URGENT! LEGISLATIVE ACTION ALERT
ADOLESCENT PREGNANCY PREVENTION CAMPAIGN
OF NORTH CAROLINA
Monday, June 23, 2008
IF YOU VALUE THE PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT NORTH CAROLINA HAS, THEN YOU NEED TO CONTACT BUDGET CONFEREES AND LEGISLATORS WHO REPRESENT YOU. IT IS EXTREMELY IMPORTANT THAT YOU START CONTACTING CONFEREES THIS MORNING. NOTE CONTACT INFORMATION AT THE BOTTOM OF THIS MESSAGE.
On Friday, June 20, after several hours of meetings by the conferees working to resolve differences in the Health and Human Services (HHS) section of the Senate and House's budget bills, the conferees reached agreement on a number of items. Unfortunately, no decisions were reached on funding for pregnancy prevention programs/initiatives. In fact, Rep. Verla Insko (D-Orange) asked that the items be "FLAGGED." "Flagged" means that the fate of these items will be determined later, and later could mean no funding. Since the conferees are millions of dollars over their spending target and will have to make cuts in order to balance the HHS budget, the funding for pregnancy prevention programs/initiatives seems bleak, and may not happen if you do not contact budget conferees. NOTE "flagged" items listed in the chart recorded below.
Some -- not all -- House members have expressed the following concerns: Questioned whether the programs are coordinated; Noted that there is lots of funding from various sources -- do not understand the funding scream; Want proof that programs are preventing pregnancies.
WHAT YOU CAN DO -- Contact conferees and share data and points that prove these programs have made and are continuing to make a tremendous difference in reducing teen pregnancy and out-of-wedlock births in NC. Results of the last outside evaluation of the Adolescent Parenting Program (APP) showed that participants were less likely to get pregnant the second time - one of the major goals of the program. Pregnant and parenting students not participating in the program were three times more likely than APP participants to get pregnant the second time. Participants in the APP were less likely to drop out of school. -- Another major goal of the program is to keep pregnant and parenting students in school. None participants in the APP program were three times more likely to drop out of school. (Funding for outside evaluation of the Adolescent Parenting Program and the Adolescent Pregnancy Prevention Program was cut about 8 years ago and was never restored.)
YOUR MESSAGE:
ASK BUDGET CONFEREES TO SUPPORT THE FUNDING FOR PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT IS INCLUDED IN THE SENATE'S VERSION OF THE BUDGET. In North Carolina, funding for pregnancy prevention is low when compared to surrounding states. Legislators appropriate $1.79 million in state funds and the bulk of the remaining money going to combat teen pregnancy comes from federal block grant funds. As a result of legislative cuts made in 2001 and never restored, federal block grant funding is more than $ 1 million less than what was being appropriated in 2000 for pregnancy prevention and out-of-wedlock birth prevention.
ASK BUDGET CONFEREES TO INCLUDE ADDITIONAL FUNDING FOR SCHOOL-BASED AND SCHOOL-LINKED HEALTH CENTERS. (Conferees agreed to allow the $250,000 non-recurring funds that are included in the budget to be used for existing and new centers.)
NOTE: This chart does not contain prevention items that are "in agreement" in both budgets (Senate & House).
SENATE’S BUDGET
RATING
HOUSE’S BUDGET
RATING
Item #48 Teen Pregnancy Prevention Initiatives -- $400,000 recurring funds. This money, if approved, will save prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds. In addition, other programs that have been approved for funding will be funded, and the overall program will be made whole.
DOUBLE PLUS
House’s budget does not contain this funding, which means prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds -- will be cut. In addition, other programs that have been approved for funding will not be funded.
MINUS
Senate’s Budget does not contain this item.
DOUBLE PLUS
Current base state funding ($1.79 million) for all pregnancy prevention programs has been made non-recurring meaning that the base recurring funding has been made one-time money. (Item #49 in Money report)
MINUS
Item #48 Adolescent Pregnancy Prevention Program --- $325,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
MORE FAVORABLE
Item #45 Adolescent Pregnancy Prevention Program --- $75,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
FAVORABLE
CONCENTRATE ON HOUSE CONFEREES AND HOUSE LEADERS. MAKE YOUR CONTACTS UNTIL AGREEMENT IS REACHED ON THESE IMPORTANT BUDGET ITEMS. IF YOU DO NOT CONTACT THE BUDGET CONFEREES, THESE PROGRAMS WILL NOT BE FUNDED -- FUNDS WILL BE CUT.
Contact information for selected members of the Senate and House's budget conference committees are recorded below.
