“I implore you, in a moral sense, to not screw this thing up.”
— Steven House, advocate for the mentally ill
His voice calm and deliberate, Asheville resident Steven House encouraged the Buncombe County Board of Commissioners last week not to fear people like him.
House — who said he’s been diagnosed with paranoid schizophrenia — was one of about a dozen local advocates for the mentally ill who appeared at the board’s March 18 meeting, largely to urge the commissioners to allow caregivers, care recipients and their families a greater role on the new governing board they’re establishing as part of statewide mental-health reform.
House said he can understand why the commissioners might be afraid of the mentally ill.
“I think the reason why is because we represent the moral high ground in this situation,” said House. “I believe every society is judged civil depending [on] how well they take care of the ones who are least able to take care of themselves.”
As part of state-mandated reform efforts, the Buncombe commissioners and their counterparts in seven other WNC counties are considering whether to approve a Local Business Plan, drafted by their county managers, establishing a new agency that will coordinate mental-health, developmental-disability and substance-abuse services provided mostly by the private sector. Also at issue is how to structure a governing board for the new agency, which will replace the Blue Ridge Center.
Although House admitted that he isn’t familiar with the details of the proposed plan — or the politics involved — he made this parting plea: “I implore you, in a moral sense, to not screw this thing up. Thank you very much.”
Chairman Nathan Ramsey responded, “We’re not scared of the advocates — or I don’t think we are.”
But since reform makes county boards of commissioners ultimately responsible for overseeing mental-health services, the commissioners need a strong presence on the governing board so they can make sure the new system works, Ramsey explained.
The word from the trenches
Within the commissioners’ chambers, mental-health advocates stood out as a cohesive group, wearing red clothing and sporting badges that said: “Nothing about us without us!”
That message echoed throughout the comments aimed at the board. (In a deft bit of negotiation, advocates persuaded the commissioners to let them speak during the public-comment session — held before the start of the regular meeting — and also get 15 minutes during the televised formal session, held immediately afterward.)
In a nutshell, advocates want equal representation on the governing board for “consumers” of mental-health services, affected families and mental-health professionals. At a March 6 meeting, the county managers proposed an initial 11-member board comprising eight county commissioners or county staffers and three mental-health professionals, family members or consumers. (See “Counties pitch mental-health plan,” Feb. 19 Xpress.)
The new agency will serve Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey counties.
To make their concerns heard, the advocates announced that they’ve formed a new alliance called Coalition House Bill 381. Both the Western Carolina chapter of the National Alliance for the Mentally Ill (NAMI) and WNC Families CAN are part of the new group, named for the state mental-health-reform bill.
Micaville resident Bob Carey told the commissioners that even though the state plan calls for families and consumers to have meaningful input, to date, this hasn’t happened locally.
“Consumers, families and citizens have not been involved in the development of the Local Business Plan,” Carey complained.
Meanwhile, Arden resident Diane Bauknight urged the board not to approve the Local Business Plan until it’s been “held to the light” to make sure the gaps in services are filled and there’s a good plan for transitioning from publicly provided to privately provided services.
And Gary Lukowicz of Fairview warned the board that the top-down management style of the existing system is one of the reasons reform is needed.
“So, we’re in this muck now,” Lukowicz declared. “We have an opportunity to fix things. If you don’t have people from the grass roots telling you what they need, what’s going on with the local mental-health provider, the people that handle the money, the people that make services available — if you don’t have their input, you’re going to miss a good part of the puzzle. And five years from now, you’re going to be doing this all over again. This is the time to include families. Let them tell you their perspective of what they’re getting, what they’re not getting.”
NAMI member Nancy Herman of Buncombe County told the board they’re doing a “great job” in trying to deal with mental-health issues. But if she were in their shoes, said Herman, she’d want input from family members, providers and consumers. “Those of us who’ve been in the trenches probably have a lot to offer,” noted Herman.
The board took no action on the matter. After the meeting, however, three commissioners gave varied opinions on whether they’d be willing to give affected citizens a stronger voice on the new governing board.
