RALEIGH -- As North Carolina's leaders struggle to balance its budget, they are considering proposals to outsource parts of the state's troubled mental health and probation systems.
Lanier Cansler, secretary of the Department of Health and Human Services, said this week that he is considering privatizing the care of about 80 mental patients at Dorothea Dix Hospital in Raleigh in a unit for patients accused of crimes, including rape and murder. The patients are awaiting trial or have been found not guilty by reason of insanity.
"We're not saying this is a road we particularly want to go down," said Cansler, who was previously a lobbyist for private contractors working for the agency he now heads. "But when we're dealing with budgets and all the issues we're dealing with, we continue to look at ideas for how we might do something different or better or save money."
Cansler said he had met with representatives of at least three companies wanting to privatize part or all of the state mental health care system. He said he does not favor outsourcing the management of all care.
Among the lobbyists Cansler said he had met with is Franklin Freeman, a senior aide to former Gov. Mike Easley and now a partner with Easley at the McGuireWoods firm, which does law, lobbying and public relations.
Easley, a Democrat in office from 2001 through early 2009, oversaw the state's effort to reform the mental health system, drastically downsizing hospitals in favor of a plan to outsource treatment to private care providers. The result was long waiting lists for admission to state-run mental facilities, and community hospital emergency rooms jammed with mentally ill people who could not find treatment.
Among other clients, McGuireWoods represents The GEO Group Inc., a Florida-based company that provides prison and mental health management services to governments in the United States and foreign countries.
Perdue's spokeswoman, Chrissy Pearson, said Wednesday that the governor has discussed privatizing the care of the Dix patients with Cansler and that she is open to the idea. Pearson said she didn't know whether the governor has met with lobbyists about privatizing parts of the mental health system.
"She meets with a lot of people about a lot of things," Pearson said.
Rep. Verla Insko, a Chapel Hill Democrat who is co-chairwoman of the legislative oversight committee for mental health, said Freeman and another lobbyist, Ed Turlington, visited her to discuss privatizing the mental system.
Turlington, a lobbyist for Brooks Pierce, is a former campaign adviser to presidential candidate John Edwards and a current member of the Democratic National Committee, according to the firm's website. His client list includes UnitedHealthcare Services Inc., a national health care provider.
Insko said she does not support further privatization of the state mental health system.
Insko's objection
"They make their money by sometimes cutting services people need," Insko said. "My first preference is for the public sector to manage taxpayers' dollars correctly and not depend on a private sector company to do it."
Neither Freeman nor Turlington could be reached for comment Wednesday.
In addition to discussions about privatization in mental health, a special provision in the state Senate budget proposal calls for a possible pilot program for privatizing the supervision of low-risk offenders on probation.
The measure came as a surprise to Tim Moose, director of the state Division of Community Corrections.
"It's not anything we knew about," Moose said. "We would do, you know, what we were asked to do. But it's not something we would prefer, I'm sure."
The budget provision was inserted at the behest of Senate leader Marc Basnight of Manteo and Sen. Charlie Dannelly of Charlotte, both Democrats.
The state probation system has received intense scrutiny. In 2008, two young probationers were charged with the shooting death of Eve Carson, the UNC-Chapel Hill student body president.
Other states' changes
Dannelly emphasized that several other states have privatized elements of their probation systems. He said the idea for the study came after a meeting with a state probation officer who is one of his constituents.
Dannelly and Basnight refused to name the officer.
"He explained how, if you privatize, they could handle more cases," Basnight said. "He was really fantastic in explaining a model."
The officer spoke from personal experience but also apparently had an interest in competing for the contract if part of North Carolina's probation services were privatized, both Basnight and Dannelly said. "One could easily presume that he would be interested in having the contract," Dannelly said.
Pearson said Perdue is open to the idea of privatizing probation, but the governor is not pushing the idea.
"It's not so much about whether the officers are state employees or [private contractors], as much as it's about well-trained qualified people who are doing their jobs," Pearson said.
Sen. Martin Nesbitt, the majority leader and a co-chairman with Insko of the mental health oversight committee, illustrated his concern about privatization by recalling a experiment with it at the Department of Correction.
"We tried privatizing a prison, and it didn't work," said Nesbitt, an Asheville Democrat. "We've got enough problems in mental health already. I don't want to tempt some private company to make money on the backs of people with mental illness."
