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Macon DSS director pens letter of concern regarding pending legislation

The following was a letter sent by Macon County Director of Social Services Patrick Betancourt. More coverage of this issue will be forthcoming.

I want to take a moment to make you aware of an issue directly affecting the children and families
served by the Macon County Department of Social Services. Currently, children and families served by the child welfare system in NC are connected with their Local Management Entity-Managed Care Organization (LME-MCO) to address the mental health, behavioral health, substance use, and developmental disability issues that may have contributed to their involvement in child welfare in the first place. For nearly 50 years, children and families have been served by our local LME-MCO, Vaya Health (previously known as Smoky Mountain Area Mental Health). Recently, however, the NC Department of Health and Human Services has issued two policy papers in which they propose asking the General Assembly to allow issuance of a single, statewide plan to serve these vulnerable children and families. This statewide plan is being touted as a “silver bullet” to address system issues such as lack of providers to deliver services, equitable access to all services regardless of location, and a way in which to lower costs associated with serving these families.

However, I want to offer a counter view to these claims: that is, these concerns and many others are currently being addressed in every county in NC through a partnership between local departments of social services and their respective LME-MCO. Establishing an additional, separate statewide mental and physical health plan to deliver many of the same services already being provided through existing plans will lead to duplication of service (increasing costs overall), confusion for families and professionals alike as to whom to turn to for services, and overall system fragmentation. Such service duplication will only exacerbate the staffing shortages already seen throughout the system, especially in rural areas. Macon County, like the other far western six counties, already suffers a lack of access to resources because of both our rural nature as well as geographic location at the end of the state. It is implausible that a single, statewide plan will afford the counties in far, western NC equitable access to the same services that are received in Raleigh, Greensboro, Charlotte, or Winston-Salem. In fact, even local government officials in
Winston-Salem share concerns with a single, statewide plan. You may have seen Wes Young’s article in the Winston-Salem Journal that addresses these concerns.

Rather than a single, statewide plan, Macon County Department of Social Services trusts Vaya Health to work collaboratively with us and with our local providers to deliver care and services that the vulnerable children and families involved with child welfare deserve. I welcome the opportunity to speak with you about our concerns in more detail. If you wish to discuss this further, please feel free to reach out to me.

Thank you for your time to this important issue.



R. Patrick Betancourt, Director

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