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North Carolina

Task Force

The North Carolina Department of Health and Human Services released "State Plan 2002: Blueprint for Change" on Oct. 31, 2002. It is an evolving document related to mental health, developmental disabilities and substance abuse services that will be revised as the state works toward its goal of developing community capacity. The final plan will be ready in 2003. It can be viewed online at http://www.dhhs.state.nc.us/mhplan/draftplan.htm. An earlier planning effort, the interim Olmstead plan was released in 2000; it is available online at: http://www.dhhs.state.nc.us/docs/draftolmsteadplan-toc.htm

The Plan

The guiding principles of the recently issued Blueprint for Change are:

• Treatment, services and supports to consumers and their families shall be appropriate to needs, accessible and timely, consumer-driven, outcome oriented, culturally and age appropriate, built on consumer's strengths, cost effective, and reflect best practices.
• Research, education and prevention programs lower the prevalence of mental illness, developmental disabilities, and substance abuse; reduce the impact or stigma; and lead to earlier intervention and improved treatment.
• Services should be provided in the most integrated community setting suitable to the needs and preferences of the individual planned in partnership with the consumer.
• Individuals should receive the services needed, given consideration of any legal restrictions, varying levels of disability, and fair and equitable distribution of system resources.
• Services will meet measurable standards of safety and quality and demonstrate a dedication to excellence through adoption of a program for continuous performance improvement.
• All components of the system will be clinically effective and operated efficiently.

The Blueprint emphasizes eight core functions: screenings; assessment; referral; emergency services; service coordination; consultation; education; and prevention. The target population includes adults with mental illness, children with mental illness, people with developmental disabilities and people with substance abuse problems. The plan endorses a system that makes sure those most in need receive the appropriate services in a timely manner. It also calls for the use of a statewide system contractor to provide referral, crisis hotline services, and utilization management. The plan recommends that a full array of services be available to people in all target populations, including interpretation/translation services, housing options and employment opportunities. The Plan provides for continued consumer and family input.

Implementation

North Carolina Senate Bill 1115, enacted in 2002, specifies that all reductions designated for state facilities shall have the least effect possible on the state's ability to comply with Olmstead, and that maximum resources be retained for transfer to local programs for community capacity building.

Recent developments in the state include the receipt of a $1.6 million Real Choice Systems Change grant of $1.6 million to support implementation of North Carolina's Olmstead plan. The money will be used to examine workforce issues through the work of three work groups, consisting of stakeholders, consumers, and disability advocates. The three workgroups are 1) recruitment and retention; 2) direct care workers; and 3) consumer-directed care.

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