10/27/05 — Mental health reform debate continues

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Mental health reform debate continues

By Bonnie Edwards
Published in News on October 27, 2005 1:52 PM

MOUNT OLIVE -- Secretary of Health and Human Services Carmen Hooker Odom has softened her position on how to overcome a $28 million shortfall in the state's mental health budget.

But if local providers don't choose their new partners as part of a consolidation plan, the state will do it for them, Eastpointe Director Jack St. Clair told his board of directors Tuesday night. He said health care providers who are operating the local programs are going to have to figure out how to "be the lead dog or get out of the way and get ready to follow."

The shortfall resulted from mental health reforms that shifted mental health care from large regional providers like Cherry Hospital to smaller providers in the clients' communities.

Ms. Odom has given the local mental health programs until Dec. 15 to figure out how to form larger alliances. She expects the formation of just 10 regional programs serving a million people each to make up for the $28 million funding shortfall. St. Clair said he just doesn't see that happening.

St. Clair said Ms. Odom incensed many local mental health agencies when she suggested last month that they form even larger alliances than they already have through the mental health reform process in an effort to cut costs.

"She's been fried and sizzled by about half the people in North Carolina at this point," St. Clair said.

The mental health reform process started in 2001 with state legislation that called for the local mental health agencies to consolidate and shift patients out of large regional hospitals to local hospitals and group homes. The goal was to reduce the large hospital beds from 1,788 to 934 by the year 2007.

Eastpointe formed out of four county mental health programs in Wayne, Duplin, Sampson and Lenoir counties.

But the money expected to flow from the large hospitals into the community programs hasn't come as quickly as projected. That shortfall prompted Ms. Odom to call for the formation of the new regional programs.

She told Eastpointe to partner with three other programs in the eastern region, St. Clair said. But those programs used different computer software, and they would have difficulty sharing information.

Ms. Odom came up with the latest proposal Tuesday morning after several negotiations with local program officials. She said the only way for the alliances to be successful is for them to form voluntarily.

St. Clair said Eastpointe has always taken system reform head-on.

"We all have the wounds, but we pulled it off," he said. "From day one when system reform reared its head, we said we wanted to determine our own destiny."

The board voted to authorize St. Clair to look for new partners.

He said Edgecombe-Nash and Wilson-Greene share common software with Eastpointe, and their officials are interested in talking about forming an alliance. He said others, too, have contacted him about forming an alliance.

Meanwhile, the Eastpointe board approved giving private providers of medical care a raise for going on-call. Eastpointe had five providers quit doing on-call care, saying they wanted more money. The board approved a $25-per-shift raise for workers who agree to work on-call nights and weekends and to meet the clients in hospital emergency rooms.

"These are clinical people, not our staff," St. Clair said. "Before, we had plenty of staff, and they were happy to do it."

The board also voted to give $25 raises per shift for computer programmers to get the system back up and running when it goes down during nights and weekends. St. Clair said the computer system rarely goes down, but when it does, that puts a stop to communications. The state requires the local mental health programs to provide service 24 hours a day, and the clients have no way of contacting help in emergencies when the computers aren't working.