Who Stood to Gain by Killing New River LME After a Game of Patty-Cake: Follow the Money

Counties will bear fiscal support of New River in transition

by Jesse Campbell

County managers and interim officials with New River Behavioral HealthCare continued to chart the transition for a new service provider at a meeting Monday morning as the final days of the organization begin to unfold.
Managers agreed Monday to pay for the services of contracted physicians and therapists, some of which have not been paid since August, along with past due utilities, property insurance, and other general operating costs.
Managers had already agreed to pay for last Friday’s payroll.

“We are in dire straits,” said interim Chief Executive Officer Sharon Wilcox in regards to the current provider’s past due expenses. “Some of these physicians refuse to come to work until they are paid.”

A week after her selection as interim finance officer by the five-county board for New River, Amy Oliver expressed her desire to step down. She has agreed to continue assisting the board until her replacement is found.
Although county officials still do not know what accounted for the provider’s current financial state, they do know that NRBHC had reported financial losses as early as 2007.

According to Ann Wilson, an auditor who has worked closely with NRBHC in the past, the provider incurred a $5.8 million loss for the two-year period leading up to fiscal year 2011.

Officials from the five affected counties formed a new board upon the dissolution of a 160A interlocal agreement to assist in the transition to a new service provider for Ashe, Alleghany, Wilkes, Watauga and Avery counties.
County officials revealed that Daymark Recovery Services will serve the area as the new mental health service provider. NRBHC will cease to exist on Nov. 15.

Daymark Services has expressed interest in using NRBHC’s current buildings once the transition is complete."

http://averyjournal.com/News/story/Counties-will-bear-fiscal-support-of-New-River-in-transition-id-008959

So, as per the above article outlining the demise of New River LME, insuring/ providing services 13,000 lives (more than the company that sank out of sight about 5 years ago in western NC which insured 10,000 lives), what are the details outlining that New River LME was sucking wind as far back as 2007? If their difficulties were so onerous, why didn't the multi-county commissioners ask some serious questions?

Reporters do us such an injustice by not digging into the details.

This is what I wonder about the entire matter:

"Medicaid fraud" could be leveled at most any provider/ company in NC. "Medicaid fraud' accusations are what reportedly sank New River LME. No one has given the public any information about the details of this' Medicaid fraud' that I know of. So, where's the proof? (I expect the answer to this question to magically turn up on the Piedmont Behavioral Health LME website within a week, as is often the case when 'queries' are posed and the public is 'given an explanation.' )

People do not seem to be questioning, as French philosopher, Michele Foucault, who outlined how power manipulates, suggested we ask: "Who is speaking?" Who or what entity stands to gain by shouting fire in the theatre or 'Medicaid fraud?" When one bills Medicaid----from the standpoint of this solitary practitioner billing directly to Medicaid for therapy only services----the information that is 'demanded' by Medicaid is multi-focal. It would be pretty damn easy to commit Medicaid fraud. And if your company or LME was sucking wind because the larger parent LME (that would be Smoky Mountain Center LME) had jerked your contracts and given them to another brown-nosing organization----well, its just a matter of time you have to tread water. There's waaaayyyy more news here that is not apparent.

A more salient question might be, "Who wanted New River LME dead?" I do not have an insider's knowledge; however as per articles recently by Richard Craver of the Winston Salem Journal (newspaper: see: http://www2.journalnow.com/news/2011/oct/16/wsmet01-group-has-ideas-for-health-service), there is an outline of a pretty concerted power struggle between providers in order to wrest the reins from (what was) New River LME administration. Apparently and reportedly, providers local to Piedmont Behavioral Health (PBH) LME, which launched, basically, a hostile take-over bid on Western Highlands Network LME in western NC in June, 2011, will not talk to local reporters for 'fears or retributions.' PBH LME's hand sits lurking in the background as per Craver's articles that they were 'willing' to 'offer suggestions' which, of course, were associated with they taking hold of the reins. Moreover, the people who ARE talking to reporters and feeding them information stand to gain by slanting a take on the news that causes their companies to appear like 'knights in shining armor.'

Follow the money, as, I believe, Bill Clinton suggested. And remember to ask yourself "Who is speaking" which is to say, "Who stands to gain from this matter?"

All I know is that the last line of that article states the following:"Daymark Services has expressed interest in using NRBHC's current buildings once the transition is complete."

A curious reporter would wonder: what is the relationship between Daymark Recovery and Smoky Mountain Center LME; how much 'business' does Daymark Recovery have re: SMC LME clients?; did contracts to care for clients 'get jerked' from New River LME---somehow---and rewarded to Daymark Recovery?

Yeah, and who framed Roger Rabbit and who was playing patty-cake with New River LME? (wikipedia: " When he shows Roger photographs of Jessica 'cheating' on him by playing patty-cake (literally) with Acme, Roger becomes distraught and runs away. This makes him the main suspect when Acme is found murdered the next day."http://en.wikipedia.org/wiki/Who_Framed_Roger_Rabbit

Marsha V. Hammond,PhD Licensed Psychologist, NC

NC mental health reform blogspot since 2007: http://madame-defarge.blogspot.com/