Friday, November 07, 2008

Blame Smoky Mountain Center LME policy for not enough mental health providers

(letter to editor submitted as a response to 'Cherokee Scout' article on mental health):

Reform: Therapeutic services at risk
Not enough providers in western North Carolina

Special to the Cherokee Scout
(cut and paste):

Wednesday, November 5, 2008


Blame Smoky Mountain Center LME policy for not enough mental health providers

by Marsha V. Hammond, PhD: Licensed Psychologist, NC

Contrary to the article, which indicated that there is a lack of providers in western NC, specifically, as pertaining to the counties who have Smoky Mountain Center (SMC) LME as a mental health administrator, please bear in mind that there are no Basic Level Services authorized by SMC LME. Basic Level Services include outpatient therapy.

Currently, SMC LME, as well as all the LME's in NC, oversee only state funded clients, the 'working poor.' Soon, however, as per NC mental health law, the LME's will be managing Medicaid.

You heard me right: there are no outpatient therapy services except under the Service Definition associated w/ Community Support Services (CSS) which is being constantly defunded.

What does this mean in terms of mental health services and the numbers of providers?

Well trained doctoral psychologists are not willing to sit through 20+ hours of unnecessary, unpaid CSS training. Neither are well trained providers willing to submit 20+ pages of paperwork in order to obtain authorization for one client session.

In that SMC LME uses the vehicle of CSS, licensed providers are not able to utilize their licenses in order to practice but must submit to these additional barriers. This does nothing more than create a barrier to care for citizens of western NC under the SMC LME catchment area. That's why you don't have enough providers. Remove the barriers, and the providers will come.

Without the undergirding of Basic Level Services, this means that more citizens, unable to obtain state funded services due to barriers, go into Broughton Hospital, which has not had its Centers for Medicaid and Medicare Services accreditation re-established since August, 2007.

The cost of running Broughton, in Morganton, NC, the main psychiatric state hospital for western NC, is approximately $1,000,000/ month.

Moreover, to exacerbate the situation, there is a shortfall as associated w/ the NC state budget and this is one main reason why this is so. Thus, mental health $$ are about to be pulled.

This is not even to speak to the de-accreditation of Cherry Hospital in eastern NC where Steven Sabock was found dead after being unattended for dozens of hours.

Contrarily, under Western Highlands Network (WHN) LME, which is the other administrator of mental health services in western NC, there is no such requirement in terms of the CSS training barrier and the excessive paperwork.

The Utilization Review Department of SMC LME, headed by Charles Barry, has blocked attempts by doctoral level psychologists to provide outpatient mental health services.

If you want to do something about the lack of mental health providers in western NC, as administered by SMC LME, you need to find out why SMC LME will not allow Basic Level Services. Basic Level Services and the diminished paperwork would allow professional mental health providers to see clients and diminish psychiatric inpatient time which would save the state money.

Or would this have something to do w/ the protection of Meridian Behavioral Health Services which was created by a retiring employee of SMC LME and Tom McDevitt, who has been relieved of his director's position by the SMC LME Board?

Meridian has a contract w/ SMC LME to service all the state funded clients. And soon, the LME's will be overseeing Medicaid.

Will SMC LME continue to play favorites w/ Meridian in order to shore up an insistently collapsing provider network who cannot support themselves due to diminished work----- in order to bolster Meridian which spun out of SMC LME?


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