Ashe County Commissioners were forced Monday afternoon to provide additional tax dollars to cover immediate New River Behavioral Healthcare expenses.

“I was on the original New River board,” said Commissioner William Sands. “First we were told there was a $200,000 loss. Then it became $1,000,000 then $3,000,000. We were continually and totally mislead as to the financial standing of New River.”

Commissioners approved an additional budget amendment of $181,998 Monday afternoon, bringing the total spending on mental health in fiscal year 2011-2012 to $370,564. The county appropriated $188,566 for mental health services when the budget was passed in July; the nearly $182,000 special appropriation will be drawn from Ashe County’s fund balance, which currently hovers around $6 million.

“When people constantly ask why we have a fund balance, this is why,” said Commissioner Larry Rhodes on Monday.

The additional funds will be used to pay NRBH salaries, FICA taxes, and insurance, according to Interim Ashe County Manager Dr. Patricia Mitchell.

The move comes just days after commissioners approved the use of $115,000 in previously appropriated funds to help NRBH meet mid-month payroll and keep employees on the job and ensure mental health services would be provided for Ashe County consumers during the transition to Daymark, who was announced as the new mental health provider during the first meeting of the new NRBH board of directors on Oct. 5.

Daymark provides mental health services in 20 Piedmont counties, and serviced more than 37,000 mental health consumers in 2010-2011. NRBH, the financially struggling service provider Daymark will replace, was the sole mental service provider in Ashe, Alleghany, Avery, Watauga, and Wilkes counties, and employs nearly 300. The move will add an additional 13,000 consumers to Daymark’s consumer base.

Questions remain for Ashe, Alleghany, Avery, Watauga, and Wilkes counties as to how much, if any, each county is on the hook for if it is determined they are financially responsible for NRBH’s outstanding liabilities, which Mitchell said stands at roughly $1.2 million. Until the state Medicaid audit, launched on Sept. 22, is completed the true figure remains uncertain.

Changes coming?

Commission Chairwoman Judy Poe also raised the possibility during Monday’s work session that local authorities, namely county commissioners, would lose their oversight authority of mental health services if changes promoted by Piedmont Behavioral Healthcare are implemented.

Poe referenced an Oct. 16 article in the Winston-Salem Journal entitled, “Group has ideas for health services,” that cited “removing requirements that county commissioners serve on local management entity (LME) boards as well as requirements for geographical representation.”

“If county dollars are used to fund LMEs…I want to have some kind of oversight,” said Commissioner Gerald Price.

Mitchell reiterated those same concerns in an interview Tuesday and said, “If they start making changes to state statutes, as far as how mental health is organized, and how those services are structured, I want to know that the conversation is going on, so that I can respond appropriately.”