Thursday, August 28, 2008

Carrboro Citizen's Sisk outlines new division 'Program Evaluation Division' report which indicates: NC DHHS DOES NOT USE OUR PAPERWORK

August 29, 2008

Dear Mr. Taylor Sisk, staff reporter at the Carrboro Citizen newspaper:

Thank you so much for your wonderful article. Great to hear Tom Smith and Nick Strattus's voice for they know an enormous amount.

As per your article, I would be interested in hearing/ you writing/ or someone writing about this important matter: "The legislative report cites delays in securing federal approval of new service, which led to a delay in the implementation of overight procedures."

I noticed that a person named John Turcotte is the Director of this new division which reports to a committee within the NC STate Legislature. I called that office and I understand that Mr. Turcotte has been a program evaluator in MS and FL for over 30 years.

I furthermore noted the recommendations from this newly formed division's director (the report...besides your aforementioned note on 'Pace of Implementation' and the other header as per the pdf report document associated with the report, specifically, 'Insufficient forecasting and monitoring'):

"....•• Information not organized for decision-making. Performance goals and measures were not established for the service array at the outset, and the department’s current external reports present excessively dense data that are neither synthesized nor interpreted. The lack of useful information limits decision-makers’ abilities to understand trends and determine how well the current system is working.

The Program Evaluation Division recommends the department: • manage data and information so that its executives can readily identify key issues and respond purposively; and • improve its internal data analysis and policy development processes by continuing to move from data collection and reporting to information synthesis and knowledge management...."

You may know, Mr. Sisk, that one of the primary complaints of mental health providers practicing within NC, is associated with the ever-changing paperwork demands created by NC DHHS and implemented by the various LME's.

How comforting to know that NC DHHS has been changing the paperwork for no good reason and have no well organized manner of utilizing the literally truckloads of information which is demanded to be given to them.

Here is the link. I am forwarding it to others. I am featuring a bit of it at my NC mental health reform blogspot:

Article link:

I see that the copy of this legislative report is available here:

Excerpt from your article:

"The Report

Last week the newly formed legislative Program Evaluation Division released a long-awaited report titled “Compromised Controls and Pace of Change Hampered Implementation of Enhanced Mental Health Services.” The report is largely focused on the now well-documented excesses in the provisioning of community support services and chronicles the general mismanagement, overspending and lack of oversight in our mental health system since the passing of reform legislation in 2001, which called for privatizing services.

Community support services include, for example, assistance with grocery shopping or homework or chaperoning to movies or ballgames. The News & Observer reported that between March 2006 and January 2008, the cost of these services rose to nearly $1.4 billion, or 90 percent of all spending for community-based mental health care services. The cost of community support services was then nearly 20 times the state’s original estimate.

State officials now acknowledge that too much money has been wasted in the provisioning of community support services and – granting that these services are vital for many who are poised to reintegrate back into their communities – that too much money is being allocated to them at the expense of services that are more time- and cost-intensive to provide – local in-patient care, for example, or everyday counseling.

The legislative report cites delays in securing federal approval of new service, which led to a delay in the implementation of overight procedures, which in turn led to some new providers taking advantage of the system by “delivering an unchecked amount of services”; a failure to establish a baseline “against which to measure system performance and assess utilization and expenditures”; and reports to decision-makers that included “excessively dense data that are neither synthesized nor interpreted.”

In sum, the report is about mismanagement and abuses in the overhaul of our state’s pre-existing mental health care system – an initiative that most everyone now acknowledges is in serious need of some overhauling of its own.

What the report is not about is how mental health care reform is failing people – most particularly, those people most critically in need...."

Thanks again, Mr. Sisk


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