Orange County NC Website
citizen per month. This is a generous allotment. There has been no contract signed yet. This <br />would be a little over $5 million. This means that service funds would be handled entirely <br />separately from administration. Currently, all State and Medicaid rates include an administrative <br />portion. This will be clean and separate. It also means that the County contribution, it appears, <br />will not be required for administrative support but for services support. <br />The new governance structure is under development and there is an inter-local <br />agreement in draft farm between the three counties. The organization will be governed by the <br />new structure. <br />Commissioner Brown said that the new structure will be the three County Managers, <br />three County Commissioners, and the OPC Board will become an advisory board to the new <br />entity. <br />Tom Maynard said that the one big change is how the State pays them. They have to <br />find about $3 million a month to make ends meet. The State has delayed payments 30-45 days. <br />He said that they have had to hustle to pay their bills. The way they get paid from the State has <br />changed, but also the service definition manual has changed and it will make a difference in <br />what they get paid to do by the State. The good news is that the new definitions allow them to <br />get paid for services that they have wanted to provide (children with severe mental health <br />problems, in-home support, outreach support, better medication management, and improved <br />crisis services). They cannot develop a budget for next year until they get the service rates. <br />The downside is that some of the old things will go away. The threat was that they would have <br />a cessation of funding for developmental day services, sheltered workshops, and outpatient <br />services except by licensed people. Yesterday they learned that the State has decided to <br />postpone the developmental day issue and the sheltered workshop issue for at least a year. <br />Regarding divestiture of services, they have started with programs where there is high <br />gain and low negative impact. <br />Regarding their institutional downsizing, they have had targets for getting people out of <br />institutions, and this year they paid $500 per day for everyone in the institution over their quota. <br />This is a big risk. <br />Chair Jacobs asked how many people Orange County served for mental health and Tom <br />Maynard said over 3,000. There is a higher distribution of services to people with severe <br />disabilities. <br />Commissioner Brown gave some history of the OPC mental health system. She said <br />that the two walk-in clinics were the fundamental access points. She thinks the State is <br />interested in having LME to divest of all of these programs and put them out to bid to for-profit <br />corporations, which would break apart the programs of OPC. A lot of counties have divested all <br />of their programs. She finds this appalling and something that OPC would not want to do. She <br />wants to take responsibility for our citizens and maintain the clinics. <br />Tom Maynard said that same parts of divestiture are good, but people also want <br />continuity. They also want to strengthen the crisis program. <br />Commissioner Halkiotis asked what happens in the five-county area that divested their <br />programs and how people access private providers. Commissioner Brown said that there is <br />going to be a toll free number to give out this information. <br />Commissioner Brown said that this is the discontinuing of the 1960's public mental <br />health system. OPC has established a sliding scale funding process, so anyone with any <br />income can access the system and can afford to get help. The reform eliminates this sliding <br />scale, and this upsets her. OPC is trying not to lose it. <br />Jahn Link said that the concept is that through the Lead Management Entity {LME), the <br />three counties will continue to work together. When they look at and evaluate each county's <br />needs and there is a particular need or service, this is where they need to put in some of the <br />Human Services Safety Net funding. He said that they are trying to be deliberate in making <br />sure that no services are discontinued or that any employees are discontinued. He said that the <br />specific item this board needs to address is that the implementation date be later than July 1, <br />2004. The Board needs to ask the legislative delegation to move this date back. <br />