Why ALL the NC LME's Will Suffer Shortfalls: the Private MH Companies Creates by NC Mental Health Reform are STACKING SERVICES
I posted this as re: my comments associated with the article associated with Forsyth County commissioners being asked to cough up some more money for that part of the state as associated with the Medicaid Waiver. Sorry: don't do it. Until the commissioners figure out that it is the STACKING OF SERVICES BY THE PRIVATE COMPANIES which was allowed by NC DHHS, each one of the LME's is going to ask each county's commissioners for a 'loan' re: this Medicaid Waiver. These are my comments and this information is anchored by the article associated with the 'reason' that was given as to why WHN LME was $3 million in the hole pertaining to the firing of the CEO for 12 years, Arthur Carder.
Here is the news article and below that is my comment which was posted:
UPDATE: Backers of CenterPoint Human Services ask Forsyth County Board for $1.5 million
"The LME's are suffering a shortage of money due to the process that NC Mental Health Reform put into place, as deemed by the NC state legislature, which was to create private companies (the argument was that competition was 'good' for the business: nevermind that mental health consumers have no money and it is public money e.g., medicaid, medicare).
These private companies STACK SERVICES which is to say that if a Medicaid consumer is referred to a company by the LME, which they always are (I have not been allowed, as a solo provider to work as an In Network Provider for Western Highlands Network LME in western NC), the clients/ consumers are given the following services by such a company: CST (Community Support Team: enhanced beneficts); therapy; PSR (Psychosocial Rehabilitation; the client attends 'classes' 5 days/ week, 9 to 3 pm, as associated with a more or less cognitive rehabilitation model), etc..
Arthur Carder, CEO of WHN LME for about 12 years now, was fired about two weeks ago as WHN LME had a shortfall of $3 million and the reason given in the well written news article (see my blog: google up: Marsha Hammond Madame Defarge: if I put the URL in here, this will not post) was that STACKING of services had caused the shortfall.
So, NC DHHS, in conjunction w/ NC State Legislators, have created the mini-monsters which are the private companies which stack services.
I have several clients who continue---as they have for some time---to receive therapy services from me (they are dually eligible clients, w/ Medicare always being primary and paying the bulk of the fee and medicaid being primary) who receive Medicare services from me and these stacked services which are paid for by Medicaid ONLY.
This is idiocy. I am a doctoral level psychologist, who knows well my clients, is able to render an array of services for clients, and yet these private companies, put into action by NC Mental Health Reform, are going to bankrupt Medicaid as associated w/ mental health services in NC due to the STACKING OF SERVICES.
This asking for money will not stop until this STACKING OF SERVICES matter is tackled.
Oh, did I mention that we need a ONE PAYER SYSTEM which would collapse Medicaid and Medicare into one entity such that these kinds of duplicitous services could not take place. "