Did a local mental health agency in southeastern North Carolina authorize more care than its clients needed? Did a lot of new people sign up? Or is essential care much more expensive this year? The agency is still trying to answer these questions. In the meantime, the Southeastern Center for Mental Health may ration care for its clients seeking mental health, substance abuse, or developmental disability services paid with state money.

Southeastern got $7 million in state money for fiscal year 2007, but spent just $4.6 million. For the current fiscal year, which runs through June, the legislature allocated that same $4.6 million plus some extra money for a crisis center. Providers apparently operate on a calendar-year basis and sent a "rush of reimbursement bills" in December.

North Carolina is in its seventh year of reforming its mental health system with, at best, mixed results.