SENATE CONFEREES
HOUSE CONFEREES
Senator Bill Purcell (D) (Co-chairperson)
Room 625, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5953
H: (910) 276-7328 (Scotland, Richmond, Stanly, & Anson)
E-mail: Williamp@ncleg.net
Sen. Doug Berger (D) (Co-chairperson)
Room 622, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-8363
O: (919) 671-6565 (Franklin, Granville, Vance, & Warren)
E-mail: Dougb@ncleg.net
Sen. Steve Goss (D)
Room 1118 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5742
H: (828) 265-2943 (Alexander, Ashe, Watauga & Wilkes)
E-mail: Steveg@ncleg.net
Sen. Martin Nesbitt (D)
Room 300-B Legislative Building
Raleigh, NC 27603-5925
O: (919) 715-3001
O: (828) 252-0490 (Buncombe)
E-mail: Martinn@ncleg.net
HOUSE CONFEREES CONTINUED
Rep. Jennifer Weiss (D)
Room 532, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3010
H: (919) 678-1367 (Wake)
E-mail: Jenniferw@ncleg.net
Rep. Beverly Earle (D) (Co-chairperson)
Room 634, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2530
O: (704) 333-7180 (Mecklenburg)
E-mail: Beverlye@ncleg.net
Rep. Bob England (D) (Co-Chairperson)
Room 2219, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5749
O: (828) 245-7626 (Cleveland & Rutherford)
E-mail: Bobe@ncleg.net
Rep. Verla Insko (D) (Co-Chairperson)
Room 307 B1, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-7208
H: (919) 929-6115 (Orange)
E-mail: Verlai@ncleg.net
Rep. Jeff Barnhart (R) (Vice-chairman)
Room 608, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2009
O: (704-786-2012 (Cabarrus)
E-mail: Jeffba@ncleg.net
Rep. William Brisson (D)
Room 1325, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5772
O: (910) 862-7007 (Bladen & Cumberland)
E-mail: Williambr@ncleg.net
Rep. Linda Coleman (D) (Vice-Chairperson)
Room 301 N, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5974
H: (919) 266-9037 (Wake)
E-mail: Lindac@ncleg.net
Rep. Charles Thomas (R)
Room 418C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3012
O: (828) 681-5516 (Buncombe)
E-mail: Charlest@ncleg.net
HOUSE AND SENATE OVERALL BUDGET CONFEREES AND LEADERS
SENATE CONFEREES
HOUSE CONFEREES
Senator Linda Garrou (D) (Co-Chairperson)
Room 627, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5620
O: (336) 922-4192 (Forsyth)
E-mail: Lindag@ncleg.net
Senator Charlie Albertson (D) (Co-Chairperson)
Room 525, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5705
H: (910) 298-4923 (Duplin, Lenoir, & Sampson)
E-mail: Charliea@ncleg.net
Senator Charlie Dannelly (D) (Co-Chairperson)
Room 2010 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5955
H: (704) 392-1227 (Mecklenburg)
E-mail: Charlied@ncleg.net
Sen. Walter Dalton (D)
Room 523, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3038
H: (828) 287-2908 (Cleveland & Rutherford)
E-mail: Walterd@ncleg.net
Senator Kay Hagan (D)
Room 411, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5856
O: (336) 379-8721 (Guilford)
E-mail: Kayh@ncleg.net
SENATE LEADERS
President Pro Tempore of Senate
Sen. Marc Basnight (D)
Room 2007, Legislative Building
Raleigh, NC 27601-1096
(Dare, Beaufort, Camden, Currituck, Hyde, Pasquotank, Tyrrell, & Washington)
919-733-6854 – Raleigh
E-mail: Marcb@ncleg.net
Senator Tony Rand (D) (Rules Chairman)
Room 300C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-9892
O: (910) 222-8096 (Cumberland & Bladen)
E-mail: Tonyr@ncleg.net
Rep. Mickey Michaux (D) (Senior Chair)
Room 1227, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-2528
O: (919) 596-8181 (Durham)
E-mail: Mickeym@ncleg.net
Rep. Alma Adams (D) (Co-Chair)
Room 304, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5902
O: (336) 517-2312 (Guilford)
E-mail: Almaa@ncleg.net
Rep. Martha Alexander (D) (Co-Chair)
Room 2208, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5807
O: (704) 558-4670 (Mecklenburg)
E-mail: Marthaa@ncleg.net
Rep. Jim Crawford (D) (Co-Chair)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5824
O: (252) 492-0185 (Granville & Vance)
E-mail: Jimcr@ncleg.net
Rep. Phil Haire (D) (Co-Chair)
Room 639, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3005
O: (828) 586-1771 (Jackson, Haywood, Macon & Swain)
E-mail: Philliph@ncleg.net
Rep. Joe Tolson (D) (Co-Chair)
Room 305, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3026
O: (252) 827-2749 (Edgecombe & Wilson)
E-mail: Joet@ncleg.net
Rep. Doug Yongue (D) (Co-Chair)
Room 1303, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5828
O: (910) 276-1727 (Hoke, Robeson & Scotland)
E-mail: Douglasy@ncleg.net
HOUSE LEADERS
Speaker Joe Hackney (D)
Room 2304, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-3451 (Orange, Chatham, Moore)
E-mail: Joeh@ncleg.net
Rep. Hugh Holliman (D)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-0873
O: (336) 248-6272 (Davidson)
E-mail: Hughh@ncleg.net
Rep. Bill Owens (D) (Rules Chairman)
Room 635, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-0010
O: (252) 335-1850 (Camden, Currituck, Pasquotank, & Tyrrell)
E-mail: Billo@ncleg.net
Adolescent Pregnancy Prevention Campaign of North Carolina
3708 Mayfair Street, Suite 310
Durham, North Carolina 27707
Telephone: 919-226-1880 Fax: 919-226-1884
www.appcnc.org
If you wish to have your e-mail address removed from this distribution list, please contact Patricia Yancey pyancey@bellsouth.net or call the APPCNC office in Durham at 919-226-1880.
Monday, June 23, 2008
Smoky Mt News: MH Reform
Another bad mental health care decision
By Raymond Turpin • Guest Columnist
-Smoky Mt News
Provisionally licensed therapists are individuals who have completedtheir formal education and training, hold master's or doctoral degreesfrom accredited graduate programs, and lack only supervised hours ofpractical experience in order to qualify for their licensure exam. Foryears, they have been able to come to North Carolina and provide much-needed therapy services to Medicaid recipients while receiving adequatesupervision from licensed professionals in their respective fields.
