Dix to move to CRH in October

Indicators are very strong - including an announcement at a CRH Department Heads' meeting this week - that DMH will try to move Dix to CRH in October.

Of course, one of the reasons for building CRH was to consolidate two hospitals into one, to save the costs of operating two different hospitals. When the dust settles, DMH will have patients at three different sites, since patients will continue to be at the old JUH and at Dix, as well as at CRH.

Mayor McCrory has made clear that he wants this decision left to the next Administration. Lt. Gov. Perdue wants the move to wait until CRH meets accreditation standards. Understandably, the lame duck administration wants to finish as much of its agenda as it can before December 31. The question is how many of the options the next Governor might want to have on the table will be taken off the table by the outgoing administration.

Budget Act MH language

The 2008 Budget Act was unprecedented, in terms of the length and detail of the instructions to DHHS, DMA and DMH. The Overall DHHS Budget was cut $185.3 million, mostly due to the DMA (Medicaid) cut of $210.8 million, which itself was mostly due to the Community Services overspending debacle. DMH’s budget was increased by $21.35 million. (Language covered in the accompanying post is not duplicated here)

http://www.ncga.state.nc.us/sesssions/2007/budget/2008/conferencecommitteereport.pdf , especially pp 68 et seq

MENTAL HEALTH CHANGES

SECTION 10.15.(b) Of the funds appropriated for substance abuse services to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, for the 2007-2008 and 2008-2009 fiscal years, the sum of at least eight million dollars ($8,000,000) shall be allocated for regionally purchased locally hosted substance abuse services. These funds shall be used to support LMEs in establishing additional regionally purchased and locally hosted substance abuse programs. Funds appropriated shall be for the purpose of developing and enhancing the American Society of Addiction Medicine (ASAM) continuum of care at the community level.

SECTION 10.15.(c) The Department shall encourage the conversion of the remaining non-single-stream LMEs to single-stream funding as soon as possible.. . .

SECTION 10.15.(d) The Department of Health and Human Services shall simplify the current State Integrated Payment and Reporting System (IPRS) to encourage more providers to serve State-paid clients. This effort shall include working with LMEs to develop billing codes for relevant activities currently lacking such codes.

SECTION 10.15.(e) The Department of Health and Human Services shall consult with LMEs and service providers to determine why there have been under- and over-expenditure of State service dollars by LMEs and shall take the action necessary to address the problem.. . .

SECTION 10.15.(f) The Department shall perform a services gap analysis of the Mental Health, Developmental Disabilities, and Substance Abuse Services System. The Department of Health and Human Services shall involve LMEs in performing the gap analysis. The Department shall not contract with an independent entity to perform the gap analysis. The Department shall report the results of its analysis. . . not later than January 1, 2010.

SECTION 10.15.(g) Notwithstanding any other provision of law to the contrary, the Secretary of Health and Human Services shall not transfer patients from John Umstead Hospital or Dorothea Dix Hospital to Central Regional Hospital unless and until the Secretary provides a written report to the Governor, based on the Secretary's findings, that on the day of its opening and thereafter, Central Regional Hospital will be operated in a manner that provides a safe and secure environment for its patients and staff. On or after the date the Secretary has provided the written report to the Governor, the Secretary may transfer patients from John Umstead Hospital to Central Regional Hospital. On and after the date of the transfer of John Umstead patients, the Secretary may commence the transfer of patients from Dorothea Dix Hospital but only if the following conditions are met:

(1) At the time of commencing transfer of Dorothea Dix patients the Secretary has determined that an inspection of Central Regional Hospital indicates no findings of noncompliance with conditions of participation from the Centers for Medicare and Medicaid Services (CMS), and

(2) The Secretary finds that Central Regional Hospital is in compliance with Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) standards for accreditation.

SECTION 10.15.(h) In order to temporarily address high admissions to adult acute unit beds in the State psychiatric hospitals, the Secretary of the Department of Health and Human Services may, notwithstanding G.S. 122C-181 and G.S. 122C-112.1(a)(30), open and operate on a temporary basis up to 60 beds at the Central Regional Hospital Wake Unit on the Dorothea Dix Campus and may maintain the Wake Unit on the Dix Campus until beds become available in the system.. . .

