Wednesday, January 28, 2009

State: First 100 days critical to rebound

Prior to an abrupt change of course on Friday, state mental health officials had set in motion plans designed to begin turning around the financially troubled Albemarle Mental Health Center within 100 days.
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.”


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