This blog originally founded by Blogger who holds a theological degree and a doctorate in Counseling Psychology. Taught Psychology for 32 years and is now Professor Emeritus. Is a board-certified psychologist and was awarded the Lifetime Achievement Award in his profession. Ministered as a chaplain, and pastored Baptist and Episcopal churches. Publications cover the integration of psychology and theology. Served in the Army, the Merchant Marines and the Peace Corps.

Wednesday, October 5, 2011

New River Behavioral Health WEDNESDAY update.

After reading everything I could find from every media source, and having talked to Watauga County Board Of Commissioners Chair Nathan Miller, here is what I believe to be the case as of this moment.


1. Despite media announcements to the contrary, there is presently NO meeting of the 5 counties and Smoky Mtn Center officials scheduled for tomorrow. Apparently there is a lot of activity which will likely require the parties involved to meet, but as of now, no meeting has been formalized.

2. Back in 2006, when New River first came under the oversight/juristiction of Smoky Mtn Center, New River had a fund balance of around 8 million dollars. In addition, they have of course, continued to collect fees for their  services and also subsidies from the counties they serve. Watauga's annual payment to New River , I am told, is around $221,000. per year.

3. Since 2006 the operational expenses have apparently exceeded revenues to the extent that the $8 Million  fund balance has been depleted. A report earlier this year indicated that they would lose approximately $200K this year. A few months later, when the figure was revised upward to appx $1MILLION, the New River CEO asked for an audit. I am under the impression - but am not certain - that this audit revealed that the shortfall would be closer to $3MILLION.

4. Somewhere during this period, someone apparently made an allegation that there was Medicaid fraud involved. This is apparently  being investigated and during the interim, medicaid payments have been suspended.

5. As far as I can tell, there is no evidence of fraud that has been made public. All that exists at this point (apparently) is the allegation. BUT, there is still the matter of an organization that is out of money and not able to continue operations. Witholding of Medicaid payments certainly accelerates the demise! Whether the financial situation is the result of fraud, bad management or bad accounting, has not yet been determined. It does seem however, that alarms should have been sounded long before this time!

6. There  is also an open question as to what, if any, responsibility the various counties might have for any liabilities of New River which exceed its' assets.

I think it's fair to say that, at this point, the major concerns are for Watauga County to find appropriate replacement Mental Health Services and to limit any potential financial liabilities the county may have (If any). There will be time for adequate investigations and for assessing any blame after the immediate problems are resolved.

(See also Previous Article Here)

24 comments:

NewGuy said...

I am now hearing that the meeting is scheduled for Friday afternoon.

oatz said...

The biggest problem is that the CEO is a dumbass that ordered a new computerized accounting system that could only bill medicare or medicaid and didn't have a way to bill third party insurances. This problem has been covered up for three years! Millions lost because no one had a business degree or a second grade education.

guy faulkes said...

This situation is not a good one. Many people legitimately rely on NRBH for needed services. Hopefully the fraud or waste can be eliminated and those that really need the services can receive them from somewhere.

The Wolf did bring up an interesting side effect. Where does one now go to get the report needed for a concealed carry permit?

NewGuy said...

Another good article from Jefferson Post..

http://www.jeffersonpost.com/view/full_story/15907282/article-Counties-push-to-remove-New-River-Behavioral-Healthcare-management-?instance=home_news_lead

Blogger said...

NewGuy “and to limit any potential financial liabilities the county may have (If any).” Looks like it is already happening. Today’s Watauga Democrat: “Avery County commissioners voted Monday to fund the institution's payroll through October, a budget amendment that could cost the county up to $90,000. Ashe County has already allocated $170,000 for the year.”

If the county commissioners had let NRBH go back when all the other counties in the state did (with one exception), they would not have this liability now.

Blogger said...

NewGuy Is the meeting to be public? If so, what time?

NewGuy said...

From what I gather, things are moving pretty quickly and the situation is very dynamic. Keep in mind that the printed newspapers are, because of their lead times to print, dealing with 'yesterday's' information. What I posted was current info as of the time I posted it.

I would suggest that Steve Frank at the radio station probably would have the most current info and he usually updates GoBlueRidge.Net as news develops.

NewGuy said...

Wilkes paper...
today

http://www.journalpatriot.com/news/article_93d69514-ef79-11e0-be06-0019bb30f31a.html

inquiring mind said...

Did anyone see the classifieds? There seems to be an organization hiring mental health professionals with special consideration to NRBH employees. See Watauga Democrat jobs on line.

Anonymous said...

What about the New River staff, who have been committed to consumers day in and day out, and continue to provide services even now, losing their retirement, with their pay in question? The last thing this state needs is more unemployment.

NewGuy said...

http://goblueridge.net/index.php?option=com_content&view=article&id=13391:rare-5pm-friday-session-planned-over-new-river-bhc&catid=1

GoBlueRidge.net confirming Friday meeting scheduled for 5pm.

Blogger Away said...