SECTION 10.15.(v) The Department of Health and Human Services shall ensure that veterans and their families comprise one of the target populations for mental health, developmental disabilities, and substance abuse services in order that this population is eligible for existing funding.

SECTION 10.15.(w) The Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, shall develop a service authorization process that requires a comprehensive clinical assessment to be completed by a licensed clinician prior to service delivery, except where this requirement would impede access to crisis or other emergency services. The Department shall require that the licensed professional that signs a medical order for behavioral health services must indicate on the order whether the licensed professional (i) has had direct contact with the consumer, and (ii) has reviewed the consumer's assessment. The Department shall report the failure of a licensed professional to comply with this requirement to the licensed professional's occupational licensing board.. . .

SECTION 10.15.(x) The Department of Health and Human Services shall develop a plan to return the service authorization, utilization review, and utilization management functions to LMEs for all clients. Not later than February 1, 2009, the Department shall report on the development of the plan. . . Not later than July 1, 2009, utilization review, utilization management, and service authorization for publicly funded mental health, developmental disabilities, and substance abuse services shall be returned to LMEs representing in total at least thirty percent (30%) of the State's population. An LME must be accredited for national accreditation under behavioral health care standards by a national accrediting entity approved by the Secretary and must demonstrate readiness to meet all requirements of the existing vendor contract with the Department for such services in order to provide service authorization, utilization review, and utilization management to Medicaid recipients in the LME catchment area.. . . The Department shall not contract with an outside vendor for service authorization, utilization review, or utilization management functions, or otherwise obligate the State for these functions beyond September 30, 2009. The Department shall require LMEs to include in their service authorization, utilization management, and utilization review a review of assessments, as well as person-centered plans and random or triggered audits of services and assessments. The Department may also develop and implement a plan to return plan authorization for CAP-MR/DD slots to LMEs.

SECTION 10.15.(y) The Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, shall study Medicaid waivers, including 1915(b) and (c) waivers, for all LMEs. In cases where Medicaid waivers are not appropriate for an LME, the Department shall identify and recommend strategies to increase LME flexibility to provide case management, assessment, limit provider networks, or other innovative approach for managing care. Not later than March 1, 2009, the Department shall report its findings and recommendations. . .

SECTION 10.15.(aa) The Secretary of the Department of Health and Human Services shall not take any action prior to January 1, 2010, that would result in the merger or consolidation of LMEs operating on January 1, 2008, or that would establish consortia or regional arrangements for the same purpose, except that: (1) LMEs that do not meet the catchment area requirements of G.S. 122C-115 as of January 1, 2008, may initiate, continue, or implement the LMEs' merger or consolidation plans to overcome noncompliance with G.S. 122C-115, and

(2) The Guilford Center for Behavioral Health and Disability Services, the Smoky Mountain Center, and the Mecklenburg County Area Mental Health, Developmental Disability and Substance Abuse Authority may continue with or implement the proposed administrative service organization under development as of March 1, 2008, for merger or consolidation of any combination of these entities.

SECTION 10.15.(bb) If the Secretary of the Department of Health and Human Services desires to merge LMEs, the Secretary shall develop a detailed plan for General Assembly review on its recommendation to merge, consolidate, or establish regional arrangements or consortia of LMEs. In developing the plan, the Secretary shall consult with LMEs to obtain input on the feasibility and effectiveness of potential mergers and the time frame needed to fully implement the mergers, regional arrangements, or consortia at the local level. The Secretary shall provide the plan. . . not later than March 1, 2009.

IMPROVE AND STRENGTHEN FISCAL OVERSIGHT OF COMMUNITY SUPPORT SERVICES

SECTION 10.15A.(a) Not later than June 30, 2008, the Department of Health and Human Services, Division of Medical Assistance, shall submit to the Centers for Medicare and Medicaid Services, revised service definitions for two Medicaid billable services: (i) community support–adults, and (ii) community support-children/adolescents. The revised definitions shall focus on rehabilitative services and be developed to ensure that community support services are provided as efficiently and effectively as possible to minimize overexpenditures in community support services in the 2008-2009 fiscal year and thereafter.

