauma, including the causes, symptoms, treatments, and effects. (Sidran Institute)

Trauma treatment and therapy

How to Choose a Therapist for Post-Traumatic Stress and Dissociative Conditions – Advice on how to choose a trauma therapist. (Sidran Institute)

A Brief Description of EMDR Therapy – Covers the eight phases of EMDR therapy involved in the treatment of trauma. (EMDR Network)

Trauma recovery and self-help

Recovering from Trauma – Article on the necessity of processing emotional trauma in treatment if we are to recover and heal. (Psychology Today)

Dealing With the Effects of Trauma: A Self-Help Guide (PDF) – Guide to the healing journey, including coping strategies, where to find help for emotional trauma, and how to support recovery. (SAMHSA’s National Mental Health Information Center)

Trauma in children and adolescents

Helping a Child Manage Fears – Article on helping a child cope with traumatic events. Includes tips for helping your child and a list of common childhood reactions to trauma. (Sidran Institute)

Understanding Child Traumatic Stress – Learn how emotional or psychological trauma in children differs from trauma in adult. Includes causes, symptoms, and recovery factors. (The National Child Traumatic Stress Network)

Delving deeper into psychological and emotional trauma

Trauma, Attachment, and Stress Disorders: Rethinking and Reworking Developmental Issues – Explains the brain-based view of emotional trauma and how it affects child development. (Trauma Resources)

What other readers are saying

“I suffered abuse in my life during childhood and have just begun to face the fear and anxiety through therapy. Reading the article made me feel okay about the feelings I was having, and whenever I get really anxious I can come to this site and know that what I'm experiencing is completely normal. Where I live, mental health is not really an acknowledged thing and I did not even know about seeking help until I went to college in a large city. This resource is invaluable.” ~ New York

“I was recently in a car accident and . . . there has been an obvious deterioration in my behavioral and emotional functioning. I could not understand why the feelings weren't going away, or why I seemed to be getting worse, not better. A couple of friends suggested I was traumatized, which I initially pooh-poohed, but then I started to really consider it and finally decided to research trauma. Your article spoke to me, and clarified a great deal. I am particularly grateful for the suggestions about how to self-help and what to expect going forward.” ~ Canada

Authors: Lawrence Robinson, Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: May 2016.

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