BY NANCI BOMPEY * JULY 1, 2010
http://www.citizen-times.com/article/20100701/LIVING/307010029

More mental health patients in North Carolina's seven westernmost counties
could be served by a new provider taking over services this month.

Starting today, Smoky Mountain Center will no longer be providing mental
health services at Haywood Regional Medical Center and Balsam Center. It is
also divesting of its mobile crisis management and outpatient psychiatric
services in the region.

Haywood Regional, which previously contracted for the services, will take
over the 16-bed behavioral health unit at the hospital. Appalachian
Community Services will provide services at the 16-bed Balsam Center, a
short-term, facility-based crisis service. Appalachian will also take over
the mobile crisis management and outpatient psychiatric services serving the
seven westernmost counties in the state.

Roughly 80 full-time equivalent positions will move to Appalachian, and the
number of staff could increase, said Doug Trantham, director of the services
Smoky provided and now the clinical director for Appalachian. He said having
Appalachian provide the services, along with the services they are already
providing, will mean better integration of care for patients.

"Even if we weren't adding positions, I am confident we would be able to
serve somewhat more people and we could serve the people we are serving now better," he said.

Smoky Mountain Center, a local management entity, received a waiver to
provide services following mental health reform. Local management entities,
or LMEs, were supposed to divest of the direct services they provided and
become managers of the local service system, with private providers
providing direct services.

Smoky Mountain, like many other LMEs around the state, received the waiver
because there weren't enough private providers in the westernmost counties.
Today, it is only one of a handful of LMEs in North Carolina still providing
services.

Jim Pitts, president of the local and state chapters of the National
Alliance for Mental Illness, said Smoky had a good reputation and hopes the
services it provided will continue.

"I'd say patients and the public ought to be concerned when there is no
public provider," he said. "The private providers do well under the state
regulations ... but without the regulations they will drop services that
aren't paying for themselves."

The move from Smoky to Appalachian and Haywood Regional is in line with the state's newest regulations that seek to have mental health services provided by fewer, larger providers, said Brian Ingraham, CEO of Smoky Mountain Center.

"We understand that this is going to be a long-term relationship and a
commitment to sustain these services," Ingraham said. "We are not going to
let it fail."