Wednesday, January 28, 2009
Just as presidents are judged on their “first 100 days” in office, state officials also believe the first 3 1/2 months of their temporary stewardship of AMHC to be a “critical time” for establishing an agenda and road map for change, said Leza Wainwright, director of the N.C. Division of Mental Health, Development Disabilities and Substance Abuse Services.
To that end, state officials focused on re-establishing critical services during their first week of management at AMHC. Wainwright announced the state’s intention to keep a “medical core” of seven physicians and one physician’s assistant on staff to provide psychiatric services. The employees had been slated for termination under the mental health center’s previous management.
Wainwright also met with Albemarle Hospital Chief Executive Officer Sharon Tanner last week about resuming the 23-hour crisis unit at the hospital “in very short order.” The facility had been closed as a result of AMHC’s financial woes — woes that led the local mental health agency’s board of directors to ask for a state takeover of the agency several weeks ago.
“We will absolutely get that (23-hour crisis unit) back up just as quickly as possible,” Wainwright said.
In addition, the ARC of North Carolina, an advocacy group for people with developmental disabilities, has taken over case management for developmentally disabled clients, she said.
Wainwright originally expected the state’s operation of AMHC would last less than a year. But it was unclear how her decision on Friday to remove Tom McDevitt as AMHC’s “caretaker director” — an appointment she just announced earlier in the week — would affect that timetable.
Wainwright defended her choice of McDevitt on Thursday after criticisms surfaced about his previous tenure at a mental health agency in the western part of the state. In a series of articles, The Smoky Mountain News had raised a number of questions about McDevitt’s administration at the Smoky Mountain Center, including his $200,000-plus compensation package, alleged conflict of interest in real estate transactions and reputed heavy-handed manner with the SMC board of directors.
By Friday, Wainwright had changed her mind. She told The Daily Advance she was rescinding McDevitt’s appointment because “the shadow that had been cast” by some of his activities at the SMC would make it difficult for him to succeed at rebuilding public trust at AMHC.
A lack of trust is one of the reasons that the AMHC board, after learning of the agency’s financial problems through a recent state review, fired its former director, Charles Franklin, several weeks ago.
No decision has been made regarding a replacement for McDevitt at AMHC. State officials are looking at who might be available for the post, Wainwright said.
Once a successor is chosen, one of the state’s goals is to change the “hostile environment” AMHC cultivated for private mental health care providers, Wainwright said. AMHC currently is where other mental health agencies, also known as local management entities, across the state were 4-5 years ago when it comes to working with providers, she said.
Provider relations and customer services need to be built at AMHC, she said.
State officials are impressed with “the dedication of the staff” at AMHC and the concern that staff members have for consumers, she said
“It is fixable,” Wainwright said, even as she acknowledged that state officials still aren’t “to the bottom” of the AMHC financial situation. For instance, it’s still not clear how much of the $7.2 million the state has available for Albemarle may already be owed to providers.
During a meeting of the AMHC Board of Directors last week, Wainwright said state lawmakers’ intent was for LMEs such as Albemarle to get out of the business of providing direct services. While that can’t always be done in rural areas, it should remain the goal of the area LME, she said.
Wainwright said all appointments that clients have made with doctors at AMHC “definitely will be honored.” At the same time, “non-physician clinicians” have been converted to clinical care managers and will keep appointments through this month to “make that hand-off to another provider,” she said.
She said it’s too early to say whether all of AMHC’s satellite sites would stay open during the state’s stewardship of the agency. The expectation is that the physical locations would remain with private providers in place, she explained.
“We love partnering with other agencies” such as public health departments and hope to be able to offer psychiatric care through the “free clinics” operated by Albemarle Hospital, she said.
“We don’t have all the answers tonight,” Wainwright told the AMHC board last week. “What we have is a commitment.”
By REGGIE PONDER
McDevitt would have trouble restoring trust
Please follow the link to read further information.
By REGGIE PONDER http://www.dailyadvance.com/news/wainwright-pulls-choice-to-head-amhc-391448.html
Monday, January 26, 2009
State trying to fix shortages of beds
By REGGIE PONDER
Sunday, January 25, 2009
For Hyde County Sheriff David Mason, the face of North Carolina’s mental health system is the time officers have to spend watching severely ill patients and waiting to take them to a state hospital for treatment.
