Commissioners reluctant to pony up funds for mental health

by Jordan Green

by Jordan Green

The Forsyth County Commission’s Republican majority has signaled reluctance to grant a $1.5 million transfer to CenterPoint Human Services, an area mental health agency that manages federal, state and local funds; evaluates needs; and contracts with private providers to serve some of the county’s most vulnerable residents.

The requested transfer has been termed a “grant” because of legal barriers to the county making loans, but CEO Betty Taylor said the agency would repay it within five years.

Chairman Richard Linville, a man of few and obtuse words, said at the commission’s Aug. 9 briefing:

“It’s not clear, I don’t think, what the board may or may not want to do.”

Linville said the commission had been aware of the funding request, but decided not to address it in budget discussions earlier this year. The commission had planned to take the matter up in July, which the chairman acknowledged had passed. Later, reflecting on reductions in federal funding passed down by the NC Health and Human Services Department, Linville said, “The consequences are in place, and I’m not sure what we’ll end up doing.”

CenterPoint announced on Aug. 8 that in order to absorb a $1.1 million reduction in funding, the agency would cut $633,474 from developmental disability provider contracts, along with $333,256 to mental-health service providers.

Putting aside the $1.5 million funding request, the seven commissioners unanimously supported action by the county manager to release $4 million in funds already allocated to CenterPoint to help the agency address cash-flow difficulties.

“It will help tremendously, I think, with the cash flow, which is one of the issues CenterPoint’s dealing with is sufficient funds to staff up between now and December, and then after December the funding from Medicaid will start flowing into that,” County Manager Dudley Watts said. “It does not backfill or resolve funding issues with funds they’ve having to divert from services to do these administrative tasks….”

The agency is restructuring in January under what is known as a 1915(b)/(c) Medicaid waiver, a framework that governs the flow of federal funding to serve residents with mental illness diagnoses, substance abuse challenges and developmental disabilities. CenterPoint is requesting one-time, refundable contributions from Forsyth, Stokes, Davie and Rockingham counties, which fall under the agency’s jurisdiction. The press release issued last week indicated that if the counties did not contribute to the start-up costs of the reorganization, the agency would have to withhold funds that would otherwise go towards services.

“The providers have to absorb the cuts by cutting back on hours of service,” CenterPoint CEO Betty Taylor said after the briefing. “Family members who depend on a day program for loved ones, how do they maintain their day job?” Julie Henry, a spokeswoman for the NC Health and Human Services Department said all 14 area mentalhealth agencies, including the neighboring Guilford Center, lost a total of $19 million in federal funding. The reductions were a consequence of general scarcity of federal funding, not any punitive action, Henry said. She added that funding reductions by the NC General Assembly in recent years mean that the area agencies’ “fund balances are not as robust as they once were.”

Some consumer advocates, who have communicated their views to the county commissioners, have argued that the agency could absorb the cut by reducing salaries.

“And their point in making this public is… that the salaries are way out of line with other citizens in other areas,” District B Commissioner Dave Plyler said. “What was suggested was [if] we’ve got a big problem with getting a million-and-a-half-dollar grant from the county, then it would be wise to reexamine the monies that are being paid to the staff and see if you can’t lower that figure, if not eliminate it altogether. And, again, the answer to that question is: I don’t know.”

Taylor said that based on a compensation study conducted three years ago, CenterPoint’s salaries are in line with what other area mental health agencies in the state pay.

“The people we attract, we try to pay reasonable salaries and benefits,” she said. “There is no doubt in my mind that they wouldn’t be working for Center- Point if not for their dedication because of the stressful nature of the job.”

The agency’s most highly compensated employee, Medical Director Wayland C. Stephens, earns $240,000, while Taylor is paid $150,000. Chief Administrative Officer Ronda Outlaw and Chief Financial Officer Michael Beauchamp respectively earn $103,799 and $96,196. The remainder of the agency’s 105 employees earn less than six figures.

“What really is on the table that you’re considering now is do you fund the $1.5 million, which directly goes back into services immediately within Forsyth County to make those providers whole again, and get them back to the level of service that they were at on June 31,” Taylor told the commissioners.

Everette Witherspoon and Walter Marshall, the two Democrats on the board, urged their colleagues to grant the request.

“I’ve heard about the salary issue, and the truth is when you hire doctors their salaries are high,” Witherspoon said. “People who have doctoral degrees command high salaries. People who have advanced degrees, certifications, licensed practitioners — they have high salaries.

“More jobs will be created in Forsyth County,” he continued. “I’m not sure of the number; I think over a hundred or close to a hundred. And when you talk about compassion, doing what’s right for those with mental health diagnosis, doing what’s right for those who suffer substance abuse, doing what’s right for those who have autistic children, people who have developmentally delayed issues, people who are mentally retarded, it’s just about compassion. I think CenterPoint is good for the $1.5 million loan. They can pay back the loan, especially when they get over the jump of these initial start-up costs. And I just think it’s a great thing for Forsyth County and hopefully this board will move forward.”