Health ruling gains steam

North Carolina soon might see an overhaul in the type of care mental health patients receive.

In a case that promises to have widespread ramifications for mental health care in the state, Wake County Superior Court Judge Howard Manning Jr. has ruled that the state must provide all mentally ill patients covered by Medicaid with every medical option they need.

He sent the case back to an administrative law judge to find out if the state is complying. The judge’s evaluation should be released in the coming weeks.

The case dealt with the care of a 16-year-old Henderson County resident, Thomas Reiter.

Reiter, an adopted child who qualifies for Medicaid, has several psychological disorders. His psychiatrist prescribed two vital services for his care — 24-hour crisis intervention and stabilization and a crisis response team available to transport him if he needed to be removed from the home.

Neither service is available in Henderson County, but Manning’s ruling will require both to be available by July 1.

The ruling is the latest in a string of good news items for state mental health care advocates.

In 2001, the N.C. House passed the Mental Health System Reform, which began a shift in the care of mental health patients from statewide institutions to county-level programs.

But the bill didn’t establish new services such as the ones required by Reiter’s psychiatrist, instead relying on the private sector to implement state-funded services.

The reform bill also established the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, which regulates care in the private sector.

Despite the agency’s work, there have been problems within some private group homes.

In September 2004, a 12-year-old girl died in a Charlotte group home when a staff member improperly restrained her. An investigation showed that the staff member had not been properly trained.

In response, Carmen Hooker Odom, secretary of the N.C. Department of Health and Human Services, announced a moratorium on the licensing of new group homes in order to review the standards of already existing facilities.

To combat problems such as these, Rep. Verla Insko, D-Orange, plans to introduce a bill this week in the House that would create 10 crisis centers across the state.

“When a child has a crisis, they need a place to go for a week or two until they stabilize. Right now, if a child had a problem, they would have to go to a hospital for a few weeks or a group home for six months.”

Insko said initial cost for the crisis centers would be about $50 million, but the centers would be self-sustaining after they were built because Medicaid would provide funding.

Her proposal would further the transition from institutional to community mental health care.

“Studies have shown that home health care for mental patients is more effective in the long term and is ultimately cheaper,” said Sen. Ellie Kinnaird, D-Orange.

“There is a great deal of effort involved, especially in finding money. But right now, we’re figuring out where we are going, how to get there and how to not go broke.”

Contact the State & National Editor at stntdesk@unc.edu.