Ramsey (noting that the other seven counties must agree) said he would feel comfortable with the 11-member board proposed by the county managers, though he added that he’s willing to be flexible. The real issue, he maintained, is money — or the lack of it.
“If they had 50 advocates, how are they going to change it if the money’s not there?” asked Ramsey.
Commissioner Patsy Keever said that while she isn’t sure consumers, family members and professionals need 50 percent representation on the new board, she would favor giving them five to eight seats, to balance the eight seats allotted to county commissioners/staffers. (State law requires those boards to have between 11 and 25 members.)
Commissioner David Gantt also said the 50 percent figure seemed fair, though he wasn’t ready to commit to that approach. And like Ramsey, Gantt voiced skepticism about the overall effect of the state budget crisis on both the reform effort and on mental-health services in general.
“The net effect of [reform] is, it’s going to hurt the people who need services,” predicted Gantt.
Trickling down slowly
In the latest chapter of Buncombe County’s response to the state budget crisis — and its own austerity budget — the commissioners quietly (and unanimously) approved a whopping $4.1 million in expenditures as part of their consent agenda.
Last July, in response to community outcry over budget cuts, the commissioners decided to provisionally allocate about $6.2 million in reimbursements traditionally received from the state — provided that the state eventually coughed up the money, which it had withheld to plug holes in its own troubled budget. The state never did release the funds; instead, the General Assembly approved a new half-cent sales tax for local governments, which took effect Dec. 1.
But in the current fiscal year, the county’s share of the new tax will probably amount to only about $3.6 million, reports Finance Director Donna Clark — poking a major hole in the county’s plans.
On the plus side, however, higher-than-projected revenues from property taxes (about $388,879 extra) and the Detention Center ($120,000 surplus) have been added to the funding pool, said Budget Officer Mamie Scott, along with $113,000 trimmed from the School Resource Center’s budget.
Here’s the breakdown on the expenditures approved by commissioners: A-B Tech ($766,000), Buncombe County Schools ($1,494,036), Asheville City Schools ($234,119), Blue Ridge Center ($465,000), Pack Square renovations ($100,000), economic-development incentives ($415,000) and YWCA ($10,000). Funding for housing ($50,000) and professional services ($75,000) was included in the Planning Department’s budget. And the Sheriff’s Department received another $470,060.
The following additional expenditures were listed under the Department of Social Services “community contracts”: Eblen charities ($18,566), Pisgah Legal Services’ Children’s Law Project ($46,120), Helpmate ($9,070), United Way 211 ($30,900), YMI Cultural Center ($11,336), One Youth at a Time ($11,336) and Mt. Zion Community Development ($11,336).
Since the county won’t actually receive the full $3.6 million from the state until May 15, however, most of these agencies won’t see the money right away. A-B Tech and the city and county schools will receive their funding before March 31, reports County Manager Wanda Greene; the others will receive their payments by June 30.
Myths and facts
In other business, the board was presented with the county’s 2002 Comprehensive Annual Financial Report from Crawley, Lee & Co., which indicated a clean audit.
The commissioners also heard a report from Department of Social Services Director Mandy Stone, who offered a lengthy presentation about what she called the “myths” and “facts” concerning the agency’s child-welfare program, which has come under criticism lately. Environmental Health Director Layton Long said that rabies incidents have increased in the county recently. Planning Board Chairman Jim McElduff reported on efforts to develop new regulations governing development on steep slopes. And Emergency Services Director Jerry VeHaun (who’s also Buncombe County’s homeland-security director) updated the board on recent grants the county had received for terrorism-response training.
Two retiring, longtime county employees — Martha Hall (22 years) and Hilary Boram (30 years) — were awarded certificates of appreciation. The commissioners also gave special recognition to returning Air Force reservist Capt. Glen Matayabas of the Buncombe County Sheriff’s Department and proclaimed April 7-12 as Special Olympics Week.
Although they delayed an appointment to the WNC Air Quality Board (because Commissioner Bill Stanley was absent, noted Ramsey), they went on to make appointments to several other boards.
The commissioners also met behind closed doors for about 10 minutes to discuss two economic-development matters and a personnel item.