NORTH CAROLINA
In 2002, North Carolina reviewed its programs and services for people with mental illness or developmental disabilities to determine how to better provide community services to those with the most urgent needs. The state also received federal grant money for programs designed to increase consumer choice in services and supports.
Planning and Reports
In October 2002, the North Carolina Department of Health and Human Services published State Plan 2002: Blueprint for Change, a major plan to reform the state's system for mental health, developmental disabilities and substance abuse. The target population covered by the plan includes adults and children with mental illness, people with developmental disabilities, and people with substance abuse problems. The document emphasizes eight core functions: screenings, assessment, referral, emergency services, service coordination, consultation, education and prevention.
In 2002, the state was spending more than $1.8 billion annually to provide mental health, developmental disabilities and substance abuse services to more than 300,000 people. Under the plan, system resources will be targeted to those most in need. Priority groups will include people with most urgent needs, people from racial or ethnic minorities with service/support needs, and people with more than one disorder.
The plan proposes focusing more services in local communities rather than in centralized state facilities. A key element of the plan is the local business plan. A local managing entity, such as an area program or county government, will manage the services. The plan also calls for a statewide system contractor to provide referral, crisis hotline services and utilization management.
Adult Day Care
The Legislature in 2002 directed the Department of Health and Human Services to review and report on staffing requirements of adult day care programs and adult day health programs. The bill also decreases the maximum monthly reimbursement rate for residents in adult care home facilities from $1,120 to $1,091, effective October 1, 2002.
Grant Initiatives
The state received two federal Systems Change grants totaling about $1.3 million in 2002, which the state planned to use to connect many of the initiatives already under way to increase options for consumer choice, service, support and self-direction. The Department of Health and Human Services planned to conduct an assessment of state fiscal and regulatory policies, with a view toward initiating statutory and rule changes. The state agency intended to develop and conduct training and technical assistance with agency-based and independent providers to encourage consumer-directed practices. Demonstration models will be established in three communities to increase consumer leadership in local reform efforts.
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