Feds question payments for NC's mental health oversight

lbonner@newsobserver.comDecember 13, 2013 

— The federal government is questioning the way the state uses federal money to oversee community mental health care. The answers have the potential to upend the regional managed care system the state has developed with local governments.

The Centers for Medicare & Medicaid Services sent the state a letter in late October about the regional mental health offices. Under a state law passed in 2011, 10 regional offices receive a lump sum of Medicaid and state money to pay providers to treat people with mental illnesses, addictions and developmental disabilities.

The state has contracts with the regional offices to manage the money and networks of providers.

The letter from CMS says that the job the regional offices do should either be put out to bid so businesses could compete with counties for the work, or the counties should be paid based strictly on the work they do under a contract where they aren’t responsible for cost overruns.

“We recognize that changing a long-standing delivery system will take time and potentially state legislation,” the letter said. “We know the process begins with a frank discussion of these issues, which we would like to schedule in the near future.”

These suggested changes would partly unravel a mental health system that is still evolving and which local governments and providers are still adjusting to.

“Either way, it’s a substantial change,” said Bob Hedrick, executive director of the N.C. Providers Council.

Julie Henry, a spokeswoman for the state Department of Health and Human Services, said the state “is in conversations” with federal officials about their concerns, but has not met with them yet.

“We were very surprised by the letter,” DHHS said in a statement, which called the regional offices “important partners in our behavioral health system.”

Meanwhile the mental healthcare landscape continues to shift. Leaders of the regional offices announced Friday at their convention in Pinehurst that they were prepared to consolidate, forming four offices from 10. No timetable or regional boundaries were announced.

The state has been encouraging consolidation to increase efficiency.

In her convention address, DHHS Secretary Dr. Aldona Wos said she met with regional office leaders Friday morning and “was impressed with their commitment to consolidating and improving services for our citizens. I appreciate their effort and dedication to making our system stronger.”

Bonner: 919-829-4821; Twitter: @Lynn_Bonner

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