SECTION 10.15A.(b) In order to ensure accountability for services provided and funds expended for community services, the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, shall develop a tiered rate structure to replace the blended rate currently used for community support services. Under the new tiered structure, services that are necessary but do not require the skill, education, or knowledge of a qualified professional should not be paid at the same rate as services provided by qualified skilled professionals. The Department shall not implement the tiered rate structure until 15 days after it has notified the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, and the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services. The Department shall report on the development of the structure to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services not later than October 1, 2008.

SECTION 10.15A.(i) Sections 10.49(ee)(5) and (6) of S.L. 2007-323 read as rewritten:

"(5) All community support services are subject to prior approval after the initial assessment and development of a person-centered plan has been completed;approval.

(6) Providers are limited to four hours of community support for adults and eight hours of community support for children to develop the person-centered plan. Those hours shall be provided only by a qualified professional. Providers that determine that additional hours are needed must seek and obtain prior approval. If additional hours are authorized, the LME may participate in the development of the person-centered plan as part of its care coordination and quality management function as defined in G.S. 122C-115.4. After the tiered rates required under Subsection (b) of this section have been implemented, not less than fifty percent (50%) of community support services must be delivered by qualified professionals."

SECTION 10.15A.(j) The Department of Health and Human Services, Division of Medical Assistance, shall adopt a policy reducing the maximum allowable hours for community support services to eight hours per week. This subsection does not apply to community support services offered under a Medicaid managed care, capitated at-risk waiver.

Budget Act Conference Report

The 2008 Budget Act was unprecedented in recent memory in its attention to mental health issues.

Here is language on Mental Health from the Conference Report on the Continuation, Capital and Expansion Budgets FY 08-09 http://www.ncga.state.nc.us/sessions/2007/budget/2008/conferencecommitteebudgetreport.pdf

R = Recurring Funds; NR = Non-Recurring [one-time] funds; all figures in millions

o New Local Psychiatric Inpatient Capacity - $8.12 R - the State-paid share of new local psychiatric inpatient capacity (beds/bed days).

o Clinical Staffing Ratios at Psychiatric Hospitals - $7.28 R - for 107 positions at the State's psychiatric hospitals: 7 psychiatrists, 1 Medical MD, 40 RNs, 34 LPNs, 25 Health Care Techs

o Walk-In Crisis and Immediate Psychiatric Aftercare $4.46 R; $1.65 NR - funding to Local Management Entities (LMEs) for walk-in crisis and immediate psychiatric aftercare. Also provides funding for the purchase of telepsychiatry equipment - to support 30 psychiatrists and related support staff. Of these funds, $1,650,000 shall be used for telepsychiatry equipment to be owned by the LMEs and shall be distributed across the State according to need determined by the Department.

o Mobile Crisis Intervention Teams - $4.655 R; $1.1 NR - operating subsidies to 30 mobile crisis teams state-wide. Also provides start-up funding for 11 crisis teams to bring the total number of teams state-wide to 30.

o Recruitment and Workforce Development: $1.27 R - for recruitment and workforce development initiatives at State facilities, including psychiatrist loan repayment, increased recruitment efforts, and expansion of the Psychiatry Nurse Practitioner scholarship program. Funding for each item is as follows: Psychiatrist Loan Repayment Program in Office of Rural Health - $868,519; Expansion of Recruitment and Advertising Funding for Difficult-to-Recruit Positions - $277,000; Psychiatric Nurse Practitioner Scholarship Program at UNC School of Nursing - $125,000; Additionally, $500,000 NR is included for sign-on bonuses for hard-to recruit Registered Nurse positions at the State's psychiatric institutions in the Statewide Reserves Section of this report.

