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Changes coming to OPC Area Program

Judy Truitt

OPC Area Program has asked to run a series of articles about changes that will be occurring in the public mental health care system over the next 18 months. This first article provides a historical perspective regarding the public system and outlines the organizational shift that will be occurring.

Many of you know that the public mental health, developmental disability and substance abuse system has changed significantly over the last 10 years. In that time, I am sure that you have seen, heard and possibly experienced concerns about the system’s fundamental stability. We acknowledge that change is difficult and that change at a system level presents significant challenges to all stakeholders. So despite the fact that the purpose of this article is to lay the foundation for understanding yet more change, we believe that it is the logical culmination of the work that was started in 2005. We expect that this will bring much-needed stability and structure to our system and will position us to weather the current financial crisis and the impact of federal health care reform of the future.

OPC Area Program was established in 1968 under a North Carolina general statute that charged the agency with responsibility for both managing the public system, as well as acting as the primary provider of services for individuals who did not have access to private treatment options. That structure remained in place until October 2001, when House Bill 381 outlined a major transformation of the public system. The reform effort, spurred by demands at the local, state and federal level, redefined both management and service responsibilities.

Area programs like OPC were given responsibility for management of state and locally funded services. Management of Medicaid-funded services was given to Value Options, a private, for-profit vendor. Area programs initiated authorization systems that were designed to match consumer need with available resources and to train staff in the fundamentals of running a managed-care network. Service delivery was transitioned to private providers.

In April 2005, as part of the long-term plan, the state Department of Health and Human Services began operating a pilot project that once again joined management of state-funded and Medicaid-funded services under one umbrella. This was accomplished by implementation of a 1915(b)(c) Medicaid waiver at Piedmont Behavioral Healthcare, the LME covering Cabarrus, Davidson, Rowan, Stanly and Union counties. This pilot project has been successful, and the state, with the support of the General Assembly, has now made the decision to move forward with statewide expansion of this system.

The second article in this series will provide specific information about implementation of the statewide waiver. We will discuss the expected impact for consumers and service providers, explain how services will be approved and delivered and how funding for services will be managed. You can find more information about statewide implementation of the waiver, including the fact that OPC will be hosting a series of public forums, on our webpage at opcareaprogram.org

Judy R. Truitt is the area director of OPC Area Program. She can be reached at jtruitt@opc-mhc.org or 913-4010.

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