DIVISION MH/DD/SA REORGANIZATION PLAN
http://www.dhhs.state.nc.us/mhplan/REORGANIZATION-7-1-02.pdf

This technical document provides an overview of the planned outcomes, organizational structure, and expectations of the reorganization of the Division of MH/DD/SA. The Division will provide written information each quarter about the status of the outcomes and other modifications that will be submitted to the Legislative Oversight Committee.

The initial sections of the document review expectations and principles for Division staff members. Job descriptions and work plans have not yet been developed.

The Division director and deputy director have selected four of five chief positions. This group will make up the executive leadership team (ELT). The ELT will develop drafts and final products related to strategic developments, functions, and resources and implement a new organization structure by no later than January 1, 2003.

The ELT will:

• Include participation of the office of the assistant secretary of health
• As needed, include participation of DHHS human resources, budget, audit, and planning staff
• Consult and communicate with diverse advocacy organizations
• Include participation and consultation of a stakeholder group. The stakeholder group will consist of 19 individuals as follows:

• One primary consumer and one family member representing adult mental illness, substance abuse, developmental disabilities, and child mental health
• Co-chairs, or two designees, of the Legislative Oversight Committee
• Chair, or designee, of the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services
• Chair, or designee, of Coalition 2001
• One of the co-chairs or a designee of the state collaborative group
• Representative of the North Carolina Council of Community Programs
• Representative of the North Carolina Association of County Commissioners
• One representative of a provider organization for each area (adult mental illness, substance abuse, developmental disabilities, and child mental health).

The ELT will invite people to participate as members of the stakeholder group and will consult with advocacy organizations about the recruitment of consumer and family member representatives. Family and consumer representatives should represent families and consumers and not the position of an advocacy group if the group also provides direct services.

Director (Dr. Rich Visingardi)

Fully and solely accountable for all strategic outcomes and the individual and collective actions and efforts of the Division. Serves at the pleasure of the governor, and is appointed by the DHHS secretary and subordinate to the DHHS assistant secretary of health.

Deputy Director (Tara Larson)

Reports to the director and serves as director in his absence. Is responsible for all tactical outcomes and provides leadership for the Division’s daily operations.

State operated services of psychiatric hospitals, mental retardation centers, alcohol and drug addition treatment centers and facility-based services for children will be organized into three regions:

• West: Black Mountain, West Carolina Center, Broughton Hosptial, and Julian Keith ADATC
• Central: Whitaker School, Wright School, Dorothea Dix Hospital, John Umstead Hospital, Murdoch Center and Butner ADATC
• East: Cherry Hospital, O’Berry Center Caswell Center, Special Care Center, Eastern Adolescent Treatment Program and Walter B. Jones ADATC

Each facility will be headed by a director. One director in each region will be selected by the Division director, deputy director, and chief of state operated services to serve as a regional director.

Responsible for state’s efforts to manage relationships with communities (LMEs). It is recognized as the responsible public policy oversight agent. The LMEs are recognized as public policy management agents. This section is comprised of four teams:

• Quality Management: compliance with regulatory requirements, continuous quality improvement (performance and outcomes of LMEs), and total quality management (ultimate practices of LMEs)
• Best Practice & Innovations: responsible to research, compile, and disseminate relevant best practice, emerging best practice and innovations in the areas of mental health, developmental disabilities, substance abuse, and specialty supports and services administration and management.
• Special Programs & Projects: Responsible for coordinating development, implementation, and management of unique programs and/or special projects such as demonstrations, grants and specific policy initiatives that are statewide or immediately planned to be statewide. This includes coordination of State Plan reform efforts.
• Contract Management: routine monitoring of regular data, information and reporting requirements, routine site reviews of financial, administrative and programmatic components and special reviews/monitoring efforts. Contracts consist of financial, administrative or programmatic area of compliance, performance, or outcome.

Responsible for supporting the efforts and ensuring accountability of the operations of all of the Division sections. It is comprised of four teams:

• Budget & Finance: planning, implementing, and managing budget (expenditure) and finance (revenue) strategies
• Information Systems: technical oversight of electronic hardware and software, network and technical directions and support of the data and information systems. Coordinate with other divisions within DHHS.
• Accountability: ensuring Medicaid compliance and the integrity of state and federal dollars and fiscal systems. Coordination with other divisions within DHHS, especially DMA and the controller’s office.
• Regulatory: responsible for conducting Division activities related to regulatory obligations. Coordinates with DHHS office of the general counsel, office of the attorney general, Division of Facility Services and DMA.

The chief will be a self-identified primary or secondary consumer and will serve as the state consumer advocate. This individual reports to the director, but recruitment and ultimate selection of this position will be under the direction of the DHHS Secretary. He/she will meet with the secretary at least annually to provide an update of Division efforts. If the individual is dissatisfied with any action or lack of action planned or taken by the Division, he/she will have access to the secretary to report concerns.

This area is comprised of the former disability sections of the Division. Offers guidance, advocacy, and customer services. The chief reports to the Division director but has direct access to the secretary of DHHS. The intent is for this section to be integrated into the Division’s operations but also have direct permission and authority to report concerns and recommendations directly to the Secretary. This section is comprised of four teams:

• Child & Family Services
• Developmental Disabilities
• Adult Mental Health Services
• Substance Abuse Services

Each team is responsible for:

• Ensuring that rights are protected, including managing case investigations and system improvement efforts for client advocacy services
• Ensuring consumer and advocacy voice and input into Division planning, implementation, management, and improvement efforts
• Ensuring disability representation in the Division’s planning implementation, management, and improvement efforts

Provides administrative support for operations and coordination with DHHS to ensure achievement of the Division’s outcome expectations.

A Division Advisory Council (DAC) will be appointed by the DHHS secretary. Members of the committee will be consumers and family members representing adult and child mental health, substance abuse, and developmental disabilities. The DAC will be directly connected with the director’s office and provide input and oversight of the Division’s operations and efforts to accomplish strategic outcomes. The executive leadership team, or other staff as needed, will meet with the DAC monthly. The DAC may also contact the DHHS Secretary at any time regarding concerns with the Division. The DAC will also meet at least annually with the DHHS secretary to provide a summary of the group’s perspective regarding the Division’s efforts. Division accountability concerns raised by the DAC are the sole and full responsibility and reflection of the director.