The data is in re: what the problems are w/ mental health reform but the LME's and NC DHHS do not act on the problems
The answers are all fairly well understood now but the lack of solutions continues and that means that the LME's and NC DHHS are not doing their jobs as they see how the landscape is unfolding re: mental health care in NC. There is nothing special or exceptional about my responses. The same would be stated, I believe, by any provider who has been trying to function under the severe restrictions associated with the providing of mental health care in NC.
The below questions are extracted from a survey monkey document forwarded to a mental health listserv in NC the third week in October, 2008. I made the responses below.
The survey was sent by this woman in Wilson county: Jennifer Hancock, Executive Director The Mental Health Association in Wilson County 106 East Vance Street, Wilson , North Carolina 27893 Mailing Address: P. O. Box 652 , Wilson , North Carolina 27894 Phone: (252) 243-2773 mhawilson@embarqmail.com
Here is the link to the survey should you be interested in participating: (cut and paste):
http://www.surveymo nkey.com/ s.aspx?sm= 0AS4PS17FZbi7qHY 3CuvPA_3d_ 3d
Marsha V. Hammond, PhD
********************
Mental Health Services in Wilson County Solutions
Responses from a Buncombe and Haywood County Provider
1. In January 2009, the State of North Carolina will have a new governor. Many of the lead positions at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; Division of Medical Assistance; etc. are appointed positions. This means that our new governor will fill these positions after taking office. What are the core values that the individuals appointed to these positions MUST possess (i. e. personal conviction in the value of all humans regardless of their disability(ies))?
Response: Both staff at psychiatric hospitals and patients should be treated w/ Dignity. This means that there is enough staff to take care of anticipated & possible problems. This means that patients can expect to be paid attention to if they appear ill and unable to function. This is simply the basics.
*************
2. In January 2009, the State of North Carolina will have a new governor. Many of the lead positions at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; Division of Medical Assistance; etc. are appointed positions. This means that our new governor will fill these positions after taking office. What are the core values that the individuals appointed to these positions MUST possess (i. e. personal conviction in the value of all humans regardless of their disability(ies))?
Response: I do not live in Wilson county. However, what appears to be taking place in Buncombe county and Haywood county (more rural) is that well qualified mental health providers are presented w/ a series of Barriers which cannot be circumvented, in order to offer mental health care to people. What are these Barriers?
A. If providers do not provide CSS, then they should not have to participate in needless and time-consuming training which is not paid. This should clearly be stated by NC DHHS instead of providers having to move up the chain of LME administrators, hoping that someone can find Dr. Lancaster or Leza Wainwright and get an answer.
B. The massive paperwork associated with the providing of mental health care for state funded clients is serving no known purpose; there is no data to be obtained via NC DHHS and so why all the paperwork----unless it has been put into place in order to prevent the utilization of services. Thus, NC DHHS should make a determined effort to minimize paperwork and be clear about how the paperwork is to be used rather than obscure issues by insurmountable truckloads of paperwork which serves as nothing more than a Barrier to services.
********************
3. Providers of mental health services "cherry pick", providing services to consumers who are easier to serve and rejecting consumers who have more complex and challenging needs. How can we ensure treatment and services for individuals living with complex and challenging mental health issues in Wilson County, and statewide?
Response: Providers only cherry pick clients in order to stay financially viable. This, indeed, is the problem w/ privatizing mental health services in NC. If CSS is only allowable to the tune of no more than 8 hours/ week/ client---and if the client is schizophrenic, then savy providers will avoid these clients and they SHOULD in order to protect their continued ability to provide services.
******************
4. Case managers and qualified professionals have far too many individuals on their caseloads, even though there is to be a certain ratio. This prevents them from doing their job well. What measures, penalties, incentives, etc. can we take to ensure that case managers and qualified professionals have balanced case loads allowing for quality services and service monitoring?
Response: If you insist on the providers carrying the clients who are very ill e.g., schizophrenic, or with many behavioral symptoms associated w/ other illnesses such as some of the personality disorders, then you should be prepared to allow them to carry more clients that will allow them to remain financially viable. You cannot complain about them carrying too many clients when the system creates the scenario of disallowing enough care for time-consuming clients such that the provider works for free, in an attempt to take care of that client.
*****************
5. The mental health system if full of political jocking, and political practices, which takes the focus off the populations the system is designed to serve. How do we take the politics out of human services?
Response: You put someone who knows MH at the top. And that's not Dempsey Benton.
**************
6. When an individual with a mental illness presents at our local emergency room they are moved around and then are transferred out of the area to a state hospital. How can we develop resources in Wilson to provide a stable inpatient treatment service, preventing out of area transfers? or What can we do to decrease the need for hospitalization?
Response: The LME should participate w/ the local hospitals in order to set up psychiatric beds at that local hospital. In Haywood county, as associated with Haywood Regional Hospital, SMC LME obtained a grant in order to create those beds which are to open this week, the last week of October, 2008.
*********
9. It has been identified as a system problem with mental health services in Wilson County that there is a lack of mental health services for uninsured/underinsured who are not eligible for Medicaid. Who will provide services for those who have no means to pay, and what sources of payment are available for these services? If you list a source of payment please provide any restrictions or a link to a web based application with the restrictions spelled out.
