As mental-health reform unfolds in Buncombe and seven other WNC counties, local advocates fear they may be shut out of key policy decisions.
A public forum on mental-health reform has been set for 6:30 p.m. on Tuesday, March 25 in Laurel Auditorium on A-B Tech's Asheville campus.
Instead of publicly provided services (such as those offered by the Blue Ridge Center in Asheville), the statewide reform aims to divert public dollars to private providers, in the name of providing more choice.
Last October, Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey counties agreed to merge three separate programs into a single Local Management Entity that will coordinate mental-health, developmental-disability and substance-abuse services. Those counties' commissioners have until May 1 to approve the new agency's proposed Local Business Plan (see www.blueridge.org); it will then go to Raleigh for state approval.
One of the first decisions facing the eight sets of commissioners is the makeup of the governing board. State law requires that at least 50 percent of the board members consist of representatives of the following groups: physicians, clinical professionals, "consumers" of those services and their family members. But commissioners also may come up with their own approach, provided there's "sufficient citizen participation, equitable representation of the disability groups, and equitable representation of the participating counties," according to the statute.
At a March 6 meeting in Fletcher, the county managers pitched a plan calling for an 11-member board starting next year: eight county commissioners or county staffers and three mental-health professionals, family members or consumers. By 2006, the board would increase to 17 members, with professionals, family members and consumers outnumbering county officials 9-8.
But that scaled-back opportunity for initial public participation has disturbed some family and consumer advocates.
"After fighting for consumer & family involvement for years, I don't see turning the critical period of formulation of the LME over to 8 county managers," declared Micaville resident Bob Carey in a mass e-mail, adding later that the managers simply don't have the depth of knowledge -- or perspective -- that advocates have. In addition, he noted, "They'll have the power, because it will be 8-3."
His wife, Nancy Carey, noted: "Advocates want to be at the table at the very beginning of the LME's board. ... I want us to join hands and work together, as the law was intended."
Assistant Buncombe County Manager Jerome Jones concedes that advocates have legitimate questions. But a smaller board, he explains, could make decisions faster and still reflect community concerns.
"Our observation ... has been that the large ... boards can become unwieldy and in some cases may not provide the firm policy guidance that even the advocacy groups might prefer," said Jones.
Meanwhile, Judith West of Trend Community Mental Health Services (serving Henderson and Transylvania counties) urged the commissioners not to take too much time to make a decision, since the planned demise of publicly provided services makes it increasingly hard to retain staffers. But Jerry Rice of the Buncombe County Mental Health Reform Advisory Task Force doesn't want the commissioners to be rushed into approving a hefty Local Business Plan that was more than a year in the making. "They want [the commissioners] to come up to speed in a couple of months in what they've been drowning in 14 months," he said.