There's been talk about North Carolina needing a "vision" for mental health, after the last eight years.
One contribution ncmentalhealthvote.org has made has been to be a place where a clear vision has been articulated - it is a clinically-centered vision, where the needs of a person with mental illness is the central organizing principle for the mental health system, and everything derives from that.
So the places to start are in rebuilding the safety net where it has been tattered, and rebuilding the clinical workforce needed to take care of those in need.
The next Governor faces a daunting task, now compounded by the financial crisis that will certainly create a budget crisis for the state. In view of that, it is hard to imagine new funds flowing into the mental health/substance abuse system. The best we can hope for is to ward off budget cuts.
In view of that, the task for the first years of the next Administration will be to bolster the critical safety net services, and start the reorganization that will sustain the system when new funds become available.
As a start toward that, the NC Psychiatric Association is proposing draft legislation to revise the mental health law. We hope to assemble a wide coalition in support. It is important that we who are at the epicenter of the mental health crisis strive to set the agenda for the next session of the General Assembly.
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Real life example; We have a company that opened Jan. 1, 2005 providing DD TCM only. As you know case management was removed from the CAPMRDD waiver in 2005. My company was originally endorsed by the NC Council to provide DDTCM. Then it was mandated that we get endorsed again through our LME. On Jan. 1, 2006 TCM was not approved in the state plan and eventually the state informed us they destroyed or LME Endorsements. I started asking anyone and everyone what service definition should be followed, the old state plan or the draft of the new state plan. At that time our LME was not sure and a state person told me to follow the draft of the new state plan but she would not put that in writing. Over the past few years we have worked diligently to obtain answers regarding different guideline to follow. After observing the confusion taking place with CS audits, my urgency for a service definition increased to the point I was driving everyone crazy trying to obtain clarity! I will not even mention the Day to Day changes due to “reform” going on at the same time! Now before we have ever received a services definition (for almost 3 years) telling us what our job description is our rate is significantly cut!
I do not know if other DDTCM agencies have been asked for input. I do know we have not been asked for anything! (I.e. Job descriptions, cost reports etc) HOW DO THEY COME UP WITH A RATE CUT FOR A SERVICE THAT HAS NOT HAD A JOB DESCRIPTION/”SERVICE DIFFINITION” FOR NEARLY 3 YEARS?
How come every other service definition ends up posted on line for comments, they have forums, they obtain input from individuals receiving the service and provider input. We have to beg for any past, present or future information regarding case management.
Case management is a very hard, complicated job with a lot of stress and deadlines. THUS, TURNOVER!!!! In the DD world it is imperative that everyone involved understands the role of case management and not just for the purpose of rate cuts but for Quality, Health, Safety and Liability!!!!!
We would love to be involved with any effort regarding DDTCM!
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