03/28/07 — Agency outlines future of care for patients

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Agency outlines future of care for patients

By Matthew Whittle
Published in News on March 28, 2007 1:46 PM

MOUNT OLIVE - With three years of transformation and confusion behind them, members of the Eastpointe Board of Directors voted Monday night at Mount Olive College to give the local mental health management entity what it hopes will be a solid direction for the future.

Approving a local business plan for the next three years, the board laid out what Eastpointe's role will be, as well what needs to be done to begin addressing the concerns of clients, providers and other agencies involved in the mental health system.

"It was a massive undertaking," board chairwoman Rita Hodges said. "It's a living document, but this will serve as a guide for the next three years."

Broken down into six sections, the document outlines the major functions of Eastpointe and how those will meet the concerns voiced by clients, providers and other stakeholders at a series of meetings held in Wayne, Duplin, Sampson and Lenoir counties.

Since 2004, Eastpointe has been transitioning away from providing client services to managing and overseeing a network of more than 130 private mental health providers. Within its four-county radius, the organization serves about 293,000 people -- about 9,000 of whom are patients.

As those changes have occurred and mental health care has been divested out of the state's psychiatric hospitals and back into the community, there have been questions about where people can turn for help.

In turn, that confusion has led to more people ending up in jail, local hospital emergency departments and even in the mental hospitals for short-term stays.

Among the major complaints are:

* Clients and stakeholders not understanding how to access the system.

* The need for more intensive mental and substance abuse services.

* Communication between providers.

* Alternatives for residential placement of children, often outside the county.

* Discharging to rest homes.

* Speedier access to treatment options outside of the mental hospitals.

* The need for a mental health presence within local hospital emergency departments.

* Training law enforcement officers regarding mental health clients.

* Transportation for clients attending appointments.

* Translators for non-English speaking clients.

* Services for National Guard veterans and their families.

* Holding private providers more accountable.

Each of those, Hodges explained, was something that was brought up again and again in meetings with stakeholders.

"When you have four meetings in four different counties and the same things keep appearing, you know it's something that needs to be addressed," she said.

The most common complaints, Eastpointe executive director Ken Jones said, were the concerns about the difficulty people have in accessing care and the need for better crisis response.

To help improve in those areas, the plan calls for continued efforts to educate the community about how to access care through Eastpointe, the need for providers to follow up better with their patients, as well as the need for providers to expand their services, particularly in the rural areas of the four-county region.

It also calls for better communication between providers, especially those with different levels of care.

The goal, Jones explained, is for people to be as secure in this new multi-provider system as they once were when they came to the Mental Health Department for all their needs.

"We've got to get our providers to communicate with each other," he said. "We need at least a sense of a one-stop shop."

As part of that, Jones continued, Eastpointe and the providers also will be working to have crisis intervention plans in place that go beyond simply calling law enforcement and deal with actually treating the patients in the community.

Another major concern for the Eastpointe board is their lack of ability to hold providers accountable.

That issue, Jones explained, will be a little harder to confront.

"There are not very strict guidelines on how you monitor providers," he said. "If they're willing and able, we have to endorse them. (After that) there's not a whole lot we can do other than monitor them and report to the state.

"We need more strength and authority."

With the exception of those providers who receive payments through Eastpointe for patients with no type of insurance, the local management entity has no authority to rescind an endorsement or withhold funding without explicit direction from the state.

Under the new plan, such providers will be reported much more aggressively as Eastpointe continues to lobby for more enforcement authority.

Overall, Jones continued, he feels this new plan will have Eastpointe moving in the right direction.

"The reason I feel comfortable with it is it does have input from such a variety of sources. It's not haphazardly put together. Every statement written in this document has some meaning," he said.

And, he added, it's available for all of their stakeholders to examine.

"We've made them aware that it's out there. It's not a document that we are sending to the state and only they can understand," he said.