|
|
Reports - Health and Human Services
 |
Enhanced Services Package Implementation: Costs,
Administrative Decision Making, and Agency Leadership
(July 2009)
This follow-up to the Division's July 2008 report, Compromised Controls and Pace of Change Hampered Implementation of Enhanced Mental Health Services, examines expenditures, decision-making, and leadership associated with implementation of the Enhanced Services Package. Findings indicated a total of $2.4 billion was spent on enhanced services from April 2006 through February 2009, $827.2 million of which was North Carolina's share of the costs. Analyses suggest effective planning and better oversight could have avoided costs of $498.5 to $635.3 million, of which $177.4 to $226.2 million would have been North Carolina's share of the avoided costs. |
Executive Summary
Final Report
Presentation
Handouts |
 |
Caring for Previously Hospitalized Consumers: Progress and Challenges in Mental Health System Reform
(December 2008)
Building on the July 2008 Program Evaluation Division process evaluation, this report examines services delivered by the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services after system reform. Analyses of services received by 22,516 individuals previously hospitalized in substance abuse or psychiatric facilities suggest that gaps in community-based services persist among those discharged from state-operated facilities, and among individuals with a history of one, versus multiple, hospital discharge. Individualized tracking across facilities, service types, and funding sources is needed to improve continuity of care and to generate comprehensive statewide data. System oversight and management should focus on increasing capacity and quality of community-based services.
|
Executive Summary
Final Report
Presentation
Handouts |
 |
Controlling the Cost of Medicaid Private Duty Nursing Services
(December 2008)
The North Carolina Medicaid Program covers private duty nursing—medically necessary continuous, complex, and substantial nursing services provided by a licensed nurse in a recipient’s home. Under federal law, private duty nursing is an optional Medicaid service for adults and a required Medicaid service for children. The Division of Medical Assistance should adopt the cost-containment mechanisms used by other states for its private duty nursing benefit for adults. The Division of Medical Assistance should modify the Community Alternatives Program for Children, which is subject to budget limits, to encourage use of the waiver program by children in need of continuous skilled nursing. |
Executive Summary
Final Report
Presentation
Handouts |
 |
Compromised Controls and Pace of Change Hampered Implementation of Enhanced Mental Health Services
(July 2008)
Since 2006, the state has struggled to implement a new array of mental health, developmental disabilities, and substance abuse services. Several factors contributed to implementation problems, including the pace and scope of implementation, insufficient forecasting and monitoring, and lack of information about system performance. The Department of Health and Human Services should collaborate with other stakeholders to re-evaluate what information is needed about system performance, how it is collected, and how it is presented. Additionally, the evaluation recommends focusing analytic efforts within one specific office of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services to ensure consistency, depth, and quality of analysis.
|
Executive Summary
Final Report
Presentation
Handouts |
|
