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DSS delivered some very good news at Wednesday’s meeting of the Behavioral Health Partnership Oversight Council. The Behavioral Health Partnership (BHP) provides mental health and substance abuse services to HUSKY, SAGA and DCF clients; DSS hired Value Options to administer the program but retains a great deal of oversight. The BHP was created when behavioral health services were carved out of the HUSKY HMOs and by most accounts, things have improved significantly. (Note the very good news from last week’s Medicaid Managed Care Council meeting in improved access to dental care and a two fold increase in participating providers when those services were carved out). Discharge delays, behavioral health hospital patients who are ready to leave but can’t because appropriate community treatment is not available, are down significantly. The percent of discharges in delay dropped from 18.6% in the third quarter of 2007 to 10% last quarter; the number of cases in delay status dropped from 125 to 74. Credit went to a significant expansion of community treatment options and more focused treatment plans. (The success of carve outs strongly suggests that DSS should stop dragging their feet, stop over-accommodating the HMOs, and honestly implement PCCM).
Unfortunately that was the end of the good news. Rep. Walker asked DSS to explain the large number of children arrested at residential treatment centers. DSS and BHP will get back to the Council. Concerns were raised about the HUSKY transition to mandatory HMOs. Consumers are getting mixed messages and contradictory information. Many are concerned about the lack of providers in the new plans and the large rate increases given to the HMOs.
Then the news got worse – DSS described the Governor’s proposed budget cuts. Providers are troubled that they would not receive any rate increases under the Governor’s proposal and that payment for this year’s rate increases has been delayed making it a target for cutting to cover this year’s deficit. Many Council members were disturbed about proposals to charge clients copays for services – that patients will not get needed services, causing more expensive problems later, because they can’t afford the cost. Unfortunately, if that happens we wouldn’t know, because the Governor has also proposed eliminating funding to evaluate the BHP. Discussion also centered on the Governor’s proposal to weaken the definition of medical necessity that serves to protect consumers and guide appropriate service provision in the program. The Governor estimates $4.5 million in savings next year and $9 million the year after that – presumably in services no longer provided. The Council asked for specific examples of services being provided now that wouldn’t be under the new definition and why DSS believes these services are inappropriate or unnecesary.
Ellen Andrews