They have helped offset ongoing, serious workforce shortages in thisstate, and their services are critical to providers statewide who aretrying to meet the mental health needs of their communities. Theiroutpatient therapy services continue to be vitally important to thesurvival of North Carolina's fragile mental health delivery system,which is still reeling after years of mismanagement by the verygovernment agencies entrusted with its care and development.
In a continuance of puzzling decisions, North Carolina's Division ofMedical Assistance has announced that beginning July 1, provisionallylicensed therapists will no longer be able to provide outpatienttherapy for Medicaid recipients unless they work for a physician,accept only mental health referrals from said physician, and deliverall services on-site where the physician practices medicine. Thephysician is responsible for supervising the therapy, but provisionallylicensed therapists must still seek supervision from approved licensedprofessionals in their field in order to accrue hours towardslicensure.
If a provisionally licensed therapist does not work directly under aphysician, they will only be allowed to provide Medicaid's "enhanced"services, which consist of the services such as Community Support thatthe state has mismanaged into a confusing, excruciating exercise ofredundant paperwork, complex authorization procedures, hours ofunbillable time, and frequent denials.
As it stands, on July 1 the vast majority of provisionally licensedtherapists will be forced by DMA to interrupt their outpatient therapywork. This decision was made over the clear objections of the mentalhealth professional organization (Professional Alliance Council) thatthe Division asks for guidance on these issues.
Since there is still a severe workforce shortage in North Carolina,particularly in the rural areas, removing these very capable and much-needed therapists will plunge the system into further crisis. Fewertherapists providing these basic outpatient services will mean moreclients deteriorating to the point of requiring more intensive enhancedservices. The fact that there are not enough licensed therapists torefer these clients to will create a situation very shortly where therewill be hundreds of mental health clients in rural Western NorthCarolina losing their outpatient therapists. This scenario will also beplayed out in rural areas statewide. How is this going to improve thedelivery of services?
Also, relegating provisionally licensed therapists to only providingenhanced services will keep many recent graduates and many veryqualified therapists from wanting to come to North Carolina. Our statealready ranks near the bottom in mental health, and this will onlysolidify our reputation as a state that is bumbling its way towardobliteration of the mental health system with management decisions thatare not progressive or even helpful.
Most importantly, perhaps, I have yet to get an answer from DMA orDHHS as to why only physicians are being anointed in the new policy,and why a licensed psychologist is not being considered qualified to dothe same. Psychologists are expected to render the same decisions aboutmedical necessity for mental health services as a physician, yet we areconsidered unqualified to participate in the new policy.
The fact that after July 1 psychologists and other approved licensedprofessionals will still be required to provide supervision accordingto our various licensing boards requirements essentially makes us sharelegal and clinical responsibility for the provisionally licensedtherapists' work. Regardless, we are barred from employing them in ouragencies where we can refer to them and provide closer supervision andtraining.
I would also like to know where all of these participating physiciansare going to come from in the rural areas. Most are up to their necksin patients and expending all of their time serving their patients'medical needs and prefer to refer out to the mental healthprofessionals in the community when a mental health issue is suspected.The vast majority of physicians are not adequately trained in mentalhealth diagnosis and treatment, yet they are the ones that DMA hasdecided are now the most appropriate to directly supervise theoutpatient therapy work of provisionally licensed therapists?
In addition, why would a practicing physician want to further riskmalpractice litigation by allowing a provisionally licensed mentalhealth therapist to bill for services through his Medicaid providernumber? The only entities that this policy change will benefit are thegigantic mental health corporations that have deep enough pockets toafford their own psychiatrists. The smaller, truly community-basedagencies will be replaced by more impersonal, profit-driven mentalhealth Wal-Marts. The irony is that this is the type of situation thatreform attempted to correct in the first place.
At this point, any mental health agency in North Carolina stillfaithfully trying to provide needed mental health services for itscommunities deserves a medal. Many providers have left the state or thefield altogether, having grown weary of the ceaseless changes andincompetent leadership. Instead of policy changes that are going tofurther destabilize and demoralize us, include us in your decisions andlet's work together to create an inclusive system that works for usall.
(Raymond Turpin, PsyD, is the president and clinical director forHaywood/Jackson County Psychological Services. He can be reached atrturpin@jcpsmail.org.)
By Raymond Turpin • Guest Columnist
-Smoky Mt News
Provisionally licensed therapists are individuals who have completedtheir formal education and training, hold master's or doctoral degreesfrom accredited graduate programs, and lack only supervised hours ofpractical experience in order to qualify for their licensure exam. Foryears, they have been able to come to North Carolina and provide much-needed therapy services to Medicaid recipients while receiving adequatesupervision from licensed professionals in their respective fields.
They have helped offset ongoing, serious workforce shortages in thisstate, and their services are critical to providers statewide who aretrying to meet the mental health needs of their communities. Theiroutpatient therapy services continue to be vitally important to thesurvival of North Carolina's fragile mental health delivery system,which is still reeling after years of mismanagement by the verygovernment agencies entrusted with its care and development.
