Agenda - 12-15-2009 - 3b - Laserfiche WebLink

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28 MENTAL HEALTH TASK FORCE REPORT 2009 STRTE REPORT CH.ROS u' $ nn~'' {}. ~n . _ ~ ~. x. ~~` /~ ^ YttPgrated physical and media! care pllc% pro~arn ~('~ ! ~ ~ ~ ~ ^ ~sf ~rxa>•ceraMedlcahi E2tn;~tatemeet n 2QQ6, Nord[ Carolina's mental health system re- ceived a grade of L?,17tree years later, the grade re- mains the same, but does not eaen begin to conrly the chaos that now pervadr.re rite stttte's nrntal health rnre system. NAMI warned three years ago drat the state`s reform initiatives were changing too much, too fast, resulting in an increasingly disorganized enrlronment This predic- tion was accurate. Fortunately, a change in governors in 2@09 provides broader hope for the future. Some bright spats exist. North Carolina enacted a mental health insurance parity law in 20Q7, a major step towards impm.lnrg access to care. The state has taken jail diversion nainUt$ seriously acrd has worked to build ec- idence-based practices. Assertive Comtnunity Treatment ACT; is an acknou-ledKed interest, although the state re- cemly atmounced a sec en percent cut ut the prngram- North Carolina has pitoted lrrandng resources to Local Aianagetnent Entities CLRiEs} to build kcal capacity, drereby reducing reliance on mercroivded state hospitals. it also has a promising pilot program that integtari's men- ntl and physical health care at four LhiEs, including shared data s} teems and comtrmn measures to track results. The state else gives feedback to donors about their prescribing patterns. which is a pasitinr des-elnpment, North Carolina certifies peer specialise and antlc- pates growing this area of its mental health workforce, if fundutg can be sustained. AntMhcrS<terrgtlt is itrtprwement in aaess to tyL'tiicaid Ear cattsuttxrs who are. incarcerated lry suspertdurg, rather than terminating, L~erxEits, North Catalina faces muhiple challenges, care of the [Host complex changes drat the state atlrmpted uas ptn~a- ti:ation of community mental health sereccs, creating LkiEs for geographic regions..~fter two years of btllntg, an auditor found that cart $9t~omillion had been ~~asted; an- other fevel n[ revieww suhsequendy [otmd that number was aveascated. Bill¢tg issaes cotun`buted to both fittar- cial and clinical disarray and coincided u~th the resigna- tion i?f the HHS secrctarv. Cutrerttty, ~aluet?gdons manages Medicaid fund- ing, while. other stair dollars 3c' to the LMEs, resulting to lJ~gen~.Ne~ds v. ~y. >. , ,,, > ^ R~aTOf~~A7flfldeFFti~ aal~i 4Fih3f iD OYE21{ 5ys1L~7i improve stateho-splfal5toenableiraaslbontflnewerfacllity ^ RestnteAGTfvndtnQcus Cotlsumer and Family +:omments . ^ 'The state reorganized services several years ago:... the psychia- tdsts at! tefE--`the area" ^ "the krrptemer~abon of the peer support program has been the best Yhtrrg since sRCed broad." ^ "Jt takes 2d-d8 hours to get a hospital Ded X 1 reed to De adnt7tted' ^ °Wake Gorrnty has a crisis lnEenrention program rrhtch l am giatefttl for." more. complexity and &agmemadon. Essentially, there is a dual system fi7r outpauene care. additionally, in Zt105, the U.S. Lkpartment ofjustice (L~J} documented numzrnus safety concerns in Nirrtlt Carolina's state hospitafs. EHarts to remedy these. issues hatix not been rea~vring. L1tJJ monitors nngningprobletns at l~ix and Brout Hospitals. Cherry and Bruughtcm Hospital in Mar~trtton have- lest federal ftttidatg due tea numerous cnttcerns. The newly-.?lxnod Central Regional Hospital CQtHI in Butner was putt on notice: in 20t`aB that t`t too was at risk of losing federal. futrds. The lass of federal funds fix Cherry Hospital a e~imated N cyst the state $t3QQ,t)[1Q per month. The state's plan w close L?ix 1-laspital and txarrsfcr staff and patients to CRH has aroustd numerous con- ccrnsabout safety and staff training. The move has been dela}ed fine rimes to date. The new governor, &~v Purdue, fnherit_a a complex, dis~,~,~anted, and difficult ~gacy, but at least her dtarge is dear-ua restore cnnf3dence and order to the system. Ckaningup the mess mid improving care Enr rite state's cit- i~rts will require leadership, politleal detertmination and invoh~ernent of the. legislature, and sound in~~tments. Additional links to coverage of state mental health reform can be found at the Task Force web page at http://www.ci.chapel-hil I. nc. us/. See also tide Carrboro Citizen "Breakdown" series at httn://www.carrborocitizen.com/main/breakdown/ 26