Response: That's why you are supposed to have a functioning LME that creates funding for the treatment of state funded clients.
The below questions are extracted from a survey monkey document forwarded to a mental health listserv in NC the third week in October, 2008. I made the responses below.
The survey was sent by this woman in Wilson county: Jennifer Hancock, Executive Director The Mental Health Association in Wilson County 106 East Vance Street, Wilson , North Carolina 27893 Mailing Address: P. O. Box 652 , Wilson , North Carolina 27894 Phone: (252) 243-2773 mhawilson@embarqmail.com
Here is the link to the survey should you be interested in participating: (cut and paste):
http://www.surveymo nkey.com/ s.aspx?sm= 0AS4PS17FZbi7qHY 3CuvPA_3d_ 3d
Marsha V. Hammond, PhD
********************
Mental Health Services in Wilson County Solutions
Responses from a Buncombe and Haywood County Provider
1. In January 2009, the State of North Carolina will have a new governor. Many of the lead positions at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; Division of Medical Assistance; etc. are appointed positions. This means that our new governor will fill these positions after taking office. What are the core values that the individuals appointed to these positions MUST possess (i. e. personal conviction in the value of all humans regardless of their disability(ies))?
Response: Both staff at psychiatric hospitals and patients should be treated w/ Dignity. This means that there is enough staff to take care of anticipated & possible problems. This means that patients can expect to be paid attention to if they appear ill and unable to function. This is simply the basics.
*************
2. In January 2009, the State of North Carolina will have a new governor. Many of the lead positions at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; Division of Medical Assistance; etc. are appointed positions. This means that our new governor will fill these positions after taking office. What are the core values that the individuals appointed to these positions MUST possess (i. e. personal conviction in the value of all humans regardless of their disability(ies))?
Response: I do not live in Wilson county. However, what appears to be taking place in Buncombe county and Haywood county (more rural) is that well qualified mental health providers are presented w/ a series of Barriers which cannot be circumvented, in order to offer mental health care to people. What are these Barriers?
A. If providers do not provide CSS, then they should not have to participate in needless and time-consuming training which is not paid. This should clearly be stated by NC DHHS instead of providers having to move up the chain of LME administrators, hoping that someone can find Dr. Lancaster or Leza Wainwright and get an answer.
B. The massive paperwork associated with the providing of mental health care for state funded clients is serving no known purpose; there is no data to be obtained via NC DHHS and so why all the paperwork----unless it has been put into place in order to prevent the utilization of services. Thus, NC DHHS should make a determined effort to minimize paperwork and be clear about how the paperwork is to be used rather than obscure issues by insurmountable truckloads of paperwork which serves as nothing more than a Barrier to services.
********************
3. Providers of mental health services "cherry pick", providing services to consumers who are easier to serve and rejecting consumers who have more complex and challenging needs. How can we ensure treatment and services for individuals living with complex and challenging mental health issues in Wilson County, and statewide?
Response: Providers only cherry pick clients in order to stay financially viable. This, indeed, is the problem w/ privatizing mental health services in NC. If CSS is only allowable to the tune of no more than 8 hours/ week/ client---and if the client is schizophrenic, then savy providers will avoid these clients and they SHOULD in order to protect their continued ability to provide services.
******************
4. Case managers and qualified professionals have far too many individuals on their caseloads, even though there is to be a certain ratio. This prevents them from doing their job well. What measures, penalties, incentives, etc. can we take to ensure that case managers and qualified professionals have balanced case loads allowing for quality services and service monitoring?
Response: If you insist on the providers carrying the clients who are very ill e.g., schizophrenic, or with many behavioral symptoms associated w/ other illnesses such as some of the personality disorders, then you should be prepared to allow them to carry more clients that will allow them to remain financially viable. You cannot complain about them carrying too many clients when the system creates the scenario of disallowing enough care for time-consuming clients such that the provider works for free, in an attempt to take care of that client.
*****************
5. The mental health system if full of political jocking, and political practices, which takes the focus off the populations the system is designed to serve. How do we take the politics out of human services?
Response: You put someone who knows MH at the top. And that's not Dempsey Benton.
**************
6. When an individual with a mental illness presents at our local emergency room they are moved around and then are transferred out of the area to a state hospital. How can we develop resources in Wilson to provide a stable inpatient treatment service, preventing out of area transfers? or What can we do to decrease the need for hospitalization?
Response: The LME should participate w/ the local hospitals in order to set up psychiatric beds at that local hospital. In Haywood county, as associated with Haywood Regional Hospital, SMC LME obtained a grant in order to create those beds which are to open this week, the last week of October, 2008.
*********
9. It has been identified as a system problem with mental health services in Wilson County that there is a lack of mental health services for uninsured/underinsured who are not eligible for Medicaid. Who will provide services for those who have no means to pay, and what sources of payment are available for these services? If you list a source of payment please provide any restrictions or a link to a web based application with the restrictions spelled out.
Response: That's why you are supposed to have a functioning LME that creates funding for the treatment of state funded clients.
posted by Marsha V. Hammond, PhD at 1:08 PM
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