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2000 IISAC Fortun ) ]_'111 A F T in knowledge, service delivery was stuck in the past. The state legislature needed to address the issue, but also needed to be informed by experts in the field and the community -at- large. State Auditor Ralph Campbell continued the address with a description of the mental health study requested by the General Assembly in 1998 that was released earlier this year. Phase one of the study consisted of an update of the 1998 MGT of America study on the four state psychiatric hospitals. Phase two included an examination of the area programs and an assessment of the mental health delivery system. The contractor chosen — Public Consulting Group (PCG) — made recommendations in three broad areas: services, finances, and governance. Many of the issue's stakeholders were brought into the process: area mental health program directors, hospital administrators, and county commissioners. Significant service PCG FINDINGS REGARDING THE STATE HOSPITALS changes involving ♦ Reduce hospital bed capacity by 667 beds, reducing the total the state's four capacity from about 2,300 to about 1,600 _p Y outdated psychiatric ♦ Close Raleigh's Dorothea Dix Hospital, leaving only three hospitals were renovated campuses recommended. The i ny? I: It's the most expensive hospital to operate. Potential savings MGT study as well represent $13.2 million annually. 2. Area offers good opportunities for as PCG stated that the development of community -based services and employment alternatives for staff. 3. With proper planning, the "safeo) net" can be the hospitals needed maintained. 4. Dorothea Dix offers the richest opportunities for re -use. to be renovated � significantly, or else rebuilt entirely, at a PCG- revised cost of $490 million. PCG found that the state hospitals should focus on providing intermediate and long -term facilities rather than being the only choice for care for many patients. Many services can be provided by local organizations, although "additional analysis is needed in order to assess current services and to develop a strategy for planning, funding and implementing high - quality community based programs," according to PCG's summary report. It also stated that "North Carolina's mental health system does not currently have the capacity to treat all groups of individuals at the community level. Proposals to move entire populations into the community are not realistic and would not constitute an appropriate plan." PCG also recommended establishing a standard or core benefit package for all mental health clients, due to wide variations in community services across the state. The report found that existing local programs lack accountability both to state and to local government, and that governance and funding are not coordinated. PCG proposes adopting a County Program model that will "shift management responsibility for mental health, developmental disabilities, and substance abuse services to North Carolina's counties." Counties would be able to partner together within State guidelines. However, this shift would not become an `unfunded mandate.' 2