More problems for a broken system
At a board meeting for Western Highlands Area Program this morning, parents came forward to talk about how their children were being left to fend for themselves in a system where funds keep shrinking while the needs keep growing.
Western Highlands manages the care for people with developmental disabilities, mental illness and substance abuse problems over eight counties in Western North Carolina. Last week, the board of directors learned that the agency was $3 million in the red on Medicaid cost overruns.
This is just the latest crisis in a system that has imploded since “mental health reform” began 10 years ago. Before the system was “reformed,” area programs offered serviced and case management for people with mental illnesses, developmental disabilities and substance abuse issues who didn’t have private insurance and relied on Medicaid or state-funded services for their care.
“Reform” privatized the system before Medicaid service definitions (sort of a job description for service providers) or rates were in place, and then changes were made to the system almost weekly as service providers began to fail on a large scale.
Reform was declared over two years ago, but the changes didn’t stop, and the new GOP-controlled Legislature slashed funds for the Department of Health and Human Services, which operates the system.
Seven months ago, Western Highlands was given the go-ahead to offer case management, but the agency wasn’t prepared and a week ago, the board learned it was $3 million in the red. Agency head Arthur Carder was fired, and Charlie Schoenheit stepped in as interim CEO. Schoenheit has been with the agency since well before reform was enacted and will lead it until a new CEO is hired.
The agency came up with a plan to cut some of the rates it pays to service providers, but, thankfully, the state Division of Medicaid Services said rates can’t be cut because it would cause some providers to leave the system and have a negative impact on access to services.
But parents are saying their children’s services are being cut nevertheless.
Rebecca Demmer has two sons with autism, and they could lose services. One lives in an adult care home that is about to lose Medicaid services because more than 50 percent of the people who live there have psychiatric illnesses. He can’t move because there is nowhere for him to go. Her other son lost all services except supported employment because his level of care was changed.
David Demmer, 21, the younger of Rebecca Demmer’s two sons, was living in the home of Sue Arata, who said she received a call one afternoon to tell her he had to be moved out by 8 the next morning.
“Just like that, he had to be out,” Arata said. “They changed his level of services.”
Demmer is afraid her other son, Christopher, 26, also will lose services when his treatment plan comes up for review later this year.
Alexis Dumbar told the board that her two sons, Cameron and Christian, need services. Her older son, Cameron McCullough, 21, spoke for himself.
“Please don’t cut off stuff that is very necessary for me and others,” he said. ” I’m here wanting to be on my own. I want to own a home, I want to marry someone. Please open your hearts and let us live our lives to our best potential.”
Western Highlands board member Charles Vines said he believes the state is complicit in the mess because they audited Western Highlands and deemed the agency ready to take on the new task of case management.
Lindsay O’Keefe, a services provider who specializes in post-traumatic stress disorder, reminded the board that the Value Options, the Virginia-based company that provided case management services previously, was paid 17 percent more than Western Highlands gets for the same services.
Several service providers said they are on the edge of collapse, and if rates or services are cut, they will fold.
Child psychologist Jerry Coffey said that many of his colleagues don’t accept Medicaid anymore because reimbursements are too low and paperwork is too onerous.
Attorney Curtis Venable, representing Mission Hospitals, said the hospital wants service providers to survive and thrive because when the system fails, people land in the emergency room, which is ill-equipped to care for them properly.
“Don’t let (the state) pressure us to rush to a solution,” Venable said. “You have the opportunity to do this right and move us forward.”
Tags: Patient Pals & Family Friends
Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.
We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.
Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.
Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.
Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.
Family Friends are there to help caregivers and other family members grow into their new role.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
Life o’ Mike honors Joe Eblen
Life o' Mike presented its first Michael T. Danforth Community Service Award to Joe Eblen at a luncheon on June 8, in the Friendship Hall of First Congregational Church, 20 Oak St., Asheville.
Joe, seen here with Leslie Boyd, left, and his wife, Bobbie, has spent his life helping children and families, both as a coach and game official for more than 60 years, and as founder of Eblen Charities.
Start From Seed
Life o' Mike has a new program- Start from Seed (SFS).
SFS is a volunteer doula program aimed at providing non-medical, comprehensive support to low income, high-risk women and families of Buncombe County focusing on three areas:
1. We help new doulas with certification and training in return for their participation as a volunteer doula for SFS
2. We mentor volunteer doulas with their first few clients
3. Our volunteer doulas provide birth and postpartum doula services to low income, high risk moms, providing support and tools to empower them as a new parent.
A birth doula is a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; a postpartum doula provides emotional and practical support during the postpartum period.
Start from Seed clients are referred to us from the Buncombe County Department of Health’s Nurse-Family Partnership Program, Western North Carolina Community Health Services, and Mission Hospital. The Program is intended and designed for growing clients’ inner strength and helping them gain empowerment to help them cope with the emotional, physical and mental challenges of childbirth, labor, and motherhood.
Our new moms and their infants have many needs. If you would like to help them get off to a good start, please visit our Start from Seed web site: Start from Seed, or call Program Director Chelsea Kouns at 804-814-9946.