o Dorothea Dix Hospital Overflow Unit $5,212,166 NR; 96.85 positions - for the Dorothea Dix Hospital Overflow Unit, a 60-bed unit to remain open on the Dorothea Dix campus after the opening of the new Central Regional Hospital. Total requirements for this item are $10,731,103 with $4,767,760 in receipts from Wake County and $751,177 in Medicaid receipts. The 60-bed unit will be staffed with a total of 174.75 FTEs, of which 77.9 will be funded by Wake County receipts and 96.85 are funded by State appropriation and Medicaid receipts. Position classifications & number of FTEs for all 174.75 positions: Physician III-B (psychiatrists) (7.75) – 1 Physician IV-B (psychiatrist supervisor) ; 0.5 Physician III-A (medical MD); 1 Psychiatric Unit Administrator II; 1.5 Senior Psychologist; 3 Physician Extender II; 1 Nurse Supervisor B; 37 RNs; Nurse B (4); 66 Health Care Technicians; 6.5 Clinical Social Worker; 1 Social Work Supervisor; ; 1 Pharmacy Technician; 1 Clinical Dietitian I; 1.5 Occupational Therapist I; 2.5 Therapeutic Recreational Specialist I; 9 Rehabilitation Therapists; 0.5 Advocate I; 1 Word Processor IV; 1 Personnel Technician III (1); 4 Office Assistant IV; 1 Utilization Review Nurse; 1 Patient Relations Representative V(usually, this is for the admitting office); 1.5 Medical Records Assistant IV; 1 Floor Maintenance Assistant; 8.5 Housekeeper; 1 Kitchen Manager; 1 Food Services Supervisor; 3 Cook I; 6 Food Services Assistant; 1 Diet Clerk

o Clinical and Operational Enhancements of State Facilities $1.8 R; $0.05 NR; 19.00 positions - to improve training and supervision of direct care staff, for monitoring of State facilities, for pharmacy management, and for information technology and accounting positions: Clinical Nurse Specialists (2 at each of the three psychiatric hospitals and one at each Alcohol and Drug Abuse Treatment Center); 9 Nurse Cs; State-Operated Services Compliance Team: 4 Mental Health Program Manager IIs; 1 Mental Health Program Manager I (1) - $57,666; Clinical Policy Section: 1 Pharmacy Manager III ; 1 HEARTS Training Coordinator; DHHS Controller's Office: 1 , Accounting Technician IV, 1 Accounting Technician III; Longleaf Neuro-Medical Center; 1 Technology Support Technician;

o Resident Furnishings $0.61 R; $1.02 NR in receipts for replacing resident furnishings in poor condition in State mental health facilities.

o Realignment of Mental Health Trust Fund Funding for Housing Initiative - realignment [cut from this line] $2.0 NR - Realigns unallocated funding from the Mental Health Trust Fund to the Housing Trust Fund to continue the MH/DD/SA Housing Initiative.

o Continuing the MH/DD/SA Housing Initiative - Housing Trust Fund 7.0 NR - Provides $7,000,000 in non-recurring funding ($2,000,000 of which is realigned from the Mental Health Trust Fund) for the financing of additional independent- and supportive-living apartments for people with disabilities. The apartments shall be affordable to those with incomes at the Supplemental Security Income (SSI) level. The funds for this item are located in the Housing Finance Agency section of this report.

o Continuing the MH/DD/SA Housing Initiative - Operating Cost Subsidy - $1.0 R - Provides funding for operating cost subsidies for independent- and supportive-living apartments for individuals with disabilities. The apartments shall be affordable to those with incomes at the SSI level.

o Julian F. Keith ADATC Pharmacy $0.47 R; 4.00 positions - Provides funding for four positions to create a pharmacy program at the Julian F. Keith Alcohol and Drug Abuse Treatment Center (ADATC) to serve the expanded acute treatment beds. The Substance Abuse Prevention and Treatment Block Grant includes $70,000 for one-time start-up costs associated with the pharmacy. Position classifications, number of FTEs: 1 Pharmacy Manager I; 1 Clinical Pharmacist; 2 Pharmacy Technician

o Early Intervention for Autism $1.875 R - Provides funding for services for children ages 0-10 with autism (i.e., autism early intervention), as follows: $625,000 to the Autism Society of NC for training and collaboration with model programs and community agencies to increase availability of autism early intervention services. $1,250,000 for DHHS to contract directly for three model programs of early intervention services.

o Supportive Services for HUD 811 Projects $0.13 R; $0.155 R - Provides funding for on-going operations and start-up expenses to support 6 two-bedroom and 19 one-bedroom apartments financed through the United States Department of Housing and Urban Development.

o Program Service Funding for Group Homes $0.2 R - Provides funding for on-going program service funding for two group homes under development by the Mental Health Association in N.C., Inc.

o Traumatic Brain Injury Services $1.0 R - Provides funding for the provision of traumatic brain injury (TBI) services.

