Annual report for the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services

              Mission
Statement
North Carolinawill provide people
with, or at risk of, mental illness,
developmental disabilities and substance
abuse problems and their families the
necessary prevention, intervention, treatment,
services and supports they need to live
successfully in communities of their choice.
WWeelclocmoeme
The Division of Mental Health, Developmental Disabilities and Substance Abuse
Services, in collaboration with its partners is committed to providing quality care that
enriches the lives of consumers and their family members. The purpose of this
brochure is to provide a brief summary of the services and supports available to
North Carolina consumers and their families.
Our six guiding principles are that services and supports will be participant driven,
community based, prevention focused, recovery outcome oriented or support maximum
self-determination for individuals with developmental disabilities, will reflect best
treatment/support practices, and will be cost effective. Our commitment is to build an
effective and efficient mental health, developmental disabilities and substance abuse
service system in North Carolina.
DMH/DD/SAS Co-Directors:
Leza Wainwright Dr. Mike Lancaster
GuidiGng 2007
Principles
Participant driven: Service and support options are participant-driven
using person-centered planning to meet individual needs and choices.
Community based: Local services and supports assist consumers with
locating gainful employment and independent living in communities of
their choice.
Prevention focused: Services and supports focus on preventing a decline in consumer mental health. developmental disability
or substance abuse condition and on planning for possible crises.
Recovery and/or self-determination outcome oriented: Recovery-oriented service systems provide basic assessment, service
planning, treatment (emergency and compulsory), risk/safety concerns and support that are focused on recovery of a meaningful life for
the consumer.
Reflect best treatment / support practices: Person-centered planning will include services and supports that have been
classified as "Best Practices" because of their treatment success.
Cost effective: Providing cost effective services that are accessible, appropriate, available and affordable to the residents
of North Carolina.
Total Persons Served
0 50000 100000 150000 200000 250000 300000
Total Persons Served in the
Community - 315,338
Total Persons served in State Operated
Facilities - 24,760
Division Spotlight
Advocacy and Customer Service Section:
This section leads the division’s efforts to create a community where people with disabilities are valued and treated with dignity and where
stigma, accompanying attitudes, discrimination and other barriers to recovery are eliminated. The State Facilities Advocates Team oversees
rights protection and advocacy for consumers in the state operated facilities. The Customer Service and Community Rights Team ensures
protection of the rights of consumers served in the community, oversees response to complaints and monitors community customer service.
The Consumer Empowerment Team works to ensure a consumer and family voice in the MH/DD/SAS system and provides technical assistance
to local consumer and family advisory committees (CFACs), to local consumer controlled advocacy organizations and to self-advocacy initiatives.
MMentalH
Health
The Division of Mental Health, Developmental Disabilities and
Substance Abuse Services offers a vast array of mental health
services to the consumers in the State of North Carolina. These
services are designed to offer treatment, recovery and ongoing
support to persons within our state who need assistance with
mental health issues. These services are provided in the
consumers’ community of choice as well as through state
operated facilities.
The division works to ensure that the services offered promote
the best practices that are effective in improving outcomes for
consumers. This is accomplished in several ways: 1) The
expertise of clinical staff within the division is utilized, 2) The
division works collaboratively with other state agencies, local
management entities, law enforcement, consumers and
advocates, and 3) The division implemented the use of the
person-centered plan as a tool which ensures the voice of all
consumers is heard and valued. These efforts will greatly
improve mental health services in the State of North Carolina.
Division Spotlight
Community Policy Management Section:
This section provides leadership, guidance and oversight of the community-based service delivery system. The section performs the
functions of the single state agency (SSA) for substance abuse and of the state methadone authority. It is organized into the following teams:
the Quality Management Team, the Best Practice and Community Innovations Team, the Local Management Entity Systems Performance
Team, the Justice Systems Innovations Team and the Prevention and Early Intervention Team. The Employee Assistance Program is also
included in this section.
