sam's notes

notes on government, sports and popular culture

Thursday, December 08, 2005

......Sorry for the extended blank space. My time has been occupied with matters that require practical, as opposed to abstract, thinking: drying out a wet basement, sawing up a metal swing set, learning to use the mouse with my left hand, buying a Christmas tree.

I've also been doing research for an article on our state's mental health reform. Writing such an article is going to be tough, because the Winston-Salem Journal did an excellent job of covering the subject in this two-part article:

"The massive overhaul of the state's $2.3 billion mental-health system began with the best intentions. State officials hoped to improve the treatment of more than 358,000 North Carolina residents by moving patients from the state psychiatric hospitals to community programs.

"Better yet, the plan woud get government out of the business. Care for indigent patients wouls still be paid for by the state, but most treatment would be done by private agencies that would bill the state for their services."

Bottom line: the General Assembly mandated a reduction in psychiatric hospital beds and more streamlined adminstrative functions, with the savings going toward setting up local managing entities (LMEs).

But they're two problems: the money's not there (as it seemingly never is) and there's been a spike in psychiatric hospital stays. But there's one catch, in my view: many patients checking into psychiatric hospitals have substance abuse issues which could be managed through counseling services at the local level. So the trick is to direct those patients toward the LMEs, which is where officials want to direct the money.

It's an interesting problem. As one background source told me:

"We're not going to be able to do everything for everybody. The state just doesn't have the resources."


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