In a continuance of puzzling decisions, North Carolina's Division ofMedical Assistance has announced that beginning July 1, provisionallylicensed therapists will no longer be able to provide outpatienttherapy for Medicaid recipients unless they work for a physician,accept only mental health referrals from said physician, and deliverall services on-site where the physician practices medicine. Thephysician is responsible for supervising the therapy, but provisionallylicensed therapists must still seek supervision from approved licensedprofessionals in their field in order to accrue hours towardslicensure.
If a provisionally licensed therapist does not work directly under aphysician, they will only be allowed to provide Medicaid's "enhanced"services, which consist of the services such as Community Support thatthe state has mismanaged into a confusing, excruciating exercise ofredundant paperwork, complex authorization procedures, hours ofunbillable time, and frequent denials.
As it stands, on July 1 the vast majority of provisionally licensedtherapists will be forced by DMA to interrupt their outpatient therapywork. This decision was made over the clear objections of the mentalhealth professional organization (Professional Alliance Council) thatthe Division asks for guidance on these issues.
Since there is still a severe workforce shortage in North Carolina,particularly in the rural areas, removing these very capable and much-needed therapists will plunge the system into further crisis. Fewertherapists providing these basic outpatient services will mean moreclients deteriorating to the point of requiring more intensive enhancedservices. The fact that there are not enough licensed therapists torefer these clients to will create a situation very shortly where therewill be hundreds of mental health clients in rural Western NorthCarolina losing their outpatient therapists. This scenario will also beplayed out in rural areas statewide. How is this going to improve thedelivery of services?
Also, relegating provisionally licensed therapists to only providingenhanced services will keep many recent graduates and many veryqualified therapists from wanting to come to North Carolina. Our statealready ranks near the bottom in mental health, and this will onlysolidify our reputation as a state that is bumbling its way towardobliteration of the mental health system with management decisions thatare not progressive or even helpful.
Most importantly, perhaps, I have yet to get an answer from DMA orDHHS as to why only physicians are being anointed in the new policy,and why a licensed psychologist is not being considered qualified to dothe same. Psychologists are expected to render the same decisions aboutmedical necessity for mental health services as a physician, yet we areconsidered unqualified to participate in the new policy.
The fact that after July 1 psychologists and other approved licensedprofessionals will still be required to provide supervision accordingto our various licensing boards requirements essentially makes us sharelegal and clinical responsibility for the provisionally licensedtherapists' work. Regardless, we are barred from employing them in ouragencies where we can refer to them and provide closer supervision andtraining.
I would also like to know where all of these participating physiciansare going to come from in the rural areas. Most are up to their necksin patients and expending all of their time serving their patients'medical needs and prefer to refer out to the mental healthprofessionals in the community when a mental health issue is suspected.The vast majority of physicians are not adequately trained in mentalhealth diagnosis and treatment, yet they are the ones that DMA hasdecided are now the most appropriate to directly supervise theoutpatient therapy work of provisionally licensed therapists?
In addition, why would a practicing physician want to further riskmalpractice litigation by allowing a provisionally licensed mentalhealth therapist to bill for services through his Medicaid providernumber? The only entities that this policy change will benefit are thegigantic mental health corporations that have deep enough pockets toafford their own psychiatrists. The smaller, truly community-basedagencies will be replaced by more impersonal, profit-driven mentalhealth Wal-Marts. The irony is that this is the type of situation thatreform attempted to correct in the first place.
At this point, any mental health agency in North Carolina stillfaithfully trying to provide needed mental health services for itscommunities deserves a medal. Many providers have left the state or thefield altogether, having grown weary of the ceaseless changes andincompetent leadership. Instead of policy changes that are going tofurther destabilize and demoralize us, include us in your decisions andlet's work together to create an inclusive system that works for usall.
(Raymond Turpin, PsyD, is the president and clinical director forHaywood/Jackson County Psychological Services. He can be reached atrturpin@jcpsmail.org.)
From N&O
http://www.newsobserver.com/news/health_science/story/1115651.html
Another attack at Dix rekindles concerns A nurse is beaten by a patient, and hospital workers protest
Michael Biesecker, Staff Writer
RALEIGH - A nurse who was just days from retirement was beaten by a patient at Dorothea Dix Hospital last week, another in a spate of incidents raising concerns about the safety of patients and staff in state mental facilities.
On Friday, hospital workers again marched on the Raleigh office of Dempsey Benton, the secretary of the state Department of Health and Human Services.
They are seeking to delay the pending closure of Dix because of concerns about staffing shortfalls and design flaws with a new facility in Butner that is set to open next month.
About 500 Dix employees, the majority of the hospital's staff, signed a petition asking Benton to impose a one-year moratorium on the shutdown. They say that would allow North Carolina's next governor the opportunity to reconsider changes to the mental health system imposed by Gov. Mike Easley's administration.
A letter also was circulated among legislators this week asking that the state budget for the next year include money to keep Dix open. The letter was signed by representatives of the N.C. Sheriff Police Alliance, the Wake County chapter of the National Alliance on Mental Illness, the N.C. Public Service Worker's Union and a psychologist who works at Dix.
Data compiled by the union from federally required employee injury reports from the state's four mental hospitals for 2007 show a total of
712 staff injuries, resulting in 4,380 lost workdays. The overwhelming majority of injuries were the result of contact with patients.
An incident report from Dix Hospital released this week said nurse Carol Latham, 63, was attacked by a female patient who knocked her to the floor and started hitting her in the face.
DHHS spokesman Tom Lawrence said the ward where the assault occurred, which houses 32 patients, was fully staffed with 11 workers. He characterized the incident as minor.