For those trying to catch up to speed on the NRBH problem, here is one of the bottom lines from The arrangement between the five counties, New River and Smoky Mountain, the only one of its type in the state, required approval by the state legislature . Officials of Wilkes and the other four counties pursued this with a goal of maintaining more local control of behavioral health care services when these services were being privatized elsewhere in the state.

Blogger on the road said...

"What about the New River staff?" Let's hope it works out for them. However, it was the staff who convinced the county commissioners to maintain the responsibility for them. All the other county commissioners in the state divested themselves of this liability. New River had to get a special dispensation from the legislature to avoid divestiture.

At the time, only one board member spoke against the county commissioners' decision. He predicted what is happening would happen.

Blogger on the Road said...

I have no inside information. However, reading between the lines, it sounds like the county commissioners are now scrambling to do what should have been done from the get-go. If they succeed there will be private organations coming in to pick up things and there should be no hardships for the consumers being treated.

Blogger on the road said...

Because I am away and can't remember my password, I can't post so I will have to use the comment page until I get back. NC Mental Health sevices drifted into a deep mess in the 80's and 90's. The Legislatue demanded reform and Virginia Foxx was on that committee. The reform was done and a new non-government private system was put in its place. Only New River refused to go along.

Unfortunately, the new system has been gamed by the private providers and now there are new calls for reform. The only problem is that there are people now in power in Raleigh who wern't around then to remember how bad the old system was and why it had to be reformed. We now can't go back and we can't go forward.

The system will work if Raleigh bureaucrats weren't so incompentent and would carry out their overseeing responsibilities.

NewGuy said...

blogger....what is the function of the "Local Management Entity" - in this case Smoky Mountain Center? I thought they were responsible for overseeing New River, assuring the viability of the organization going forward, etc...

"LMEs are responsible for managing, coordinating, facilitating and monitoring the provision of mental health, developmental disabilities and substance abuse services in the area that they serve."

Every time you get politics involved in what could be better handled by private enterprise, you end up with a result like this. As I said in my initial post on the topic - it has similarities to the Appalcart fiasco with their new building and inability to keep financing straight!

Blogger on the Road said...

NewGuy, The LME is much like a managed healthcare company. They take in the money and pay the private providers. The LME is to be seperate from the providers. I think I am correct when I say that New River providers were a quasi-governmental entity.

The LME sources of money are Medicaid, State funds, insurance, and private payers. The resal problem is the recession. Where they privatized, as money ran low, the private providers had to eat the loss. After reform, the New River providers talked the commissioners into keeping them as a type of quasi governmental private provider entity. Thus, unlike the rest of the state where private providers suffered as LME's ran low, New River's providers were this local group. Now as the LME goes under, it means River provider group goes under.

Blogger gone said...

Time on computer ran out before I could correct errors. See you later.

Sarkazein said...

Headed for Wall Street?

oatz said...

Seriously folks its as simple as New River doesnt have a computer system to bill third party insurance companies! They have been covering it up for three years! Companies that can actually pay instead of tax dollars have not been billed in over three years. New River went from a 3 million surplus and in three years is 7 million in the hole. A therapist should do therapy and a business person should "run" the business.

Blogger said...

Oatz: "A therapist should do therapy and a business person should "run" the business."

Yes. When the LME's were established, this was what had been hoped for. However, some LME's such as New River, gave the old providers the choice of either continuing being providers, or to take on the administrative jobs of the LME. Some of the best providers chose to run the LME's.

In the old system before reform, mental health centers were run by people trained to do therapy, not administration. The resulting mismanagement of many area programs became one of the sources of the scandals that led to the original demand for reform.

So, after reform when providers took over the LME's, it defeated one of the purposes of the reform.

NewGuy said...

oatz seems to have some knowledge of the problems. Maybe he will share more with us?
Thanks Oatz.

inquiring mind said...

Why is that government signs on the dotted line and then drops the ball? They always seem to be taken by people who want to take the taxpayers and those who are responsible for oversight are too busy or just plain don't care. Then something goes wrong. The problem is that they never clean up their act; it just keeps happening.

Maybe it needs to be private and the government needs to stay out of it - too much government! The taxpayers don't need this kind of liability. It looks like the New River employees are being offered first dibs on jobs.

And, as for pensions, they probably will not be as lucrative as those government babies are. That's just the way it is; join the rest of us. And, those health insurance and dental plans will not be as lucrative as those government treats are. Again, join the rest of us. Anyway, it won't be long until all of the government employees will be joining the rest of us in the trenches without employer subsidized health and dental. Gone will be the days of retiree health plans. And, as of the pension plan; they will be replaced with 401k plans. Life's a bitch.

oatz said...

I have several friends that either work or have been "rif" reduction in force in the past 15 days at New River. The problem IS that simple, I know its scary to believe, but its true. Therapists make BAD business leaders especially in this case. Just because its a non-profit doesn't make it ok to loose money. Especially when a second grader could have fixed the billing issue.