Perdue & McCrory on budget bill change on state hospitals

North Carolina's candidates for governor issued dueling statements Wednesday in response to a last-minute change in the state budget approved Wednesday that will make it easier for the administration of Gov. Mike Easley to open a new mental hospital in Butner and close Dorothea Dix Hospital in Raleigh.

The campaign of Lt. Gov. Beverly Perdue, the Democratic candidate, sent an e-mail statement Wednesday morning.

"I strongly disagree with the budget provision that allows patients to be transferred to Central Regional Hospital before Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JCAHO) standards are met," said the statement attributed to Perdue. "Secretary Benton should not authorize transfer until Central Regional meets those standards -- the long-term safety and care of both patients and staff must not be compromised."

The campaign of Republican candidate Pat McCrory issued a statement reaffirming his opposition to closing Dix.

"In another secret back room meeting, the political establishment in Raleigh has arrogantly dismissed the welfare of mental health patients and decreed through the budget that the state does not have to comply with the same regulations it places on everyone else," said McCrory, who is mayor of Charlotte. He said Perdue, the presiding officer of the Senate, should have stopped the change in the budget.

(from the News and Observer, 7/10/08, http://www.newsobserver.com/2771/story/1136633.html )

Bev Perdue on mental health

From her website - 4/18/08 - http://bevperdue.com/release_details.asp?id=1070

We need to get serious about the goal of quality health care for all North Carolinians – and that must include mental health care.

Thousands of our fellow citizens struggle everyday with mental health concerns. North Carolinians who face mental illness, developmental disabilities, and substance abuse issues as well as their families deserve our staunch support in dealing with their challenges.

My background in health care tells me that it makes no sense to separate mental from physical health care. The best research confirms that many patients have mixed mental and physical health issues. Thus I am proud that my plan for expanding health care coverage to all children and more low-wage working parents has been praised by such leading advocates as Adam Searing of the North Carolina Health Access Coalition for containing "the most significant changes in health care access in North Carolina in, quite literally, decades." To read more, go to bevperdue.com/healthcare.

Specifically in the mental health arena, my priorities include the following:

1) Extend Community Care model to mental health

North Carolina's Medicaid program has recently moved to the forefront in emphasizing the importance of a "medical home" for the primary care of adults and children. Our Community Care of North Carolina has developed a very cost-effective and quality-driven model of statewide case management through health care community networks. As Governor, I will extend this kind of collaboration and community network to the delivery of mental health services. Every person served by the mental health system should have the benefit of strong and effective case management to maximize treatment and service plans. In my view, the concept of a medical home should play a major role in helping to revitalize our badly tattered mental health system, for Medicaid recipients and others served by the system as well.

As North Carolina's next Governor, I also want to establish the national model for an integrated approach to behavioral and primary health services for patients with mental health, development disability, and substance abuse problems. One of my top goals will be to break down the barriers to the coordination of mental and physical health care.

2) Establish a “safety net” for those in need

We must also develop a basic safety-net which those in need of mental health services will have available to them. These core elements will provide a strong foundation for a true community-based system of care. Today there are just too many opportunities for people in need to fall between the cracks.

The quality and degree of care cannot be dictated by zip code. That is why I will take such immediate steps as expansion of the Office of Rural Health's loan forgiveness initiative to place more mental health professionals in the rural parts of North Carolina where they are desperately needed. This kind of state incentive can make a huge difference in the choices young students and professionals make when they are considering careers in mental health. As chair of our state's Health and Wellness Trust Fund, I have already developed an innovative loan assistance initiative to help our rural hospitals modernize and provide more up-to-date services across the board. Modernizing hospitals as well as attracting new health care providers will represent significant boosts to economic development in our small towns and surrounding rural areas, while at the same time enhancing the level of care for some of our most vulnerable citizens.