"She was hit in the neck and nose, doing no real damage," Lawrence said.
But Latham, reached at her home, told a different story.
"I'm so sore I can hardly move," said Latham, who has worked at Dix for eight years. "No assault is minor, ever. This is the first time I have ever been attacked."
Latham's glasses were broken and her nose bloodied, resulting in swelling and bruising to her face. X-rays showed no fractures.
Contrary to what administrators claimed, Latham says she was alone with nine female patients when a woman with a well-documented history of violence attacked her. The other staff members working that night were either looking after male patients in a neighboring hall or were elsewhere in the building.
The ward where Latham was attacked houses forensic patients -- those either facing criminal charges or who have been deemed mentally incompetent to stand trial.
"She just calmly walked towards me and starting beating on me," Latham said.
"It's a very unsafe unit, because of the type of patients they have."
Latham said she was offered a position at the new hospital in Butner, but she has instead chosen to retire from state employment and take another job in the private sector, she said.
Her last day of work will be July 30.
"I haven't felt safe for the last three or four years," she said.
"It's too stressful. I won't miss it."
michael.biesecker@newsobserver.com or (919) 829-4698
Another attack at Dix rekindles concerns A nurse is beaten by a patient, and hospital workers protest
Michael Biesecker, Staff Writer
RALEIGH - A nurse who was just days from retirement was beaten by a patient at Dorothea Dix Hospital last week, another in a spate of incidents raising concerns about the safety of patients and staff in state mental facilities.
On Friday, hospital workers again marched on the Raleigh office of Dempsey Benton, the secretary of the state Department of Health and Human Services.
They are seeking to delay the pending closure of Dix because of concerns about staffing shortfalls and design flaws with a new facility in Butner that is set to open next month.
About 500 Dix employees, the majority of the hospital's staff, signed a petition asking Benton to impose a one-year moratorium on the shutdown. They say that would allow North Carolina's next governor the opportunity to reconsider changes to the mental health system imposed by Gov. Mike Easley's administration.
A letter also was circulated among legislators this week asking that the state budget for the next year include money to keep Dix open. The letter was signed by representatives of the N.C. Sheriff Police Alliance, the Wake County chapter of the National Alliance on Mental Illness, the N.C. Public Service Worker's Union and a psychologist who works at Dix.
Data compiled by the union from federally required employee injury reports from the state's four mental hospitals for 2007 show a total of
712 staff injuries, resulting in 4,380 lost workdays. The overwhelming majority of injuries were the result of contact with patients.
An incident report from Dix Hospital released this week said nurse Carol Latham, 63, was attacked by a female patient who knocked her to the floor and started hitting her in the face.
DHHS spokesman Tom Lawrence said the ward where the assault occurred, which houses 32 patients, was fully staffed with 11 workers. He characterized the incident as minor.
"She was hit in the neck and nose, doing no real damage," Lawrence said.
But Latham, reached at her home, told a different story.
"I'm so sore I can hardly move," said Latham, who has worked at Dix for eight years. "No assault is minor, ever. This is the first time I have ever been attacked."
Latham's glasses were broken and her nose bloodied, resulting in swelling and bruising to her face. X-rays showed no fractures.
Contrary to what administrators claimed, Latham says she was alone with nine female patients when a woman with a well-documented history of violence attacked her. The other staff members working that night were either looking after male patients in a neighboring hall or were elsewhere in the building.
The ward where Latham was attacked houses forensic patients -- those either facing criminal charges or who have been deemed mentally incompetent to stand trial.
"She just calmly walked towards me and starting beating on me," Latham said.
"It's a very unsafe unit, because of the type of patients they have."
Latham said she was offered a position at the new hospital in Butner, but she has instead chosen to retire from state employment and take another job in the private sector, she said.
Her last day of work will be July 30.
"I haven't felt safe for the last three or four years," she said.
"It's too stressful. I won't miss it."
michael.biesecker@newsobserver.com or (919) 829-4698
In the News: Federal Auditors, Dix Attack, Southeastern Mental Health
Federal Auditors
Federal auditors are in North Carolina reviewing the records of about 200 mental health companies as part of an examination of a lucrative service called community support. The state Medicaid office sent letters to companies June 5 telling them that auditors would be on their doorsteps no later than June 30. Auditors are reviewing 301 patient records, chosen at random, as part of an investigation into whether the state has paid improper claims. The federal government is withholding $138 million from the state because of questions about the service. Federal authorities told the state in April that it was withholding a $175 million payment but later reduced that.
Community support is a mental health service that is supposed to teach clients basic skills and help them control their behavior. State audits have shown, however, that in some cases, companies charged as much as $61 an hour to take clients to malls or movies or to sit with them in school. In most cases, the work was done by employees with high school diplomas. A News & Observer investigation found the state wasted at least $400 million on the service. The audit could result in the state being asked to repay money for claims that aren't deemed proper.
Wayne Peel of Williamston, who runs a training company for mental health providers, said some good may come of the audit. Not all clients with mental disorders can be helped by community support, Peel said, and the audit may result in a clear definition of who should get it. "Right now, it's wide open," he said. State lawmakers have proposed slashing community support spending and putting legal limits on the service. (Lynn Bonner, THE NEWS & OBSERVER, 6/22/08).
