Category Archives: Mental.Health

They thought they were going to rehab. They ended up in chicken plants

Source: Amy Julia Harris and Shoshana Walter, Reveal News, October 4, 2017
 
Across the country, judges increasingly are sending defendants to rehab instead of prison or jail. These diversion courts have become the bedrock of criminal justice reform, aiming to transform lives and ease overcrowded prisons.  But in the rush to spare people from prison, some judges are steering defendants into rehabs that are little more than lucrative work camps for private industry, an investigation by Reveal from The Center for Investigative Reporting has found.  The programs promise freedom from addiction. Instead, they’ve turned thousands of men and women into indentured servants.  The beneficiaries of these programs span the country, from Fortune 500 companies to factories and local businesses. The defendants work at a Coca-Cola bottling plant in Oklahoma, a construction firm in Alabama, a nursing home in North Carolina.  Perhaps no rehab better exemplifies this allegiance to big business than CAAIR. It was started in 2007 by chicken company executives struggling to find workers. By forming a Christian rehab, they could supply plants with a cheap and captive labor force while helping men overcome their addictions.

… At some rehabs, defendants get to keep their pay. At CAAIR and many others, they do not. Legal experts said forcing defendants to work for free might violate their constitutional rights. The 13th Amendment bans slavery and involuntary servitude in the United States, except as punishment for convicts. That’s why prison labor programs are legal. But many defendants sent to programs such as CAAIR have not yet been convicted of crimes, and some later have their cases dismissed. … CAAIR has become indispensable to the criminal justice system, even though judges appear to be violating Oklahoma’s drug court law by using it in some cases, according to the law’s authors. … The program has become an invaluable labor source. Over the years, Simmons Foods repeatedly has laid off paid employees while expanding its use of CAAIR. …

Future of Frederick County’s mental health clinic in flux as responsibility for services changes

Source: Kate Masters, Frederick News-Post, September 30, 2017
 
When it comes to mental health and substance abuse services at the Frederick County Health Department, one thing is sure: On Oct. 2, the department’s methadone program will be handed off to Concerted Care Group, a private company based in Baltimore that provides addiction treatment services.  What’s less clear is the fate of the department’s mental health clinic, a small group of psychiatrists, social workers and counselors who together provide mental-health care to roughly 1,500 low-income clients, according to a letter drafted by employees at the clinic. … Beavan and two other staff members were also startled, she said, when representatives from their labor unions, the American Federation of State, County and Municipal Employees and the American Federation of Teachers, forwarded them an email from Alex Doring, the chief of labor relations and risk management at the Maryland Department of Health. The message addressed representatives from both unions and referenced a hard shutdown date of Dec. 31, 2017, for the clinic.  “Frederick Co. Health Department has decided to close its mental health clinic on December 31, 2017,” Doring wrote. “… I would like to schedule a teleconference “to discuss 1) ‘the relative merit of a layoff versus a separation for lack of appropriation,’ and 2) ‘in an effort to develop appropriate arrangements for affected employees.’” …

Study finds shortfalls in KanCare coverage for mental illnesses

Source: Allison Kite, The Topeka Capital-Journal, September 24, 2017

A new analysis of the state’s Medicaid program, KanCare, found recipients with mental illnesses often face barriers to getting the care they need, and it served as confirmation to some health advocates who have previously raised issues about the program. … The study found KanCare recipients with serious mental illnesses had a hard time getting information about their coverage, acquiring needed medications and finding some providers, especially specialists. Hall said fewer than 20 percent of the 189 recipients she and her co-authors surveyed had spoken with a care coordinator, someone designated to help individuals covered by KanCare organize appointments and access care. For some health advocates, that critique echoed concerns they have heard since the state rolled out KanCare in 2013. …

Read full report.

