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NC Shifts Mental
Winston-Salem Journal (NC) - 7/13/2012
State legislators passed a bill recently that provides more power to groups that oversee behavioral health services in the state.
Senate Bill 191 was passed by a 29-10 vote, a day after a House version of the bill passed by a 115-1 vote. The bill would become law if Gov. Bev Perdue signs it.
The bill has received criticism from local and state advocates for shifting much of the oversight of a managed care organization from county commissioners to the N.C. Department of Health and Human Services. The benefit for county governments, particularly those with tight budgets, is that the changes could limit their liability for MCO overspending and put it on DHHS.
A more controversial change -- creating a new category of oversight group called a behavioral health authority -- was removed from the bill June 21. A BHA would not have been required to have any advocacy group members on its board.
The bill affects 11 local management entities, or LMEs, such as CenterPoint Human Services -- 10 of which are becoming MCOs under the Medicaid waiver program being rolled out by Jan. 1.
The waiver program is intended to combine the management of Medicaid and state funds at the community level to reduce costs and add more accountability. MCOs would operate with fewer restrictions on how they manage the mental-health, developmental-disability and substance-abuse providers and services they oversee.
State Rep. Nelson Dollar, R-Wake, a co-sponsor of the bill, said, "The concept of BHA will likely be looked at in the future, but I think the primary focus over the next year or two will be the successful conversion of the LMEs to LME/MCOs fully functioning in the waiver environment."
Perhaps the most controversial portion of the bill is allowing MCOs to keep as confidential "competitive health care information." Advocates have protested the confidentiality inclusion, saying an MCO should not be allowed to designate information or products as proprietary -- then license them as a revenue stream -- if they were developed through taxpayer money.
Laurie Coker, a local advocate who served on a subcommittee that provided recommendations on the bill, said the bill reflects agreements derived from "a level of critical discussion rarely had in committee meetings that involve such a variety of perspectives."