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State plans to consolidate mental health centers

Fayetteville Observer (NC) - 2/14/2014

Feb. 14--Less than a year after Cumberland County's mental health center merged with a larger body, the state looks set to push through more consolidation.

A draft plan would combine Alliance Behavioral Healthcare -- which serves Durham, Wake, Johnston and Cumberland counties -- with a neighboring eight-county group.

Statewide, the plan condenses the 10 current organizations into four.

The proposal pairs Alliance with Sandhills Center, which has eight member counties, including Lee, Harnett, Hoke and Moore.

The plan requires legislative approval. Whether that will happen this year has not been determined.

A news release from the state Department of Health and Human Services said DHHS will work with the organizations, and the Council of Community Programs that represents them, on a timeline for consolidation pending final approval of the plan.

It's part of a shift to managed care in public mental health funding, with each organization given a block of federal funding according to its population of Medicaid-eligible patients, rather than receiving the money case by case. The money is paid to private providers in each county who offer treatment.

State regulators say the model is more efficient and saves money.

Over the last decade, the state has gradually upped the number of people an organization must cover in order to receive funding. Last year, that forced Cumberland to merge with Durham-based Alliance.

The county got four seats on the Alliance board as part of the merger. One of them, county Commissioner Kenneth Edge, said he hopes that merger will be given time to work before the next wave of consolidation is approved.

"We're so young," he said. "Some of these other organizations have been merged for a long time."

Cumberland, which spends about $4 million on mental health care each year, loaned Alliance $1.6 million for start-up costs as part of the merger agreement. Wake and Durham also made loans.

Edge said Alliance has the money to repay the loan this year, but has asked the counties to defer the payment for a year so Alliance can invest in new technology.

That will require approval from each county board. Once repaid, the money would be returned to the county's mental health reserves.

How the consolidation plan would affect that loan is not known.

"We don't know, if we go with Sandhills, how much money it's going to cost us," Edge said.

Nor is it clear how each county would be represented in such a large organization.

"It's going to happen; we just don't know when it's going to happen or how," Edge said. "I think our clients are being well served. We just need to be patient until we find out what the state's going to do."

Staff writer Gregory Phillips can be reached at phillipsg@fayobserver.com or 486-3596.

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