New River Behavioral Health Care: Waiting for the autoposy

With the announced closing of New River Behavioral Health Care, the mayhem that is the only constant in the state’s mental health system has claimed yet another victim.

According to news reports, the former LME that morphed into a provider agency after its July 2007 merger with Smoky Mountain Center is almost $3 million in debt and being audited, with commissioners from the counties served holding emergency meetings to see how best to continue services to the agency’s 13,000 clients and hopefully retain jobs for its 300 employees. And, of course, they’re trying to sort out who’s responsible for the agency’s bills as well.

Beginning in the ’60s as a community mental health center, the reasons for New River Behavioral Health’s demise are likely complex and varied. But before the agency becomes just another footnote to more than a decade of chaos, it’s worth considering how the continued consolidation of providers and LMEs may have affected New River’s financial health. At the very least, it’s worth considering the power that LMEs have to make or break an agency. And on the surface at least, the decision by Smoky Mountain Center to award a contract for services in its Central Region to RHA Health Services could be seen as the final nail in NRBH’s coffin.

Whether friction remained from the 2007 merger or not, by June 2010, New River’s discontent had made it into the minutes of the Smoky Mountain Center’s board. Those minutes refer to rumors that New River’s board was looking to meet with county commissioners of SMC’s Northern Region to discuss jumping to another LME, likely Crossroads Behavioral Healthcare. Those minutes, which include a fairly lengthy discussion of the issues involved, can be read here.

A year later, things had not improved, with minutes from this past May’s Smoky Mountain Center’s board meeting, noting a letter from the NRBH board with the following concerns:

  • Not receiving the Central Region RFP
  • Overmonitoring of NRBH service delivery
  • Not being able to reconcile the claims processing procedures
  • Professional Relationships – the feeling that NRBH staff was not valued

On September 9, New River announced on its website that it would be discontinuing its services to Smoky Mountain’s Central Region — Alexander, Caldwell and McDowell Counties — that had been awarded to RHA. On September 22, the Department of Health & Human Services through its Division of Medical Assistance announced Medicaid payments to New River had been suspended due to allegations made against New River. And a week later, Smoky Mountain Center CEO Brian Ingraham announced New River would be closing.

Perhaps it’s just a matter of New River simply not performing well, but the rapidity with which the dominoes fell last month would seem to indicate there’s more to it than that. And while an official cause of death may never be forthcoming, the end result is that the state will soon have one less provider, with another provider agency ready to step in and strengthen it’s already strong statewide prescence.

David Cornwell

Executive Director

North Carolina Mental Hope



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