New Mental Health-Care Policy Has to Change, Easley Says
Posted February 7, 2008
Raleigh, N.C. — Gov. Mike Easley says he believes the state can work through issues with a new mental health-care policy that has thousands of families in the state concerned about care for their mentally disabled loved ones.
The Department of Health and Human Services policy, Implementation 35, limits the hours family members can get paid to care for mentally or developmentally disabled relatives who would otherwise be placed in an institution.
The state plans to have health-care providers from outside the home go in to cover the remaining hours for which it has been paying relatives.
As the policy stands now, there are no exceptions.
"One size does not fit all in health care, whether you're talking about mental health or physical health," Easley said. "We have to design different plans for different people."
Implementation 35 is a concern for Bill Hancock, of Bailey, who is unsure whether he will be able to find a provider to care for his 25-year-old son, Wayne, when the policy goes into effect Feb. 22.
Wayne was 80 percent brain dead when he was born, and he requires constant care. Deemed qualified by the state, Hancock has cared for him his entire life, receiving compensation for 105 hours each week.
Under Implementation 35, the state will pay him for 50 hours a week.
Hancock says he has not been able to find an outside provider, and with a shortage of nurses, he might have to place his son in a state facility.
"I think that (Implementation 35) has to be changed," Easley said. "It's simply not going to work if there's not a health-care provider in the area, and you have someone in need of help and the family member is offering to help, then you're going to have to have a plan and a protocol to deal with that situation."
Medical providers admit there is a nursing shortage across the state and expect it to continue for years.
"If they haven't found a provider yet, they're not going to have one on Feb. 22," said Annaliese Dolph, an attorney for the Raleigh-based nonprofit Disability Rights North Carolina.
Dolph says placing mentally disabled patients in institutions will cost the state more than paying family members to care for them.
"Fiscally, it is cheaper to maintain someone in the community than to have them in an institution," she said.
She says there also could be costly legal issues with Implementation 35 if the policy does not provide an accommodation for situations where it doesn’t work.
"The issue here in North Carolina, and the way the policy is being implemented, is there are no exceptions," Dolph said. "And so, if there is a family in rural North Carolina who cannot find a provider to take on these extra hours, then they may simply not get all the services they should have access to (under law)."
The new policy, which Easley says is the DHHS's response to a federal mandate, does not require state lawmakers' approval.
After receiving e-mails and phone calls to his office, Sen. Larry Shaw, D-Cumberland, who opposes Implementation 35 as it is, sent a letter to DHHS Secretary Dempsey Benton asking for a moratorium on the policy.
Shaw wants to introduce a bill during the next legislative session to stop the policy, but the session doesn't begin for three months.
"I think we're all hoping – and Sen. Shaw's letter certainly indicates – that this doesn't go into effect under the harsh guidelines that are being put out there now," Dolph said.
"I think we're all hoping that accommodations will be allowed to make this policy workable and practical and not discriminatory."
Benton has not responded to Shaw's request, but Easley said he has faith Benton will be able to alleviate some of the concerns raised.
"At some point, you have to get away from rules and regulations so much and concentrate on what is in the best interest of the person you're trying to help," Easley said. "And sometimes, these rules and bureaucracies get in the way of what it is they're designed – and really do want – to do, which is help the person."
"And we're not going to have that problem here (in North Carolina). We're going to work this out."