US/NC/health/mental: Difference between revisions

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<section begin=navbar />{{#lst:North Carolina|navbar}}: [[mental health/US/NC|mental health care]]<section end=navbar />[[category:US/NC]]
<section begin=navbar />{{#lst:North Carolina|navbar}}: [[mental health/US/NC|mental health care]]<section end=navbar />[[category:US/NC]]
* '''Localities''': [[/Chapel Hill]], [[/Durham]]
* '''Localities''': [[/Chapel Hill]], [[/Durham]]
* '''Pages''':
** [[/2001 reform]]: an ongoing crisis


==Overview==
===2001-2008 Reform Crisis===
''Most of this information comes from the N&O articles linked below. Overall, the article sounds like it could easily be cherry-picking a relatively simple, clear-cut story from what must in reality be much more complicated; information is needed from other sources.''
In 2001, the North Carolina mental health care system underwent sweeping changes designed to decrease costs overall, but with the opposite actual effect; the cost has now (as of 2008-02-24) more than doubled, to $1.5 billion a year. The N&O theorizes that this is because standards are being applied with extreme unevenness: some people are receiving services they don't really need, while others who desperately need service are receiving nothing, or the wrong services. (The example they cite, however, may make sense in context; the article doesn't give enough details to tell for sure &ndash; but the pay rate of $61/hour was clearly much too high for the type of service.) Too much money went to "[[community support (NC)|community support]]", it says, and not enough to critical services.
The 2001 reform apparently planned to shift care responsibility away from centralized institutions and out to community facilities; unfortunately, the counties were told to unload their responsibilities before the funding for the local groups was approved by the [[US government|federal government]]. Federal approval finally arrived in late December 2005, and the new services were launched 2006-03-20.
In February 2007, the [[NC DHHS|Health and Human Services]] (DHHS) accountability team started an audit; in November, DHHS declared a moratorium on new services. On 2007-04-04, the "community support" rate was slashed to $40/hour and then raised back to $51 on 2007-04-26.
Many new service providers were formed to take advantage of the restructured funding; [[Dominion Health Services]], a {{instate|Raleigh|NC}}-based company with about 1000 employees which went door to door looking for customers for the new "community support" services, was among those &ndash; and has now been asked to return $1.5 million (of a total of $59 million from companies which DHHS says broke the rules).
==Related Pages==
==Related Pages==
* [[North Carolina|state]] [[NC government|government]] entities:
* [[North Carolina|state]] [[NC government|government]] entities:
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** [[developmental therapy]]
** [[developmental therapy]]
** [[local management entity]]
** [[local management entity]]
 
** [[Psychiatric Residential Treatment Facility]] (PRTF) (defined by US HHS)
** [[Residential Treatment Facility]], divided into Levels I, II, III, and IV -- seems to be less intensive than PRTF
* documents
** [[:File:us-nc-1201spec.pdf|NC DMA: December 2001 Special Medicaid Bulletin - Mental Health]] gives [[Medicaid/NC|NC Medicaid]] qualifications and admission criteria for:
*** [[Mental Health Service Provider]]
*** [[Substance Abuse Service Provider]]
*** [[Psychiatric Residential Treatment Facility]]
*** Level II through IV [[Residential Treatment Facility]]
==Links==
==Links==
===Directory===
===Directory===
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* [http://naminc.org/ NAMI NC]: National Alliance on Mental Health, NC Chapter
* [http://naminc.org/ NAMI NC]: National Alliance on Mental Health, NC Chapter
* [http://www.nchealthpolicy.org./ NC Health Policy Gateway], a project of [[Duke University]] and [[NC Blue Cross Blue Shield]]
* [http://www.nchealthpolicy.org./ NC Health Policy Gateway], a project of [[Duke University]] and [[NC Blue Cross Blue Shield]]
===News===
* '''2008.04.06''' [http://www.newsobserver.com/2771/story/1026986.html State keeps mentally ill teen at jail]
* '''2008.02.26 - 03.03''' [http://www.newsobserver.com/news/health_science/mental_health/  Mental Disorder: The Failure of Reform]:
** '''Part 1''': [http://www.newsobserver.com/2789/story/962049.html Reform wastes millions, fails mentally ill] "Mental-health changes in North Carolina were intended to improve community treatment and give taxpayers good value, but they have done neither. Providers took clients shopping, swimming and to movies for $61 an hour. And the cost of the community support program was more than 10 times what the state expected."
** '''Part 2''': [http://www.newsobserver.com/2789/story/965714.html Companies cash in on new service] "Community support is lucrative for providers, but reviews say many clients don't need the mental-health service. Now the state wants its money back."
** '''Part 3''': [http://www.newsobserver.com/2789/story/971029.html Serious mental therapy fades] "North Carolina's 2001 mental-health reforms aimed to make its mental hospitals places of last resort and to have as many people as possible seek treatment near their homes. But now people with severe needs are left without care."
** '''Part 4''': [http://www.newsobserver.com/2789/story/975411.html Caregivers abuse patients, and usually get away with it] "Charges are filed in just 13 percent of cases. The lowest-paid, least-trained workers spend the most time with patients."
** '''Part 5''': [http://www.newsobserver.com/2789/story/976809.html Patients die from poor care; families don't hear full story] "Since December 2000, at least 82 patients in the state's mental institutions have died in ways that raise questions, including homicides and suicides."
** '''Q''': [http://www.newsobserver.com/2789/story/976757.html How can N.C. fix a broken mental health system?] "In 2001, state legislators and Gov. Mike Easley's administration set out to reform the public mental health system with a sledgehammer." This was apparently intended to lead into a reader-driven discussion, but it's not clear where any reader comments might have ended up.

Revision as of 23:39, 20 October 2009

<section begin=navbar />{{#lst:North Carolina|navbar}}: mental health care<section end=navbar />

Directory

Local Management Entities

Organizations - Autism

  • Autism Society of NC (links)
  • TEACCH Treatment and Education of Autistic and related Communication-handicapped CHildren: "an evidence-based service, training, and research program for individuals of all ages and skill levels with autism spectrum disorders. Established in the early 1970s by Eric Schopler and colleagues"

Organizations - Other

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