Related:

Fact Meter: Kansas budget director’s chart offers misleading view of KanCare waiting list
Source: Tim Carpenter, Topeka Capital-Journal, August 28, 2017

The fate of thousands of Kansans with intellectual or developmental disabilities who don’t receive benefits for which they’re qualified remains a contentious issue more than four years into operation of the state’s privatized $3 billion Medicaid system. Shawn Sullivan, budget director for Gov. Sam Brownback, discussed during a presentation to a House and Senate oversight committee the need for sustained state government revenue growth to shrink the waiting list for home- or community-based services through Medicaid. …

Kansans share KanCare concerns with legislative panel
Source: Tim Carpenter, Topeka Capital-Journal, August 22, 2017

Individuals and associations representing enrollees in Kansas’ Medicaid program shared frustration Monday with difficulty securing services for thousands of people eligible for assistance as well as with Gov. Sam Brownback’s declaration of policy victory for saving the state treasury $1.4 billion after turning the system over to three insurance companies. … Dozens of issues were raised at the Capitol during a hearing of the Kansas Legislature’s joint committee on KanCare oversight. Testimony in support of the KanCare insurance providers and state agencies blended with complaints raised repeatedly over the years. This inquiry by legislators occurs at a time of transition, with Brownback preparing to leave office and the state applying to the federal government for permission to continue with KanCare, which serves more than 400,000 low-income adults, pregnant women and people with disabilities. …

Continue reading

CalOptima Takes Mental Health Administration In-House

Source: Thy Vo, Voice of OC, September 11, 2017

CalOptima, the county’s health care plan for low-income and elderly residents, now will administer its own mental health care services, after the agency voted to phase out its $41 million-a-year contract with Magellan Health. The agency’s Board of Directors voted Sept. 7 to take administration of mental health services for a majority of the health plan’s members in-house, including responsibilities like contracting with mental health providers, processing reimbursement claims and overseeing therapy programs for patients with autism. Patients still will see outside specialists for treatment. This will be the third time in three years the agency has made a major change in the management of its mental health services, and the change comes just one year after the agency approved its original contract with Magellan. … CalOptima is the federal and state financed health plan for about 800,000 county residents, roughly a quarter of the population. … The change was prompted in part by a contract dispute between CalOptima and Magellan in July, which may have left some patients without mental health care for nine days when the company refused to process Medi-Cal payment claims. …

KDADS Secretary makes pitch to privatize Osawatomie

Source: Melissa Brunner, WIBW, August 30, 2017
 
The Kansas Dept. for Aging and Disability services is making the case to privatize the Osawatomie State Hospital.   Secretary Tim Keck presented information Wednesday to state lawmakers and community leaders. Over nearly two hours, Keck detailed the history Osawatomie, the issues it has experienced in recent years and steps the state has taken to address the problems.  Looking to the future, Keck detailed a bid from Correct Care Recovery Solutions to rebuild and run Osawatomie, which lost federal certification in 2015. Correct Care runs mental health facilities around the country. …

Related:

State officials hope to replace, privatize Osawatomie State Hospital
Source: Peter Hancock, Lawrence Journal-World, August 30, 2017

State officials in Kansas began laying out their case Wednesday for why they think the state should replace the aging and troubled Osawatomie State Hospital with a new facility and hand over management of the facility to a for-profit, out-of-state corporation. Tim Keck, secretary of the Kansas Department for Aging and Disability Services, which manages the psychiatric hospital, said the hospital has become too challenging for the state to manage, and it is time for the state to make a decision. …

Kansas Lawmaker Leary Of Plans To Privatize Osawatomie
Source: Celia Llopis-Jepsen, KMUW, August 23, 2017

The Kansas Department for Aging and Disability Services has unveiled a proposal to build a new mental hospital at Osawatomie, which a Tennessee company would run. But Kansas House Minority Leader Jim Ward says the agency should be exploring in-house options. “This administration has a terrible history of privatization. Whether it be child support collection, DCF, KanCare,” Ward says. KDADS Secretary Tim Keck says the private operator would bring expertise and the ability to recruit mental health professionals. But, he says, his department is keeping an open mind. …

Kansas agency may privatize state psychiatric hospital working to regain federal funds
Source: Allison Kite, Topeka Capital-Journal, August 16, 2017
 
