Gov. Roy Cooper unveiled his plan Wednesday that will put $1 billion into addressing North Carolina’s mental health and substance use crisis. His budget proposal will be released in the coming days and will include the investments detailed in the Mental Health Plan.
Anxiety and depression rates have soared since the COVID-19 pandemic, especially for students when the state closed schools during that time. NC Department of Health and Human Services issued a press release last month that shows North Carolina saw a 22% increase in overdose deaths in 2021, the highest number of overdose deaths in a single year on record in the state, and that 77% of those deaths likely involved fentanyl, often in combination with other substances.
In addition, the North Carolina Child Fatality Task Force issued a report last month stating that the suicide rate for youths between the ages of 10- and 17-years-old reached the highest in two decades in 2021 in North Carolina. There were 62 suicides among young people in this age range, 42% of those being among teens ages 15 to 17.
“Our mental health system is under significant stress and in need of major investments to make sure every family, student, and North Carolinian can get critical care,” said Cooper, a Democrat. “This plan tackles the ongoing mental health crisis in a direct and meaningful way by investing in the whole-person health of North Carolinians. It will empower workplaces, schools, and local governments in search of more ways to help their communities, and most importantly, it will save lives.”
There may be a better alternative, however, by repealing Certificate of Need laws.
“Gov. Cooper wants to spend $1 billion in taxpayer funds to address a mental health and substance abuse crisis he helped create through his draconian, harmful, and needless Covid lockdowns,” said Brian Balfour, senior vice president of research, John Locke Foundation. “Another alternative to provide access to needed care that wouldn’t cost taxpayers a dime would be to repeal Certificate of Need (CON) laws, especially those restricting mental health and substance abuse facilities. A 2021 study released by the John Locke Foundation found that CON laws are associated with a state having 20% fewer psychiatric hospitals and fewer affordable substance abuse facility options. This should have been done years ago, and should be done without having to expand Medicaid.”
The plan outlines three areas for investment in the continuum of behavioral health care: making behavioral health services more available when and where people need them, building strong systems to support people in crisis and people with complex behavioral needs, and enabling better health access and outcomes with data and technology.
In the area of making behavioral health services more available, Cooper proposes raising Medicaid reimbursement rates by $225 million for behavioral health services. Reimbursement rates have not been updated since 2013.
A proposed $175 million to improve access to routine, integrated care in communities and schools would invest in behavioral health alongside physical health services provided through primary care, schools, and clinics.
He also wants $150 million to help those leaving jails to transition back to the community, increase jail-based programs that restore mental capacity for trial, and provide resources to judges who determine when other services may help.
Under the section on building strong systems to support people in crisis and with complex needs, Cooper wants to put $200 million into a statewide behavioral health crisis system that would include housing support, mobile crisis teams, and better services in drop-in clinics.
An additional $100 million would go toward child welfare and family well-being, with community support and foster homes for children that enter child welfare services with complex behavioral needs.
Cooper also wants to give $100 million toward creating sustainable hospitalization and step-down options as demand for in-patient treatment is higher, while staffing has reduced the number of available beds. He also wants to see an increase in open beds in step-down facilities
Finally, he wants to allocate $50 million for telehealth in rural communities, better tracking for psychiatric beds, and increased use of electronic health records.