Monday, June 09, 2008

Mercer II Reports: comparing western NC's two LME's: 25% counties of NC's 100 counties

Overall Mercer II Report:
*Note: the purpose of the series of Mercer Reports, grossly, as stated in the news services and attributed to the governor's office, are associated with 'whether the LME's are ready to oversee Medicaid.'
Smoky Mountain Center LME (SMC) LME report within the larger one:

SMC LME: failed 17/40 possible items; all items are not 'weighted equally' in terms of importance. Document will not allow you to cut and paste. remember that SMC LME is run by accountant Tom McDevitt and most consistent approval rating as per Mercer Report is associatted with first criteria, specifically, Operational Category.

Failure items include matters which I have taken SMC LME to task about, and which are also regarded in the Haywood county community to be lacking:

* no separation of system management from service delivery functions

(Stephen Puckett, PhD, is the Clinical Director, and he has the capacity to blockade services, which has occurred as per this practitioner, as well as he feeds into the management of SMC LME. In other words, there is no separation of duties and the clinical director's job is impinged upon by the over-riding financial desires of SMC LME's financial concerns. How does this play out re: SMC LME specifically? All clinical care is thrown to Meridian Behavioral Health Services, run by Joe Ferraro, retired SMC LME employee)

*no check re: 'UM/UR committee'

(Months ago I asked why SMC LME did not have on its website information about its CFAC, which is the consumer/ consumer's relatives committee which tackles problems within the LME from the perspective of people outside the LME. After pressure from NC DHHS, the notes were put on line. what did they reveal?: a CFAC which was mostly non-attended.

Charles Barry, the manager of Utilization Management, almost sole-handedly runs the UM department and Dr. Puckett and Mr. Barry seem to collude re: denial of authorization and threats of audit should the practitioner attempt to forego the Community Support Services (CSS) training which is intended for the CSS highschool graduates, rather than the professional trained mental health practitioners)

*no check re: Crisis Services

Synopsis re: SMC LME:

The non-separation of the clinical arm of the SMC LME and the adminitrative arm of SMC LME is perhaps the most troubling item highlighted in this report. It reveals an LME whose clinical administration, inclusive of making authorizations available to clinicians in the community, is always being monitored by the more carefully monitored financia/ administrative arm of the LME.
Western Highlands Network (WHN) LME report within the larger Mercer II Report


WHN LME failed 10/40 points. all items are not 'weighted equally' in terms of importance. Document will not allow you to cut and paste.

* no check re: UM/UR committee

*no check re: Crisis Services
Comments: (marsha hammond, phd, clinical licensed psychologist)

1. It appears that the non-cut and paste single item related to Crisis Care needs to be broken up into components. There are 2 at the current time. Within the 1st category, there are 6 items.
Given the problems w/ Crisis Services across NC, it is surprising (though maybe not, given the heat on this matter) that it has been accorded 2 checks per the Mercer II Report.


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