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BOCC
Date
2/20/2007
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Minutes
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<br />7. Special Presentations <br />a. VF't: Area Ulr@CiOr Upgaie On LOCaI IVlental FiealtCl KeTOrm <br />The Board received an update from the OPC Area Program Director on local impacts, <br />progress achieved, and future prospects under statewide Mental Health Reform. <br />Assistant County Manager Gwen Harvey said that the Board made a request at the <br />January retreat to receive an update from the OPC Area Director related to the progress under <br />statewide reform. The Board also has an the agenda tonight consideration of a public hearing <br />far the legislative agenda, and the proposed goals presented to the delegation, which includes <br />consideration of mental health reform and calling upon the State to help local governments with <br />providing mental health services. <br />Area Director of OPC Mental Health Judy Truitt highlighted some areas of progress. <br />First of all, there was a report mandated by the state legislature that is available at <br />http:l/www.dhhs.state.nc.us/mhddsas/. The report indicates that North Carolina ranks 45t" in <br />the nation on the amount of money that is spent in the mental health system, and ranks 49t" in <br />the nation in the development and implementation of community-based services. The report <br />indicates that North Carolina continues to have a very strong reliance on facility-based and <br />institutional-based programs, which the consultant identified to be a critical issue for the State. <br />The consultant indicated that, in order to bring continuity of care to an optimum level, North <br />Carolina would need to allocate $2.7 billion to the mental health system. Continuity of care is <br />defined by the consultant as providing what the consumer needs when they need it, in the depth <br />and breadth of services that will resolve or stabilize their mental health, substance abuse, or <br />developmental disability issues. <br />Another issue is related to how North Carolina, in its mental health reform effort and in <br />the divestiture of service programs, has created a free market far providers that has been <br />described as haphazard. In North Carolina, providers who are willing and able are able to open <br />shop and can do so and there is an explosion of providers. The question becomes whether <br />there are adequate financial resources to fund and support all of those providers. <br />Another critical issue identified by the consultant is that North Carolina ranks 16`" in the <br />nation on the use of state psychiatric hospitalizations. This over-reliance has resulted in <br />admission rates that are much higher than the national average, and it also means that more <br />funds are being dedicated to inpatient psychiatric hospitalizations than in other states. Orange <br />County averages about 23 admissions per month during this fiscal year to John Umstead <br />Hospital. <br />Another issue identified is that there are many issues regarding who has the ultimate <br />responsibility within the system. The consultants believe that community-based services are <br />overall lacking in the State, but noted that there is a particular concern in N. C. related to <br />substance abuse treatment services. Statistics provided to the LOC indicate that 64°~ of the <br />new prisoners going into the Department of Corrections have substance abuse problems and <br />20°~ of the individuals admitted to the State psychiatric hospital have a primary diagnosis of <br />substance abuse rather than mental illness. <br />Regarding quality and access to care, OPC has a provider community of over 240 <br />providers that provide over 100 services in the three-county area. The provider network is <br />strong in what the State defines as best practice models. <br />She said that she would be glad to meet with any of the County Commissioners or any <br />other group to discuss other issues related to the report. <br />The second area is that the primary divestiture of all of the service programs within the <br />OPC network was carried out between October 2005 and June 2006. Providers that were <br />divested and services that were moved into the private market are reasonably stable, but the <br />system remains very fragile. During calendar year 2006, 5,152 consumers were served across <br />the three-county area. Seventy-two percent of the consumers were ages 18-65; 25°~ were <br />children under the age of 18; and only 2.6% were aged 65 and older. Almost all of the children <br />
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