Sometimes, for those seeking behavioral health care treatment, necessary help simply isn’t there.
Pathways to Life, a group of clinics in North Carolina and Virginia serving those with behavioral health needs, recently had to shutter its Hardee Road location. Pathways CEO LaMont Chapell said it was no longer possible to provide adequate treatment and keep the lights on.
“Everything’s about services, my friend,” Chappell said. “And, when (managed care organizations), with this new health care reform, when they start denying services to clients that qualify for the service and that need the service, then it is impossible for providers to even operate in those areas.
“They’re literally cutting – in the matter of 30-60 days – without any type of notice, services in half.”
Public money to cover behavioral health treatment goes from the state government to regional MCOs and local management entities (LMEs). These groups funnel money to health care providers.
“(The LMEs and MCOs) don’t see how that affects the providers on the ground because they get money directly from the state and they manage it, so they don’t have to worry about really, really, really working hard to maintain budget numbers and things like that, and also providing services,” Chappell said.
Kathy Baker with Eastpointe, the LME that oversees 12 North Carolina counties including Lenoir and Greene counties, said the organization is working to pair those displaced patients with other providers.
“We actually received a call from a former staff member of Pathways to Life to let us know it was closing its Kinston office,” Baker said. “And, our network operations director contacted the Pathways to Life owner who confirmed this was true.
“What Eastpointe has done, we began working immediately on transitioning their members they were serving to other providers – we started doing that on (Nov. 15).”
Baker added Eastpointe had more providers than demand for services.
In the last budget passed by the General Assembly, LME administrative budget funding was cut by $15 million, and dollars to alcohol and drug treatment centers were reduced by $4.9 million.
At the same time, $9 million more went to fund beds in local hospitals for short-term crisis treatment, and $1.8 million – with $250,000 in one-time funding – when to the training of Medicaid-certified doctors for treatment of childhood trauma.
Debby Dihoff, executive director for the North Carolina chapter of the National Alliance on Mental Illness, said rapid changes in state health care policy and funding is creating problems for people who have serious needs.
“They want to have a provider they can count on who, if they go into crisis, they can call them day or night,” Dihoff said. “And some of that isn’t happening because of tremendous flux to the system, with small companies who aren’t making it financially, closing down.”
She added, “And all that change – think about if you had to change doctors all kinds of times. Your care would be interrupted. You would have lost medical history. There are things that happen like that, that I think that churning is going on right now.”
In regard to funding questions, Baker said, “What I will say is there is an effect that we now have more providers than we have a demand for service. So, that certainly creates a business impact.”
Dihoff suggested care needs to be provided somehow.
“The LME may also be right – maybe from their point of view, there are plenty of providers, but there’s something missing there, where getting access easily is not happening for those families,” Dihoff said.
Those who are no longer able to receive treatment from an Eastpointe-connected provider and need help switching to another may reach the Eastpointe call center at 800-913-6109, or the TTY number for the hearing impaired at 888-819-5112.
If you need help regarding a provider in Craven, Jones or Pitt counties, those are covered by East Carolina Behavioral Health. ECBH can be reached at 877-685-2415.
Wes Wolfe can be reached at 252-559-1075 and Wes.Wolfe@Kinston.com. Follow him on Twitter @WolfeReports.