The North Carolina Department of Health and Human Services recently laid out a road map for improving behavioral health services in the state. The report to the state legislature was the result of numerous stakeholder meetings and six listening sessions across North Carolina. In fact, it goes beyond mental health: The Department of Health and Human Services (DHHS) stresses the importance of breaking down silos to deliver “whole-person care.”

The result is a document that is important reading for all health care providers – behavioral and physical – in North Carolina. It provides rich information and gives a sense of direction for where state health leaders want to go, although they acknowledge this is merely a first step.

“There’s a shared understanding that this plan will evolve over time to meet the changing needs of North Carolina’s residents,” said Mark Benton, DHHS Deputy Secretary for Health Services, in a press release. “What we’re laying out builds upon the strengths of the current behavioral health system and looks to a future where everyone is able to access the right care at the right time.”

Below are a few highlights from the report:

• DHHS under Democratic Governor Roy Cooper renews its call for Medicaid expansion under the Affordable Care Act. This continues to be a controversial proposal in North Carolina, and health leaders are now framing it as another way to help fight the opioid crisis. (You can find more detail on pages 32 and 33.)
• In an effort to expand access for longer stays at residential treatment centers – and to reduce state costs to support alcohol and drug abuse treatment centers – DHHS is seeking a federal waiver to the institutions for mental diseases (IMD) exclusion. If granted, this would open up more Medicaid dollars for institutional care for mental health issues. (More information on page 44.)
• Throughout the report, there is a major emphasis on shifting toward community-based care. The report describes the important role community-based services play in getting people timely, high-quality care. This ultimately could mean more opportunities for home and community-based care providers, although the devil will be in the details.

As noted above, the DHHS report is a first step in what will likely be a long road toward concrete changes. We will continue to monitor the plan as it evolves and state lawmakers have their say.