Dix Attack
Dorothea Dix Hospital workers again marched Friday to the office of state Department of Health and Human Services Secretary Dempsey Benton after a nurse was beaten by a patient. The beating, which occurred about two weeks ago, is the latest in a spate of incidents raising concerns about safety at state mental facilities. Hospital workers are seeking to delay the pending closure of the Raleigh hospital because of concerns about staffing shortfalls and design flaws with a new facility in Butner that is set to open next month. About 500 Dix employees signed a petition asking Benton to impose a one-year moratorium on the shutdown. A letter also was circulated among legislators last week asking that the state budget for the next year include money to keep Dix open. The letter was signed by representatives of the N.C. Sheriff Police Alliance, the Wake County chapter of the National Alliance on Mental Illness, the N.C. Public Service Worker's Union and a psychologist who works at Dix.
An incident report from Dix Hospital released last week said nurse Carol Latham, 63, was attacked by a female patient. DHHS spokesman Tom Lawrence said the ward where the assault occurred, which houses 32 patients, was fully staffed with 11 workers. He characterized the incident as minor. But Latham told a different story. "I'm so sore I can hardly move," said Latham, who has worked at Dix for eight years. Latham's glasses were broken and her nose bloodied, resulting in swelling and bruising to her face. X-rays showed no fractures. Contrary to what administrators claimed, Latham said she was alone with nine female patients when a woman with a well-documented history of violence attacked her. The other staff members working that night were either looking after male patients in a neighboring hall or were elsewhere in the building. (Michael Biesecker, THE NEWS & OBSERVER, 6/21/08).
Southeastern Mental Health
More than 100 people involved with the state mental health system in southeastern North Carolina gathered for an impromptu rally Friday to voice their concerns about an expected cut in funding for mental health treatment in the region. Most of the anger of those who showed up for the impromptu rally was directed at the Southeastern Center for Mental Health, Developmental Disabilities and Substance Abuse Services, the regional mental health agency in charge of allocating the state funds among service providers in Brunswick, New Hanover and Pender counties.
Center administrators warned providers earlier this month that funding for services likely would be tighter than it has been when the new state budget year starts. Now, many families and clients are being told that their treatment will likely be scaled back -- in some cases from 14 hours a week to a half-hour a month. "My son is not going to be able to work. He could end up institutionalized," Sandra Nesbit of Pender County said about her 21-year-old son. "I'm very, very angry." Even though state budget negotiations are ongoing, the center does not expect to get more than $8.3 million, the same amount it ended up receiving this fiscal year.
The state funding dropped from previous levels after the center did not spend its full allocation two years ago, and center officials are not optimistic the state will bump the total amount back up to previous levels. After scrambling with the drop in state money this year, including dipping into reserve money and scaling back on the number of hours that could be reimbursed, the center was able to cover about $12 million for services, director Art Costantini said. But some of those options will not be available in the coming year, he said. "The problem is we've got $8.3 million to work with. We can't build a $12 million budget," he said. "It's illegal to contract to offer to pay services that we don't have the money to do." Costantini said he is looking at other potential sources of funding to augment the state money, but declined to offer details. (Vicky Eckenrode, WILMINGTON STAR-NEWS, 6/21/08).
Federal auditors are in North Carolina reviewing the records of about 200 mental health companies as part of an examination of a lucrative service called community support. The state Medicaid office sent letters to companies June 5 telling them that auditors would be on their doorsteps no later than June 30. Auditors are reviewing 301 patient records, chosen at random, as part of an investigation into whether the state has paid improper claims. The federal government is withholding $138 million from the state because of questions about the service. Federal authorities told the state in April that it was withholding a $175 million payment but later reduced that.
Community support is a mental health service that is supposed to teach clients basic skills and help them control their behavior. State audits have shown, however, that in some cases, companies charged as much as $61 an hour to take clients to malls or movies or to sit with them in school. In most cases, the work was done by employees with high school diplomas. A News & Observer investigation found the state wasted at least $400 million on the service. The audit could result in the state being asked to repay money for claims that aren't deemed proper.
Wayne Peel of Williamston, who runs a training company for mental health providers, said some good may come of the audit. Not all clients with mental disorders can be helped by community support, Peel said, and the audit may result in a clear definition of who should get it. "Right now, it's wide open," he said. State lawmakers have proposed slashing community support spending and putting legal limits on the service. (Lynn Bonner, THE NEWS & OBSERVER, 6/22/08).
Dix Attack
Dorothea Dix Hospital workers again marched Friday to the office of state Department of Health and Human Services Secretary Dempsey Benton after a nurse was beaten by a patient. The beating, which occurred about two weeks ago, is the latest in a spate of incidents raising concerns about safety at state mental facilities. Hospital workers are seeking to delay the pending closure of the Raleigh hospital because of concerns about staffing shortfalls and design flaws with a new facility in Butner that is set to open next month. About 500 Dix employees signed a petition asking Benton to impose a one-year moratorium on the shutdown. A letter also was circulated among legislators last week asking that the state budget for the next year include money to keep Dix open. The letter was signed by representatives of the N.C. Sheriff Police Alliance, the Wake County chapter of the National Alliance on Mental Illness, the N.C. Public Service Worker's Union and a psychologist who works at Dix.
An incident report from Dix Hospital released last week said nurse Carol Latham, 63, was attacked by a female patient. DHHS spokesman Tom Lawrence said the ward where the assault occurred, which houses 32 patients, was fully staffed with 11 workers. He characterized the incident as minor. But Latham told a different story. "I'm so sore I can hardly move," said Latham, who has worked at Dix for eight years. Latham's glasses were broken and her nose bloodied, resulting in swelling and bruising to her face. X-rays showed no fractures. Contrary to what administrators claimed, Latham said she was alone with nine female patients when a woman with a well-documented history of violence attacked her. The other staff members working that night were either looking after male patients in a neighboring hall or were elsewhere in the building. (Michael Biesecker, THE NEWS & OBSERVER, 6/21/08).
