Archive for March, 2011

March 31, 2011

Privatizing Education in NC

by Richard Edwards

This week I attended a lunch and learn sponsored by NC Policy Watch around Charter Schools in NC. NCPW has a page about the ongoing negotiations here.  You can also read a paper supportive of charter schools here, and more about the political football that’s being played here. Based upon the attendees, I was expecting a crowd of advocates who had largely made up their minds about charter schools, and generally, I wasn’t wrong.

There are a lot of strong opinions. Earlier in the week, I had spoken by phone with Eddie Goodall at the NC Alliance for Public Charter Schools, a strong advocate for charter schools expansion, and Senate Bill 8, which not only lifts the cap on charter schools, but eliminates the minimum enrollment (currently set at 65), and wouldn’t require charter schools to provide either transportation or nutrition to its students, but still allows charters to get the same rate per child as public schools.  Certainly he has a stake in this, and questions have been asked whether he’s an advocate or a lobbyist, but his main point to me was, “if it’s good for kids, and it’s good for taxpayers, we’ll figure out how to make it happen.” Seems eminently reasonable. But are charter schools good for kids?

Dr. Helen Ladd from Duke U. presented some good but dated (2002) statistics about problems associated with charter schools in NC–including increased racial segregation and decreased performance overall among students who transitioned from regular public schools to charter schools in the early years (1998 to 2002). You can read a draft of Dr. Ladd’s research online (warning: pdf).

Rep. Rick Glazer, from Fayetteville, followed, speaking on the history of charter schools in North Carolina, having been in the legislature when the original law was passed. Despite some pretty bad experiences with charter schools that failed early on, Rep. Glazier voiced support for expansion of charter schools in a limited role. There is an opportunity for independent, progressive organizations to run quality school settings and act as a learning lab for innovative practices, something that large schools systems find difficult to do. Too many charter schools too quickly, however, leads to decreased standards of quality, lost in the proliferation–as it did in the late 90’s when charter schools were new in NC.

Interestingly, both Rep. Glazier and Mr. Goodall from the NC Alliance for Charter Schools agree on this point–NC made it too easy for public charter schools to be set up in the early going, and our children paid the price. What started as an opportunity to be innovative and progressive led to a retail mentality in our schools. There needs to be a higher bar set for such a fundamental service–our educational system–than simply who can complete the application and show themselves as willing and able,  without any track record of success.

For those of you accustomed to reading my angle about human services to people with mental health issues or people with intellectual or development disabilities…what does this sound like?



March 21, 2011

CABHA–One Year Later

by Richard Edwards

Last week, I presented to the Mental Health Subcommittee at the NC Legislature on the Critical Access Behavioral Healthcare Agency (CABHA) implementation. We had been asked by Benchmarks NC, an advocacy organization to which my employer belongs, to speak on our experience with implementing the Critical Access Behavioral Healthcare Agency model over the past twelve months.

You can view my presentation here, but the main points are these: we have found the CABHA model to be very effective in our organization; but woefully underfunded; and that the transition to a CABHA-based provider community is far from over.

In terms of cost, the primary costs of the CABHA model are the personnel costs of the Medical Director and Clinical Director, for which there has been no additional funding. That’s significant given that these are likely two of the highest paid positions in any mental health organization. But now that we’ve been at this for over a year, it is impossible for me to imagine going back to having physicians without a Medical Director, or not having the support of our Clinical Director in responding to a crisis or developing support plans for the individuals we serve. Their impact has just been too valuable, even if we decided not to be a CABHA in the future.

The challenge this presents for our agency and others is that CABHA is a one-way street, in a way. If your Medical Director and Clinical Director are really doing their jobs, they become linchpins in the organization, and there’s no way to get around how much benefit they bring. That said, if the state doesn’t do more to support the CABHAs, the sustainability of the CABHA model is in doubt, begging the question–if CABHA is a one-way street, where does it dead-end?

Beth Melcher, from the NC Department of Health & Human Services, spoke to the subcommittee first and told the members, plainly, there are too many CABHAs (approaching 200). You can see the full list here. There are certainly more than anyone anticipated, but does that mean there are too many? Maybe, maybe not–but the truth is, there are more CABHAs than will survive. Here’s one reason why…Community Support Team.

Currently on the list are 71 CABHAs providing Community Support Team (CST), which is a service for adults with mental health and/or substance abuse issues. That is fully a third of the total, and CST has not only had additional training requirements put on it in the past six months, but has actually had hours available cut from 15 hrs/week (maximum) to 3 hrs/week (on average), and has had a rate cut on top of all these changes. Agencies are exiting CST as quickly as they can, because the rate simply cannot support the service. But these 71 CABHA agencies are providing CST, and will continue to provide CST, because they have to demonstrate a continuum of services–meaining, a variety of enhanced mental health or substance abuse services–meaning, they are a on a one-way street.

Without CST, they lose their CABHA status. With CST, the whole agency could go under. And without significant changes in the way the state supports CABHAs, we will continue to see rapid attrition of providers as reality sets in.

So while we have turned a corner in the mental health system, we are not, to mix a metaphor, out of the woods.  My angle is that CABHA is the right direction, but without additional support, it could mean another dead end.

But that’s just my angle–what are your thoughts?