The Kansas Department for Aging and Disability Services is considering privatization for a troubled state psychiatric hospital that has now passed an initial step toward regaining some federal funding. KDADS Secretary Tim Keck said the department was considering a bid from Correct Care Recovery Solutions, which runs other mental health facilities across the country, to rebuild and privately run Osawatomie State Hospital.  The department also announced in a press release Wednesday that the acute care unit at the state psychiatric hospital had passed an initial survey required to get that part of the hospital re-certified by the federal Centers for Medicare and Medicaid. …

Kansas Official To Outline Privatization Plan For Osawatomie State Hospital
Source: Jim McLean, KCUR, August 14, 2017
 
One way or another, Tim Keck wants to replace the state’s aging Osawatomie State Hospital with a new mental health treatment facility.  Though he is meeting with some resistance, the secretary of the Kansas Department for Aging and Disability Services is pushing lawmakers to consider privatizing the state-run psychiatric hospital, which in recent years has been beset by operational problems.  On Tuesday Keck will outline a privatization plan submitted by a Tennessee-based company to stakeholders and legislators during a 1 p.m. meeting at hospital’s administration building. …

Osawatomie Contract Bidder Has History Of Safety Issues At Its Florida Psychiatric Facilities
Source: Meg Wingerter, KMUW, February 23, 2017

Correct Care Solutions, a Tennessee-based company that is the sole bidder for a contract to operate Osawatomie State Hospital, has a history of safety problems at the state psychiatric facilities it runs in Florida. Officials with the Kansas Department for Aging and Disability Services (KDADS) declined to provide details this week on Correct Care’s bid to operate Osawatomie State Hospital, one of two state facilities for people deemed a danger to themselves or others. The department is evaluating the proposal and hasn’t given a timeline for whether or when it would bring it before the Legislature. Under a law they approved last year, lawmakers must approve the contract before KDADS can move forward. …

‘Tough’ Budget: New Funding Unlikely For Kan. Mental Health System
Source: Meg Wingerter, Hays Post, February 12, 2017

A key Kansas lawmaker says the state doesn’t have the money to fix problems in its mental health system, which a new report says are getting steadily worse. The report, the second from a task force created in 2015 to advise the Kansas Department for Aging and Disability Services, says the system has continued to deteriorate. The task force’s first report, issued about 18 months ago, concluded the system was “stretched beyond its ability to provide the right care at the right time in the right place.” Rep. Brenda Landwehr, who chairs the House Social Services Budget Committee, agreed there are substantial gaps in the system but said lawmakers are virtually powerless to respond because of the depth of the state’s budget problems. … Given the amount of projected red ink, Landwehr said the state can’t afford to implement task force recommendations that would require significant new spending. Specifically, she said, it can’t afford to add psychiatric residential services for people covered by KanCare, the state’s privatized Medicaid program. … In the updated report, task force members also signaled their opposition to privatizing Osawatomie State Hospital, citing concerns about the quality of care delivered by for-profit contractors in other states. … More than 60 [House members] have signed on to a bill that would prohibit the privatization of either of the state’s mental health hospitals unless authorized by the Legislature. …

Read full report.

Privatization considered at Osawatomie State Hospital
Source: Charity Keitel, Miami County Republic, November 23, 2016

After more than a year of improvements, renovations and the pursuit of recertification, the Osawatomie State Hospital’s (OSH) future continues to remain in a state of flux. Kansas Department for Aging and Disability Services (KDADS) Interim Secretary Tim Keck recently announced that a request for proposal (RFP) for privatization of the operation of OSH has been put into effect. The RFP entails several specifications and could allow for a partial privatization of the hospital or a full bid for the entire operation. The RFP states that the state may award one contract to assume responsibility for providing at least 206 inpatient beds within the state of Kansas, but a minimum of only 94 inpatient beds would be required to be maintained at the current Osawatomie State Hospital campus. The remaining beds could be maintained at the OSH campus or at another KDADS-approved facility within the state hospital’s 45-county catchment area. Despite the RFP, Keck said it in no way means that privatization is a certainty in OSH’s future. He said he believes it is worthwhile to consider all the options even those that may not come to fruition. The RFP can be rescinded at any time for any reason at the state’s discretion. … Jones went on to say that he does not agree with an RFP that plans to move beds away from OSH and not increase functions there. He said the RFP seems to allow for a move of beds away from the state hospital as an option, which he does not favor. … It’s his belief that the legislators need to push back and make sure the RFP does not make it through the legislature. …

