Thursday, March 19, 2009

75 Psychiatric Beds leaving western NC with years of planning necessary to create community mental health beds in hospitals

It took more than two years---from my very limited perspective as an outside observer---to get the 16 adult psychiatric bed unit up and going in Haywood Regional Medical Center in Clyde (next to Waynesville) NC. I'm guessing that there were years of planning work prior to that.

In order for Medicare/ Medicaid beds to be created within general / community hospitals, a great deal of planning has to take place. You do not simply open a unit and declare you are ready to see patients.

In order to carefully attend to matters associated with CMS (Centers for Medicare & Medicaid Services) and preserve the beds for possible Medicaid patients' admissions (most people w/ severe and persistent mental illness, SMPI have Medicaid) , the IMD exclusion rule is taken into account.

I assume that this is why there are few to no private free standing psychiatric hospitals and assumably why Asheville lost psychiatric beds that were here 20+ years ago e.g., Charter Hospital & Appalachian Hall in Asheville, NC

Governor Perdue is taking away 75 of Broughton's beds. I understand that no adult wants to be hospitalized at Broughton (I have heard differently about the child and adolescent units) but there is no in-the-works community / general hospital psychiatric beds in the works----that I know of. Yes, its a good idea to keep people w/ mental health challenges in their communities.

No, its not a good idea to rely on the already fractured 'community support' systems which are composed of limping-along Endorsed Provider companies----which is what NC Mental Health Reform was supposed to be about in the first place. However, that, apparently is what is intended as per this Associated Press (AP) article:


"North Carolina's proposed state budget would reduce the size of two state mental hospitals to save more than $6 million a year. The plan would rely on community treatment for those patients."

I sure hope that the state legislature gets a jump on this which is stated in the Raleigh News & Observer article:


"Perdue's budget would shut down 50 beds in state psychiatric hospitals -- 25 at Cherry Hospital in Goldsboro and 25 at Broughton Hospital in Morganton -- saving more than $6 million a year. ......The budget adds $12 million to contract 111 additional local hospital beds for mentally ill patients, a priority for legislators interested in mental health policy."


Here is my comment to the Raleigh News & Observer article outlining the additional loss of the 25 beds at Broughton:

" 75 PSYCHIATRIC HOSPITAL BEDS ARE LEAVING WESTERN NC: Adding these 25 Broughton beds to the already proposed loss of 50 more PUBLIC MEDICAID Broughton beds= 75 lost psychiatric beds in western NC. The 50 beds are to be transferred to a PRIVATE FREE STANDING ONLY 14% Medicaid (IMD exclusion rule per CMS) beds endeavor put together by Centerpoint LME/ NC DHHS/ and Old Vineyard Behavioral Health. I have asked for a release of the documents associated with those closed doors meeting (HEY, Gov Perdue: where's that transparency?) which was indicated in a 2.20.2009 memo put out by Centerpoint LME. Here's MY question: Was Cansler the lobbyist, during his revolving door career, who advanced this project BEFORE he was Secretary of NC DHHS? May have to evoke FOIA via Electronic Frontier Foundation in order to hack thru shrubbery blockading the real view. Marsha Hammond, PhD:"


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