She’s been living in a group home in Forest City for the last couple of years, but she said she’s ready to return home to her friends and family in Franklin. Now at the age of 25, she said she’s ready to prove her mental health condition is being properly managed and reclaim her independence.
“I’m fully capable of taking care of myself,” Nix said. “I can basically run this house myself — I do everything around here.”
Nix must prove to the state she has the mental capability to take care of herself, but a lack of state funding may prevent her from even getting the chance. In order to have her rights restored, Nix’s attorney Chase Wells filed a petition for restoration to the Macon County Clerk of Court Victor Perry.
With any petition for restoration, Wells said the clerk of court has the statutory option to order a multi-disciplinary evaluation for the petitioner.
“This consists of a psychological evaluation and a social worker evaluation, each one being summarized in a report by contracted professionals who will recommend that the person does or does not need a guardian,” Wells said. “They cost around $1,000 to perform.”
Funding not available
The Macon County clerk issued an order stating that Vaya Health, which manages public funds for mental health services in 23 Western North Carolina counties, “shall prepare and provide a current multidisciplinary evaluation of the respondent.”
Since the MDE is for an indigent client, the state is responsible for funding the evaluation. The N.C. Department of Health and Human Services provides funding for those types of services annually and Vaya Health distributes those funds to providers in WNC.
However, Vaya Health and the other agencies that manage public mental health funds across the state are not receiving enough funding from the state to meet the demand for these types of evaluations. Upon receiving Nix’s order for a MDE, Vaya Health informed the clerk of court that funding is not available right now.
Under the current law, Vaya spokesperson Allison Inman said the cost of the MDE is the responsibility of the DHHS if the person is indigent.
“Vaya is only responsible for arranging for the MDE, but we cannot arrange for an MDE without a guaranteed source of funding to reimburse the provider,” she said.
In the past, Inman said Vaya expended up to $100,000 per year to pay for MDEs using its Single Stream Funding (funding for mental health, intellectual/ developmental disability and substance use services for the uninsured, under-insured and indigent population not eligible for Medicaid.)
The General Assembly reduced Vaya’s Single Stream Funding by $7.4 million for 2017-18 and by $7.5 million for 2018-19, which Inman said is restricting the agency’s ability to use these funds to pay for MDEs. Now, she said DHHS only provides about $40,000 a year to pay for all MDEs needed across the state.
Vaya and other regional funding agencies must submit invoices to the state for reimbursement to access these funds on a first-come, first-serve basis.
Inman said Vaya was notified Nov. 21 that all funds available for MDEs for fiscal year 2017-18 had been expended. Vaya and other regional agencies have advised DHHS that the annual amount allocated for MDEs is insufficient to meet the statewide demand, but right now their hands are tied.
“This is in addition to the approximate $31 million in non-Medicaid dollars cut from Vaya’s funding between 2009 and 2015. This policy of reducing service funds for individuals without Medicaid has been underway for the last decade and is severely eroding our ability to provide services for this population,” she said. “For this reason and as we announced in June and July of last year, we are targeting these limited dollars toward direct treatment and crisis services. Using this funding to pay for an MDE directly reduces the amount of funding available for substance use treatment and other critical services in our communities.”
Wells said he sees the refusal to fund the evaluation as a direct violation of the court order from the clerk, who is treated as a judge under the law of guardianships.
“Normally the procedure to follow when a court order is violated is to issue a ‘Show Cause’ order and set a hearing date where the violating party must appear and explain to the judge/clerk why they failed to follow the order and why they were not held in contempt,” Wells said.
Vaya maintains that it’s the DHHS in violation of the order as the state department is responsible for funding the evaluations.
“We would consult with our board, legal counsel and NC DHHS if such an order were issued,” Inman said.
Cuts to Vaya are being passed along to many of the local entities providing mental health and substance abuse services in the region, including Appalachian Community Services and Meridian Behavioral Health Services. A larger Virginia-based health provider bought ACS last year, which has helped the provider maintain and expand services, but Meridian is still operating as a nonprofit entity. Meridian has had to cut services and reduce employee salaries to make ends meet and is starting a major fundraising campaign to avoid future cuts.
Overcoming the past
In the meantime, people like Nix are stuck in limbo just hoping they can get their request in first on July 1, 2018, and get an evaluation approved when that limited amount of funding is still available. But when someone else has had control over your life for the last seven years it can be difficult to be patient.
Wells said his client was young and going through a hard time with her family when a judge deemed her incompetent.
“It was a close case — she almost didn’t need the guardian. Since the original guardianship order, she’s grown up and matured and is ready to have her rights restored,” he said. “She basically runs the home she lives in, communicates with me by email, Google hangouts and smartphone, expresses herself well, cooks, cleans, and manages what little money she is allowed to keep.”
Nix feels like none of this should have happened to her and chalks it up to a series of unfortunate events that culminated in the worst possible way. Her father got custody of her when she was 15 because there were some allegations of her mother being abusive toward her.
However, Nix said her father placed her in foster care where she bounced around from house to house until she was 18. Her father then got guardianship over her when she was deemed incompetent and she lived with him and her stepmother.
“It just started to go down hill from there. When I was 19 — almost 20 — it was to the point it was too much. Living with them became unbearable. I know I could have brought it on myself a little by running away from my dad,” Nix said. “But my stepmom took me to police department threatening to arrest me if I kept running away.”
Not being able to handle her anymore, Nix’s guardianship was transferred and she ended up in the group home in Forest City — hours away from her friends and family. Her mother and younger brother come to visit her when they can but because of the alleged abuse when she was younger, she is only allowed to have supervised visits with her mom.
“We can only have two-hour visits and they have to be supervised,” Nix said. “I can’t see my grandparents in Georgia and they’re in their 80s.”
Nix said she’s stuck in the house most of the time because her guardian at the group home is so strict about letting her go out and do things on her own and she can’t have a job or it would interfere with the Social Security checks she is currently collecting.
“I would rather work 40 hours a week instead of having a check and being in a group home,” she said. “I’d rather be living with my mom. I’m engaged to someone here I’ve been with for two years and I can’t even go out on a date with him.”
On her restoration petition, Nix wrote that she’s spent the last several years working toward being independent and responsible despite her past problems. She shops by herself, prepares meals, helps clean the house, pays her bills and makes her own doctor appointments.
“I’ve learned to cope with my anxiety and PTSD,” she wrote. “I go to regular counseling and I take my medication regularly.”
She knows she isn’t perfect, but if given the chance, she wants to prove that she is a different person than she was the last time she appeared in court. If she gets her rights restored, Nix plans to move back to Franklin and live with her mother until she can get a job and find her own place. Long term, she wants to move away from North Carolina and start a new life with her fiancé, but right now that dream seems out of reach until more funding is available for her evaluation.
“I have enough people on my side saying they’ll testify for me saying I’m stable enough,” she said. “But right now I have to pull strings just to figure out how to get a test that costs $1,000.”