Continue reading

Michigan begins to design 4 pilot projects to test mental health integration

Source: Jay Greene, Crain’s Detroit Business, August 4, 2017

What is going on at the Michigan health department about designing four pilot programs to test a controversial plan to combine physical and behavioral Medicaid services among mental health agencies, providers and HMOs? So far, nothing, at least on the selection and design of the pilots. … Section 298 is a controversial budget section that, under Snyder’s original plan put forth in early 2016, would have allowed some of the state’s health plans to manage the $2.6 billion Medicaid behavioral health system. The Medicaid HMOs already manage a nearly $9 billion physical health system. Over the past two years, Michigan’s 11 Medicaid health plans have lobbied legislators and the public to try a semi-privatized approach under Snyder’s plan, which was finally approved in June. … Republicans in Michigan want to test the concept in four pilot projects that everyone believes will be Kent County, an urban area like metro Detroit, a northern Michigan rural area and in western Michigan, which could include Kalamazoo County, sources tell me. Lori said the state has not received any formal suggestions for where the four pilots would be located. …

Related:

Plan to privatize Mich. mental health aid advances
Source: Karen Bouffard, Detroit News, June 20, 2017
 
The first step in a plan to turn control of Michigan’s $2.6 billion mental health budget over to privately owned insurance companies is poised for inclusion in next year’s state budget, despite a wall of opposition from mental health providers, patients and families across Michigan.  The contentious plan is embedded in two provisions of the state budget for the Department of Health and Human Services, part of the Omnibus Budget bill approved by the state House on Tuesday expected to be approved by the state Senate on Thursday. …

Lobbying ramp-up precedes mental health funding proposal
Source: Justin A. Hinkley, Lansing State Journal, April 27, 2017

Physical health insurers ramped up lobbying operations and far out-spent their behavioral health counterparts in the months before lawmakers pulled an about-face on who should manage billions of Medicaid dollars for mental health services. Community mental health groups and allied advocacy groups spent about $52,400 on lobbying in 2016, nearly $8,700 more than their average from the previous three years, state records show. That happened as they fought to maintain management of Medicaid money for behavioral health. However, lobbyists for the private insurers who currently manage Medicaid dollars for physical health spent a combined nearly $838,000 last year, about $21,000 more than their previous three years’ average as they seek to take over the mental health dollars. … That ramp-up happened as lawmakers and Gov. Rick Snyder’s administration changed positions on the Medicaid issue — to the benefit of the physical health insurers. In February 2016, Snyder called for the private health management organizations who oversee physical health spending to also take over mental health money by Oct. 1, 2016. Lawmakers denied that proposal and instead asked the administration to study the issue and make recommendations by spring 2017. The administration did that last month, changing its position from 2016 and calling for the two funds to remain under separate management. Last week, however, lawmakers in the Senate advanced a budget proposal that would give the mental health money to HMOs by 2020. …

Continue reading

Governor agrees to direct-care worker raises

Source: Ben Gocker, Adirondack Daily Enterprise, March 30, 2017

Gov. Andrew Cuomo surpassed the state Legislature Tuesday in offering pay raises to people who work with those with disabilities. Cuomo’s $55 million goes beyond $45 million proposed by both the state Senate and Assembly. Cuomo had not included any increases for these workers in his initial state budget in January. The size of the increase will be worked out in ongoing budget negotiations between the two legislative chambers and the governor. The additional funds would help direct-support professionals who work for nonprofit organizations that contract with the state, such as the Adirondack Arc and Citizen Advocates, but not workers for state agencies such as the Office for People with Developmental Disabilities, who tend to have better pay and benefits. … #bFair2DirectCare, a statewide coalition of advocates for New Yorkers with developmental disabilities, their families and their direct care providers, has been fighting for better pay for these private-sector workers. … Most of the funding Adirondack Arc receives comes from Medicaid, and CEO Sadie Spada said consistent cuts to Medicaid affect her organization’s ability to pay workers what they deserve. …