“I sat with one for 39 hours myself,” Mason said Friday. He said it was bad enough when a department with enough deputies to provide relief had to rotate officers through several consecutive shifts to watch a patient, but a small department that can’t do that might find one individual tied up for a full day and a half.
“It’s a total failure,” Mason said of the state’s mental health system. “The State of North Carolina needs to contract out with another state because the State of North Carolina has fallen right off the scale with it. Terrible is not even a word to describe it.”
Patients aren’t getting the quality or quantity of treatment they need, he said.
Mason found no comfort at Thursday night’s meeting of the Albemarle Mental Health Center Board of Directors with state officials from the Division of Mental Health and county commissioners, county managers and department heads from the 10 counties served by the Albemarle area mental health management agency.
“I didn’t hear a thing that said there were any improvements coming,” he said.
Mason said the problem for sheriff’s departments, which transport severely ill patients to state psychiatric hospitals, had been getting worse for years.
“This is not a new issue,” he said. “It’s an ongoing issue.”
The problems arise when state hospitals refuse to receive patients, he said.
Leza Wainwright, state DMH director, said when Mason raised the issue at Thursday’s meeting that state officials couldn’t “pretend” to have “unlimited elasticity” at the state psychiatric hospitals. When it’s unsafe for both existing patients and staff to add another patient at a hospital, officials will make the tough decision to refuse additional patients, she said.
State officials don’t like people having to stay in local emergency rooms for extended periods, she said, and the answer is additional beds for psychiatric treatment at community hospitals.
The state hospitals should be for “people who can’t be served elsewhere” and people who need a three-day stay to adjust their medication should be served in the community hospitals, she said.
Wainwright said Albemarle Hospital was interested in adding psychiatric beds and Chowan Hospital also might be willing to add inpatient psychiatric treatment to its services.
The General Assembly has appropriated $20 million to “grow” inpatient hospital beds in the state, she said.
Wainwright said officers’ 30- and 40-hour stays with patients “won’t stop tomorrow” but state officials are working toward such circumstances being extremely rare.
The only way to ease the pressure for sheriff’s departments is through the statewide effort to develop community inpatient psychiatric beds, she said.
“We’re really hoping that hospitals will begin to re-open those beds and re-offer those services,” Wainwright said.
An Albemarle Hospital spokesman said Friday the hospital expects to receive a proposal from DMH within 60 days regarding the possible opening of inpatient psychiatric beds.
“Beyond that, we would have to wait until we saw the proposal,” said Chip Romanovich, hospital spokesman.
Point of View:
Better mental health care, better N.C. economy
John H. Gilmore
CHAPEL HILL - Everyone has a hand out in anticipation of receiving some of
the massive economic stimulus package expected from President Barack Obama's
administration. Bankers, automobile makers, road and bridge builders,
mortgage holders, small business owners and green energy suppliers are all
I would propose another, perhaps unusual addition to the list of things that
will stimulate the economy in North Carolina -- good mental health.
There has been much debate about how to fix our state's devastated mental
health system. Using the economic stimulus package to build a better mental
health system would actually go a long way toward improving the economic
future of North Carolina.
A recent study in the American Journal of Psychiatry found that in 2002
alone, serious mental illness cost the United States $193 billion in lost
earnings -- that's about 25 percent of the $750 billion economic stimulus
package being proposed by Obama.
Lost earnings are just the tip of the economic iceberg of mental illness.
The National Institute of Mental Health has estimated the total annual
economic cost of mental illness in the United States to be about $317
billion, when the additive costs of psychiatric care and disability benefits
are considered. This does not include the costs of prison and jails, in
which an estimated 16 percent to 22 percent of inmates have mental
illnesses. It also does not include the higher costs of medical care and
early mortality associated with mental illness.
While mental illness accounts for more days of disability than all physical
illnesses combined, North Carolina invests much less in its mental health
system than other states; we rank 43rd in the nation in per capita spending
on the treatment of mental illness.
A recent N.C. Institute of Medicine report found that fewer than 1 in 10
residents who abuse alcohol or other substances get treatment, even though
substance use costs North Carolina's economy more than $12 billion a year.
We should spend a portion of the stimulus package to rebuild North
Carolina's crumbling mental health infrastructure. Stable, publicly run
safety-net mental health clinics or clinical homes should be established in
every community and provide modern treatments that are scientifically based
and easy to access.
