Beacon bombs, blames reporting Saturday, January 09, 2010 1:42 AM
By Janet Conner-Knox Times Staff Writer
A local agency that oversees mental health services takes too long assisting people who ask for help and need either urgent and routine care, according to a new state report.
The Beacon Center scored beneath the 65 percent state performance requirement in most areas according to the N.C. Department of Health and Human Services quarterly report in December. That report is "intended to capture how well people are getting into care and continuing care in their chosen community," said Beverly Bell, liaison for the Division of Mental Health and The Beacon Center.
The Beacon Center oversees mental health, developmental disability services and substance abuse services (MH/DD/SAS) in Wilson, Green, Edgecombe and Nash counties. It screens and pre-approves providers of those services for local residents.
Karen Salacki, area director of The Beacon Center, in part blamed underreporting by providers of services for the poor scores and said the center is looking to improve its numbers.
"Our management team will be reviewing the report and developing a plan to address the areas where desired benchmarks were not met," Salacki said in an e-mail to the Daily Times.
LMEs are not penalized for failing to meet state requirements.
Getting 65 percent or higher in the performance rating could allow The Beacon Center to get what's called single stream funding. That means an Local Management Entity (LME) such as The Beacon Center has more flexibility in how it spends its money, Salacki said. It does not mean the LME gets more money.
The report has 21 measures which include how long it takes an individual to get care.
People who have emergent (life-threatening) needs are expected to get care within 2 hours of requesting it. Those in need of urgent care should get help within 48 hours and people who need routine care are expected to get it within 14 days.
The Beacon Center only met the state's requirement with those with emergent needs.
The report also grades LMEs on how quickly a person receives treatment or support after entering care.
In that same category the state also looks at whether clients begin to receive enough services to reduce their occurrences of crisis and to improve the clients chances on recovery and stability.
The Beacon Center did not meet any of the standards in that category.
The report looked at how many people are entering state hospitals in crisis and need to be stabilized.
According to the report, the state wants adequate community services to help patients and that would reduce the number of people who go to the hospital for short term stays, leaving that space available for people with more complex needs.
The report states that DHHS aims the use of state psychiatric hospitals to be less than 46 percent for short term patients.
The Beacon Center scored 62 percent in its use of psychiatric hospitals.
The Beacon Center did not score well in continuing care after a patient is discharged from the hospital.
The state also gave The Beacon Center low scores in how often children receive services in non-family settings.
The Beacon Center earned high marks for how infrequently patients are readmitted state hospitals.
Scores were above state requirements for services to people who needed adult and child mental health also adult and child developmental disabilities.
Yet The Beacon Center fell short in that category with adult and adolescent substance abusers that needed help.
janet@wilsontimes.com | 265-7847
Director's ResponseHere is how Karen Salacki, area director of The Beacon Center, explained the center's low performance on a state report in two e-mails to the Wilson Times:
"The timely access initiation is measured only by billing that is from state funded or Medicaid funds. If a consumer has private insurance, Medicare, etc. then their service units are not reported.
Additionally, if a LME funds a provider with non-UCR (unit cost reimbursement) funds on a 1/12 basis then individual consumer services are not captured. The numbers for some services are also under reported due to providers not submitting billing for individual consumers in a manner that allows them to be captured for the report you cite."
...
"As we work in partnership with providers and the Division it is our collective goal that the data be accurate and that we have agreement on what is measured and ensuring that the data exists to accurately reflect compliance or non compliance.
Reporting of services is something that is done by the provider of the services but there are internal and external factors that impact data reporting and when reports are completed. One example was cited in my earlier e-mail where a provider is reimbursed on a 1/12 (one standard amount per month) basis and not a per person amount. Another impacting factor is that a provider of Medicaid services can have over one year to submit a claim for payment so if you are measuring service usage rates in order to capture all billing occurring in the measured time you would have to measure over a year retrospectively or you would have to measure an earlier time knowing that all billing may not yet be submitted.
Many of our providers bill very near the time that the service was provided but that is not always the case and much of our substance abuse funding is allocated on a 1/12 basis."