Malloy budget would close Danbury mental health service

Source: Rob Ryser, News Times, March 2, 2017

A state-run office that helps 300 people from greater Danbury manage mental health and addiction afflictions would be closed as a cost-saving measure under the governor’s proposed budget for 2017-2018. The Danbury branch of the Western Connecticut Mental Health Network would be privatized under Gov. Dannel P. Malloy’s budget plan, saving a projected $1 million. The 39 workers at its Triangle Street location would be transferred to other offices. The proposal means that the region’s most vulnerable population would instead get needed services from charities and private-sector providers. … Malloy’s office responded that the state plans to invest $3.2 million of the Danbury network’s $4.2 million budget in private-sector services to ensure a successful transition. … Miriam Delphin-Rittmon, the commissioner of the state’s Department of Mental Health and Addiction Services, heard concerns from case managers that people served by the office would lose important state resources if the proposal is adopted by the state legislature. … The governor has also proposed privatizing a state mental health network in Torrington. …

Murray State Board of Regents Discuss Budget, Legislation, More in February Meeting

Source: Matt Markgraf, WKMS, February 25, 2017

… The Board considered options to reform or outsource healthcare and mental health services for students, faculty and staff, based on recommendations from consulting group Hodgkins Beckley on Friday. Options include increasing the budget for services provided, outsourcing services to a contracted health provider as Western Kentucky University has done, shifting costs out of the budget by adding a mandatory fee of around $150 dollars per student or implementing insurance and Medicaid. … MSU health services currently cost around $925,000 a year: $529,000 for health care and $396,000 for counseling. The board weighed pros and cons of six options as presented. … The third option outsources health services but keeps counseling services on campus. Urgent care clinics would be contracted to come on campus to operate services. Students would pay for the visit or use insurance or Medicaid. Employees could use insurance. While this option would significantly reduce costs, there would still be some cost the university attached. Western Kentucky University has a model like this one. The fourth option outsources services, provides funding for short term counseling, health services would be based on insurance. This is different than the third as it’s more insurance-based. … Regent Chair Steve Williams said the presentation was “food for thought” and offered a starting point for further discussion. …

Privatization could save some money at API, not at youth centers

Source: Andrew Kitchenman, APRN, February 6, 2017
 
Consultants who studied the privatization for the state found that management of the institute, as well as operating the state’s juvenile justice detention centers, are better done by the state.  Coy Jones is the senior consultant for Public Consulting Group and said savings depend on how many patients are at the psychiatric institute. … The state also couldn’t find savings in privatizing pharmacy services at Pioneer Homes.  The state studied privatizing services as a result of a new law that overhauled Medicaid in Alaska. The Senate Health and Social Services Committee held a hearing on the studies Monday.

Related:

Studies recommend against privatizing psychiatric hospital or juvenile jails
Source: Michelle Theriault Boots, Alaska Dispatch News, February 1, 2017

Alaska would not benefit by using contractors to run its juvenile jails or the Alaska Psychiatric Institute, according to a pair of Legislature-ordered reports on privatization written by consultants. The feasibility studies were mandated as part of a health care bill passed by the Alaska Legislature in 2016. With Alaska facing a $3.2 billion budget crisis, the privatization studies were supposed to examine whether the state could hand over management of its only psychiatric hospital and its short-term juvenile jails to private groups and save money without threatening the quality of services. The answer for juvenile jails was an unqualified “no.” Rather than corporate prison companies like Geo Group, which the Department of Corrections uses to run halfway houses around the state, the state seemed to be looking for a different approach for running detention centers where arrested teenagers are held short-term. … Alaska’s Department of Corrections already leans on the world’s largest private prison company, Geo Group, to manage all but one of its halfway houses.

… For the overburdened Alaska Psychiatric Institute, privatization might end up being more expensive than state control, the study found. Handing over management of the psychiatric hospital to a private company or a nonprofit would cost more “even after significant staff reductions,” according to a letter on the study’s findings sent by Davidson to legislators. It would be better, the evaluators found, if the state continued to manage the hospital that is supposed to serve as Alaska’s safety net for mentally ill people.