Southeastern Mental Health
More than 100 people involved with the state mental health system in southeastern North Carolina gathered for an impromptu rally Friday to voice their concerns about an expected cut in funding for mental health treatment in the region. Most of the anger of those who showed up for the impromptu rally was directed at the Southeastern Center for Mental Health, Developmental Disabilities and Substance Abuse Services, the regional mental health agency in charge of allocating the state funds among service providers in Brunswick, New Hanover and Pender counties.
Center administrators warned providers earlier this month that funding for services likely would be tighter than it has been when the new state budget year starts. Now, many families and clients are being told that their treatment will likely be scaled back -- in some cases from 14 hours a week to a half-hour a month. "My son is not going to be able to work. He could end up institutionalized," Sandra Nesbit of Pender County said about her 21-year-old son. "I'm very, very angry." Even though state budget negotiations are ongoing, the center does not expect to get more than $8.3 million, the same amount it ended up receiving this fiscal year.
The state funding dropped from previous levels after the center did not spend its full allocation two years ago, and center officials are not optimistic the state will bump the total amount back up to previous levels. After scrambling with the drop in state money this year, including dipping into reserve money and scaling back on the number of hours that could be reimbursed, the center was able to cover about $12 million for services, director Art Costantini said. But some of those options will not be available in the coming year, he said. "The problem is we've got $8.3 million to work with. We can't build a $12 million budget," he said. "It's illegal to contract to offer to pay services that we don't have the money to do." Costantini said he is looking at other potential sources of funding to augment the state money, but declined to offer details. (Vicky Eckenrode, WILMINGTON STAR-NEWS, 6/21/08).
Monday, June 16, 2008
Collective Bargaining covered on WUNC-TV
WUNC –TV covered collective bargaining on its program, Legislative Week in Review. Note that a supporter’s collective bargaining button is featured prominently on the website. Hit play video and skip ahead to about 9:10. The coverage of collective bargaining is about 4 minutes long and includes many of the workers who spoke. We also get to hear from opponents: the President of Capital Assoc. Industries and John Hood of the John Locke foundation.
http://www.unctv.org/legweek/
NASW-NC is a member of the NC HOPE coalition. http://www.nchope.org/
http://www.unctv.org/legweek/
NASW-NC is a member of the NC HOPE coalition. http://www.nchope.org/
Asheville Times Editorial- Provisional licensure
June 15, 2008
Mental health care threatened
Leslie Boyd
The state could lose more mental health service providers on July 1 if a new rule goes into effect as planned.
The regulation would disallow practice by many provisionally licensed therapists, counselors, social workers and psychologists who now provide critical mental health services.
Marissa Kent-White works with families and children in Haywood County. She said many of the children are in Department of Social Services custody and need the stability offered by a single counselor.“In two weeks, I’ll have to walk away from them,” she said.
A provisional license in mental health fields is akin to a medical internship. Professional status requires one-two years of supervised experience after earning an advanced degree.
Provisionally licensed workers in the mental health field are usually supervised by professionals in their own specialty — other therapists, counselors and psychologists. The new state rule would allow them to be supervised only by a physician, such as a psychiatrist, if they are to receive Medicaid reimbursement.
Tara Larsen, of the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services, said the new rule will draw more family-practice physicians into the mental health system, but service providers and advocates say the new rule would severely limit where and how people with provisional licenses could work.
“In general, I don’t know what the department’s motivation is on this,” said Tom McDevitt, CEO of Smoky Mountain Center, the local management agency for 12 counties in Western North Carolina. “In the seven westernmost counties, there is only one practice with one part-time psychiatrist who could supervise these people. This is going to be very problematic for us.”
Currently, those with provisional licenses can perform Medicaid services, including outpatient counseling. After July 1, they will perform mostly services such as community support and crisis services as part of a team. Medicaid will not reimburse for the more basic services that state boards insist be part of their training.
“What is the logic in graduating people we need to do the work and then not letting them do it?” McDevitt said. “We will have a system that won’t pay people for the work they need to do to become fully licensed.”
Raymond Turpin, a licensed psychologist with a Ph.D., employs four provisionally licensed professionals in Haywood and Jackson counties, where providers are in short supply. One of those he supervises is Kent-White.“At a time when there aren’t enough providers to go around, this is unconscionable,” Turpin said. “Doctors here are busy, and they don’t want to take on patients with severe mental illness. They hardly have time to see the patients they have already.”
Larsen said Turpin and other psychologists could form a contractual relationship with a physician and retain their employees.But the employees still would not be able to perform the duties they do now, and Turpin and McDevitt believe most doctors would be reluctant to assume responsibility for workers employed by someone else.“We’re asking them to put their medical malpractice insurance on the line,” Turpin said.
Before adopting the new rule, the state consulted an advisory team of professionals in social work, psychology, marriage and family therapy and counseling, but the rule adopted was much narrower than the team recommended.
