County searches for mental health ally

After rejecting a merger with the mental health management system in Alamance and Caswell counties, Orange County’s provider is searching for other partners.

Judy Truitt, area director of the OPC Area Program that serves Orange, Person and Chatham Counties, said the program withdrew from negotiations with Alamance-Caswell Local Management Entity in December.

“The board felt that our goals were not in sync and that we were working for different outcomes,” Truitt said. “At this point we are in several discussions, we are moving forward.”

But the program, which manages publicly-funded mental health, developmental disability and substance abuse services is still looking for another mental health program to merge with.

A merger would consolidate services and save the state money.

Truitt said OPC is the fourth smallest local management entity in the state. She said the state is putting pressure on these smaller entities to merge to reduce the number in the state.

“The state is interested in continued mergers because it would be cost saving,” Truitt said.

Alamance-Caswell, which dropped below the state’s required service population of 200,000 after Rockingham County dissolved its membership, began to look for other organizations to join with to meet state requirements last year.

Alamance-Caswell officials have written a memorandum of agreement to merge with Piedmont Behavioral Healthcare after plans to combine with the Orange-Person health care management organization fell through, but nothing has been finalized.

David Carter, chairman of the Alamance-Caswell board, said the board began to meet and talk with other entities but decided on Piedmont Behavioral Healthcare because of its vast experience in the Medicaid system.

Mental health care providers are also encountering regulations because of a reform movement aimed at providing better services to county residents.

The introduction of the Critical Access Behavioral Health Agency system required smaller providers to conform to certain state regulations to receive Medicaid reimbursement funds.

To fit the model, agencies must provide five core services, such as outpatient therapy and a community support team.

“There were services that were not being offered by these agencies because they were not lucrative,” said Mark Van Sciver, spokesman for the N.C. Department of Health and Human Services. “They were only providing services that were making money.”

Van Sciver said some providers did not fit the requirements and were forced to merge with others to fit the model.

Truitt said the system has addressed many problems, but no one anticipated how many agencies would be certified as Critical Access agencies.

As of January, 1175 agencies had been certified, according to a speech by Beth Melcher, assistant secretary for mental health, developmental disabilities and substance abuse services for the health and human services department.

“That was an unintended consequence of the CAHBA effort. The state thought a lot of the agencies would not be able to achieve the status,” Truitt said. “We have limited resources — (the state) can’t support all of the providers.”

Carter said he has mixed feelings on the health care reform that sparked these new regulations.

“It’s hard to move forward when we don’t have the funds to back it up. Someone isn’t receiving the services they need,” Carter said.

“Did North Carolina handle it the best way they could? No, absolutely not.”

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