11/01/09 — HHS chief: Mental health system changing

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HHS chief: Mental health system changing

By Matthew Whittle
Published in News on November 1, 2009 1:50 AM

North Carolina Department of Health and Human Services Secretary Lanier Cansler was in Goldsboro Thursday, seeking to ex-plain to consumers, providers and other mental health officials how the system is likely to change over the course of the next year.

He explained that when the state Legislature and Gov. Beverly Perdue cut $400 million from mental health services -- part of a $1.7 billion cut to health and human services as a whole -- it forced officials to begin implementing a series of changes a little quicker than they had originally anticipated.

"We're doing in 90 days what we'd like to do in 18 months," Cansler said.

But he believes that officials are on the right track with their changes -- primarily the eventual elimination of the community support services program, which was the crux of the much-maligned mental health reform effort.

To replace it, he explained, the state wants to create a more comprehensive system -- one that focuses on a "clinically founded" approach to quality care.

"We want to see people as a whole, rather than as a mental health person or a physical health person. We want to make sure that individuals are getting the right services by the right people at the right time, and we're going to have much tighter control over that," Cansler said. "As bad as the budget is, it gives us an opportunity to work to deliver care in a more efficient and productive manner, and to make sure we're moving in the direction we need to go. The one thing I don't want is another big failure.

"This is a positive."

Ken Jones, director for Eastpointe, the local management entity overseeing mental health services in Wayne, Duplin, Sampson and Lenoir counties, explained the goal is to create a system in which care is overseen by only one case manager with the help of a physician and providers provide a continuum of care, rather than the current piecemeal approach.

"It's much like we had before -- the old mental health system," he said, except with more coordination, choice and oversight.

And while he agrees that this is a good direction for mental health to go, he's concerned about the timing.

"It's a difficult time right now," Jones said. "There's so much change in the system. I think it's the right direction, but there's still a lot of thought that needs to be put into this."

He explained that with the current economic climate and the existing budget cuts, some providers are already cutting back on services or shutting their doors altogether, and that with these new changes, even more are expected to be eliminated.

"There will be some providers who will close," Cansler said. "But I cannot protect the providers. That cannot be my No. 1 concern."

But, he said, officials are trying to be flexible as they work to make the transition as smooth as possible, gathering input from consumers, providers and other health officials as they develop the new system.

"We know where we're trying to go, but we also know it may not be exactly a straight line to get there," he said.