“There’s a desperate need in the system for trained professionals,” said Sally Cameron, executive director of the N.C. Psychological Association.McDevitt said the need is most desperate in rural areas, and he is certain the new rule will cut access to services, not enhance it as state officials believe.“It’s still a mystery to me how they reach some of their decisions,” he said. “We have squandered the money, alienated the workforce and betrayed the people we’re supposed to be serving. Whatever reform was supposed to be, it has failed miserably.”
http://www.citizen-times.com/apps/pbcs.dll/article?AID=200880614049
Mental health care threatened
Leslie Boyd
The state could lose more mental health service providers on July 1 if a new rule goes into effect as planned.
The regulation would disallow practice by many provisionally licensed therapists, counselors, social workers and psychologists who now provide critical mental health services.
Marissa Kent-White works with families and children in Haywood County. She said many of the children are in Department of Social Services custody and need the stability offered by a single counselor.“In two weeks, I’ll have to walk away from them,” she said.
A provisional license in mental health fields is akin to a medical internship. Professional status requires one-two years of supervised experience after earning an advanced degree.
Provisionally licensed workers in the mental health field are usually supervised by professionals in their own specialty — other therapists, counselors and psychologists. The new state rule would allow them to be supervised only by a physician, such as a psychiatrist, if they are to receive Medicaid reimbursement.
Tara Larsen, of the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services, said the new rule will draw more family-practice physicians into the mental health system, but service providers and advocates say the new rule would severely limit where and how people with provisional licenses could work.
“In general, I don’t know what the department’s motivation is on this,” said Tom McDevitt, CEO of Smoky Mountain Center, the local management agency for 12 counties in Western North Carolina. “In the seven westernmost counties, there is only one practice with one part-time psychiatrist who could supervise these people. This is going to be very problematic for us.”
Currently, those with provisional licenses can perform Medicaid services, including outpatient counseling. After July 1, they will perform mostly services such as community support and crisis services as part of a team. Medicaid will not reimburse for the more basic services that state boards insist be part of their training.
“What is the logic in graduating people we need to do the work and then not letting them do it?” McDevitt said. “We will have a system that won’t pay people for the work they need to do to become fully licensed.”
Raymond Turpin, a licensed psychologist with a Ph.D., employs four provisionally licensed professionals in Haywood and Jackson counties, where providers are in short supply. One of those he supervises is Kent-White.“At a time when there aren’t enough providers to go around, this is unconscionable,” Turpin said. “Doctors here are busy, and they don’t want to take on patients with severe mental illness. They hardly have time to see the patients they have already.”
Larsen said Turpin and other psychologists could form a contractual relationship with a physician and retain their employees.But the employees still would not be able to perform the duties they do now, and Turpin and McDevitt believe most doctors would be reluctant to assume responsibility for workers employed by someone else.“We’re asking them to put their medical malpractice insurance on the line,” Turpin said.
Before adopting the new rule, the state consulted an advisory team of professionals in social work, psychology, marriage and family therapy and counseling, but the rule adopted was much narrower than the team recommended.
“There’s a desperate need in the system for trained professionals,” said Sally Cameron, executive director of the N.C. Psychological Association.McDevitt said the need is most desperate in rural areas, and he is certain the new rule will cut access to services, not enhance it as state officials believe.“It’s still a mystery to me how they reach some of their decisions,” he said. “We have squandered the money, alienated the workforce and betrayed the people we’re supposed to be serving. Whatever reform was supposed to be, it has failed miserably.”
http://www.citizen-times.com/apps/pbcs.dll/article?AID=200880614049
From our friends at the NC Justice Center
North Carolina Justice Center224 S. Dawson St.
Raleigh, NC 27611
www.ncjustice.org
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Tell NC Senate to Keep Funding Critical Health & Childcare Programs
Senate Budget proposal looks grim and may include cuts to NC Health Choice and child care programs
Since the NC House passed their version of the state budget, Senate leaders have been scrambling with their version of the budget and the news is distressing. The Senate budget, which will likely come out early next week, will reportedly contain substantial cuts to vital program areas like Health and Human Services.
Programs that provide low-income kids with affordable health insurance (NC Health Choice and NC Kid’s Care) and help low-income parents with the skyrocketing costs of childcare (child care subsidies) may face cuts and are in jeopardy.
With the number of uninsured in North Carolina rising everyday and nearly 30,000 kids on the child care subsidy waiting list, now is not the time to be cutting critical programs that help working families weather the economic downturn.
Contact NC Senators TODAY and tell them it’s important to provide full funding to NC Health Choice, NC Kid’s Care and to maintain the funding for child care subsidies.
Click HERE To TAKE ACTION
Raleigh, NC 27611
www.ncjustice.org
Unsubscribe
Tell NC Senate to Keep Funding Critical Health & Childcare Programs
Senate Budget proposal looks grim and may include cuts to NC Health Choice and child care programs
Since the NC House passed their version of the state budget, Senate leaders have been scrambling with their version of the budget and the news is distressing. The Senate budget, which will likely come out early next week, will reportedly contain substantial cuts to vital program areas like Health and Human Services.
Programs that provide low-income kids with affordable health insurance (NC Health Choice and NC Kid’s Care) and help low-income parents with the skyrocketing costs of childcare (child care subsidies) may face cuts and are in jeopardy.
With the number of uninsured in North Carolina rising everyday and nearly 30,000 kids on the child care subsidy waiting list, now is not the time to be cutting critical programs that help working families weather the economic downturn.
Contact NC Senators TODAY and tell them it’s important to provide full funding to NC Health Choice, NC Kid’s Care and to maintain the funding for child care subsidies.
Click HERE To TAKE ACTION
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