I know that we cannot neglect the need for strong in-patient services. To the extent possible, these services should also be community-based, close to home, family, and other resources. But the state cannot walk away from its obligations. If needed services are absent in a local area due to a lack of private providers, we must work to put them into place through public facilities.

3) Overhaul system to focus on outcomes

The state's overall approach to planning and implementation in mental health care must also be overhauled. We need a fundamental shift to a focus on outcomes – setting high program and service standards and then clearly stating what results we can and should expect while setting up the conditions most likely to achieve the best possible outcome for each person.

One way we can foster the highest quality services is to actively promote the best practices in the field. My vision is for the state to develop centers of excellence within our colleges and universities to advance evidence-based models and continue to build capacity for high-quality services across the state. Through these evidence-based models we can point the way to more effective and efficient services. We can also better support the ongoing training and development of our professionals who work in the fields of mental illness, developmental disabilities, and substance abuse services.

I know that changing mental health care in North Carolina is something far more easily said than done. Yet we cannot stop until we have a system that achieves access to high-quality mental health, developmental disability, and substance abuse services for all North Carolinians. We certainly need better funding. Our low standing in the National Alliance on Mental Illness' rankings of expenditures per capita is inexcusable. But funding is only one piece of this puzzle. We must work on many fronts to achieve the changes and improvements we need.

Many people, both professionals and volunteer advocates all across this state, are working their hardest every day to improve our system. The scale, complexity, and rapidity of change that they have endured over the past few years have been daunting but they are committed and determined. Our state needs the benefit of multiple perspectives as we work through the serious issues now facing our system. We will need to adopt a disciplined approach to maximizing system improvements. And we must make sure that government officials and the mental health community listen to and learn from one another.

As North Carolina's next governor, I will be directly involved in meeting our mental health challenges. I understand that our efforts will need sound leadership, accountability, policies, and coordination throughout state government and the system of services for mental health, developmental disabilities, and substance abuse. We all know someone – a family member, a friend, a co-worker – who is dealing with the challenges of mental health concerns. These are deeply personal issues for all of us. And they are critical issues for building a better North Carolina as well. I pledge to be the leader our state needs to establish a system of high-quality services that yields the best possible outcomes for those it serves.

Pat McCrory on mental health, Dix

N&O letter 6/27/08 Keep Dix open http://www.newsobserver.com/print/friday/opinion/story/1122013.html

I agree wholeheartedly with your June 24 editorial on the need to keep Dorothea Dix hospital open. Earlier this month, I held a news conference in Raleigh calling on the General Assembly to keep Dix open for another year. On Monday, June 23, I wrote Gov. Mike Easley, Lt. Gov. Beverly Perdue, Sen. Marc Basnight and House Speaker Joe Hackney urging them to personally intercede in this matter.

With the problems surrounding mental health escalating, the current administration appears to be implementing changes without proper planning. As a result, hundreds of millions of dollars are being misspent, poor medical treatment is being given to mental health patient, and concerns are rising for the safety of patients and staff in state mental facilities.

It is unacceptable that a nurse was beaten at Dix last week due to inadequate supervision of patients. It would be grossly irresponsible to close the hospital without making the necessary preparations for handling patients in a secure environment.

Dix hospital must be kept open and properly staffed for another year. This will give the next governor a chance to evaluate its closing and recommend the best way to address the growing scandal in mental health programs.

Pat McCrory

Charlotte

http://www.newsobserver.com/print/friday/city_state/story/1122070.html
Under the Dome N&O 6/27/08 :

Dix hospital

Pat McCrory has called for Dorothea Dix hospital to remain open for another year.

In a letter sent this week to Gov. Mike Easley, Lt. Gov. Beverly Perdue and other top Democratic leaders, the Republican gubernatorial nominee urged them to keep the Raleigh mental hospital staffed until the next governor could implement mental health reforms.

