
{"id":18586,"date":"2011-06-02T08:55:52","date_gmt":"2011-06-02T12:55:52","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=18586"},"modified":"2011-06-02T09:05:43","modified_gmt":"2011-06-02T13:05:43","slug":"compromise-proposed-on-pending-behavioral-health-care-bill","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2011\/06\/02\/compromise-proposed-on-pending-behavioral-health-care-bill\/","title":{"rendered":"Compromise proposed on pending behavioral health care bill"},"content":{"rendered":"<p><strong>By Taylor Sisk<\/strong><br \/>\n<em>Staff Writer<\/em><br \/>\nAs the General Assembly discusses legislation that would once again overhaul the state\u00e2\u20ac\u2122s mental health, developmental disability and substance abuse services system, a change has been proposed to that legislation that has won the approval of an influential statewide organization that advocates for people with developmental disabilities.<br \/>\nDave Richard, executive director of The Arc of North Carolina, said that last week\u00e2\u20ac\u2122s announcement by Rep. Jeff Barnhart and state Department of Health and Human Services Secretary Lanier Cansler that local management entities, or LMEs, could continue to contract with outside agencies to provide certain case management services for those with developmental disabilities means his organization will no longer oppose the House bill.<br \/>\nBarnhart, a Republican of Cabarrus County, is a primary sponsor of the bill that would grant to providers of mental health, developmental disability and substance abuse services a 1915(b)(c) waiver of the Social Security Act, freeing them from certain Medicaid provisions. The waiver allows states to move agencies that manage services (in North Carolina, LMEs) from a fee-for-service delivery system to one in which LMEs are given a fixed dollar amount.<br \/>\nPiedmont Behavioral Healthcare (PBH) \u00e2\u20ac\u201c the LME that oversees publicly funded behavioral health care services for four counties immediately east of Charlotte \u00e2\u20ac\u201c has been operating under the full 1915(b)(c) waiver model since 2005 as a pilot project.<br \/>\nThe pending legislation would roll out the waiver statewide. LMEs would be given all Medicaid, state and local funds in a lump sum \u00e2\u20ac\u201c thus producing a managed-care system. Proponents of the waiver say this provides for more accountability and improved efficiencies at the local level.<br \/>\nLast Friday, an action alert was sent to Arc members explaining that the proposed change would allow LMEs to contract with outside agencies to provide targeted case management services to the developmental disability population.<br \/>\nConsumers of behavioral health care services, as well as their families and other advocates, have been concerned that, under the waiver system, case management would no longer be offered as a stand-alone service, but by the LMEs as a component of managed care. Advocates argue that people with developmental disabilities will be hardest hit if case managers familiar with the particular needs of their clients, whose sole responsibility is to advocate for the individual, are eliminated.<br \/>\nFor those with developmental disabilities, case management includes client assessment, writing a treatment plan, referral to a provider for service and monitoring the delivery of that service. Under the proposed change, those duties could be shared by the LME and an outside advocate.<br \/>\n\u00e2\u20ac\u0153Though this does not replace independent case management as we know it\u00c2\u00a0today,\u00e2\u20ac\u009d the Arc wrote to its members, \u00e2\u20ac\u0153it will allow for people with developmental disabilities to have someone outside of the [LME] writing the plan and assisting with finding appropriate services.\u00e2\u20ac\u009d\u00c2\u00a0<br \/>\nAs defined by the Centers for Medicare &#038; Medicaid Services, said Rep. Verla Insko of Orange County, another primary sponsor of the bill, \u00e2\u20ac\u0153case management is a management function and is appropriately placed within the LME. I agree with that.<br \/>\n\u00e2\u20ac\u0153One of the battles I lost during reform was not leaving case management with the LMEs,\u00e2\u20ac\u009d or, as they were known prior to reform measures launched in 2001, area programs.<br \/>\nBut Insko acknowledges that case management for the developmental disability population is a bit different than for those with a mental illness or substance abuse issues, in that it includes some direct services.<br \/>\n\u00e2\u20ac\u0153I would rather it all stay with the LMEs,\u00e2\u20ac\u009d Insko said on Wednesday. \u00e2\u20ac\u0153But this is a compromise I can live with.\u00e2\u20ac\u009d<br \/>\nJennifer Hancock, a case manager and advocate based in Wilson, said that many families and providers from across the state are disappointed in The Arc\u00e2\u20ac\u2122s endorsement, saying the proposed change \u00e2\u20ac\u0153does not meet the needs of the families across the state who rely on their case managers for much more than simply writing the annual [person-centered plan] and referring them for services.\u00e2\u20ac\u009d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A change has been proposed to that legislation that has won the approval of an influential statewide organization.<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-18586","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/18586","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=18586"}],"version-history":[{"count":3,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/18586\/revisions"}],"predecessor-version":[{"id":18589,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/18586\/revisions\/18589"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=18586"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=18586"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=18586"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}