A Note From Secretary Brajer: Much Has Been Accomplished at DHHS

Raleigh

As Governor Pat McCrory’s administration winds down, I would like to call to mind some of the significant accomplishments achieved during the past four years through the Department of Health and Human Services under the Governor’s leadership and with his support.

On behalf of the Department, I’d like to begin by thanking all who have believed in our mission and partnered with DHHS to improve the health, safety, and well-being of North Carolinians: Governor McCrory’s team, legislators, the judiciary, our sister state agencies, citizens who made their voices heard, advocates, stakeholders, providers and past and present DHHS team members. 

Let’s take a look at what WE achieved together:

  • Medicaid – Improved financial performance, turning annual operating deficits of up to $500 million to budget surpluses for three years in a row. Savings accomplished through strong oversight, responsible budgeting, pharmaceutical savings and improved fraud detection efforts.
     
  • Medicaid Reform – Following state-wide engagement, North Carolina submitted a waiver request on time to the federal Centers for Medicare and Medicaid Services on June 1, 2016. The waiver seeks a North Carolina solution to improve patient outcomes, integrate physical and behavioral health, increase flexibility to invest in improving population health, extend care to families to increase the likelihood of children being reunited with their families, encourage providers to achieve the long-term goal of improving health outcomes, and asking health plans and providers to share responsibility with the state for achieving health outcomes within budget.
     
  • Division of Health Benefits – Established to support North Carolina’s transition to accountable, pre-paid health plans for Medicaid.
     
  • Governor’s Task Force on Mental Health and Substance Use – Chief Justice Mark Martin and I co-chaired the Task Force, which presented recommendations for long-term solutions to the state’s mental health and substance use challenges. The budget signed by Governor Pat McCrory supported this initiative by providing $20 million to implement task force recommendations. Two pilot programs will provide case management to individuals going through critical transitions. One pilot program will establish Facility-Based Crisis (FBC) centers for children and adolescents.
     
  • Crisis Solutions Initiative – Launched in 2013 to address the care needs of individuals in behavioral health crisis, this initiative focuses on identifying and implementing best known strategies for crisis care, while reducing avoidable visits to emergency departments and possible involvement with the criminal justice system.
     
  • Mental Health First Aid – Mental Health First Aid trains community members to recognize and appropriately respond to the mental health and substance use needs of others showing signs of a possible issue or experiencing a crisis. North Carolina has trained more than 30,000 citizens in Mental Health First Aid and more than 450 Mental Health First Aid instructors since fall 2013.
     
  • Crisis Intervention Team training – Since 2013, DHHS has provided technical assistance in training more than 3,000 law enforcement officials, paramedics, EMTs and firefighters to assist individuals experiencing a mental health, substance use or developmental disability crisis.
     
  • New Cherry Hospital – A new three-story Cherry Hospital facility opened in Goldsboro. The state-operated psychiatric facility serves citizens in 38 eastern North Carolina counties. In coming months, Cherry Hospital will expand its capacity to 313 beds and more than 1,300 employees.
     
  • Naloxone Standing Order – First responders, legislators and health care officials supported the initiative to make naloxone, a life-saving opioid reversal drug, more accessible to help stem the statewide epidemic of opioid overdose-related deaths. First standing order to be issued for a medication in more than 139 years of public health in North Carolina. It was passed unanimously by the General Assembly.
     
  • Emerging Diseases – Coordinated federal and statewide responses to the emerging pathogen Zika, and coordinated planning and response to the Ebola epidemic.
     
  • Engagement of Health Care Providers – State Health Director visited all 100 counties to engage and listen to providers in local health departments and safety net systems. They provide the critical infrastructure that serves people across the state.
     
  • Five-year Perinatal Health Strategic Plan – The plan strives to improve birth outcomes for all families through an innovative approach that highlights strategies for addressing biomedical, social and economic inequalities.
     
  • Statewide IT Programs – NCTracks – North Carolina’s largest IT project, is the first multi-payer system in the country. Its implementation eliminated $3 million a month in processing costs from the previous system and its certification by the federal government has returned $17 million in revenue to the state.
     
  • Statewide IT Programs – NC FAST – Implementation replaced 19 legacy systems to a single intake process to determine eligibility and accelerate access to healthcare and other benefits.
     
  • ICD-10 – Successfully implemented ICD-10, the federally mandated change affecting payment codes for all physicians.
     
  • State-Operated Facility Savings – Closed a $17-million structural budget gap in state operated hospitals and care centers through contract reductions, pharmacy procurement savings and staffing time management.
     
  • Office of Internal Auditor – Increased staff from six to more than 30 to assess, develop and implement internal audit plans.
     
  • Child Welfare - Fully implemented a process to monitor and evaluate child welfare practice in county Departments of Social Services. All 100 county DSS agencies are implementing Program Development Plans with each agency receiving follow-up reviews every six months. Since July 2015, more than 230 on-site child welfare practice reviews have been completed.
     
  • Hurricane Matthew – DHHS response included setting up and manning emergency medical centers and mobile Emergency Room units, leading implementation of disaster food stamp benefits for 41 counties and roughly one million citizens, coordinating the movement of vaccines to affected areas, and sustaining the 24/7 operations of five state-operated facilities in flooded areas.

These descriptions provide only a brief snapshot of each of these achievements and don’t, by any means, capture all that has been accomplished. They are each supported by countless hours of work, collaboration with partners, meetings with stakeholders, discussions, deliberations and fine-tuning, all aimed at improving accountability and providing services that improve the health, safety and well-being of North Carolinians.

It has been my honor to have served a governor who has been so dedicated to the stewardship of our great state.

Richard O. Brajer, Secretary
N.C. Department of Health and Human Services