Legislature throwing mentally ill under the bus: tomorrow is a day of action

{Division of Medical Assistance Team Forsaking North Carolina's mental health service recipients}

Tomorrow BlueNC will join with bloggers across North Carolina to urge our readers to contact legislators and bureaucrats in an effort to reverse a killing blow first mentioned here yesterday. This post is a background piece for the action tomorrow.

In 2001, North Carolina undertook a massive reform of its mental health system. The network of publicly funded providers had grown bureaucratic, bloated and stagnant. While individual practitioners continued, in most cases, to provide excellent care, the system was buckling under its own weight and lacked innovation.

The mental health system reform was intended to improve services and cut costs by introducing competition. In this regard the plan was a success, hundreds of private providers sprung up across the state to provide psychiatry, counseling, psychological services, case management, day treatment, job training, and community based services to mentally ill children and adults.

The problem, of course, is that despite being dead last in the nation in spending on mental health, state legislators wanted to cut more deeply, more lethally. They changed the definitions of the services they reimbursed. They slashed the rates at which doctors and therapists were paid, driving many away from providing services to impoverished children and families. They changed the system again and again and again, and many providers, including the massive New Vistas in western North Carolina, shut their doors and sent their clients into the streets.

There are a few dozen providers left after the storm of 2006. They are among the most creative, flexible, innovative entrepreneurs in the nation, somehow staying in business despite the state's every attempt to force them into bankruptcy.

The state decided to kill mental health services once and for all on the day before Good Friday. Mere hours before the state would commence a 4-day holiday, word came from the Division of Medical Assistance that reimbursement rates for Community Support services would be cut by a third, from $60/hour to $40/hour.

Community Support services, a new service definition created by the state les than a year ago, allow clients to receive needed help in life skills (balancing a checkbook, etc.), accessing resources like child care, or practicing behavioral skills vital to living independently. Without these services, many clients will end up unemployed, expelled, or institutionalized.

The state, unwilling to try systems that have worked in other states, is going to kill the last few private providers by forcing them into this choice: Hire only low-wage workers who will provide sub-par services, or lose money and go out of business.

Tomorrow I'm going to ask the North Carolina Blogging Community to join with BlueNC and Scrutiny Hooligans in calling for a reexamination of this catastrophic decision. I'll ask you to call and email legislators to demand a fair shake for the mentally ill. There is no one to speak for them, so it is up to us.

Thanks, and I'll see you tomorrow.

This is crossposted at Scrutiny Hooligans and BlueNC by Screwy Hoolie.