Neb. auditors criticize the way state agency managed mental-health reform over past 6 years

Auditors critical of Neb. mental-health reform

OMAHA, Neb. — State auditors said Tuesday the Nebraska Department of Health and Human Services has mishandled mental-health reform and failed to develop some regulations required by a 2004 law.

The Legislature’s Performance Audit Committee report identified several concerns. The auditors say the state agency overseeing the state’s shift from state psychiatric hospitals to more community-based care as required by a 2004 law is falling short of several planning goals. HHS officials have yet to develop a statewide comprehensive plan to guide the six regional boards that distribute funding for mental-health care.

Scot Adams, director of behavioral-health services for the state, defended the way his agency has handled the reforms, but said he would use the report’s findings to continue making improvements.

“I think that behavioral-health reform has gone generally very well,” Adams said.

HHS’ Division of Behavioral Health is responsible for overseeing the reforms passed in 2004 and making sure that every part of the state has needed services available.

“The Committee is extremely concerned about the audit findings, which it believes demonstrate serious failings in the Department’s implementation of the 2004 Nebraska Behavioral Health Services Act,” said the state senators who oversee the auditors.

Sen. John Harms of Scottsbluff, who is chairman of the committee, said he was troubled by the auditors’ findings, but he believes HHS is making progress.

“I believe that we’re in good hands,” Harms said. “I have confidence that they’ll fix it.”

Adams says his agency has developed a number of regulations for mental-health care in Nebraska, and those regulations will be updated this year.

Adams also said that even though the state doesn’t yet have a strategic plan in place, all six regional behavioral health boards do. The state’s strategic plan should be ready by the end of the year, he said.

“I still think we’re in compliance with the law, but we’ll be in a better place by year’s end with the new regulations,” Adams said.

Even if some required regulations are missing, Adams said it’s unlikely the regional boards would be unclear on what’s expected of them. That’s because Adams holds weekly phone conferences and monthly meetings with all regional administrators to address any issues.

The report also questioned why the regional boards were allowed to use slightly different standards when auditing their books or evaluating contracts with service providers.

Adams said all the regions must meet certain minimum requirements. But once the minimums are met, he said, some variation is allowed to help meet the needs of different parts of the state.