Monday, November 03, 2008

Will NC's county commissioners do the right thing in terms of monitoring mental health services in NC?

Article sent as letter to editor by Mary Annecelli associated with her experience as a mental health advocate under Centerpointe LME, in eastern NC:

LETTERS TO THE EDITOR Winston-Salem Journal Published: November 1, 2008
and footnote below letter.



Long before the election mantras about "change," our Forsyth County commissioners were presented detailed information regarding issues with CenterPoint, the Local Management Entity (LME) that functions like an HMO. It assesses, refers and approves payment for mental health, developmental disability and substance abuse services for Forsyth, Stokes and Davie counties.

The Mercer Report, along with the state Department of Health and Human Services report of May 2008, confirmed that CenterPoint spent over $8 million, a whopping 23.7 percent of its $34,681,146 budget, just for administration -- while those in need in our community were denied critical medical services.

Concerned citizens weren't asking for new money, but seeking accountability for tax dollars. Concerned citizens asked commissioners to exercise their legally mandated oversight of funds already allocated, to ensure critical medical services for eligible citizens and responsible CenterPoint board-member selection.

Forsyth County commissioners are integral to any solution and have been passive thus far. The local election really matters. Let's elect new commissioners -- Nancy Young, John Gladman II and Dave -- and send a message to all commissioners: failure to be responsive to local taxpayers is not acceptable.




Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville/ Waynesville, NC
e mail: cell: 404 964 5338

RE: county commissioners interfacing w/ the LME boards (and being on the LME boards) and what this means

November 3, 2008

Dear Mary Annecelli (mental health advocate in eastern NC associated w/ Centerpointe LME):

Thank you for your outline of problems associated with encouraging the county commissioners, associated w/ counties in easterh NC associated w/ Centerpointe LME, to do something about the 24% administrative costs (what the LME employeese are paid) associated w/ that dysfunctional LME.

IN other words, your point seems to be that the commissioners of those counties are refusing to look at the conundrum of high LME salaries as against the backdrop of severely curtailed services to the citizens who receive (or not) mental health services living in the catchment area associated w/ Centerpointe LME.

I would like to suggest that county commissioners in Haywood county are experiencing some of the same challenges in terms of understanding what to do about a lack of providers and problematic delivery of mental health services.

Recent e mail exchanges about difficulties of the Haywood county commissioners seems to be associated with they having a different set of information about providers under SMC LME----than the providers have.

I assume that SMC LME has never indicated to them that providers in western NC have been trying to provide services for state funded clients----what the LME's have so far been authorized to oversee-----but rather the information created by SMC LME---- which created Meridian Behavioral Health Services---- is that the 'next plan' is to continue to utilize the same providers (Meridian Behavioral Health Services providers). The Haywood county commissioners do not seem to understand that other providers have experienced great difficulties in providing services. There are providers here; they simply cannot work w/ SMC LME when SMC LME has created a privileged position for Meridian Behavioral Health Services which necessary excludes providers not working for Meridian.

Ms. Enloe, a good commissioner in Haywood county, and also on the Board of SMC LME, stated this past week in an e mail to several people, concerned about these issues, suggested that I involve SMC LME administration, specifically, Bill Hambrick, a nice man to be sure, as pertaining to her suggestion that I 'let him know how you feel.'

I told her I had made suggestions and complained FOR YEARS re: the lack of well qualified providers being allowed to obtain authorization for services for state funded clients. SMC LME refuses to have Basic Level Services (no outpt services) except under the Community Support Services service definition. And, as you know, CSS, is being constantly defunded.

I surmise that the reason that SMC LME has all of its state funded clients, the 'working poor'-----remember, the ones that mental health reform was supposed to be about----being served under the Community Support Services service definition, is in order to preserve what they saw as fleeting mental health care services as mental health reform moved into western NC and as SMC LME divested of all of its clinical people.

And so, SMC LME worked with former SMC LME employee Joe Ferraro, in order to create Meridian Behavioral Health Services in 2001 or so and Meridian picks up all the state funded clients and has a privileged seat at the table re: mental health services under SMC LME.

The nature of this privilege is just now being revealed as Tom McDevitt finishes his tenure, having been removed by the SMC LME Board, as associated w/ conflict of interest pertaining to real estate matters (his wife is a real estate agent; I do not know the details re: this) and his daughter was working at SMC LME. Tom was quoted this past week in a newspaper article that the reason that Meridian was 'created' by SMC LME was because the LME was afraid that there would be no mental health services available in western NC.

Mr. McDevitt, an accountant by trade, did, to my mind, a good job of managing SMC LME. The REAL conflict of interest is associated with SMC LME determinedly continuing to give Meridian Behavioral Health Services a special position----the direct result which is other mental health care providers cannot work in the environment when the struggle to give mental health services to clients is so time-consuming.

Here is an overview of 2 recent news articles which give indication that:

1. I was correct re: SMC LME's persistent support of Meridian Behavioral Health, a matter which had never been spelled out.

2. Haywood county commissioners do not understand that Meridian has had a privileged position and seem to believe that all that is necessary is for providers to inform SMC LME administration, specifically, Bill Hambrick, about their concerns.


Friday, October 31, 2008
What NOW from the Haywood Cnty Comm & SMC LME re: some new company to take over direct mental health care services?
".....If you fold two recent articles together, what you come up with is that SMC LME is intending to create ANOTHER 'shadow' company (as is Meridian Behavioral Health a shadow company associated w/ the LME, having spun off via Joe Ferraro, former SMC administrator, and Tom McDevitt, about to be the former Director of SMC LME.)


Article one, FINALLY explaining Tom McDevitt's 'operation' as associated with having created Meridian Behavioral Health as Joe Ferraro spun out of SMC when it was morphing into an LME: ****************

Mental health reform fails to empower
New mental health system wasting taxpayers’ money
By Quentin Ellison:

(cut and paste):

"To avert a total crisis, McDevitt said that a spin-off nonprofit organization – then Mountain Area Support Services, today called Meridian – was formed. Ferrara became chief executive officer of that group, while McDevitt stayed with Smoky Mountain..... “We basically split Smoky into two different organizations, with quality leadership and quality board members,” McDevitt said...."


Article 2: Mental health reforms are on the way

Vicki Hyatt - Editor: The Mountaineer (Waynesville, NC)

....During a work session last week, Haywood County commissioners met with representatives from the Smoky Mountain Center to learn more about the coming changes. At stake is the status of Medicaid reimbursement funds, which will no longer be given to a third-party contractor as of September 2009, and instead will be provided directly to the local management entities.

One option for a new model provides a way the transition can be relatively seamless and use basically the same health care providers that are now in place within the community....."

Unfortunately, mental health providers not associated w/ Meridian Behavioral Services, will not be able to work w/ SMC LME, due to the privileged position given to Meridian Behavioral Health Services.


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