Civitas Review

60 Minutes Highlights Shortage of Psychiatric Beds


Earlier this week, 60 Minutes produced an outstanding documentary earlier this week on the subject of mental health. The report highlights the case of Gus Deeds, the son of Virginia state senator Creigh Deeds. After his father was unable to admit him to a psychiatric crisis bed, Gus stabbed his father and then took his own life. It is a gut-wrenching video to watch, but I highly recommend watching it all the same. This story has played out in some form or another in thousands of American households in recent years.

Although the events described in the 60 Minutes segment are about Virginia, they perfectly encapsulate two major problems in North Carolina:

  • Shortage of inpatient crisis beds. When people experience psychiatric crises that cause them to become dangerous, there is often nowhere for them to go. In North Carolina, the average wait time to get admitted to a psychiatric bed from an emergency department is over three and a half days. From 2007 to 2012, the number of people served by the state psychiatric hospitals decreased by 75 percent.


  • No care continuity. Psychiatric hospital beds are not intended for long-term care. Even still, providers or insurers often discharge people before they are actually stable. Once discharged, few patients are able to continue treatment – often because they do not believe that they are sick.  Mary Jo Andrews, a mother who was interviewed in the 60 Minutes segment, explained: “There’s really no place after the hospital so the kids end up coming back home right where the situation started.”

For the first time in a long time, the state and federal governments are starting to turn their attention to mental health. Policymakers should start by addressing the area of greatest dysfunction: the crisis system. By increasing the number of inpatient beds, policymakers can ensure that people in crisis are able to get help when they need it. And by implementing programs like assisted outpatient treatment, policymakers can help to ensure the continuity of care for people who repeatedly fall through the cracks of the mental health system.

State Pension Oversight: Fox Guarding Hen House?


Today Forbes has an update written by the investigator hired by the State Employees Association of NC (SEANC) to evaluate NC's state pension system for potential pay to play conflicts.

Some interesting snippets:

Last week I was surprised to learn that both the North Carolina Department of State Treasurer and the State of Connecticut Office of State Treasurer, which oversee massive state pensions of $83 billion and $26 billion respectively– states in which a publicly elected Treasurer serves as the sole trustee of workers’ retirement funds–have a leading plaintiff class action law firm, Cohen Milstein, serving as their outsourced Compliance Counsel.

As a former in-house Director of Compliance of one of the largest asset managers, I can envision many thorny ethical dilemmas and potential conflicts of interest that may arise.

For example, I would want to know whether any firm selected as Compliance Counsel to a public pension, or persons affiliated with them, have made contributions to the campaigns of any politicians involved in overseeing these funds. According to Brian Balfour, Policy Director for the Raleigh-based government watchdog group the Civitas Institute, State Board of Elections records indicate Cohen Milstein employees donated $5,000 to sole pension trustee North Carolina Treasurer Janet Cowell’s campaign fund in 2012. Evidently Cowell learned nothing from donation scandals that plagued her predecessor.


Pay-to-play concerns related to political donations by class action lawyers pitching their services to public pensions is commonplace, attracting more attention in recent years but is still largely overlooked by state bar associations, state and federal regulators and law enforcement. If the Compliance Counsel reviewing political giving by pension money managers has itself been donating to the sole pension decision-maker, that, in my opinion, is not a terribly promising start. (emphasis added)

Such actions raise still more concerns about conflicts of interest coming from Cowell's office. The results from this investigation could prove interesting reading.

From Boston to Philly: New Visions Taking Shape


tea party

The Boston Tea Party Ships & Museum and Old South Meeting House staged a re-enactment in 2012. Photo from

Last night, in offering the Tea Party response to the president,  Sen. Mike Lee of Utah observed that if the American Revolution started in Boston, it journeyed to Philadelphia. That is, the stirring of revolt had to be followed by concrete steps to change the government. Yesterday brought a couple of steps on that journey, including one tentative step offered by Sen. Richard Burr of NC.

Conservatives are often lambasted for offering just criticism, not constructive proposals. But  Sen. Lee (a speaker at our Conservative Leadership Conference)  outlined a broad vision for reform, while our Sen.  Burr joined with colleagues to offer a new response to Obamacare.

If you didn't catch Lee's response to the State of the Union Address last night, you can see it here.

For one thing, it's not even 12 minutes long, which is a great improvement over the drone of platitudes in the Obama speech.

Plainly, Lee was  offering an outline of reforms. That's one reason we're very eager to hear more from him at our Conservative Leadership Conference.

One key point of emphasis Lee has been making: Any successful conservative reform movement must address the real problems of the poor and  the middle class.

His approach also tries not to pit one group against another, but instead address all groups. Lee insisted real conservatism doesn't mean you're on your own, it means we're in this together.

He also took the offensive. I like this line: "Obamacare is the Godzilla of inequality." That's important: Conservatives must stay on the offensive.

Real reform, however, must include interests sometimes thought to be "on our side." For instance,  he said, "If we're going to reform welfare, we really should start with corporate welfare."

And another line is that while making government smaller is vital, it's just as important to encourage "bigger citizens." Limiting government will only be possible if we the people step up to do more.

Anyway, check out the whole speech.

And sign up for CLC. We're really excited about what we'll see there, and I think you'll agree.

Meanwhile, Sen. Burr is joining with two colleagues to offer an alternative to Obamacare. Avik Roy, one of the best writers on health issues, said this plan — offered with Sens. Coburn and Hatch – "is a serious, constructive, and pragmatic one."

He lists important caveats as well, and many conservatives will feel it doesn't go far enough. Nevertheless, the Coburn-Burr-Hatch proposal, along with others, contributes to the debate.

Roy's article covers a lot of ground in a short space, so it's well worth reading.

Lee Offers Vision for Conservative Reforms


Mike Lee, one of our CLC speakers, gave the Tea Party response to the State of the Union Address.

Some excerpts are available here. (Maybe video too by Wednesday morning.)

One telling quote:

“But where does this new inequality come from? From government — every time it takes rights and opportunities away from the American people and gives them instead to politicians, bureaucrats, and special interests.”

He doesn't just make things look bad by denying the liberal accusation; he turns it into a weapon and directs it back at liberalism. And he's tactful but clear that he thinks Republicans need to clean up their act too.