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MINUTES ORANGE COUNTY BOARD OF HEALTH June 26, 2008 Board of Health Minutes Transcription completed by Anne Miles Cassell 2 June 26, 2008 • A Community Mental Health Needs Assessment, • a power point overview summarizing the OPC Crisis Plan, • OPC Mental Health 2nd and 3rd quarter reports on access, triage for referral to emergent, urgent, and routine care, indicating how many people accessed care and their needs. Ms. Truitt said the state has created an unnatural split between consumers who are indigent and need state funded services and Medicaid funded consumers. OPC is only able to access information on Medicaid funded consumers, therefore OPC is unable to capture information on the latter and it creates a gap in information. Despite the fact that the legislature has put millions of dollars into the system it is a major issue. This fiscal year OPC lost approximately $1.5 million dollars. OPC Mental Health in 9th in the state in the amount of funds allocated to mental health. She stated that transportation, transitional services, and crisis services are several of the most pressing issues. Currently cooperation with UNC has helped with stabilizing patients before OPC can provide services. One hour of clinical service per month for severely and persistently mental ill people is not enough. There is a need for more psychiatrists that are dedicated to public health sector. She says the state feels strongly that there are too many local mental health entities and favors a regional reorganization to manage mental health as being more cost effective. OPC feels a local degree of governance brings better results. In the area of mental health OPC ranks 9th in state in the amount of money expended per county. The others in the top 9 are all single county programs. Orange, Person, and Chatham Counties are actively involved and actively support OPC and mental health. She noted that Orange County puts millions of dollars in the public mental health system. Mark Sullivan, Executive Director of the Mental Health Association of NC, stated that in addition to points brought up by Ms. Truitt, system instability and service quality are issues due to state reform of the mental health system. Many citizens do not know how to access the services they need and many have complex medical needs in addition to their mental health needs. Psychiatry for the target group population and quality case management for the non-target population are two of the most pressing issues. He commended Healthy Carolinians involvement and support of the mental health needs of the county. He asked the Health Department to add mental health to its chronic disease program. He would like to see UNC, the county and the Orange County Health Department to work more closely to this end. Dr. Anthony Lindsey, UNC Psychiatrist, said he felt fragmentation of services is a serious problem. Patients do not know how to access the services they need after they are released from the hospital. This is especially problematic with those suffering from a mental illness. For severely ill patients there is a benefit to a broad array of services being in one location. UNC sees about 30,000 outpatient visits per year in a clinic that was designed for 26,000 and services are available