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Mental Health agencies merge

WINTON – Two public agencies overseeing access and management of services for mental health, substance use and intellectual/developmental disabilities have entered into a formal agreement to consolidate the organizations. The Boards of Directors for Wilmington-based CoastalCare and Greenville-based East Carolina Behavioral Health (ECBH) have agreed to form one new agency as of July 1.

The new public agency will manage state funds and Medicaid dollars for behavioral health services across 24 counties in eastern North Carolina.

East Carolina Behavioral Health (ECBH) currently services 19 counties from the Virginia state line to the Crystal Coast: Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Hertford, Hyde, Jones, Martin, Northampton, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, and Washington.  Coastal Care services from the Crystal Coast to the South Carolina line: Brunswick, Carteret, New Hanover, Onslow and Pender counties.

This consolidation is in line with the Medicaid Reform Plan developed by the NC Department of Health and Human Services and endorsed by Governor Pat McCrory.

“We believe that this consolidation will create an even stronger organization than we are currently as separate agencies and will position us to provide even better services to individuals in our 24 counties who need mental health, developmental disability and substance abuse services,” said Bland Baker, Northern region director, in addresses this week to the Boards of County Commissioners, first in Hertford County, and later in Bertie.

“If a multi-area program has above 1,250,000 consumers, then the rules state that they may propose an alternate board structure, which is what I’m here to talk about,” Baker said in introducing the new proposal to the Commissioners.

The merger would make the new organization service a population of more than one-and-a-quarter million consumers, which in turn allows it to alter the board structure from its current form.

A two-tiered board structure is proposed in order to keep the governance at the local level with the use of regional advisory boards, which in turn would elect representatives to the governing Board of Directors.

Currently, the four Roanoke-Chowan counties (Gates, Northampton, Hertford, and Bertie) plus Martin, Chowan, and the finger counties are located in the northern region of the merger area. The other two regions will be the central and the southern region that complete the 24-county conglomerate.

“Each of these regions will have equal representation (on the advisory board) that will make recommendations to form the governing board,” Bland continued. “That representation consists of one county commissioner or designee, and one appointee. That appointee follows someone in the expertise area: Social Services, financial experience, or health care experience. The regional boards would also involve local stakeholders responding to the unique community needs and priorities, as well as promoting understanding and collaboration at the local level and providing local participation in monitoring the performance and services within each region.”

The Boards’ jobs include evaluation, recommendation, and identification with regard to member counties within the region.

“They would have to identify community needs and concerns and monitor the resolution of those concerns,” he added. “It also includes monitoring services on a local level. They’d look at things like access to care; that people are getting the services they need when they need them, and make recommendations on improving those services.”

Bland said the regional board would also report to the counties, responding to any concerns and giving feedback, approving the by-laws.

The other board in the two-pronged system would be the Regional Advisory Board consisting of a county commissioner, a Consumer Family Advisory Committee (CFAC) member, and two appointees, hopefully someone with experience in finance, insurance, healthcare, and the like.

“In summary, we’ve got three regions covering 24 counties, which means three regional advisory boards to maintain that local presence, and to address the needs of those communities at the local level,” Bland stated.  “There would be direct representation of this group up to the Regional Advisory Board up to the governing board and the CFAC’s would be members of both boards as well.”

Bland said consolidation was voluntary and that the state had allowed most of the Medical Care Organizations (MCO’s) to supervise their own mergers, lest it become mandated.

“We’ve sort of tried to be pro-active,” Bland stated.

Commissioner Johnny Ray Farmer deemed the consolidation plan and the formation of the two boards as an excellent plan.

“With this new organization of the board we’ll have at least one county commissioner, a CFAC, and two other persons from the business community representing our county instead of one,” Farmer said.

Bland, an 18-year veteran of the mental health field, said he would be the contact person for any issues within the 10 counties of the region or the area.

“Because we’ve gotten so big, having a regional board at the local level creates a connection,” Bland said. “This gives everybody some representation.”

Bland made a similar presentation before the Bertie Commissioners the following day and the Boards in both counties approved the resolution of support for the re-structuring of the MCO group.

“What happens if one (of the 24) county doesn’t agree to this resolution,” wondered Hertford County Manager Loria Williams, referring to any counties that might dissent.

“I’m hoping we would be able to persuade them to come on board,” Bland replied.