Although the agenda for the Legislative Oversight Committee had not specific DD updates, we did think the following information would be of interest to members of our community.
The first Mental Health, Developmental Disability, and Substance Abuse Services Joint Legislative Oversight Committee of this legislative interim took place on Wednesday, September 8, 2010.
The meeting opened with the introduction of members and a review of the legislative changes that were made during the 2010 session.
Secretary of Health and Human Services Lanier Cansler addressed the members of the committee with a comprehensive review of the changes occurring inside the Division of MH, DD, SAS.
On the topic of Dorethea Dix, Secretary Cansler explained that there were no appropriations made to operate the Dix facility during this biennial. The proposal to close Dix will need to be presented to the Council of State. If approved by the Council of State a bill will be presented to the members of the legislature during the long session. A bill will need to pass the legislature for Dix to be closed.
When members of the committee questioned the dispersion of the Dix beds and the forensic unit, Secretary Cansler stated that the 26 bed minimum forensic unit will remain at Dix and that there will be no reduction in total state beds. There will be increases in beds at Cherry and Broughton that will reflect the number of beds that will close at Dix.
Secretary Cansler did state that even with the changes at Dix the state will be operative at 14 million over budget.
Deputy Secretary of DHHS Mike Watson gave an update on the implementation of CABHA (Critical Access Behavioral Health Agency). Watson began the presentation with a review of the basic CABHA service requirements and the certification process. Currently there are 67 certified CABHA’s (67%-for profit). In addition there are 30 CABHAs that are completing the Medicaid enrollment process and an additional 14 that are in the enrollment process.
In a review of the distribution of CABHA required services Deputy Secretary Watson stated the following:
5 counties=1 CABHA
50 counties=2-5 CABHAs
36 counties=6-10 CABHAs
2 counties=11-15 CABHAs
3 counties=16+ CABHAs
There are 4 counties that do not currently have consumers receiving CABHA required services. Watson specifically addressed the lack of CABHA services in the ECBH LME catchment area. Currently there are 170 new applications that are beginning the CABHA process.
One of the concerns that was brought up by Representative Earle was how do the providers that have completed the CABHA process merge into the two new 1915 b/c managed care waiver sites. Deputy Watson stated that the division would recommend that the LME accept all of the CABHAs in that catchment area. However, it is clear that there are no specific guidelines on how to make this merger or how to protect the CABHAs during the transition.
The final presentation of the day was on the transition of youth from the Level III and Level IV group homes. The presentation began with a review of the legislation and the state guidance offered on how to transition youth out of Level III and Level IV homes.
Prior to the legislation, there were 2532 youth in Level III homes and now there are 620 remaining. This is a difference of 2608 youth in this placement. For Level IV homes there were 133 youth in these residential services and currently there are 29 youth remaining. There is a concern over where the youth went and did the child succeed in the transition back to the community. To address these concerns DMH is working with UNC Behavior Health Research to follow up and study the status of the youth who were discharged from the Level III and Level IV residential settings.