Jule Huabbard / Wilkes Journal-Patriot
Updated: Wed Jul 6, 2016
Preliminary plans for a facility in North Wilkesboro to improve access to crisis care and divert people needing this care from hospital emergency departments were discussed during a Wilkes County commissioners meeting Tuesday morning.
The “facility-based crisis center” would serve residents of the northern region of Smoky Mountain Local Management Entity (LME), which encompasses Wilkes, Ashe, Alleghany, Watauga and Avery counties.
Using state, federal and local funds, Sylva-based Smoky manages behavioral healthcare services through contracts with providers in Wilkes and 22 other western North Carolina counties.
Shelly Foreman, senior director of public affairs for Smoky, shared details of this and other aspects of Smoky’s community and capital reinvestment plan in the meeting, which she said calls for spending about $17 million of the LME’s fund balance in the 23 counties.
Foreman said the facility-based crisis center would be an addition to the Daymark Recovery Services building at West Park, North Wilkesboro, “which is great because that way people have access to (Daymark’s) out-patient services.”
Daymark leases the building from Wilkes County government and is the primary provider of behavioral healthcare services in Wilkes.
According to literature Foreman provided, the Smoky board reserved $1.3 million of the fund balance for the facility-based crisis center in North Wilkesboro.
She said meetings involving County Manager John Yates, other local government, Smoky and Daymark representatives have been held “to figure out how we’re going to pay for this.”
Yates said in an interview that he was told that it would be a 16-bed center with about 9,000 square feet of floor space costing about $2.1 million.
Yates said he also was told that conditions of all but two of the people brought to the Wilkes Regional Medical Center Emergency Department under petitions for involuntary commitment for in-patient hospitalization due to psychiatric or controlled substance problems in the last six months were such that they could have been treated at the new center planned in Wilkes instead of elsewhere.
It will also serve people seeking help through voluntary commitment.
Foreman said a facility-based crisis center is “one step below in-patient hospitalization” in facilities such as Frye Regional Medical Center and Cannon Memorial Hospital.
Residents of Smoky’s northern region (Wilkes, Ashe, Alleghany, Watauga and Avery counties) will be among the few people in the 23 counties who live more than the recommended maximum distance of 30-45 miles from a facility-based crisis center after one of them opens soon in Lenoir. Ground was broken on the facility in Lenoir this spring.
When a magistrate or court clerk signs a petition saying a person is or could be dangerous due to mental illness or substance abuse, a law enforcement officer transports the person to WRMC for evaluation to determine if the person should be involuntarily committed to a licensed 24-hour treatment facility.
Due to limited space in these 24-hour facilities, people at Wilkes Regional Center awaiting involuntary commitment typically wait several hours and sometimes over a day. Officers must be with them while they wait so it takes officers away from other duties.
County Commissioner Gary D. Blevins, who represents Wilkes on the Smoky’s county commissioner advisory board, said the new center will have different arrangements for security so this burden on local law enforcement will be eased.
Blevins said that according to Daymark Recovery Services CEO Billy West, the new center will provide over 20 new jobs.
Foreman said, “Because of the kind of program this is with people there who know how to deal with crises, they (officers) will have someone there they can relinquish custody to…. so the law enforcement officer isn’t sitting there waiting while the person is evaluated” and during placement.
She said Smoky has increased its emphasis on community-based resources and programs for crisis care.
“The State of North Carolina has continued to diminish the number of beds in state hospitals for people who don’t have insurance…. It’s very challenging to find (behavioral healthcare) beds for people who are elderly, for kids…. It’s just a really, really hard situation,” she said.
“The one caveat I have is that the State of North Carolina continues to cut (funding for) behavioral health services…. They’ve probably cut multiple things from your perspective. The state has mandated that we replenish what they cut with our fund balance, which is the money we are using to do the expansion services,” she said.
“We believe we are going to be able to do the vast majority of these, but we will continue to watch funding and keep you updated.”
Foreman said updates will be provided at Smoky’s county commissioner advisory board meeting. She said Blevins never misses those meetings and is a strong advocate for county interests.
Eddie Settle, chairman of the commissioners, asked who decides the membership of the board that actually governs Smoky. “I’ll just tell you, people in the northwest (counties) feel they’ve been treated like a red-headed stepchild,” he told Foreman.
She said the board appoints its own members who, as directed by the state, represent certain areas of expertise rather than certain counties or areas. There are no representatives from Wilkes.
Foreman said Smoky recently held community meetings in every one of the 23 counties “and by far the community felt they were very well served” by Smoky and Daymark. There are plans for more of the community meetings, she added.
Foreman said part of why she is working completely on county relations is to make sure county government officials have that same perception “and same level of knowing who to call if you have questions or concerns.”
She said Smoky also put funds and efforts into making transitional housing available for people recovering from substance abuse addiction.
Smoky also is working with every department of social services in its 23 counties on a program called Life Sets, which “is an intensive program working with kids who are aging out of foster care.” She said the goal is helping people ages 16-21 acquire job skills.
Smoky put $400,000 for developing a process to identify young people on track to ending up in jail and work with local officials to steer them otherwise, she said.
Foreman said Daymark and other providers in Wilkes with contracts from Smoky Mountain provided mental health and substance abuse services to almost 3,200 people in Wilkes in 2014-15. She said about 2,100 of these people were on Medicaid and about 1,000 were served through state funds.
She said these same providers served 2,350 people in Wilkes in the first six months of this year.
“The number of people being served seems to be what you would think would be served” in Wilkes based on the county’s population and in comparison to other counties, Foreman added.
The 2016-17 Wilkes County government budget included $254,200 for the Smoky Mountain Center, the same as the prior year.
Article Reference: Involuntary Commitments among issues addressed:Crisis Center Planned Here