Monday, April 21, 2008

Press, Governor. and NC DHHS continue to allow blame of Endorsed Provider private companies for Community Support Services over-spending

Dear Editorial Board of The Daily Tarheel:

Please do your homework prior to feigning shock

YOU'D BEST BE 'SHOCKED' BY NC DHHS's MISMANAGEMENT RATHER THAN BY PRIVATE PROVIDERS

Marsha V. Hammond, PhD: Clinical/Health Licensed Psychologist, Asheville, NC e mail: hammondmv@netzero.com

April 21, 2008

Hiya:

You stated, in your opinion piece: "Shockingly, many of the health care workers employed by private companies to provide services to the community had little or no experience in the field and no college diploma." (see below for cut and paste of this editorial board posting).

A reading of the Service Definitions or guidelines as associated with Commnity Support Services, developed by NC DHHS, as pertaining to the paraprofessionals which provide the bulk of the skills-based training, as pertaining to the services which you are alluding to above, specifically Community Support Services (CSS) indicates the following:

1. high school graduates met the criteria put forward by NC DHHS
2. the one year of experience was waived by NC DHHS back in 2005/2006

Please see: Community Support - Adult MH/SAQuestions and Answers (8/5/05) http://www.dhhs.state.nc.us/MHDDSAS/servicedefinitions/archives.htm

Your complaint is with NC DHHS, not with the Endorsed Provider companies.

Moreover, I would not say that the money was 'wasted'; many Medicaid clients received good services on the basis of these Community Support $'s.

If the state was concerned about the delivery, they should have figured it out prior to putting the criteria of the program forward.

The people to write to are: Dempsey Benton, Secretary; Leza Wainwright, co-director of mental health services; Mike Lancaster, co-director of mental health services.

Marsha V. Hammond, PhD
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Associated editorial board comment, April 21, 2008
Unhealthy system
http://www.dailytarheel.com/media/storage/paper885/news/2008/04/21/Opinion/Unhealthy.System-3337741.shtml
Withheld funding apt response to mental health failuresBy: Editorial BoardIssue date: 4/21/08 Section: OpinionJust as citizens have a responsibility to faithfully pay their taxes each spring, governments have a responsibility to ensure that tax money is spent wisely and usefully.

North Carolina's state government has obliterated its end of this unwritten pact by wasting at least $400 million on mental health reform since 2001.

Knowing that, the federal government's Centers for Medicare and Medicaid Services did well to punish the state by withholding $175 million in federal funding from community support programs during the last three months of 2007.

We wish the state had gotten a warning before the money disappeared because reforming the system will likely require money. But the punishment is justified.

We just hope the loss of federal funding will incite state officials to revamp a mental health program suffering from innumerable ailments.

In 2001 evidence indicated the N.C. state government leaned too heavily on state psychiatric hospitals, and legislators responded by enacting reforms to treat more mental health patients in their own communities rather than the state's four overcrowded hospitals.

Under the new system, private health care providers replaced local governments in the delivery of mental health services.The community support program, intended to cost the state less than $5 million per month, soon cost more than $50 million because of bloated private health care bills, money-hungry providers and a government that seemed to ignore it all.

Shockingly, many of the health care workers employed by private companies to provide services to the community had little or no experience in the field and no college diploma.

Regardless, the state paid these workers as much as $61 per hour for services deemed "unnecessary" 89 percent of the time by a Department of Health and Human Services review.

Rather than delivering useful services to patients in need, providers often took clients shopping or to the movies, all at the expense of N.C. taxpayers.

While private health care providers cashed in on this faulty system, the state's 210,000 residents who seek state help each year received worse service.

From March 2006 to January 2008, the government spent $1.4 billion on the wasteful community support programs and only $78 million on services statistically more effective at decreasing the chances of hospitalization.

Luckily, the federal funding is being taken from the community programs. In this case, less is probably more.

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