By Taylor Sisk
Staff Writer
Local elected officials are concerned with the recent announcement of a restructuring of services for mental health, developmental disability and substance abuse in Orange, Person and Chatham counties. The Orange-Person-Chatham (OPC) Area Program – the local government agency tasked with providing oversight and management of these services – has announced that a private service provider with whom it contracts, Caring Family Network, plans to restructure its offices in both Orange and Chatham counties, and that the move will have an effect on service capacity.
“This move to cut services is exactly what we feared would start to happen under the state’s reform efforts,†said Orange County Commissioner Mike Nelson.
According to OPC, Caring Family Network indicated that the recent rate cut by the state for Community Support services was the primary motivation for the moves.
That cut was announced in April by North Carolina Department of Health and Human Services Secretary Carmen Odom Hooker, who has since resigned to become president of the Milbank Memorial Fund, a New York-based health-policy foundation. The Medicaid rate reimbursed to organizations providing Community Support services had been $60.96 an hour. It has now been reduced to $51.28.
Caring Family Network is an Ohio-based company with local administrative offices in Durham; it was awarded a contract in 2006 to provide services throughout the area that include psychiatry, substance abuse and outpatient therapy. It currently serves approximately 1,000 individuals in Orange County. The company will be consolidating its Hillsborough and Chapel Hill offices, with most services being provided in Chapel Hill. It will also be consolidating its Pittsboro and Siler City offices.
OPC director Judy Truitt said her office has not yet received the specifics of the plan from Caring Family Network. Her understanding at present is that while most services will transition to Chapel Hill, Hillsborough will continue to operate as a satellite office. OPC has requested a timeline and transition plan, which Truitt said she expects to receive by the end of this week.
OPC provides screenings and referrals, monitoring of local service providers and manages the distribution of state money for services.
“We have had many conversations with Caring Family Network over the last few months about the [Community Support services] rate cut,†said Truitt. “We’re working with them closely to help them move forward.â€
The rate cut was the latest in a series of changes made in the provisioning of mental health, developmental disability and substance abuse services by the state Department of Health and Human Services (DHHS) under Hooker Odom’s direction.
Those changes were in some measure initiated in response to the U.S. Supreme Court’s 1999 Olmstead ruling. In that ruling, the court stipulated that, in keeping with Title II of the Americans with Disabilities Act, Medicaid-eligible individuals should not be discriminated against by being forcibly institutionalized when they might otherwise be provided services within their communities.
A plan is now in place to close two mental health facilities – Dorothea Dix Hospital in Raleigh and John Umstead Hospital in Butner – to be replaced by a new hospital in Butner, with a net loss of approximately 200 beds. DHHS also began transitioning a number of services away from governmental providers to private companies.
Nelson says the announced changes to the provisioning of services in this area are substantiation of the ill effects of privatization: “Basically, the state has forced privatization of services for the mentally ill. I believe some services are best provided by the state. Mental health is one of those.â€
State reforms originally called for the closing of nearly 700 beds. But as admissions continued to climb, the closings had to be curtailed, with less money then going to community-based programs.
State Senator Ellie Kinnaird said she was upset to learn of the restructuring. She said she believes the consolidation of the clinics is the wrong direction to take given that the idea behind the revamping of the state’s approach to mental health has been to treat more people in their own communities.
Nelson said that when he was campaigning for commissioner last year, mental health reform was the most-frequently raised topic among constituents. Reform efforts by the state, he said, have failed miserably:
“This is a good example of why blindly following the ideology of privatization is misguided. The folks who need these services in our county are going to be hurt. They will probably have less access to good, quality care. It’s a shame.â€