Gov. Pat McCrory's administration pledged Thursday to repair North Carolina's struggling system for treating people with chronic mental illness and substance abuse, but provided few details about how it would fix the problems.
State Department of Health and Human Services Secretary Aldona Wos called a news conference to announce a new Crisis Solutions Initiative to include government officials, health care professionals, law enforcement and patient advocates. She said the new panel will study local programs around the state that are having the most success getting people help.
Wos pointed to the longstanding problem of people with mental illness languishing for days in hospital emergency rooms while waiting for scarce inpatient psychiatric beds, as well as the confusing and often limited options for patients seeking more routine treatment in communities where they live.
However, Wos provided few specifics, including how much those fixes might cost or where the money would come from. She said her agency is only at the beginning of a very long process.
"We will ask this coalition to assess our existing structure in the state and recommend possible policy changes to help break down the barriers to care for our patients," Wos said. "We will succeed. You have my continued pledge that I, my devoted staff, will continue to work with each other, will continue to work with all of you, to make sure that we provide the best possible service for the citizens of our state."
She said the new proposals would be data driven, with accountability provided through a new "scoreboard" tracking key statistics about ER visits and hospitalizations already collected by the state.
McCrory appointed Wos, a wealthy Greensboro doctor and Republican political donor, to lead the state's massive health and human services agency in January. Her tenure has resulted in sharp criticism from members of her own party over six-figure contracts awarded to politically-connected advisers and high salaries for young ex-campaign staffers with little or no experience in the areas they were hired to oversee. The agency also bungled roll outs of pricey new computer systems for processing Medicaid claims and food stamp applications.
After Wos finished her remarks, she hustled out of the room with aides without taking any questions from the media.
McCrory did not appear with her but said in a statement saying improving mental health services will be a "top priority" for his administration.
"By bringing people together to implement strategies that work, we can better serve the thousands of North Carolinians who struggle with mental illness and substance abuse," said McCrory, a Republican.
In pledging to find solutions, McCrory and Wos are taking on one of the thorniest and most complex problems in state government.
Democratic Gov. Mike Easley and state legislators initiated an ambitious reform plan in 2001 that forced the shutdown of county-run mental health centers and halved the number of beds in state psychiatric hospitals in favor of a plan to save money by shifting patients to private community based providers. The results have been skyrocketing costs, jammed emergency rooms and more people with mental illness ending up either homeless or in jail.
A decade of efforts to undo the damage have either triggered the resignations of Wos' predecessors or left them frustrated and humbled.
Wos spoke Thursday in a secure courtyard at WakeBrook, a new Raleigh treatment built with $23 million in local taxpayer funds from Wake County without any financial support from DHHS. Because state officials barred counties from directly providing any mental health services, WakeBrook is operated by UNC Health Care as part of a $40 million commitment to help divert those needing mental health services away from local emergency rooms through close coordination with law officers and paramedics.
State Division of Mental Health Director Dave Richard, charged by Wos with overseeing the new Crisis Solutions group, conceded only the state's largest and wealthiest counties could afford to build a facility like WakeBrook. When pressed, Richard offered no indication that small or rural counties could expect significant additional resources from the state.
Richard said those now running DHHS had learned from past mistakes. In many ways, the new facility praised as a model operates much like the one-stop county-run mental health programs dismantled under the state's 2001 plan.
"One of the tragedies of reform as we did it was that we lost some really high quality things," Richard said. "We're in a different age now. You can't go back to the old mental health center that we knew. But we can create comprehensive mental health services in the communities so people should know where they can go and this is the opportunity to do it."