CHAPTER 2: CHANGES IN THE CURRENT SYSTEM http://www.dhhs.state.nc.us/mhplan/stateplanpart2.pdf

This chapter outlines activities that have occurred since the release of the State Plan 2001. This includes a listing of the Area Programs/Counties that have requested to be considered as part of the first phase in becoming a Local Management Entity (LME) in the new system. Twenty-one area programs representing 61 counties are on the list.

Chapter 2 recognizes the need for community service expansion but also acknowledges that most of the work has been centered on developing services for those identified in the Olmstead Plan initiative. Specifically, these are individuals who have been hospitalized longer than 60 days and have completed an assessment and interview process that has determined they are capable and desire to live in the community. Regional planning groups comprised of representatives from the state hospitals and area programs are developing plans for the service needs of these individuals. Efforts also are underway to improve collaboration in discharge planning. This chapter does not contain a discussion about efforts to expand the capacity of services to individuals currently living in the community and needing support services to remain there.

Downsizing of the state hospitals already has begun and these efforts are detailed in the chapter. Specifically, certified nursing facility service units at Broughton and John Umstead have been eliminated and the service at Cherry Hospital has been reduced. These individuals have been transferred to community nursing facilities. The Wright Transitions program at Dorothea Dix has closed. Five individuals will remain at Dorothea Dix and the remaining 22 individuals have been or are in the process of being discharged into the community. The Division is requiring monthly service monitoring and on-site visits by Division staff to review the progress of each individual discharged from the program.

Secretary Hooker-Odom has proposed a plan to consolidate John Umstead Hospital and Dorothea Dix Hospital in a new hospital that would serve the central region of the state. The plan reports that several sites for the new hospital are being considered. There is no discussion about how such a decision will be made or what planning is being done for transition or to develop community services to compensate for reduced capacity.

Plans are underway to expand the intermediate and skilled nursing level beds in the western region at Black Mountain Center so that its bed capacity and mission are similar to that of the NC Special Care Center in Wilson.

Whitaker School, a residential program for 38 youth ages 12-17 located on the grounds of John Umstead Hospital, will be closed at its present location. The state will expand the program’s re-education model of treatment to two new centers that will serve a total of 36 youth. The new units will open in December 2002 with funding from the Mental Health Trust Fund.

This chapter also provides many statistics documenting the prevalence of mental illness in children and adults.