Lanier Cansler, North Carolina’s new secretary of health and human services, minced no words, proclaiming, “I’ve made it clear: Mental-health reform is over.”
Citing a pattern of “constant change and problems” since 2001’s failed attempt to transition patients from state hospitals into community-care networks that never adequately materialized, Cansler declared, “We’ve got to create the facilities … [and] work with providers and allies to make this a strong system.” Although the concept of reform was good, “We had a lot of things go on and no real direction,” he said.
The agency’s deputy secretary from 2001 to 2005, Cansler had previously served four terms as state representative from Buncombe County. A certified public accountant with experience managing a health-related business, he wants to focus on rebuilding a network of dedicated psychiatric beds in community hospitals statewide.
The secretary shared his ideas at a March 14 panel discussion in Asheville sponsored by the League of Women Voters, joining state Sen. Martin Nesbitt Jr., local mental-health activist Jim Pitts and Lt. Ross Dillingham of the Buncombe County Sheriff’s Office, who spoke about the specialized training instituted for deputies dealing with mental-health crisis situations.
Cansler said, “I feel like my No. 1 priority is to re-establish trust with the Legislature and the public.”
Nesbitt, meanwhile, hailed Cansler’s appointment, saying, “We now have someone in charge that gets it, and who can take it where it needs to go.” A senator since 2004 following 12 terms in the House, Nesbitt served as co-chair of the Joint Legislative Committee for Mental Health Reform and currently co-chairs the Senate Committee on Mental Health and Youth Services.
Health and Human Services, the biggest state agency, has some 19,000 employees (and swallows about 25 percent of the proposed state budget), said Nesbitt, asking, “How do you turn that ship around? I’ve tried rudeness and awfulness.” Now, he vowed, “I stand ready, willing and able to help Secretary Cansler. We have told him, ‘Anything you need, we will support.’”
“We’re acutely aware there are not enough providers,” Cansler told the audience. “A lot are struggling to survive. … As rapidly as we can, [we have to] stabilize the situation. We can’t build on it until we stabilize.”
Nesbitt agreed, saying Western North Carolina has pioneered the model for the state.
In a later interview, Nesbitt elaborated on that comment, saying, “The real bright spot is, we started two years ago with a pilot program, last year [opened] about 160 beds with a $9 million appropriation. They asked for 111 more and [the governor budgeted] a $12 million appropriation—recurring. If we can get the system to handle crisis at the local level, I believe the rest will fall into place.”
Asked about the overall mental-health provisions in Gov. Bev Purdue‘s state budget proposal, announced March 17, Nesbitt said: “She did a pretty good job. I’m really hopeful.”
If Mr. Cansler ‘gets it’ then why does he not release the information associated with private talks between NC DHHS/ Centerpoint LME (Winston Salem)/ Old Vineyard Behavioral Health which caused 50 beds to move away from Broughton Hospital, the public psychiatric hospital in western NC. Private, free-standing psychiatric hospitals, such as are being created by Old Vineyard, w/ the western NC beds, cannot take more than 14% Medicaid patients because the Centers for Medicare & Medicaid Services (CMS), in their wisdom, indicated that as many people w/ mental health issues also have physical health issues, it would be best that psychiatric beds be WITHIN general hospitals. Or is there something lurking in the background as, perhaps, associated w/ Mr. Cansler’s ‘sandwiched’ lobbyist life: 2000-2006, 2nd in command person at NC DHHS; 2006-2008, lobbyist for his company which landed the $250 million Medicaid job for Value Options, then his client; 2008- present, 1st in command of NC DHHS, as Secretary. Do tell, Mr. Cansler.
Marsha V. Hammond, PhD: Clinical Licensed Psychologist: NC Mental Health Reform blogspot: http://madame-defarge.blogspot.com/