2007 Persons Served who had
a Mental Health Diagnosis
Mental Health
Children:
65,598
Adults: 173,282
Total served within
the community: 238,880
DD Developmental
Disabilities
The Division of Mental Health, Developmental Disabilities, and Substance
Abuse Services is committed to serving consumers with developmental
disabilities through its state-of-the-art service offerings and Community
Alternatives Program for Individuals with Mental Retardation / Developmental
Disabilities (CAP-MR/DD). The program waiver provides more services
and supports consumers who choose to live in the community of their choice.
Because developmental disabilities are likely to continue throughout life, the
services are available for as long as they are needed. These consumers are
offered numerous services such as help in a crisis, day treatment, personal
assistance and employment services, just to name a few. As a result of the
program waiver, the division is seeing an increase in consumers with
developmental disabilities who 1) receive services that help them
live at home, 2) live at home and have safe day/employment settings, and
3) live away from home and participate in community activities.
Division Spotlight
Operations Support Services Section:
This section is responsible for providing support and ensuring coordination with DHHS and among all other sections of the division. This
section is composed of three teams: the Planning Team, the Division Affairs Team and the Communications and Training Team. The
Planning Team is responsible for strategic planning, planning support, project management and resource development. The Communications
and Training Team is responsible for public communications, internal and stakeholder systems, communications, academic systems liaison,
human resources management, and all tasks related to internal and external training. The Division Affairs Team is responsible for rule making,
legislative liaison functions, client appeals, and support for the NC Commission for MH/DD/SAS.
2007 Persons Served who had
a Developmental Disability Diagnosis
Developmental Disabilities
Total served within
the community: 19,123
Children:
5,753
Adults: 13,370
Substance
Abuse Services
The Division of Mental Health, Developmental Disabilities and Substance
Abuse Services provide an array of services and supports to consumers
and family members. Our goal is to provide services and supports to prevent,
treat, reduce, or eliminate substance abuse issues. The division offers
services and supports to partners at the community level to foster
prevention and intervention for individuals and families through best
practices and environmental change. Of the estimated 54,188 children
and adolescents (ages 12-17) in need of substance abuse services
(based on IPRS and claims data), 6.1% or 3,279 received substance abuse
treatment services. An estimated 10,000 youth or approximately 10% (in this
same age group) received prevention services (SAPTBG compliance reports).
Best practices such as the Strengthening Families Program are being implemented
through prevention services. The Strategic Prevention Framework (SPF) has been
adopted to promote comprehensive prevention approaches throughout the state.
We seek to provide services that are data-driven that meet the needs of the intended
consumer, and provided by qualified, caring professionals.
Persons Served who had
a Substance Abuse Diagnosis
Substance Abuse Services
Total served within
the community: 57,335
Adults: 55,360
Children: 1,975 SAS
Division Spotlight
Resource/Regulatory Management Section:
This Section is responsible for providing support throughout the Division and State facilities and providing regulatory guidance. This is
accomplished by three teams. The Budget and Finance Team which is responsible for overall planning and management of the budget;
the Information Services Team is responsible for the information technology components of systems management, business automation and
systems support. The Accountability Team is responsible for regulatory interpretations, monitoring, pre-admission screening and annual
resident reviews, monitoring for standards compliance for the provision of mental health and substance abuse services within local jails and
State correctional facilities, and targeted reviews. The Contract Management and Development Team negotiates, manages and monitors
non-local management entity contracts, as well as managing property, inventories and purchasing.
2007
HHiigghhlilgihgthedte Adr eAasr eofa As cocfo mApclcisohmmepnlti shment
Many people across the State of North Carolina participate in the public system of services for people facing mental health,
developmental disabilities, and/or substance abuse challenges. They are consumers of services, family members, peer supporters,
advocates, legislators, managers and staff working as providers of services and at local management entities (LMEs).
