Ashe County Commissioner Judy Porter Poe presented information to her fellow board members that Ashe County spends more money per capita for mental health funding than other surrounding counties, even though each county receives the same basic services.
“It’s not fair we’re getting the same programs as Wilkes, and they aren’t paying near what we are per person,” said Poe during the commissioners’ planning meeting on May 20.
According to Poe, Ashe County allocates $6.91 per person to Smoky Mountain Center for mental health services. Alleghany allocates $10.43 per person, Avery allocates $5.18, Watauga allocates $4.24 and Wilkes allocates $3.72.
“We’re going to have to decide if we’re going to continue paying this amount of money while other counties are paying nothing,” said Poe to the board.
Even though Alleghany County is paying more per capita than any other county in the five-county region, county manager Don Adams said per capita figures could be misleading.
“Yes, it seems unfair when you looks at it per capita,” said Adams. “However, there is a base-cost of operations for mental health services, making it look like smaller counties are paying more.”
Since 2008, Ashe County has budgeted $189,566 each year in “maintenance of effort” funding to Smoky Mountain Center. During the same time frame, Alleghany County averaged $115,270 per year, Avery County $91,840, Watauga County $221,194 and Wilkes County $299,118.
Adams said before the establishment of LME Smoky Mountain Center, each county funded a small, regional entity called New River Behavioral Health, where each county recieved services based on individual funding.
“No matter how you look at our five counties, we’ve been very supportive of mental health, it’s when you start comparing our region to other places in the state that you start to see some real discrepancies,” said Alleghany County Manager Don Adams.
“We had a very good system here,” said Adams, “even before I got here, our region invested in mental health.”
New River Behavioral Health serviced the mental health needs of the five-county region for several years. Even though NRBH was regional, each county was represented on a very small board.
According to Adams, the State of North Carolina decided monies from the state would be more efficiently handled by a regional entity as opposed to a local entity.
As the state began restructuring how mental health care operated, it was decided that funding for administration and funding for providers should be separated. Thus, the LME Smoky Mountain Center for Mental Health was born to administer mental health services to an even larger region, and NRBH became a care provider, and was renamed New River Service Authority.
However, NRSA soon became insolvent and collapsed, according to Adams.
Recognizing the need for a new mental healthcare provider, Smoky took on Daymark Recovery Services as the area’s central provider. However, unlike NRBH, Daymark is a private entity, and counties do not have official representation on Daymark’s board.
“Mental health is in a strange hybrid situation, it goes back several years when the state decided funding for administration should be separated from providers’ funding,” said Adams. “Before, we knew the money was pretty much going to just our county,” said Adams.
“For as long as I have been here, there has been a rule that restricts counties’ abilities to reduce funding for mental health,” said Adams. “That wasn’t a problem until the LME was created. Now county funding goes to Smoky.”
Daymark CEO Billy West also noted the regulations that restrict counties’ abilities to decrease allocations for mental health funding.
“Most counties gave what they gave because they set an arbitrary number years ago, and have been stuck with that amount,” said West. “I think it’s a legitimate concern that a county wants to make sure it’s getting it’s money’s worth.”
“I think the better question is if a county is getting its money’s worth,” said West.
Daymark offers three main support services to Ashe County residents: walk-ins, mobile crisis and medical service.
“I can definitely show we use county dollars to provide those three services to Ashe County residents,” said West.
“For that $190,000, they (Ashe residents) are getting $1.7 million back in services,” said West. He also said Ashe County is receiving health services for people without health insurance.
Still, West said he believes the Ashe County Board of Commissioners is acting responsibly by discussing the
“I’m glad to hear they are discussing mental health funding,” said West. “This is an issue that has been discussed for 40 years, but it’s new that they (county leadership) are talking about it,” said West.