Saturday, December 06, 2008

Tell me, Rep Verla Insko, how the LME's are going to manage Medicaid when they cannot even manage the state funded clients' mental health care?

Breakdown: The will to find a better way
by Taylor Sisk:

".....Among the changes made in the course of mental health care reform in North Carolina was the recruitment of an out-of-state company called ValueOptions to review and process all Medicaid payments.

Chapel Hill’s Rep.Verla Insko, a sponsor of the mental health care reform legislation and co-chair of the joint legislative committee on mental health, says of that decision, “It was a mistake. It undermined the basic goals of reform, which were to have the public sector manage a unified budget – a Medicaid, state-dollar and local-dollar budget – to provide services within each catchment area.” Instead, today we have a two-payer system, further fragmenting the funding and delivery of services.

The Legislature is now taking action to remove ValueOptions, from the equation.

Insko says that LMEs serving 30 percent of the state’s population will this year reassume the management of Medicaid dollars, and that if all goes well 30 percent more will do so next year and 40 percent the next.

Another move in the right direction, according to Insko, is an effort to integrate mental and physical health care services through Community Care of North Carolina, which operates out of the North Carolina Office of Rural Health and Community Care. It’s an effort championed by Governor-elect Perdue...."


My comment to the above article, online:

"I cannot get even ONE state funded client authorized for treatment at either Western Highlands Network (WHN) LME or Smoky Mountain Center LME who administer 25% of NC's mental health care. Medicaid works pretty well under Value Options. Today I went UP TO WHN's office as I cannot get an e mail reply back re: my query pertaining to authorization of a state funded client. Everyone was in a meeting; when I send e mails to the appropriate people, no one answers me back.

Please tell me, Verla Insko and Martin Nesbitt, co-chairs of the NC Mental Health Reform Legislative Oversight committee how I am supposed to manage when the quite well functioning Value Options loses its Medicaid authorization contract and the LME's----who have not been able to authorize efficently the state funded clients----pick it up? I WANT TO KNOW.

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville/ Waynesville, NC


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