"I believe that the present problems are not a result of the legislatively passed reforms to provide local care for mental health patients," he wrote. "The scandal is a result of poor planning and implementation of the reforms. The next governor should be given the opportunity to bring new leadership to this area."

In the letter, McCrory says that the recent beating of a nurse at Dix shows there are continuing problems with the state's mental health care system.

From the McCrory website: http://www.patmccrory.com/docs/articles/McCrory-Calls-on-Administration-to-Keep-Dorothea-Dix-Open.html

McCrory Calls on Administration to Keep Dorothea Dix Open
‘Next governor should be given opportunity to bring new leadership to mental health’

Charlotte, N.C. – Mayor Pat McCrory today [June 23, 2008] wrote to Gov. Mike Easley, Lt. Gov. Beverly Perdue, Senate President Pro Tem Marc Basnight and House Speaker Joe Hackney to urge them to keep Dorothea Dix Hospital open and adequately staffed for another year. McCrory argued this would give the state’s next governor the opportunity to implement necessary mental health reforms. Below is the text of his letter:

“With problems surrounding mental health reform escalating, the administration appears to be implementing changes without proper planning. As a result, hundreds of millions of dollars are being misspent, poor medical treatment is being given to mental health patients, and concerns are rising for the safety of patients and staff in state mental facilities.

“It was reported on June 21 that a patient beat a nurse in the forensics unit of Dorothea Dix Hospital. It is unacceptable to inadequately supervise patients who are among the most violent being treated at Dix. Closing Dix without adequately preparing for handling forensics patients in a secure hospital environment is dangerous for patients, health care workers, and the public.

“I’m writing to ask you to keep Dorothea Dix hospital open and properly staffed for another year. This will give the next governor a chance to evaluate its closing and recommend the best way to address the growing scandal in mental health programs.

“During a June 2 news conference in front of the Legislative Building, I called on the legislature to keep Dix open for another year. I am now calling on you to personally intercede on behalf of the patients, staff, and the public. I understand that a version of the budget has passed the House and the Senate and is now before a joint conference committee to reconcile the two versions. However, inaction during this session could result in tying the hands of the next governor.

“This past week the Wake County Chapter of the National Alliance on Mental Illness, the N.C. Sheriff Alliance, the N.C. Public Service Workers Union, and a Dix psychologist wrote the legislature requesting Dix be kept open for another year. On Friday, hospital workers again marched on the office of the Secretary of Health and Human Services seeking a delay in the closure.

“I believe that the present problems are not a result of the legislatively passed reforms to provide local care for mental health patients. The scandal is a result of poor planning and implementation of the reforms. The next governor should be given the opportunity to bring new leadership to this area.”

From McCrory Website: "Policy Statement: Health Care"

http://www.patmccrory.com/docs/issues/Policy-Statement-Health-Care.html

Reform failed reform.
The current mess of our mental health system can be traced back to the “reform” measures backed by Governor Easley in 2001. Unfortunately, these “reforms” have wasted millions of taxpayer dollars, decreased community care, and left our mental health system without accountability. We need to establish citizen councils to review contracts and certify nonprofits; stop closing hospitals and reducing the state’s number of beds available to mental health patients; work with providers and Local Management Entities (LME’s) to meet the needs of local communities for short term care; provide new leadership to help citizens with developmental disabilities, substance abuse, and mental illness to lead productive lives in local communities; and establish clear priorities that will re-introduce accountability, allow interagency coordination, and bring care to those who need it.

Gubernatorial nominees weigh in on new state hospital

From the N&O, June 2:

Pat McCrory, the Republican candidate for governor, called on the state to keep Dix and Umstead open for a year to give the next governor a chance to bring in new leadership. "The hasty move to a new facility without adequate staffing and with design flaws only makes a bad situation worse," he said.

Lt. Gov. Beverly Perdue, Democratic candidate for governor, said the new hospital isn't ready to open, but she said she did not agree on imposing a deadline of a year.

"I don't believe one patient should be moved to Central Regional until we have adequate staffing and the safety issues are resolved," she said.

McCrory criticized the Department of Health and Human Services for not publicizing the results of work groups Benton appointed and said the work group report on the new hospital should be made public.