Should Alaska Psychiatric Institute be privatized?
Source: Annie Zak, Alaska Dispatch News, August 26, 2016

Members of the mental health community and general public had a chance on Thursday to voice concerns and ask questions about the possibility of the state-run Alaska Psychiatric Institute becoming a private entity. A Boston-based company called Public Consulting Group Inc., is conducting a feasibility study to identify and analyze potential options for how to best manage API. … The Legislature passed a broad health care bill this year that mandates the Alaska Department of Health and Social Services, in partnership with the Alaska Mental Health Trust Authority, look at whether a private contractor for API works for the state. The feasibility study will examine several options for what to do with the facility, including keeping it under state ownership and contracting out for some operations; forming a public corporation to operate API; keep it under state ownership but look for new sources of revenue; and contracting with a nonprofit or for-profit third party to take over management and operations. … A private operator of API would be subject to a state oversight committee, according to the DHSS. … The plan is to have the API feasibility study ready for the Legislature to review in January. …

Psychiatric hospital privatization to be discussed
Source: The News Miner, August 22, 2016

The Alaska Department of Health and Social Services and the Alaska Mental Health Trust Authority are hosting a roundtable discussions about privatizing the Alaska Psychiatric Institute, Alaska’s only public psychiatric hospital. A study about privatizing the hospital is a mandate of Senate Bill 74, signed into law by Gov. Bill Walker earlier this year. The Public Consulting Group, Inc., won the contract for the feasibility study on June 11 to identify and analyze potential options for privatizing the hospital. …

Alaska selects winning bids for privatization studies
Source: Zack Hale, State of Reform, July 19, 2016

Alaska’s sweeping Medicaid reform bill, signed into law last month by Gov. Bill Walker, included provisions that require the state to hire outside contractors to perform feasibility studies for privatizing some parts of the state’s health care system. Specifically, the law mandates an analysis of the privatization of certain pharmacy services, juvenile facilities, and the Alaska Psychiatric Institute. So far the state has received two winning bids from firms that will perform feasibility analyses for the privatization of juvenile facilities and the state’s only public psychiatric hospital. … Carter Goble Associates, LLC, (CGA) submitted the winning bid to examine the feasibility of privatizing the programs offered in the Department of Juvenile Justice’s short-term secure detention facilities for youthful offenders. CGA’s winning proposal can be read here. … Public Consulting Group, Inc. (PCG) submitted the winning bid to conduct a feasibility analysis for privatizing certain aspects of the Alaska Psychiatric Institute, which the proposal notes “serves as the sole safety net for the entire state.” PCG’s winning proposal can be read here. …

Alaska looks into privatizing some health and juvenile justice services
Source: Annie Zak, Alaska Dispatch News, May 27, 2016

The Alaska Department of Health and Social Services on Wednesday put out requests for proposals for studies that would examine privatization of services at the Alaska Psychiatric Institute, four Division of Juvenile Justice facilities across the state, and the pharmacy program at Alaska Pioneer Homes. … For API, some of the options include contracting a for-profit or nonprofit entity to take over management and operations; forming a public corporation to operate the hospital; keep it under state ownership and look for new revenue streams; or keep it under state ownership and contract out for certain services. … The state is also looking at potential options to privatize four short-term juvenile detention facilities in Nome, Ketchikan, Kenai and Palmer. The state is asking whoever performs the feasibility study also analyze the possibility of converting one or more of the facilities to offer nonsecure residential mental health and/or substance abuse treatment services. … Alaska Pioneer Homes, which provide assisted living care and pharmaceutical services to people 65 and older, is a state-run program that is “serving a greater proportion of high acuity residents than in the past, as prospective residents have been staying in their own homes as long as possible,” the RFP said. … The state wants an outside contractor to look at the costs and income of the current pharmacy program, as well as the needs of the program (like pharmacist consultations, or managing medication), to find out what the best option is to privatize it.