These safety-net clinics, needed before, are even more critical now that the
faltering economy and state budget cuts will further disintegrate the
already fragmented privatized public mental health system. Investment in a
statewide mental health electronic medical records system would ultimately
reduce costs and improve the quality of care.
All money should be invested wisely, with a solid business plan based on
accountability, reduced paperwork and administrative costs and with a clear
understanding between the state and local communities about who is
responsible for what.
The Government Office for Science in London has recently suggested that to
prosper economically amid the demands and pressures of complex and rapidly
changing times, countries must maximize their "mental wealth." A critical
part of the "mental capital" that a country or a state uses to build a
better financial future is good mental health.
A decent mental health system that addresses the basic needs of the
residents of North Carolina will pay for itself in reduced disability,
improved earning potential and lower costs for medical care and
incarceration. A decent mental health system will stimulate our economy by
helping us all apply our mental capital to the challenges that lie ahead in
these uncertain times.
(John H. Gilmore, M.D., is Thad and Alice Eure distinguished professor of
psychiatry at UNC-Chapel Hill and director of the UNC Center for Community
Friday, January 23, 2009
Cindy has done much progress with her position as director. Last summer Cindy convened a roundtable of experts from around the country to explore the intersection of custody and domestic violence. Cindy directed the office to develop and explore ways to equip communities to assist victims with custody disputes and prevent the negative consequences of giving custody to abusers. OVW will continue to provide updates on this initiative and policies as they are implemented.
Last April Cindy vowed to renew OVW's commitment to ending sexual violence. As a result, OVW will launch the Sexual Assault Services Program this spring. OVW will launch a Sexual Assault Demonstration Initiative in partnership with the National Institute of Justice
OVW presented at the International Family Justice Center Conference in England, showcased the work of our field partners at the UN Crime Commission in a forum of over 40 countries, and brought our experiences fighting violence against women to women's organizations in Africa. We created remarkable connections across borders and oceans and look forward to the day when women can live in a world free of violence.
Deputy Director Catherine Pierce, a 15-year OVW veteran, will assume leadership responsibilities.
Office on Violence Against Women
800 K Street NW, Suite 910
Washington, DC 20530
Phone (202) 307-6026 * Fax (202) 305-2589
Thursday, January 22, 2009
- REMINDER: Ryan White Part B Providers
meeting is on Friday, January 23, 2009, 9:30 am - 3:30 pm at the
Raleigh, Room 1A224.
- The North Carolina Community AIDS Fund is pleased to
release our inaugural request for proposals. Through this first RFP, the
Fund will award 4-6 contracts averaging $65,000 for prevention and care
services. There will be a series of optional introductory meetings to
discuss the application and answer questions: Greenville (January
Winston Salem ( January 28th ),
Ashville (January 30th), Conference
Call (February 2nd ). Further details of
these meetings are included in the RFP. Applications are due February 23, 2009 by 5pm,
notification of awards will be made by April 1, 2009 for a May 1 start.
The program year will run from May 1, 2009 through October 31,
2010. Any questions about the NC Community AIDS Fund and the
RFP, questions should be directed to Beth.Stringfield@duke.edu. (2
- SAVE THE DATE: Women of
Color and HIV: 2nd Annual Community Forum. The event will be held on
Friday, March 6,
2009 from 8:30am - 2:30pm at the Durham
Marriott. Registration is now open!! To register and get more
information go to http://docme.mc.duke.edu/women-hiv.html.
- As a reminder please be sure you are
using the most current ADAP forms located on the State website http://www.epi.state.nc.us/epi/hiv/adap2.html. If a new form
is not used the application will be pended and you will be asked to
transfer the information onto a new application form. These are available
in both a Word (savable) and PDF format. It is preferred that you
complete the form by typing in the information, not writing it. Some
additional tips for completing the ADAP application is attached. (1
- JOB OPENING: for a
Clinical Social Worker/Substance Abuse Counselor at the Early Intervention
Clinic at Lincoln Community Health Center. This position is funded
by SAMHSA through HIP as part of the Carolina Alcohol and Drug Expansion
Team (CADET) program, which is administered by HIP. The purpose of
this program is to bring substance abuse and other mental health services
to people living with HIV in this area by placing clinical social
workers/substance abuse providers in HIV treatment clinics. Although
the position is hired through LCHC, the SA counselor will be part of a
team of CADET providers whose work will be carried out largely at the EI
Clinic. The job opening is posted at http://www.lincolnchc.org/jobpostings.html.
