Final Countdown For Guilford Center

The Guilford Center ­– the Guilford County department that, for decades, has administered mental health care and substance abuse treatment and provided hands-on clinical care for county residents – will soon cease to exist.

On Thursday, Oct. 4, the Guilford County Board of Commissioners is expected to vote to approve a hard-fought contract that will eliminate the once huge county department and will, on Jan. 1, 2013, turn all of the services the department formerly provided over to Sandhills Center Inc.

The commissioners have little choice in the matter: If they vote no to the deal, the State of North Carolina will come in and take over, do away with the Guilford Center, and reassign the county's mental health administration and substance abuse services in any manner the state sees fit – and it would do so at a cost determined by state mental health officials.

The Oct. 4 motion will finalize the merger of the Guilford Center with Sandhills Center, an eight-county – soon to be nine-county ­– mental health administrative collective that covers much of central North Carolina.

In recent years, state legislators have passed new requirements for administering federal dollars based on the belief that larger administrative economies of scale would be more efficient and would save money. While there may be savings, there is widespread agreement among mental health officials in North Carolina that the new administrative and clinical structure isn't as effective in delivering wholesale systematic quality mental health services and substance abuse treatment to state residents.

The problem of transition to the new system is exacerbated by the fact that the clients who use these services are often negatively affected by change.

Acting Guilford Center Director Billie Martin Pierce has stepped down twice as director of the center over the years and she's now on her third stint as director.

Back in the late '90s, the Guilford Center had about 550 employees. However, over the last decade, the center has been divesting services and employees, and, as of Jan. 1, 2013, it will have no employees left.

As ordered by the state, Guilford County divested all of its clinical workers earlier this year and hired private providers to take over those operations.

All that remains is the divestiture of the administrative services and Pierce said that many of those workers hope to get jobs with Sandhills.

"At last count there were 65 people currently employed," she said, "and the maximum number Sandhills will have as its local presence in Guilford County will be about 89."

Pierce said that, so far, no county employees have officially been offered jobs with the coming Sandhills office in Guilford County. However, once the commissioners give final approval to the merger agreement on Oct. 4, and the Guilford Board signs off on the deal the following week, many of the 65 remaining Guilford Center employees are likely to find out that they will continue coming to work in the same workplace after the start of next year – but they'll be employed by Sandhills.

Pierce said Guilford Center employees who get jobs with Sandhills should have informal notification by mid October.

She said some Guilford Center workers plan to retire on Dec. 31, some already have retired in light of the merger, and others have found or will find work with Guilford County government in a different department.

While the employees may continue on, the Guilford Center Board will be dissolved and will not meet again after the first of the year. Instead, the local operations will be run by the Sandhills Center board.

The Guilford Center Board is a nine-member board currently chaired by Bert Davis Jr. Guilford County Commissioner Paul Gibson serves on the board as the representative of the Board of Commissioners.

One commissioner from each county may also serve on the Sandhills board. Gibson is running for reelection to the Board of Commissioners – he's currently an at-large commissioner but he is running for the District 5 seat.

If elected, Gibson said he may or may not serve on that board as he would like to feel out other commissioners to see if any of them want to serve in that role.

Gibson said he has a great deal of respect for Sandhills, but he added that, during his time on the Guilford Center Board, he's witnessed the damage of the massive divestiture of services.

Gibson said part of the evidence is that mental health patients are showing up in jails and prisons more and more.

There is a chance that, if county officials had communicated with the local delegation of state representatives a desire to fight the consolidation mandate, Guilford County might have been able to get an exemption.

The legislation that forced consolidation exempted counties above a certain population and, as written, it only exempted Mecklenburg and Wake counties – the state's two counties with the largest populations. Guilford County is third in population in the state and, District 62 state Rep. John Blust told the Rhino Times last year that, if he had been made aware this was a concern, he may have been able to get the state legislature to exempt Guilford County as well.

Gibson and others overseeing mental health in Guilford County said that they were never aware of that as possibility until after the fact.

"The first I knew about that possibility was when I read the quote by John Blust in The Rhinoceros Times," Gibson said.

Pierce said it's hard to argue that the current mental health services arrangement is ideal given what Guilford County was once able to offer its mental health and substance abuse clients.

"I think everyone agrees the Guilford Center provided good service, managed the budget well and had a good reputation both administratively and clinically," she said.

Mental health reform and mandated divestment legislation began taking effect in 2001, and Pierce said the signs were clear even back then that the clients would suffer. She said that, at that time, she began seeing "cracks and fragmentation" in the mental health treatment system.

Pierce said she fought the changes as hard as she could.

"We tried to hold onto our clinical services as long as possible," she said.

A ruling by state officials last year, however, meant Guilford County wouldn't be allowed to keep its mental health and substance abuse treatment clinical services, since Guilford County would have representation on the Sandhills board. State officials ruled that would be a conflict of interest.

Guilford County spends about $10 million a year funding the Guilford Center and it will now pay Sandhills to handle those services instead.

Over the last several weeks, county officials have been hashing out the final sticking points of the agreement with Sandhills. The contract that will be submitted to the commissioners on Oct. 4 calls for Guilford County to lease the space in the county now being used for these services to Sandhills at no real cost.

The contract calls for Guilford County to lease the first and second floors of the Bellemeade Building at 201 N. Eugene St. in Greensboro to Sandhills for $1 per year beginning on Jan. 1, 2013 for a period of three years. The county has the option to extend that deal every year thereafter.

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If, at any time, the county decides not to extend the deal – or if Guilford County sells the building – the county must find similar suitable office space for Sandhills under the same terms of that agreement.

Parking in downtown Greensboro is becoming a more and more valuable commodity every day, and this contract states, "åThe number of spaces available shall be up to 65, the same number of spaces available to Guilford Center staff as of June 1, 2012."

The contract calls for identical office space deals for the other county buildings that the Guilford Center now occupies: Sandhills will lease the first floor of 211 S. Centennial St. in High Point for $1 a year and the same goes for the Guilford County Substance Abuse Treatment Center at 5209 W. Wendover Ave.

As part of the merger, Guilford County will also make a one-time payment of $3.5 million to Sandhills in a series of monthly installments. That amount in large part represents Guilford County's contribution to the contingency fund of Sandhills' budget.

On Jan. 1, Guilford County will join Anson, Harnett, Hoke, Lee, Montgomery, Moore, Randolph and Richmond counties as members of the Sandhills Center mental health administration collective.

Pierce said the Guilford Center has had a long storied history of service, and she said it's a shame the department will cease to exist at the end of the year.

"On Dec. 31, we will turn out the lights," she said. "Then, everyone will take New Year's Day off and, when the lights come back on, it will be Sandhills."