Together, we have set our sights high and are making significant changes in the system. It is our intent during the next two years to
highlight an area of accomplishment on a quarterly basis by publishing a web-based report. While the focus will be on the achievement,
attention will be given to stakeholders, funding, and challenges faced. In this initial report, the accomplishments include increased
availability of crisis services statewide, enhanced community services, increased access to services delivered by quality providers
and building the workforce.
County General
Funds: 114.17M
Other
Receipts:
179.41M
State
Appropriation:
622.41M
Medicaid: 2.37B
State Facilities:
621.42M
State
Administration:
35.46M
Community: 2.63B
2007 Funding of Public MH/DD/SAS
System by Setting SFY 2007 (3.28B) 2007 Funding of Public MH/DD/SAS
System by Sources SFY 2007 (3.28B)
Crisis
A
Crisis
major effort is underway to build statewide crisis services substance abuse problems for short-term treatment rather than
for the public MH/DD/SAS system. Crisis services are being send them to state psychiatric hospitals. To improve continuity
integrated locally as part of a comprehensive crisis services of care, each local management entity assigns a hospital care
focus. In 2006, the NC General Assembly initiated funding to coordinator to help consumers return to their communities from
establish local crisis services and added $22,947,826 for the state psychiatric hospitals.
2008-2009. As part of the process, each local management
entity developed a crisis services plan. The new legislation
funds mobile crisis teams, walk-in and follow-up crisis services, In 2006, the NC General Assembly
beds at community hospitals for psychiatric crises, START crisis
model for developmental disabilities and crisis respite beds. The initiated funding to establish local
division and local management entities are collaborating with
providers, health departments, community hospitals, NC Hospital crisis services and added $22,947,826
Association and the Division of Medical Assistance to develop the for 2008-2009. House Bill 2436, 10.15. (j) - (n)
statewide crisis network. The state’s three Alcohol and Drug Abuse
Treatment Centers (ADATCs) expanded to admit more persons with CCoonnssuummere Fro Fcuosc us
Consumers and family members have the right to accessible, affordable, available
and appropriate services. The division carries out several strategies to help empower
consumers and family members. The division developed the Consumer Handbook: A
guide for understanding the mental health, developmental disabilities and substance
abuse service system in North Carolina to help consumers and their family members
understand how to access services, assert rights and realize responsibilities. In addition,
the division conducted a statewide conference as well as nine regional Consumer and
Family Advisory Committee (CFAC) trainings designed to increase the effectiveness of
these advisory committees. Through the trainings, consumers and family members build
new skills, expand group networking, and share experiences. Division staff also
conducted trainings across the state to providers, local management entity customer
service and consumer affairs office staff, and to local consumers and family members.
“ ”
Quality Providers
Workforce Development
As the population grows, the need for a competency-based, well-trained and stable MH/DD/SAS
workforce increases. Achieving a stable workforce requires collaboration and strategies among
agencies, organizations and educational institutions. The division and stakeholder partners
recognize the importance of developing effective methods to retain, recruit and train employees
who provide services and supports in communities and in state facilities. After a year-long study,
the division and the NC Commission on Mental Health, Developmental Disabilities
and Substance Abuse Services published, The Workforce Development Initiative, a report that
examined workforce challenges for the MH/DD/SAS system. In April 2008, the report’s 12
recommendations cover structures to support the workforce, broadening the concept of
workforce and strengthening the workforce.
Quality Providers
Highly qualified providers are important to the MH/DD/SAS system.
The division works diligently to develop strong partnerships with
service providers to ensure that the needs of individuals and families
are met and that a wide range of providers are available throughout
North Carolina. Provider endorsement by the local management entity
is recognition that the provider meets or exceeds the requirements in
rule and policy including those for training, use of evidence-based
practices and quality improvement measures. Providers seeking new
enrollment after July 1, 2008 for services that require national
accreditation are required to earn national accreditation within a year
of their enrollment as a provider. The division developed a monitoring
tool to standardize monitoring of providers by the local management
entities. Providers are required to enroll in the NC careLINK - an
internet-based information and referral system that allows NC citizens
to search for local provider services in areas such as language spoken,
transportation offered and fees.
