Every year, more than 300,000 people are served by the state's public mental health, developmental disabilities and substance abuse services system. We owe these consumers and their families the best possible service. We owe the taxpayers efficient and effective use of their money.

When Gov. Mike Easley asked me to lead the Department of Health and Human Services last May, he made it clear that my top priority is improving our state's mental health system. Since becoming secretary, a number of steps have been taken to do just that.

In January, a series of actions were announced to improve services in state facilities. As a result, the employees responsible for day-to-day operations of the state facilities report directly to me. This has enabled us to make a number of important changes -- including a complete restructuring from the top down at Broughton Hospital.

In my early days here, I met with dozens of individuals familiar with the system, asking them what they thought needed to be done. I found a lot of people with really good ideas. It became apparent that we needed to bring some of these fresh ideas to the table.

That's why we've convened two work groups of experts from outside the state system to help us improve services.

One group is focused on the state's psychiatric hospitals, addressing administrative and patient services issues associated with treatment, safety and employee working conditions. This group is putting together clear, practical procedures to be consistently implemented across the system.

Another group is developing a comprehensive strategy to improve community-based crisis services. That group is looking at which services need to be available in all areas of the state, what services currently exist and where to fill the gaps. This will include facility-based crisis services, mobile crisis and short-term inpatient treatment options.

We need to serve people in their communities, but we must ensure that there are appropriate and adequate services in these local areas when they are needed.

We have also worked to further tighten provision of Medicaid-funded Community Support Services.

Some of the actions we have taken include: changes in the definition of the service to focus on rehabilitation treatment, reduction in the hours of allowable benefits, increased provider training, and sanctions against providers that have acted improperly. These actions range from termination from the Medicaid system to requiring paybacks from providers based on a review of their records.

The department is also ensuring that more services are provided by professionals where appropriate, rather than people with high-school diplomas, which improves the quality of services. The spending on these services is now being reduced because of these efforts.

At Gov. Easley's direction, my job is to ensure that we have a safe, accountable public system for mental health, developmental disabilities and substance abuse services.

North Carolinians deserve a system that is well run -- providing a high standard of care and ensuring that tax dollars are well spent by closely managing costs. These changes will make certain that is the case.