Shortly after Odom’s tenure began, the N.C. General Assembly passed legislation revamping the mental health care delivery system. The aim was to get people out of state-run hospitals and back into the community, where an array of private providers would care for them. Local care would be overseen by area mental health programs, which became local management entities or LMEs.
The goals were admirable. In addition to bringing care closer to home, by privatizing the system the state hoped to offer consumers more choice.
But from the beginning, the reform has been an almost unmitigated failure, with constant turmoil between the state, the LMEs and private providers.A consultant hired to evaluate the state’s mental health delivery system said in January that the state provides inadequate, ineffective and inconsistent treatment; lacks sufficient crisis intervention and community detoxification services; and has a poorly functioning system for screening people with mental illness and providing community-based support.
The consultant said the state comes in dead last when it comes to per capita spending on mental health, but it ranks No. 1 in admissions to state hospitals.
Funding for mental health is controlled by the state legislature, but it is Odom’s job to clearly assess the needs and ask for the money to address them in her annual budget request.
Instead, according to state Sen. Martin Nesbitt, Odom failed to even include in her budget request about $19 million the legislature designated for local management entities last summer.
The most recent calamity to befall the benighted mental health delivery system came in the form of a 33 percent rate cut for community support services. Such a drastic cut will undoubtedly curtail the availability of services.
This is the part that caught my eye: Without consulting the legislature, Odom removed the responsibility for management of Medicaid services from the LMEs and contracted with Value Options, a national company based in Virginia, to perform the function. The lack of local oversight allowed some companies to abuse the service.
NCDHHS's own internal audit (as reported in the N&O) indicates some companies billed the state for suspect services or none at all.
I'll bet some folks (although not many) remember "disproportionate share". In that fiasco, Hooker-Odom gave away the key to the Medicaid cash-box . . . to a "private third-party vendor" (also known as Carolinas Medical Center) . . . and a program designed to reimburse hospitals for indigent care was pilfered to the tune of an estimated half-billion dollars.
According to the Citizen-Times, Odom has failed one of the most critical tests of leadership — to be able to identify problems, determine and articulate what needs to be done to solve them, rally the necessary support and resources and implement the solutions.Her boss, Governor Mike Easley, wants an investigation.
Have at it Mike. Start at the top.
2 comments:
From: Marsha V. Hammond, PhD: hammondmv@netzero.com:
From a provider, indeed, one of those mysterious '20 Community Support Providers' present, in person, at the DMA meetings this pas week:
"Mark Benton heard the grave concern raised by the providers in the meeting over the
proposed rate. He went to the rate committee and suggested they hold off making a decision
for another week to give more time to look at the agency audits. The secretary has agreed.
Their will be more meetings next week to continue work on the rate.
Sent from my BlackBerry® wireless device."
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It's good that you're there as every single person associated with DMA has me blocked from sending them e mails. However, there is always the mail.
I'm passing your info on (and not naming the individual). Meantime, the REAL problem behind all of this, which created the boondoggle to begin---or more accurately----gave Odom a means to (again) gig the mental health reform movement and destabilize it (again)----is the following matter and I know this from working closely with Direct Care, LLC:
As associated with CommunitySupport, and as per the drive a truck through Service Definitions created by DMA, which SHOCK SHOCK (Odum pretends after the event) allow use of high school graduates (screened and assigned by the Endorsed Provider), and as per the training (lack thereof) given by DMA employees and associates to Endorsed Providers, there was no indication in the training that those in the field were supposed to be writing such detail notes as 'took little Joey swimming and in keeping with Goals, socialization increased as per interaction with other children and as pertaining to supervision by an adult', blah blah blah....such that Easley and Odom are able to get away with the MURDER of saying that they are SHOCKED SHOCKED that little children were being taken swimming and people were assisting them with their homework.
This is just a bunch of posing for the press in order to make it look like they are doing their work when in fact Odom has mismanaged the matter from the beginning:
1. Vague Service Definition which is guide and template of activities of Endorsed Providers
2. Poor training associated with service definition and absolutely no indication that notes were to be created such that reflected all the details that go into 'taking little Joey swimming.'
THAT"S the audit that should be done: the audit on Odom and Mosley's mismanagement of Community Support from the GET GO.
Yesterday's Raleigh News Observor piece was indication that Easley and Odom have NO IDEA---and/ or choose to try and steal the limelight of 'we did good by the citizens and halted the theft of mental health monies. I know which one I think is the truth. Odom has NO IDEA how she has created this mess associated with her lack of vision, lack of knowledge about mental health care, lack of ability to train people in a manner that fulfills what they believe Community Support is supposed to be about.
Marsha V. Hammond, PhD (use any part of this you like: please keep my name with it so I can continue to accumulate interested parties: thank you).
The above comment was published as I received it.
I know what it is like to have my e-mails blocked. I believe the entire NC General Assembly has black-listed me.
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