CenterPoint loses $1.1 million in funds

by Amy Kingsley

The mall can be a scary place for a child with autism.

Just ask Chris Cota, whose 7-year-old daughter Lexi suffers from the neurological condition that impairs her ability to communicate and process information. When she lived in Winston-Salem, Lexi needed regular therapy to overcome her department store terror.

“She had a tremendous fear of going to the mall because of the size of the place,” Cota said. “All the noise and the people were really intimidating.”

Her therapists started small. On the first trip they pulled into the parking lot. She made it to the sidewalk on the second. Eventually she touched the door, opened it and stepped in – a major breakthrough in five baby steps.

“It was wonderful,” Cota said.

While it lasted, that is. Cota’s daughter became a client of Forsyth County’s mental health system at an inauspicious time for the agency – several years after the state mandated the privatization of services and during a federal reorganization that shifted funds available to her.

CenterPoint Human Services, the agency that manages mental health services in Forsyth, Davie and Stokes counties, kept the family in limbo for a year before awarding them the 15 hours of community support services that enabled their daughter’s shopping-mall triumph. Then the agency took back several hours of aid that would have given Cota and his wife an occasional break from the demands of raising an autistic child.

Less than four months after the Cota family became clients at CenterPoint, the federal government eliminated community-based services, a Medicaid program serving children like Lexi. Alternative programs absorbed 370 of the 500 CenterPoint clients who had been receiving community-based services, said Finance Director Kevin Beauchamp. The state stepped in to serve the remaining 130 clients by establishing a program of developmental therapy that would operate without the approval of the federal Medicaid system.

They drew up a budget, checked CenterPoint’s books and adjusted their funding accordingly. On Jan. 23, 2007, halfway through the fiscal year, the NC Department of Health and Human Services awarded CenterPoint $589,765 to pay for the developmental therapy program for children. That was on top of $625,614 the state had devoted to developmental therapy in August 2006 that Beauchamp said was carved out of other portions of CenterPoint’s budget.

The extra money allocated for children never found its way to families like the Cotas. Beauchamp said CenterPoint wasn’t allowed to fund developmental therapy for new clients but could only use the money on the 130 children shut out of other federal programs.

“At the cutoff date we were given,” Beauchamp said, “someone new to the system would not have developmental therapy as an option.”

By the end of the year, CenterPoint had spent only 3.6 percent of its mid-year bonus. Beauchamp said CenterPoint – which doesn’t provide any services itself – didn’t have enough time to add new therapists and didn’t want to increase the hours of families already receiving therapy because they would have to decrease them again just a few months later. Families enrolled in developmental therapy would need to meet with case workers and adjust their plans to get any extra hours – a process that can take weeks or even months.

CenterPoint was also limited by the state’s strict funding rules. The agency cannot shift funds between different divisions, so money allocated for developmental therapy could not be used for substance abuse or mental health programs, Beauchamp said.

Because CenterPoint didn’t use all of its allocation, including funds for other programs besides developmental therapy, the state cut the agency’s budget for the following fiscal year by more than a million dollars. If CenterPoint had spent the $625,614 it received early in the fiscal year, it would have received the money the next year. The $589,765 it received in the middle of the year would not have been recurring, said NC Department of Health and Human Services spokesman Brad Deen. So the agency started fiscal year 2007 with much less money for adults and children like Lexi.

Beauchamp said CenterPoint spent 100 percent of its money last year and will start the next year with the same amount of money. A year later, the agency will switch to single-stream funding, which means that the state will award their funding in a lump sum instead of buckets allocated to individual programs. That will give CenterPoint greater flexibility to spend money of the programs that need it most.

Almost half of the state’s two-dozen mental health agencies qualify for single-stream funding, Beauchamp said.

“The qualification for single-stream funding is that your organization has to have demonstrated good management,” he said.

Cota heard from CenterPoint last year that his daughter now qualified for the developmental therapy services she had been locked out of the year before. But the family couldn’t take advantage of it because they had already made plans to move to South Carolina, where more services are available.

“We knew that if we stayed it would be a constant battle to get services,” he said.

Within a month of moving to South Carolina, the Cotas qualified for the service hours that would allow them to take a break from caring for their daughter – services they had been denied in Winston-Salem.

“The people who are getting services in Winston-Salem are always just having to fight to keep them,” Cota said. “It’s just really hard on families.”

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