Sunday, October 19, 2008

Professional Mental Health Providers : we have been blocked from providing services while the LME's complain about having no providers

EXCUSE ME: If the LME's would remove the barriers for the professional mental health providers, you would, I believe, see the state's money more efficiently spent.

WHY does Smoky Mountain Center LME, the largest LME in NC, utilize the more expensive Endorsed Provider service Community Support Services in lieu of Basic Services? There are no Basic Services at SMC LME. All outpt therapy is included under the Enhanced Services Service Definition, Community Support Services.

This disallows mental health providers from providing outpatient therapy.

The only purpose it serves is to shunt services towards Meridian Behavioral Health Services, which was created as Smoky Mountain Center moved away from being a community mental health center to administrating mental health services in western NC.

Is this WHY SMC LME disallows Basic Services inclusive of outpatient therapy?


There is no place within NC Mental Health Reform for mental health providers to submit input. Not via NAMI; not via the LME's; nowhere. And you cannot get answers to your questions unless you can convince someone at the LME to go and get the answer.

Donald Reuss of Western Highlands Network LME thought my question about outpatient therapy merited a response and got the answer. THANK YOU.

Harold Carmel, MD, of the NC Psychiatric Association, has indicated over the past several days that NCPA is going to be submitting some suggested changes to NC mental health reform law.

Let's hope that this includes some feedback from professional mental health providers who have had very little ability to provide feedback into NC's failing mental health reform. Let's hope that outpatient therapy, utilized in the way that it could be, is paid attention to.

HOwever, psychiatrists do not generally do outpatient therapy and there is no indication that NC Psychological Association understands what has been going on.

I have a lot of clients who would have been in the hospital w/o my support, rendered on a 24/7 basis. They can call me anytime...and they do. They are my outpatient therapy clients and I treat their needs seriously and listen to them.

It would be nice to be LISTENED TO for a change, by people who tinker w/ mental health reform.

When I went to the Haywood NAMI meeting on Thursday, October 16, 2008, Meg Hudson, part-time employee for Smoky Mountain Center (SMC) LME and part-time employee for Meridian Behavioral Health, run by a retired SMC LME employee, gave a talk on the new beds being opened at the end of October at Haywood Regional Hospital just outside of Waynesville, NC.

SMC LME's Doug Trantham, Director of Emergency Services, has worked hard to put this into place.

I spelled out for Meg Hudson, who is to be one of the social workers on the new behavioral health unit at Haywood Regional Hospital, as well as the members of NAMI there, and Dr. Ardeman, the new psychiatrist for that behavioral health unit at Haywood Regional Hospital, that SMC LME has ALL of its outpatient therapy under the Service Definition, Community Support Services, and that professional mental health providers who are unwilling to sit thru 20+ hours of CSS training, as required by the Utilization Review Department of SMC LME, headed by Charles Barry, are unable to provide outpatient therapy services at SMC LME.

So please do not complain about the lack of mental health providers when I have told you exactly what the problem is. I cannot be the only professional mental health provider who is unwilling to sit thru 20+ hrs of unpaid, unnecessary CSS training.

I had last week asked WHN LME's Director of Provider and Consumer Services, Donald Reuss, if he could get an answer to the matter of 'whether professional mental health providers who render outpt therapy have to go thru the 20+ hours of CSS training for Western Highlands Network (WHN) LME in order to be 'employees' (the only status that psychologists have as associated w/ NC Mental health reform' and he came back w/ an answer from someone---Lancaster or Wainwright----an answer that I have been trying to get from Lancaster & Wainwright over the past week.

NO, stated Mr. Reuss: if you do not provide CSS training, then you do not have to go thru the 20+ hrs of CSS training. Here is his response and I believe this is useful for other professional providers who also have been unable to render outpt psychotherapy for state funded clients:


Dr. Hammond,
You do not need to have the 20+ hours of training for enhance services to do basic outpatient services. Your license is evidence enough that you have the appropriate training to provide that outpatient therapy.

Donald Reuss
Director of Provider and Consumer Relations
Western Highlands Network
356 Biltmore Avenue, Asheville NC 28801
(828) 225-2785 x2969
Fax- (828) 225-2784


To suit, more indicators of increased hospitalization when, frankly, the professional mental health providers could be utilized.


Lawmakers to weigh mental-health funding during tough economy

By Vicky Eckenrode
Staff Writer

(cut and paste):

“When the General Assembly comes back into session in January, and the new governor takes office in January, they’re going to be faced with an awful lot of need and I’m afraid less money than now,” she said.

Coupled with overall money concerns, state lawmakers also will be bombarded with a number of issues plaguing the state’s mental health system. .....

Since legislators left Raleigh this summer, Broughton Hospital, a state mental facility in Morganton, lost its accreditation, meaning it might lose payments from private insurers.

Another state facility, Cherry Hospital in Goldsboro, lost its certification for federal Medicare and Medicaid payments after complaints about patient abuse and safety. Part of the hospital closed where a patient died after not being attended to for more than a day...."


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