Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, August 4, 1995 TAG: 9508040038
SECTION: VIRGINIA PAGE: B4 EDITION: METRO
SOURCE: ASSOCIATED PRESS
DATELINE: RICHMOND LENGTH: Medium
Dr. Timothy Kelly, commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services, gave a state mental health commission details of a pilot project planned for the Tidewater area. If the General Assembly approves, the state would hire a private organization to oversee outpatient mental health services.
A managed-care organization would administer how care is delivered. A private agency could track patients' progress more efficiently and provide more advanced automation than the state could, Kelly contends.
Patients could get better and faster care that way, he said.
``It's a mechanism to improve accountability, efficiency and quality of care,'' Kelly told the joint subcommittee studying the deinstitutionalization of mental health patients. About 35 states already have some sort of managed care for mental health, he said.
Kelly said the plan is being driven in part by legislation in the Republican-led Congress that would convert federal health care funding into block grants to states. The state would look more kindly on services that operate efficiently, Kelly said.
Congress also wants to cap the amount it spends on Medicaid, which may require the state to come up with additional Medicaid dollars, Kelly said. That also shows the need for greater efficiency in state health care programs, he said.
``If we don't move forward we are going to be dead in the water when these changes and imperatives come down,'' Kelly said.
Making the system more efficient also would help the state provide outpatient services to the estimated 10,000 people who are on waiting lists, Kelly said.
Virginia provides outpatient mental health, mental retardation and substance abuse services to about 188,000 people who can't afford to pay or who have exceeded the coverage permitted by their private insurance policies, Kelly said. The state provides in-patient services to about 5,000 people in mental institutions and mental retardation training centers, he said.
Kelly said if the pilot project is successful, it could expand throughout the state mental health system.
Some advocates for the mentally ill disagree with the department's plan.
Contracting with a private agency would take critical funding away from the state's 40 community service boards, said Val Marsh, executive director of the grass-roots Virginia Alliance for the Mentally Ill.
``They are taking money out of the very side of the equation that needs more money,'' she said. ``It is not logical.''
Kelly offered no estimates of how much the state would pay a private company for the service.
Marsh said some states, such as California and New Hampshire, have come up with effective managed-care plans that focus on getting people out of mental hospitals and treating them in the community.
Republican Gov. George Allen, who appointed Kelly last year, proposed sweeping spending cuts during the 1995 General Assembly session that would have sliced $6 million from community service boards. The legislature rejected the proposal.
Marsh said the managed-care plan follows Allen's agenda.
``It is a first initial step toward privatizing the public mental health system, which is in line with the Allen administration's philosophy,'' she said. ``We're just handing over lock, stock and barrel all these critical things to a company that is driven by profit.''
Del. Anne Rhodes, R-Richmond and chairwoman of the joint subcommittee, told Kelly she was concerned a managed-care approach would lead the state to scale back on services provided by the community service boards.
But Kelly said service would continue to be provided as it is currently but oversight would be better.
No specific managed care company has been identified yet for the pilot plan, Kelly said.
The plan will be presented to legislative subcommittees next month and could begin as early as January if approved, Kelly said.
by CNB