Details on $1 billion for N. Carolina mental health unveiled

A proposal on how North Carolina should spend $1 billion in one-time funds from the federal government to improve mental health care for children, adults and criminal offenders is taking shape with a bipartisan House measure filed on Tuesday.

The legislation goes into detail on what to do with a large chunk of the anticipated $1.8 billion to be received stemming from the state's decision last month to expand Medicaid coverage to hundreds of thousands of low-income people.

More people are struggling with mental health and substance abuse disorders — leading to higher rates of depression, drug overdoses and youth suicide, according to Democratic Gov. Roy Cooper's administration.

“We stand united before you, committing our resources against a common enemy,” Rep. Kristin Baker, a Cabarrus County Republican, psychiatrist and a bill sponsor, said at a Legislative Building news conference. “And it’s an enemy that threatens us. It threatens to steal our joy, it threatens to steal our children, threatens to steal our lives.”

The proposal largely aligns with Cooper’s suggestions in his state budget that he unveiled last month, and was developed with help from state health department leaders, according to Rep. Donny Lambeth, a Forsyth County Republican and another sponsor.

The lack of more private and public hospital beds contributes to 300 people daily sitting in emergency departments seeking behavioral health services, House members said. And they say dozens of children with complex service needs are sleeping in these departments or in local social services offices.

“There is nowhere else to go,” said Democratic Rep. Carla Cunningham of Mecklenburg County, another sponsor.

Tuesday's bill would spend $225 million to raise over three years reimbursement rates for behavioral healthcare providers to care for Medicaid patients. The proposal envisions spending $100 million toward caring for people in the state's psychiatric hospitals, including to help raise compensation for the hospitals' workers and to implement electronic medical records programs there.

There's $150 million to assist with helping people within the criminal justice system get mental health treatment or avoid jail. Other spending would help develop community-based mental health services, including mobile crisis teams and short-term accommodations for youth in need of services and housing for adults. There's also money for the 988 Suicide & Crisis Lifeline.

Lambeth, a chief House budget-writer, said he hoped that the spending line items are ultimately added to the final state budget. He said a key senator on mental health issues has expressed support for the spending, with some exceptions.

Lambeth acknowledged that since the $1 billion is a one-time bonus, some long-term initiatives contained in the House proposal would need more permanent sources of money.

The Senate is expected to pass its version of the budget in May. The House's edition of the budget set aside the $1 billion in reserves but didn't contain specifics on how to spend it.

Thanks to language in the Medicaid expansion law, a separate state budget law must be enacted for the coming year in order for expansion to occur, and ultimately for receipt of the bonus funds.