State chief: AMHC not denied waiver

By REGGIE PONDER
Staff Writer

Monday, January 05, 2009

The state’s top mental health official said Monday that her office wants to work with local officials to provide for mental health and related services in the Albemarle area.

Leza Wainwright, director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services of the N.C. Department of Health and Human Services, also said she wanted to set the record straight about reports the state had denied Albemarle Mental Health Center the waiver needed to continue providing direct services in the area.

“That is not true,” Wainwright said. “It’s not true that the state would not grant that waiver.”

She said the waiver had been approved though 2009 and could have been considered for renewal for future years.

“It’s a year at a time,” she said.

Wainwright said that if an audit of AMHC —expected to be completed this week —shows serious problems with local management of services, her office’s first choice would be to work with local officials to fix the problems.

Since the local management entities (LMEs) are created by counties, the division’s preference is for the 10 counties in the area to develop a plan to correct any deficiencies in AMHC’s performance, she said.

But if the counties are unable to come up with an adequate solution, Wainwright said, state law gives the division three options.

If an LME is failing to perform one or more functions satisfactorily, the state office can put it on notice, develop a plan for correcting the problem and work with local administrators over a three-month period to correct the problem. If, at the end of three months, the problem persists, then state officials can farm out that particular function to another LME in the same region, she said.

The second option, applicable to a severe problem in fiscal management, would be to “take over (the LME’s) ... financial management,” Wainwright said. State officials recently took over financial management of the Southeastern LME in the Wilmington area, she said.

The third — and most drastic — option is for the Division of Mental Health to take over LME functions, contract directly with service providers, “and go all the way up to and through abolishing the board of the local entity and establishing a caretaker board,” Wainwright said. “We’ve never exercised that option, but that is the ultimate authority that the state would have.”

Wainwright said she hoped none of the more extreme alternatives would come into play at AMHC.

“Our preference would be to work with those 10 counties,” she said.

As AMHC changes from providing direct services to working entirely with private providers, Wainwright said she knows there are good private providers available but has “some concern about the ability of existing private providers to ramp up very, very quickly.”

She said she was particularly concerned given that the division’s awareness of the financial problems at AMHC “began with complaints from private providers that Albemarle wasn’t paying them.”

That history could make some private providers reluctant to step in and fill the gap, she said.

Wainwright said she also was concerned with the way AMHC was handling the decision to close the 23-hour crisis unit at the hospital. She said she understood the AMHC Board of Directors was planning to discuss a plan for crisis services at a board meeting tonight.

“What’s the plan?” she asked. “I would hope the plan would be in place before you made the decision to close the 23-hour” center.