Thwarting the bear

Seeking to head off potential action by the state, members of the local mental-health board have scurried to protect its assets and programs from being devoured by legislative changes.

The Blue Ridge Area Authority (the public governing board for the Blue Ridge Center) took two controversial steps at its Dec. 6 meeting to soften potential fallout from a potential revamping of mental-health services by the General Assembly next year. The Blue Ridge Center provides community mental-health, substance-abuse and developmental-disabilities services to residents of Buncombe, Madison, Mitchell and Yancey counties.

The Authority voted to turn Blue Ridge Homes — an umbrella for its four-county residential and day programs for the mentally retarded — into a freestanding and self-perpetuating private nonprofit agency.

The Authority also decided to make a contingency plan for its $16 million worth of buildings, in case the General Assembly significantly changes the statute that set up the state’s mental-health authorities (including Blue Ridge). If that happens, the Authority-controlled nonprofit that owns its buildings will become a freestanding nonprofit entity — not subject to Authority control, Area Director Larry Thompson explained. And if that nonprofit is ever dissolved, the four member counties will decide what happens to the buildings. Otherwise, the state could take over the buildings if the legislature chose to dissolve the Authority, officials warned.

“It’s to keep the state out of our pockets,” Authority attorney David Matney told the board.

Blue Ridge Area Authority members are anticipating legislative action that would restructure North Carolina’s 39 area mental-health systems — including theirs. The General Assembly has been studying a reform plan that would cut the number of beds in the state’s mental hospitals and make local mental-health programs more uniform and accountable across the state. A legislative committee is slated to make reform recommendations to the General Assembly next year.

“In my humble opinion, you want to protect yourself when there’s a big bear on the prowl,” said Authority member (and Madison County Attorney) Larry Leake during the board’s discussion.

But state Rep. Lanier Cansler — contacted later — said the board’s actions may be premature (he also noted that “the bear’s the one that’s giving them the money”).

Cansler hopes the Authority will meet with the local legislative delegation to discuss their plans.

“I hope that they would at least bring everybody into the loop so we can all work on this together,” Cansler offered. “I think they need to go cautiously and we need to be a part of this, because the real bottom line is the people.”

Blue Ridge Homes is operated by the Blue Ridge Area Foundation, a publicly controlled (but technically private) nonprofit corporation the Authority created in 1983 to accept donations, Thompson said. Blue Ridge Homes has 200 employees and 70 residents, who live in group homes in Mars Hill, Swannanoa and Weaverville. Blue Ridge Homes also operates day programs in Mitchell and Yancey counties, along with a day program in Asheville, Thompson said.

The board’s action will allow the foundation to continue to operate Blue Ridge Homes and provide services, although with less public oversight.

The Authority’s action to protect its assets specifically involved changing the articles of incorporation of Blue Ridge Human Services Facilities Inc., a separate Authority-controlled private nonprofit corporation. That nonprofit was created by the Authority in 1992 so it could borrow money, build mental-health centers in the rural counties and expand the center in Asheville — something the Authority itself couldn’t legally do, Thompson said.

“We don’t want a major situation where the state says the area program and all its assets — which could be defined to include the Blue Ridge Foundation and Blue Ridge Human Services Facilities — would go back to the state,” Thompson said after the meeting.

Such a move, Thompson warned, could freeze assets, cause the buildings to be taken over by the state, and force Blue Ridge Homes to cease operating — which could put its employees, residents and day-program attendees at risk.

But Cansler commented later that the state wants to make services more available.

“I don’t think the state government’s going to do anything that’s going to limit the availability of services,” Cansler noted.

In addition to the specter of state action, Matney said the trend in the mental-health field is for case managers such as Blue Ridge to move away from providing services themselves. In the case of Blue Ridge Homes, the Area Authority has been both the case manager and the care provider.

Although all but one board member agreed with the proposal, it still sparked controversy at the Authority’s meeting.

Yancey County representative Nancy Carey — the lone Authority member to vote against the proposals — said she feared the actions could lead to the elimination of the Blue Ridge Area Authority as a public entity.

“We are not only talking about contingency plans that allow private nonprofits to replace Blue Ridge Area Authority,” Carey said in a prepared statement she read to the board. “Our approval could possibly enable stealing the mental-health system from the public. No!”

She cited concerns that family members and Blue Ridge clients might lose their chance for input into decisions by turning the foundation into a freestanding agency. She also was distressed that the Authority hadn’t adequately informed the public that such changes were afoot and hadn’t asked for public input.

Authority meetings are open to the public, one board member noted. And Buncombe County representative Judy Morris said the Authority’s subcommittees had discussed the proposals at length.

“The consensus was, we thought this was the prudent thing to do,” Morris countered.

Matney said the foundation doesn’t own any major assets, adding that it must be made independent if it is to continue to provide services.

Leake said he thought Carey seemed troubled about the counties giving up control.

“As county attorney, I can promise you: Madison County never gives up control over anything unless there’s a good reason,” Leake declared.

Leake went on to explain that when the Authority set up the foundation years ago, nobody believed the General Assembly would be “on the attack.” He added that he believes local control is the best means for providing the best services.

But Carey insisted,”I want a local public entity, not a private!“

Matney added that if the Blue Ridge Center is occupying the buildings (which board action would make safe from state takeover) and providing services, only the court system could evict them.

Reactions after the meeting were mixed.

“The issue is what would happen to local control if the Blue Ridge Authority goes away,” Authority Chair Dr. John Parham said. “If it goes away, this is a mechanism to ensure some kind of local control.”

In his mind, ensuring that services can continue outweighs Carey’s concerns about the lack of public input.

“If the state structure changes, there won’t be any public input anyway,” Parham reasoned.

But a different view was expressed by Jayne St. Clair, who sits on two advisory committees to the Authority. She thinks the board is entertaining further plans that they haven’t publicly disclosed, and she described the claim that Blue Ridge Homes clients would have no place to go as a “scare tactic.”

“I think it’s a terribly bad idea,” St. Clair said about the move to privatize Blue Ridge Homes. “I think it would eliminate the oversight, the public oversight which we have now, which is little enough. Right now, the county commissioners are a part of the oversight, plus we have input from consumers and family members, and that would not be assured with a private nonprofit. … Now it’s seriously underfunded and administratively top-heavy, and that’s with public oversight. Without public oversight, the situation can only get worse, as far as I can see.”

However, Louis Pugh, executive director of the Irene Wortham Center (a private nonprofit that contracts with the Blue Ridge Center to provide developmental-disabilities services) agreed that the trend is for Authorities such as Blue Ridge to discontinue providing direct services, to avoid the potential conflict of competing with the private sector.

Although any restructuring could cause jobs to be cut, even Pugh doubted that any Blue Ridge Homes residents would go homeless.

“There are a fair number of protections in place for folks,” he said. “That seems like that would be a pretty extreme thing.”

Overall, Pugh expressed confidence in the organization and the people there.

“This sounds like a correct decision,” Pugh offered.

The changes will become official at the Authority’s next meeting, when additional members will be appointed to both nonprofit corporations’ boards. The new boards then will amend their charters, Thompson said. The meeting — which is open to the public — will be held at 6:45 p.m. on Wednesday, Jan. 31, at the Pittman Dining Hall at Mars Hill College in Mars Hill.