Smoky Mountain’s decision to cut mental-health providers meets objections

Smoky Mountain LME/MCO holds community gatherings every couple of months to promote discussion and transparency.

A WNC mental-health agency faced tough questions earlier this week about its decision to limit its publicly funded services to a select group of providers.

Western North Carolina’s lead mental-health agency, Smoky Mountain LME/MCO, held a community forum Tuesday, June 23, that packed Asheville’s First Baptist Church. After a brief presentation by agency staff, a question-and-answer segment focused on the agency’s recent controversial decision to limit its publicly funded mental-health services. Smoky Mountain LME/MCO serves individuals with mental health, developmental disability and substance use issues in a 23-county area from Alleghany and Wilkes in the northeast mountains to Cherokee in the west. The public managed-care organization oversees Medicaid, state and local funding, and it offers a comprehensive health plan for individuals and families in need.

“You’ve explained how important your various services are,” said Whitney Hibbitts, a therapist from Carolina Outreach, who then expressed  concern that the agency’s decision will negatively affect the community by limiting consumer choice among a diverse pool of approaches and treatment models.  “Why did you decide to decrease the number of agencies that provide these services and in turn decrease people’s access to these services?” she asked. Carolina Outreach was recently notified that its contract with Smoky Mountain for Medicaid-funded intensive in-home services will not be renewed after after Dec. 31, 2015, which will impact its mental health services for children and their families in six counties in North Carolina.

Currently, Smoky’s consumers have a broad selection of providers to choose from when it comes to their mental health needs. This varied selection ensures that those seeking services are able to make their own decisions when it comes to choosing a provider. Consumers are given the opportunity to make selections based on their own preferences regarding certain aspects of care such as which doctors a provider has on staff, what therapeutic practices are used, location and easy access. Carolina Outreach and other providers who will suffer from the cut are concerned that Smoky’s decision will mean that in the future consumers will have a significantly smaller list of providers to choose from, which will make it more difficult for those seeking mental health services to receive quality care that is easily accessible.

We're not doing anything to decrease access," Brian Ingraham, CEO of Smoky Mountain LME/MCO, told those who attended a June 23 forum.
We’re not doing anything to decrease access,” Brian Ingraham, CEO of Smoky Mountain LME/MCO, told those who attended a June 23 forum.

Tuesday’s forum gave Carolina Outreach and other providers a chance to express their concerns publicly. Smoky managers Christina Carter, chief operations officer, and Brian Ingraham, chief executive officer, were both present at the meeting and replied to Hibbits’ questions and those of others who spoke.

“Smoky is committed to having a relationship and partnership with you,” Carter said. “It’s all about how we do this together, the giving and the taking. It’s no different in a personal relationship than it is in a relationship with an organization, the media and its partners, even when we agree to disagree.” She explained that the intention behind Smoky Mountain’s community forums is to provide a sanctioned space for open discussion. “I know many times the decisions we make are not always understood,” she said. “But we are committed to transparency and honesty, so we hope to have a conversation today through question and answer.”

Ingraham chimed in to justify Smoky’s decision-making process: “What we’ve done this year is what we do every year. We simply made choices about the continuation of certain services with certain providers. “We’re not doing anything to decrease access,” he said. “Whenever we make a decision to no longer contract with a provider for a service, we have a very diligent process around how consumers are linked to the same service or other services, so there’s nothing about any decision we would make about contracting that would reduce access.”

Carter added, “We have months to complete these transitions, not weeks,” she said. “We’re committed to making sure not to lose anyone in the process.”

Even with the question-and-answer segment, however, there were still multiple hands up in the audience when Smoky officials ended the question-and-answer period, in order to leave time for networking and individual questions about care and services.

Willow Burgess-Johnson, Western Region Director for Carolina Outreach.
“Carolina Outreach and its many community supporters believe that quality, access, diversity and consumer choice should be drivers in decisions affecting behavioral health consumers,” said Willow Burgess-Johnson, western region director for Carolina Outreach.

Xpress asked Willow Burgess-Johnson, western region director for Carolina Outreach, what her company had to say about Smoky’s decision to cut providers. “Carolina Outreach and its many community supporters believe that quality, access, diversity and consumer choice should be drivers in decisions affecting behavioral health consumers,” Burgess-Johnson replied. “Tuesday’s community meeting was an opportunity for Smoky to engage in an open dialogue. Unfortunately, there was not enough time for many to share their concerns with Smoky’s decision and how it would affect families in need. We remain committed to contributing to and improving the behavioral health system.”

Xpress asked Ingraham if he considered the forum to be a success. “I do,” he said. “It’s unfortunate that people get upset about information about providers. … A lot of them came today to work the agenda to their direction, which may have inadvertently alarmed some people. The main goal was to be available in the community.”

FOR MORE INFORMATION, see Smoky Mountain’s website and Carolina Outreach’s Facebook Page.



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About Melissa Sibley
Melissa Sibley is from a tiny town near the coast of North Carolina called New Bern, and will be a senior next year at UNC Asheville. She is a Literature major with an emphasis on Creative Writing, and a Psychology minor. She plans to stay in Asheville after graduation and continue to work on her personal and public writing through internships/employment with local publications. Follow me @MissMelissaSib

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2 thoughts on “Smoky Mountain’s decision to cut mental-health providers meets objections

  1. Grant Milin

    Are people with mental health needs in WNC doing as well as they could with high benchmark services (e.g. Scandanavian level healthcare here in the US) and low limits to those services?

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