Wednesday, January 02, 2008


Marsha V. Hammond, PhD Clinical Licensed Psychologist, NCe mail:

January 2, 2008

Dear Mr. Benton and Ms. Wainwright:

Thank you, Ms. Wainwright, for forwarding to me this information (see below this e mail for I have enclosed your response re: the CFAC question I had).

I have another question and I will put it in writing to Mr. Benton as he seems to be able to get people to answer questions : can you ask SMC LME to state clearly on their website as to their not providing Basic Level Services for state funded clients rather than misleading providers and causing providers to spin their wheels for a long time as they attempt to find out how to obtain Basic Level Services-----which SMC LME does not offer?

As it turns out, I have recently severed my relationship w/ SMC LME as they will not provide Basic Level Services for state funded clients and I do not provide Community Support Services.

Ms. Wainwright informed me of this herself, specifically, you indicated, Ms. Wainwright, in a recent e mail to me that SMC LME was within their right to not provide Basic Level Services. This is quite out of keeping w/ the other LME's, I believe.

Additionally, as pertains professional participation in mental health reform, I would submit that the relegation of psychologists to being demanded to squeeze into the CSS format is a clandestine attempt to dumb down therapy for state funded clients (QP's and CSS personnel are being painted as offering 'therapeutic' services as per the new CSS Service Definitions; I sent in my comments).

Though DHHS has stated that Basic Level Services are to be available, SMC LME, instead, decided that it did not offer Basic Level Services. This is a puzzle to me as one would think that this would be cheaper than the costs of CSS.

Dr. Puckett stated to me a few months ago:

"....Since 7/1/06 it has been SMC’s policy to utilize state funds only for enhanced benefit services for target population consumers. Exceptions are made when it is clearly demonstrated that *****appropriate enhanced benefit services are not available***** to meet consumers’ needs. If you believe that this is the case for a consumer you are serving you may submit a PCP or PCP-Lite via SMC’s Communication Center with clear justification for a basic benefit service better meeting the consumer’s needs for review by a Care Manager.Steve PuckettSteve Puckett, Ph.D.Clinical Operations Director"

Puckett would insist that I refused to keep re-submitting PCP's for state funded client 040974 and Mr. Barry stated as pertaining to my too many conversations associated w/ state funded client 040974, that I was acting 'unprofessionally' and had a 'great deal of trouble writing PCP's' (e mail 12/07).'

They implied that if I just kept submitting version after version of PCP's that I could get authorization for state funded client 040974 who specifically requested outpatient therapy from me-----something I struggled to make available to her for over 2 years. I grew very weary of doing a paper chase about a matter which SMC LME had no intention of attending to. I therefore severed my relationship w/ SMC LME.

In 2003 or so, SMC LME created a contract w/ Meridian Behavioral Health Services in order to offer WRAP training and cohort driven services for state funded consumers. No therapy can be provided for state funded SMC LME clients unless it is associated w/ CSS. This effectively blocked providers, such as myself, from being able to work with state funded consumers even if the clients did not want WRAP training and did not want CSS. Meridian Behavioral Health Services was founded by Joe Ferraro who retired from SMC LME sometime earlier this decade.

As re: the Basic Level Services, I provide outpatient therapy in keeping with my doctoral training. I am not willing to go through 20 hours of CSS in order to work w/ SMC LME who demands that all outpatient therapy be contained within CSS. I therefore am not available to work w/ state funded clients as per SMC LME. I continue to see Medicare and Medicaid clients in this area.

To some significant degree I severed my relationship w/ SMC LME as I could not get them to tell me the straight story : is there or is there not Basic Level Services?

I corresponded w/ Charles Barry, manager of QM, Dr. Puckett, clinical director, and Bill Hambrick, director. No one ever provided me with the answer to my question and indeed the staff there seemed to think I was trying to pull some wool over their eyes as re: not wanting to waste my time obtaining training I did not need.

Here is the information from the SMC LME website re: their statement that they do provide Basic Level Services----which they stated to Ms. Wainwright that they do not. It would be useful to consumers and providers to have the correct information rather than having to ask many times and finally contact Mr. Moseley in order to get the answer about whether Basic Level Services for state funded consumers were available.

Here is what the SMC LME manual states (website states this was updated in November, 2007):

SMC online manual:"BASIC SERVICES Mental health, developmental disability or substance abuse services that are available to North Carolina residents who need them whether or not they meet criteria for target or priority populations."

In the spirit of providing accurate information to both consumers and providers, and in that SMC LME does not want to offer Basic Level Services to state funded consumers, could you ask them to correct their web page?

An observation: The members of CFAC are many as associated w/ SMC LME. In reviewing the notes on the SMC LME website, five or fewer members from this list are in usual attendance.

'Self governing' doesn't work if no one attends. I had been trying to get in touch w/ SMC CFAC members in order to state to them my concerns about this client, 040974. I contacted by US mail the chairman of the SMC LME board and several of the CFAC members. I had to send the letters to the CFAC members via Shelley Lackey in that there was no way to get in touch w/ them: no telephone numbers ; no mailing address.

I have never received any information back from my query and this CFAC and board has met since my inquiry. The December minutes of the CFAC meeting are not online at this time and so I do not even know if any of my mail was received or noted.

Moreover, the general consensus amongst mental health providers, consumers and their families is that the CFAC's are toothless and under the thumb of the LME's. This, certainly, is supported by the efforts I had to put forward in order to even get ANY CFAC notes or information.

Therefore, anything related to 'quorum'-----if that is what permits the CFAC to function, is never available. I might surmise that given the area of SMC LME, many people simply cannot make the meetings and therefore a more efficient mechanism in order to create consumer participation would be in order.

Thank you again, Ms. Wainwright and Mr. Benton, for this information. I appreciate being able to participate at least to the point in being able to advantage the community to some online information as associated with such a large geographical area.

Here is the CFAC list from the SMC LME webpage.

Sincerely, Marsha V. Hammond, At 01:53 PM 1/2/2008 -0500, Leza Wainwright wrote:
Dr. Hammond:Secretary Benton requested that I respond to your inquiry to him regarding the Smoky Mountain Consumer and Family Advisory Committee (CFAC). Your correspondence with Secretary Benton indicated concerns that the Smoky Mountain CFAC minutes were not available on the web and that Smoky Mountain staff had not given you contact information for two CFAC members, as you requested.I am pleased to tell you that the Smoky Mountain CFAC has now chosen to have the minutes of their meetings posted on the Smoky Mountain Center website.

The minutes are available at by clicking on the hyperlink labeled "meeting notes" on the right hand side of the page. Minutes for all meetings thus far this state fiscal year have been posted and future minutes will also be posted.

As you know, CFACs are by state statute designed to be a "self- governing and a self-directed organization" (G. S. 122C-170 (a)) so the decision to post the minutes on the Internet had to be made by the CFAC.

As for your request to be given contact information for specific Smoky Mountain CFAC members, I am told that the membership of the Smoky Mountain CFAC have decided that they do not want their individual contact information distributed.

Instead, there is a dedicated e-mail address at The Smoky Mountain Center ( that can be used to contact CFAC members.

Of course, employees of The Smoky Mountain Center cannot compel volunteer CFAC members to respond to inquiries, but I have been assured that any inquiries received are passed along to the appropriate CFAC members.I hope this information is helpful. If you have further questions regarding the roles and responsibilities of CFACs or any specific CFAC, please contact Ann Remington in the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services central office.

Ann is the team leader for a team of state employees who provide support to CFACs statewide. Ann can be reached at or via telephone at 919-715-3197.

Leza WainwrightDeputy DirectorDivision of MH/DD/SAS


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