For more information, contact Sandra Gormez at (919) 560-7688 or by email
- JOB OPENING: at the
Health Inequalities Program for the position of Senior Research Aide,
which is a full-time Duke position that that is basically an interviewer
job. They are looking
for someone with good communication skills and the ability to work well as
a team member, a real ability to follow instructions and attend to details
but at the same time is a self starter who can take initiative. This
particular position would be very suitable for someone interested in
issues of mental health, substance abuse, and HIV. The job is posted
on the Duke HR website and the requisition number is 400273015.
The web address is: https://www.hr.duke.edu/secure/jobs/external.html
- Register today for the HIV 201: The
Basics and Clinical Aspects training scheduled for February 19 from
9:00am - 4:30pm. This training entail group activities and in-depth
discussion on the HIV disease, it’s life cycle, trends and more.
NCSAPCB and ACU continuing education units are available. See
attached flier for more information (1 attachment)
The board of directors of a cash-strapped regional mental health agency in northeastern North Carolina has asked the state to take over administration of the agency. John Morrison, an attorney for the board of the Albemarle Mental Health Center, said the state has agreed to the request and will appoint a caretaker director by Tuesday. After a recent audit revealed that the center was out of money, the board fired its longtime director Charles Franklin. On Jan. 2, it announced that it was divesting services for mental health, developmental disability and substance abuse in Camden, Chowan, Currituck, Dare Hyde, Martin, Perquimans, Pasquotank, Tyrrell and Washington counties. Morrison said Thursday that the board was concerned about the impact on consumers in the 10-county area and believed it needed the state's help to deal with the challenges. The 15-member panel also asked the state to conduct a forensic accounting of the center, an evaluation of staff and a staff salary comparison. (THE VIRGINIAN-PILOT, 1/15/09).
According to a January 16th article in The News & Observer,North Carolina could provide health insurance to nearly half the 296,000 children in the state who lack coverage under legislation that's on the fast track in Washington.
The Children's Health Insurance Program, which the U.S. House of Representatives broadened Wednesday, provides health care to children whose families make too much money to qualify for Medicaid insurance. If the Senate goes along as projected, President-elect Obama could sign the bill soon after taking office Tuesday. The measure includes an extra $32.3 billion to cover 4.1 million more American children who don't have health insurance.
To find out more please visit:
Wednesday, January 21, 2009
> Starting this month, NARAL Pro-Choice NC and Planned
> Parenthood of NC will begin volunteer phone banks to
> identify supporters of comprehensive sex education. We will
> be calling to ask each supporter for their email address, if
> they are willing to contact their legislator by phone and/or
> meet with them in person, and if they are interested in
> becoming more involved with HYNC.
> In past years, it has been clear that legislators MUST see
> demonstrated support of their constituents for comprehensive
> sex ed before they will support it. That's where we come in!
> The legislative session starts THIS MONTH! Don't miss out on
> your chance to play an important role in restoring
> lifesaving sex education to North Carolina's schools!
> Here are your chances to volunteer-- please note all phone
> banks are from 6:00-8:30pm and dinner is always provided!
> Asheville- RSVP to Genevieve at
> Monday, February 23
> Chapel Hill- RSVP to Alison at firstname.lastname@example.org
> Tuesday, January 27
> Thursday, January 29
> Charlotte- RSVP to Genevieve at
> email@example.com or Deann@ProChoiceNC.org
> Tuesday, January 27
> Wednesday, February 18
> Wednesday, February 25
> Wednesday, March 18
> Wednesday, April 15
> Fayetteville- RSVP to Jessica at
> Tuesday, February 17
> Thursday, February 19
> Wednesday, February 24
> Greensboro- RSVP to Genevieve at
> Wednesday, February 24
> Join NARAL Pro-Choice NC Today!
The Team Daniel Foundation has created a magazine for
individuals with developmental disabilities and their
families. A subscription order form is located on our
Please review and subscribe today! The first issue is
packed with information you will not want to miss!
If you would like to write an article for upcoming issues,
please contact Janel Green at firstname.lastname@example.org or
Wednesday, January 14, 2009
You can find it here: http://www.ncdhhs.gov/mhddsas/servicedefinitions/servdefupdates/index.htm