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<p>Medicaid expansion and reform is a topic of spirited discussion at the mental health care community’s annual gathering in Chapel Hill.
By Taylor Sisk
The mental health advocacy community rallied this past weekend in preparation for this year’s General Assembly session. Some 300 people turned out at the William and Ida Friday Center for Continuing Education in Chapel Hill Saturday morning for the 37th Annual Legislative Breakfast on Mental Health.
Attendees heard from elected officials, service providers, family and consumer advocates and the state Department of Health and Human Services’ Assistant Secretary for Mental Health, Developmental Disabilities and Substance Abuse Services Dave Richard.
This year’s theme was “NC Mental Healthcare: Crisis, Discrimination & Solutions.”
The proceedings began with a panel presentation from Charlene Lee, Troy Manns, Madison Baldassari, Shannon Lachot and Steve Bailey, sharing stories of either their own recovery or that of a family member.
Special guest speaker Ronnie Beale, president of the state Association of County Commissioners and a Macon County commissioner, then offered a lively address with some self-deprecating humor: “Don’t let my New York City accent fool you, I’m from North Carolina,” he said in the distinctive cadence of the Western North Carolina mountains.
Beale then launched into an impassioned defense of the need for more, better and more easily accessible mental health care services, calling upon the legislature to restore lost money and beds.
Richard, the morning’s keynote speaker, addressed discrimination, saying, “We have to make sure that lay leaders, school leaders, people in our faith communities understand mental illness and mental health needs.”
“We’ve got to stop talking about reducing stigma,” Richard said. “We have to talk about eliminating stigma.”
‘Take ahold of your seats’
Medicaid reform and expansion then took center stage in a town hall-type forum that included several legislators.
Asked about revamping the state’s Medicaid system, Rep. Marilyn Avila (R-Raleigh), who sits on the Joint Legislative Oversight Committee on Health and Human Services, said, “I’m going to ask everyone to take ahold of your seats. Because as we’re discussing it right now, I hope it doesn’t take place. And I’ll tell you why.
“The issue is not how you administer the programs but what you do with the programs.”
The tendency of government, Avila said, is to “consolidate and standardize” a program to make it “easy and efficient for government, not necessarily the people it serves.”
She said the state should promote collaborations that focus on outcomes and not be concerned about how they’re administered and “who calls the shots.”
She praised Community Care of North Carolina, saying it provides “good, integrated care.” CCNC is a not-for-profit statewide network of primary care providers that focuses on preventive measures and continuity of care. The program receives state money to coordinate care for many of the state’s Medicaid patients.
Another featured speaker, Sen. Mike Woodard (D-Durham), cued up a discussion of Medicaid expansion in his remarks, saying, “It ain’t gonna happen” because the current legislative leadership won’t consider it.
Rep. Paul Luebke (D-Durham) drew applause when, as a participant on the town hall forum, he said he felt it was important to acknowledge that the leadership of the House and Senate and the governor “still are not accepting Medicaid expansion under the ACA. They won’t do it.”
“It hurts so many people,” Luebke said. “It’s just wrong that our House and Senate leadership under the Republican Party is not doing the right thing.”
Sen. Fletcher Hartsell (R-Concord), also a member of the Joint Legislative Oversight Committee on Health and Human Services, responded, stating, “Unless and until we develop an overall system that is based on health – not on sick care, not on physical versus mental – and create payment reimbursements in such a way that they are associated with outcomes, nobody’s going to be successful.”
“The problem is coming up with systems that have effective outcomes and mechanisms by which providers can be paid, in effect, what they’re worth and what they provide and what they’re successful with,” Hartsell said.
‘We can do better, folks’
In his opening address, Ronnie Beale had sounded a unifying theme.
“We have opportunities,” he said. “We know where the problems are. We have the people to fix them…. We can do better, folks, by working together.”
Beale then underscored the gathering’s emphasis on ending discrimination.
“One of these days, somewhere, sometime, when you see [a flier like this],” he said, holding aloft a hand-printed sign, “you’ll know we’ve made progress. It’s going to be in your church bulletin, it’s going to be on your convenience store door, it’s going to be somewhere.
“Here’s what it’s going to say: ‘Benefit for Ronnie Beale. On any Saturday night at your local school. Hot dogs, hamburgers, chips, cakewalk options…. Come help with our friend who suffers from severe mental health issues.’
Until you see such a flier, he said, one that speaks as openly of mental health issues as we do of other maladies, “folks, we’ve not made much progress.”
This drew perhaps the loudest applause of the morning.