Wednesday, April 9, 2008

In the news...

MENTAL-HEALTH OFFICES:Five of North Carolina's 25 county and regional mental-health offices are performing below average, according to a new report. The report, commissioned by the state Department of Health and Human Services and released Friday, found that seven offices were doing above average work and 13 were doing average work. Under a law passed in 2001, the local mental-health offices were forced to give up most of the responsibility for treating patients and now monitor private companies offering treatment. The state hired Mercer Government Human Services Consulting for $794,000 to evaluate how the local offices were doing and to suggest efficiencies. The Mercer study is the first evaluation of the local offices by an outside group.
Dr. Peter Morris, medical director for Wake County's human services department, said he wasn't surprised by the low grade Wake County's office received because it needs computer upgrades to manage contracts and services. The report does not reflect the quality of services available in the county, said Morris. "This is about the management of that care, and we need to improve," Morris said of the below average marks.
The report suggests cutting the number of local offices from 25 to 20 and creating three to five regional management offices, where a local mental-health office and specialty companies compete to do most of the administrative work. It also suggests hiring a statewide management company. No matter what the state decides, all offices should have full-time psychiatrists as medical directors, medical doctors on call for crisis services and trained specialists on their clinical staff, according to the report. Rep. Verla Insko, D-Orange, said she liked some of the recommendations but would hesitate to farm out management to private companies. "I want to leave oversight of the public system in public hands," she said. (Lynn Bonner,THE NEWS & OBSERVER, 4/05/08).
MENTAL-HEALTH PANEL:Department of Health and Human Services Secretary Dempsey Benton named a panel in January to investigate problems in North Carolina's mental-health system. But none of its 32 members are users of mental-health services or their family members."The exclusion gives the impression that individuals with a mental illness either aren't smart enough, aren't savvy enough, aren't connected enough to sit at the table," said David Cornwell, of N.C. Mental Hope. Cornwell sent a letter last week asking Benton to rethink the group's membership. Eighty-nine people and assorted groups signed on.
The Facility Management Working Group is wrapping up its work, and the secretary's one-sentence reply to Cornwell by e-mail makes a last-minute change look unlikely."Your petition has been received and will be considered in establishing future work groups," he wrote. Through a spokesman, Benton gave a similar response to questions about the petition. Benton, tapped last year to lead the health department through Gov. Mike Easley's last year in office, is likely to leave before a new governor takes over in January. Benton was confronted with a limited window of time to turn input from the public into a budget request to Easley, work group member Robin Huffman said."I think it's just real easy to criticize a work group that doesn't have every group represented," said Huffman, executive director of the N.C. Psychiatric Association.
The group also lacks members from western North Carolina, where providers are scarce in some rural parts and whose residents are served by a hospital in Morganton that lost its federal certification last year over a patient death and injury. Nearly half of the petition's signers come from the region. Debra Dihoff, state director of the National Alliance on Mental Illness and a panel member, also said the panel was chosen with an eye toward moving quickly to tackle a crisis. Dihoff was one of the people who signed Cornwell's letter."I suspect (Benton) appointed me to represent the family and consumer voices," she said."I do my darnedest, but it's not really the same." (Jordan Schrader, ASHEVILLE CITIZEN-TIMES, 4/04/08).
FINDING TREATMENT:Administrative Law Judge Donald Overby has given the state until today to come up with a plan to move a mentally ill 14-year-old girl who has been in juvenile jail for more than two months because no appropriate treatment can be found for her. The girl, identified in court papers as S.R., has been locked up since Jan. 28. One of the girl's lawyers, Lewis Pitts, asked for an administrative hearing to force the state to find proper care for the girl, claiming the state Department of Health and Human Services was violating the girl's Medicaid rights. Pitts said that District Court Judge William Kluttz has held at least nine hearings on the case since the girl was placed in the jail, but no one found another place for her. A case manager with a private company is looking for a place to send her. The Rowan County social services department has legal custody of the girl. But Pitts said it is the state's responsibility to find a place for her.
Overby agreed, ordering the state to find her a facility with locked doors where she can receive intensive treatment. "As a matter of law, as a matter of fact, and as a matter of human rights and fundamental decency, it is an abysmal failure of us as human beings and as a society ... for this 14-year-old child to be illegally locked up in a juvenile detention center, and to have been locked up without treatment since January 18, 2008, because the North Carolina mental health system has been unable or unwilling to locate treatment at a PRTF [psychiatric residential treatment facility]," the order said. Overby rejected the argument from the state's attorney that the state is not responsible for finding the placement, but has the duty only to pay for it. Assistant attorney general Diane Pomper argued for the state. She could not be reached for comment. Any plan will have to be approved by the local mental health office, Piedmont Behavioral Health. (Lynn Bonner, THE NEWS & OBSERVER, 4/06/08).

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