Workforce Development
National Accreditation
SStattaet Fea Fcialitciielsi ties
Legend:
State Facilities web site:
http://www.ncdhss.gov/mhddsas/statefacilities.htm
Alcohol and Drug Abuse
Treatment Centers
Julian F. Keith
1-828-669-3400
R. J. Blackley
1-919-575-7928
Walter B. Jones
1-252-830-3426
Developmental
Centers
Caswell
1-252-208-4800
Murdoch
1-919-575-1000
J. Iverson Riddle
1-828-433-2731
Psychiatric
Hospitals
Broughton
1-828-433-2111
Central Regional
1-919-764-7200
Cherry
1-919-731-3513
Dorothea Dix
1-919-733-5540
Residential
Programs for
Children
Whitaker School
1-919-575-7048
Wright School
1-919-560-5790
Neuro-Medical
Treatment Centers
Black Mountain
1-828-669-3100
O’Berry
1-919-581-4000
Longleaf
1-252-399-2112
Division Spotlight
State Operated Services Section:
This section is responsible for defining the purpose, roles and responsibilities of state operated facilities. These roles and responsibilities are
developed through partnerships with regional advocates, LMEs, area/county programs, counties, provider systems and division stakeholders.
This section is also responsible for enforcing statewide standards for each type of state operated service (by disability group and within unique
programs). The standards reflect best practice and are understandable, accountable, appropriate, efficient, effective and consistent with
national regulatory and accreditation compliance, performance and outcome expectations.
LLocaMl ManaEgement Entities
Local Management Entities (LMEs) are agencies of local government area authorities or county programs and are responsible for
managing, coordinating, facilitating and monitoring the provision of mental health, developmental disabilities and substance abuse
services and supports in the catchment area served. LME responsibilities include offering consumers 24/7/365 access to services and
supports, developing and overseeing the provider network, and handling consumer complaints and grievances.
There are currently twenty-four (24) LMEs that serve all one hundred (100) counties in North Carolina. Many offer translation services for
clients who do not speak English. For a complete list of the LME agencies, please visit: http://www.ncdhhs.gov/mhddsas/lmedirectory.htm.
LMEs and their Member Counties
Western Region Central Region Eastern Region
Unless otherwise noted, the LME name is the county name(s). wise indicated, the LME name is the county name(s).
Reflects LMEs and regions as of July 1, 2008. ts LMEs and regions as of July 1, 2008
Mental Health
Partners
Dynamics of
Person-Centered
Planning
Build on individual and family strengths.
Support consumer empowerment and provide recovery
and self-determination choices.
Develop individual programs that promote dignity,
respect, competence and appropriate independence.
Create community connections with natural and
community supports.
Adapt planning to an individual's culture, ethnicity,
religion and gender.
Build and respect partnerships of providers and
individuals and families.
2007 00-04: 1,439
45-54: 53,547
35-44: 56,832
21-24: 21,012
10-14: 28,060
15-17: 25,883
05-09: 17,944
25-34: 53,948
65+: 12,327
55-64: 24,967
18-20: 19,379
2007
2007
State Psychiatric Hospitals- 18,498
Male: 163,061
Female: 152,277
ADATC - 3,733
Developmental Centers - 1,713
Neuro-Medical
Treatment Centers - 723
Residential Programs for Children - 93
Persons Served
by Gender
Persons Served by
State Operated Facilities
Persons Served
by Age
DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary.
DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary.
DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary.
DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary.DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary. DMH/DD/SAS emblem. Care-Line - 1-800-662-7030.
State of North Carolina, Michael F. Easley, Governor, DHHS, SAS, Dempsey Benton, Secretary.