Dr. Harold Carmel's April 25 Point of View piece "A dismal mark indeed," gives a misleading impression of North Carolina's commitment to the mentally ill.

Carmel first blames the state for apparent abuses among some providers of community support services. This is akin to blaming the banks for Jesse James. The department has taken steps to address these abuses, ensure that they do not recur and refer cases for criminal prosecution as necessary.

More shockingly, Carmel accuses the administration of failing to fund mental health adequately. He fails to note that the governor recommended, and the General Assembly enacted, substantial increases in the mental health budget for the current year. He fails to note that the state allocated the majority of this money in August for local management entities to spend on eligible clients.

However, a substantial amount of the money that has been sent to the LMEs -- approximately $93 million -- will not be spent this year. It would be fiscally irresponsible to allocate even more money when the LMEs apparently cannot spend what they have, given all of the needs facing the state that could use the money wisely and prudently right now.

Finally, Carmel fails to note that mental health reform was a legislative response to a 1999 federal court case and a state audit of the system. The changes in law were dramatic, and the administration suggested a more phased-in approach that assured clear accountability.

This administration has increased support for crucial mental health services through the Medicaid and mental health divisions by $250 million since 2001. Money is available but has not been spent by these local groups, which are not directly accountable to state government. These are serious challenges to vulnerable people. Unfounded accusations do not help these people in crisis at all.

Dan Gerlach

Senior Policy Adviser for Fiscal Affairs

Raleigh

(The length limit was waived to permit a fuller response to the article.)

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