Wednesday, April 23, 2008

News from around the state (with thanks to Diane Bauknight)

The Daily Tar Heel
Unhealthy system

Withheld funding apt response to mental health failures

Just as citizens have a responsibility to faithfully pay their taxes each spring, governments have a responsibility to ensure that tax money is spent wisely and usefully.North Carolina's state government has obliterated its end of this unwritten pact by wasting at least $400 million on mental health reform since 2001.Knowing that, the federal government's Centers for Medicare and Medicaid Services did well to punish the state by withholding $175 million in federal funding from community support programs during the last three months of 2007.We wish the state had gotten a warning before the money disappeared because reforming the system will likely require money. But the punishment is justified.We just hope the loss of federal funding will incite state officials to revamp a mental health program suffering from innumerable ailments.In 2001 evidence indicated the N.C. state government leaned too heavily on state psychiatric hospitals, and legislators responded by enacting reforms to treat more mental health patients in their own communities rather than the state's four overcrowded hospitals.Under the new system, private health care providers replaced local governments in the delivery of mental health services.The community support program, intended to cost the state less than $5 million per month, soon cost more than $50 million because of bloated private health care bills, money-hungry providers and a government that seemed to ignore it all.Shockingly, many of the health care workers employed by private companies to provide services to the community had little or no experience in the field and no college diploma.Regardless, the state paid these workers as much as $61 per hour for services deemed "unnecessary" 89 percent of the time by a Department of Health and Human Services review.Rather than delivering useful services to patients in need, providers often took clients shopping or to the movies, all at the expense of N.C. taxpayers.While private health care providers cashed in on this faulty system, the state's 210,000 residents who seek state help each year received worse service.From March 2006 to January 2008, the government spent $1.4 billion on the wasteful community support programs and only $78 million on services statistically more effective at decreasing the chances of hospitalization.Luckily, the federal funding is being taken from the community programs. In this case, less is probably more.

Asheville Citizen Times
State to replace juvenile centers
Jordan Schrader
published April 19, 2008 12:15 am

RALEIGH – Unlike its larger and more violent neighbor in Swannanoa, Buncombe Regional Juvenile Detention Center doesn't tend to make headlines.
But like Swannanoa Valley Youth Development Center, state officials say, the short-term youth lockup on Asheville's Lee's Creek Road is old and unsafe.
"It's been a maintenance nightmare forever," said Sen. Martin Nesbitt, D-Buncombe.
It's time to bulldoze the facility, juvenile justice officials told lawmakers this week. They want to spend more than $13 million to tear down and rebuild three of the state's nine Detention Centers, temporary holding places for youth facing criminal sanction.
An updated facility could help prevent incidents such as a December attack on two staff members.
A counselor facing a violent juvenile Dec. 14 reported taking a hit to the mouth and an elbow to the eye, while another employee helping wrap up the youth was struck in the face and back. Within an hour of being shackled, the boy had broken free of his leg irons and was shouting from his room threats to kill the counselor.
The counselor watched the boy's fury for nearly three more hours until deputy sheriffs arrived to take him to the adult jail, the kind with cells, guards and career criminals.
"When kids come to detention, they're more unpredictable" because they haven't undergone mental health assessments that are available at other state facilities, Buncombe director Debby Burchfield said.
"They come in off the streets, essentially."
Triple-bunking, lack of technology
The Buncombe jail was built in 1953 as a sanctuary for runaways and today holds just 14 juveniles. The state wants to replace it with a 24-bed unit.
A state report envisions 24 rooms separated by living areas encircled by security fences. It would have three classrooms, a room for family visits and space for appointments with mental health care professionals, social workers and court counselors — all watched over by cameras.
It would be a far cry from the current design of the jail, which makes it hard to keep a close eye on the young but often dangerous inmates.
The building's seven bedrooms are perpetually double-bunked and occasionally triple-bunked, Burchfield said. Youth must be taken from their rooms to use the bathroom. The wooden doors lack electronic locks.
There is a perimeter fence, but no security cameras, and an intercom needs replacing.
The new building would probably go up on the same site, said Michael Bryant, director of juvenile detention services.
Statewide overhaul
The Buncombe site is in the worst condition of the detention centers, but those serving the Wilmington and Fayetteville areas also need to be rebuilt, according to the report.
Cumberland Regional Juvenile Detention Center should relocate to a less crowded area, Bryant said.
Sports fans drop by hoping to pick up tickets to watch the Fayetteville FireAntz play hockey or the Fayetteville Guard play arena football. They're told they want the building next door, Crown Coliseum.
If lawmakers agree, the projects would join a lengthy plan for new juvenile lockups whose construction will long outlast the Easley administration.
State officials Thursday dedicated the first of the state's new Youth Development Centers, in Chatham County. Three more open in May.
Another is in the works, and legislators will be asked in the session starting next month to fund four more, an overhaul that began with a 2003 state audit sparked by violence at Swannanoa that found the youth prisons had substandard buildings.
"Money's going to be tight," said budget co-chairman and Rep. Mickey Michaux, D-Durham, on prospects for new buildings. "We're just going to have to take a close look."
It will be up to Gov. Mike Easley's successor to pursue construction of a promised 32-bed unit to replace the Swannanoa center, whose old property on Old U.S. 70 is being turned over in stages to an adult women's prison.

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