Transition, reform, reorganization — anyway you phrase it, North Carolina’s mental health care system is undergoing a serious period of change.
By Jan. 1, the state’s dozens of local management entities that have acted as the first stop for community care for decades will consolidate into a network of 11 managed care organizations.
According to Greg Olley, a developmental disabilities psychologist and chairman of the NC Mental Health, Developmental Disabilities and Substance Abuse Services Commission, this consolidation will provide patients with more efficient and affordable care.
“The biggest change from, say 20 years ago, is really the privatizing of services,” he said. “The state will get almost entirely out of the business of service provision on a local basis and be in the business of managing care and the finances of care.”
On top of this restructuring, the state is also in the middle of determining just how the Affordable Care Act will affect the 3,465 mental health care facilities in North Carolina.
According to an August 2010 estimate by the Substance Abuse and Mental Health Services Administration, between one-fifth and one-third of uninsured Americans have mental or substance abuse disorders.
In North Carolina, that means there are at least 260,000 previously uninsurable residents who will now be eligible to get coverage through the Pre-Existing Condition clause of the Affordable Care Act. Because of this clause, insurance companies can no longer turn people away because of pre-existing conditions like mental health or substance abuse disorders.
Along with 26 other states, North Carolina opted out of the federal program that sells insurance to people with pre-existing conditions and created its own organization to oversee the implementation of the Pre-Existing Condition Insurance Plan.
Since its establishment in 2007, the NC Health Insurance Risk Pool has helped more than 10,000 North Carolinians obtain health insurance, but like other stages of the current transition, this is only the beginning.
Sharnese Ransome, a spokeswoman from the state Department of Health and Human Services, said the analysis of how the Affordable Care Act will affect mental health care in North Carolina has not been completed.
“We know that the ACA will give more people access to health insurance, but just how that increased access will impact the state we’re not sure,” she said. “We just haven’t gotten there yet.”
While he said that the changes are sure to save the state and patients money, Olley agreed that the future of mental health care in North Carolina remains a work-in-progress.
“The Affordable Care Act is lengthy and complicated,” he said. “Most of our discussions at the mental health commission have to do with the availability of state funds and Medicaid funds, both of which might be affected by the ACA but in what way, and how soon, and who it would affect — these are things that are still being sorted out.”
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