North Carolina State Spending On A Community-based Mental Health Program Drops 50% In One Year

Main Category: Mental Health
Also Included In: Psychology / Psychiatry
Article Date: 19 Nov 2008 - 7:00 PDT

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The State Department of Health and Human Services (DHHS) has reduced spending on a community-based mental health program by nearly 50 percent over the past year.

For the first four months of the current fiscal year, which began July 1, expenditures for Community Support totaled $183 million. Over the same period last year, July-October 2007, Community Support expenditures surpassed $355 million. The current spending levels are below even those of July-October 2006 - $195 million - when the program was less than a year old.

DHHS Secretary Dempsey Benton said the heightened efficiency has not come at the expense of Community Support recipients. "We have observed no systematically adverse conditions that hamper the ability of the 'at risk' population to be served," Benton said.

The Department has also observed an increase in the numbers of recipients served by other community-based mental health and substance abuse services, which are provided by more clinically specialized providers. "This means that consumers served inappropriately by large amounts of the basic Community Support service in the past are now more appropriately served by these new, more enhanced services," Benton said.

Community Support was launched in March 2006 as one of an array of community-based state mental health services. It was designed to be a time-limited service that helped adults and adolescents with a diagnosis of mental illness or substance abuse to be able to live and function in their communities while receiving other community-based services.

Reviews and audits by DHHS found that Community Support in many cases was not being provided appropriately. Problems ranged from paperwork and documentation errors to recipients who either received excessive amounts of the service or who did not have an actual diagnosis of mental illness or substance abuse.

Secretary Benton credited the one-year, 48-percent drop in spending to several factors:

• -- tightening service definitions, including an emphasis on Community Support as a clinical service that must meet acceptable medical standards;

• -- recouping payments from providers who either provided the service improperly or could not document appropriately;

• -- suspending enrollment of new providers;

• -- raising providers' qualification requirements;

• -- limiting weekly hours of the service for adults;

• -- performing closer reviews upon initial requests for the service;

• -- processing appeals more timely, which reduces costs for continued services while appeals are pending.

Additional provisions to the Community Support service are currently awaiting approval from the federal Centers for Medicare and Medicaid Services. These include even tighter service definitions, a tiered payment rate for providers and more upgrades to provider qualification requirements.

North Carolina Dept. of Health and Human Services
www.dhhs.state.nc.us