State mental health officials are willing to give local offices power to manage patient care -- but only if those offices are willing to merge with their neighbors.

Dempsey Benton, head of the state Department of Health and Human Services, wants the legislature to consider a plan that would have 25 local offices consolidate to form nine regional offices. The state pays the local offices about $132 million for administration, and DHHS wants savings.

Regional offices would share in savings and would regain the job of authorizing mental health services for Medicaid patients.

About two years ago the state hired a company, ValueOptions, to do the work. Local offices complained, and some legislators blame the decision for the exploding costs of a basic mental health service called community support. Medicaid pays most of the bills for public mental health care.

The local offices continue to authorize care for patients whose care is paid for with state and local money. That's typically for patients not poor enough to qualify for Medicaid but who don't have private health insurance coverage.

A report by Mercer Government Human Services Consulting said having separate systems is a bad idea. "It's nearly impossible to manage a system with state money separated from Medicaid money," said Kathy Sternbach, a Mercer project manager.

3-year transition

On Thursday, Benton presented a timetable to a legislative mental health oversight committee that would have the first regional office open by the year's end, with the mergers complete over three years. The mergers are part of a plan that includes building a statewide network of professionals who can respond to emergencies and having the state pay for doctors, nurses and social workers at local clinics.

The local offices have a spotty history of cooperation. None developed regional plans for emergency services when asked to a few years ago. Yvonne Copeland, executive director for the local mental health offices' association, said she did not know whether the lure of regaining some powers would entice local offices to merge.

Not all legislators on the committee agreed that mergers were a good idea. Even those who want consolidation said Benton's timetable was too aggressive. Rep. Beverly Earle, a Charlotte Democrat, said that, with all the problems the state mental health system has, mergers aren't a priority.