Wake will revamp mental health care

RALEIGH -- ******

CORRECTION

A story on 1B Tuesday incorrectly stated that that UNC's health care system is partnering with Wake County to create a new local mental health agency to oversee use of federal Medicaid funds. UNC is working with the county to study how services are provided. The county is separately developing a new agency to oversee mental health services.

****** People in Wake County who have problems with mental illness, developmental disabilities and substance abuse will likely be getting help under a new managed-care plan mandated by state legislators.

The Wake County Board of Commissioners is partnering with UNC's health care system and the state health and human services department to replace Wake's local mental health agency, which monitors and provides some care to eligible people with behavioral health problems.

The new agency, to be independent of Wake Health and Human Services, will oversee treatment based on per-person payments from Medicaid, the federal health care program for low-income people. Under federal health care reform, as many as 500,000 more North Carolinians could be become eligible for Medicaid in the next few years, making it crucial to rein in spending, state officials said.

"We are moving at breakneck speed to a whole new model of behavioral health care," said Beth Melcher, assistant state secretary for mental health, developmental disabilities and substance abuse services.

Under managed care, patients could benefit from higher quality and better coordinated care, said assistant county manager Joe Durham.

The changes, including the ability to dismiss providers who don't get results, are all part of pressure from the state and from the federal government to get a handle on costs in Medicaid, one of the most expensive entitlement programs.

"It's a very complicated process that involves lots of entities," said Kevin FitzGerald, chief of staff of UNC Health Care. "Wake County represents such a substantial portion of the state's population that it's really important that we get it right."

Wake commissioners were filled in on the proposed changes at a work session Monday. Board chairman Paul Coble noted that Wake County has made a priority of improving mental health care locally.

"We're here to provide services and they're short-term services," he said, referring to the treatment Wake provides at Holly Hill Hospital and the new WakeBrook facility.

"If we're not careful we could become the new gathering ground before people are sent to Butner," a state mental hospital, Coble said.

During an April meeting the Wake County Human Services and Environmental Services Board approved of the local control that the changes could bring, but suggested that planners should seek more community input in the form of public hearings.

Wake has to present a proposal to the state for its new structure by the end of September, although officials have asked for an extension. Some other North Carolina counties have already adopted a new plan.

Legislation by the General Assembly says all new arrangements must be in place by July 1, 2013.