Access to care and crisis intervention training for law enforcement officers top the business plan for Alliance Behavioral Healthcare, the state-funded agency charged with disbursing public mental health dollars in Wake and Durham counties.

Both were among the top local initiatives for the agency’s 2014-2016 plan as presented to Durham and Wake county commissioners Monday. Read a copy of the plan on the Durham commissioners’ website
here. The plan, which identifies service gaps and lays out strategies for addressing those gaps, requires review by county officials before Alliance can submit it to the N.C. Department of Health and Human Services.

Durham Commissioner Michael Page, a local pastor who sits on Alliance Behavioral Healthcare’s board of directors, says the group is pushing an array of services to meet longtime service gaps in the community. Page said substance abuse treatment is his top priority for Durham.

“I just think right now we’re in a stage of the game where people need to be able to access services and be able to access it fairly readily,” he said.

Alliance serves a combined population of about 1.7 million—187,000 of which are Medicaid eligible—in Durham, Wake, Cumberland and Johnston counties.

According to Alliance’s business plan, the group will focus on speeding access to mental health providers, citing seven- to 10-day waits after residents called for services. Alliance execs also say they will roll out crisis intervention courses for law enforcement officers in the region, noting residents with mental illness are sometimes taken to jails when they would be best served in a mental health care facility. The report did not offer specifics about the frequency of such events.

Those were just a few of the goals contained in Alliance’s business plan, which also reflected a statewide push for community-based treatment methods, meaning supported housing options, employment and in-home treatment teams intended to head off institutionalization.

State health officials negotiated a settlement with the federal government in 2012, pledging to spend an estimated $287 million on job training, treatment and housing for people with mental illnesses over eight years.

If state lawmakers renege on the settlement, they risk a lawsuit from the U.S. Department of Justice. The state settlement stemmed from a Disability Rights North Carolina complaint that the state institutionalized too many of its residents for years, rather than promoting community programs that encourage independence.

Nevertheless, the Republican-controlled N.C. General Assembly has cut roughly $100 million from mental health funding in the last five years, state Rep. Verla Insko, D-Orange, told INDY Week in June.

Meanwhile, groups like Alliance, referred to as local management entities or LMEs, are under intense scrutiny from mental health advocates statewide, who worry the budget-strapped state’s reliance on private companies such as Alliance to manage public mental health cash will lead to increasing costcutting.
Orange County’s LME, Cardinal Innovations, is already the subject of a federal Office for Civil Rights investigation into whether its denial of Medicaid reimbursements for undocumented immigrants breaks the law.

The Alliance business plan presented Monday did not include financial information about the group. Alliance CEO Ellen Holliman could not be reached for comment on the business plan this week, but Page says he believes the agency is doing the best it can despite legislative rollbacks.

“Until they can fine-tune this process, it might very well be the best we can do right now,” Page said. “We have to have the services.”