A recent Mercer Organization Review of the North Carolina Department of Health and Human Services (DHHS) Division of Mental Health, Developmental Disabilities and Substance Abuse Services (Division) told a great deal about the organizations ability to manage standards and quality of state general and federal block grant funds that support LMEs. Because the Division seeks to improve its quality monitoring, the Mercer Review was contracted to give an impartial review of and suggestions for structure, staffing, methods and strategies for behavioral health programs and funding.
Currently, most NC Medicaid health services are compensated though a practice called fee-for-services. However, beginning in 2005 1915(b)(c) waivers were implemented in an LME serving Cabarrus, Davidson, Rowan, Stanley and Union counties to allow more flexibility and autonomy within the area. After positive reviews, this LME’s success resulted in the NC DHHS trying to expand the Section 1915(b) and 1915(c) waivers statewide. There are currently several bills in the General Assembly addressing these waivers such as H424/S316, S465, and S422.
However, the unfavorable report of the NC DHHS shows that expansion of waivers and implementation of ObamaCare will mean additional oversight responsibilities for the Division that they may not be ready to handle. Final recommendations for how to improve the Division and the Division’s responses can be found here.