Category Archives: Mental.Health

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. …

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. …

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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. …

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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.

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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.

An Input Adjustment Method for Challenging Privatization: A Case from Michigan Prison Health Services

Source: Roland Zullo, Labor Studies Journal, December 17, 2016

Abstract:
I investigate the feasibility of completely privatizing prison physical and mental health service. The study is based on bid documents from Michigan’s 2012 exploration of privatized health care, along with historical documents. Five lessons are reported: (1) Price differences are largely attributable to staffing strategies, with private agents using fewer full-time equivalent (FTE) and less-qualified staff; (2) privatization ushers in personnel practice that is less structured for long-term employee retention; (3) managed competition is impractical due to qualified provider scarcity and desirability of client-patient continuity; (4) tension between best practice medicine and the profit motive is unresolvable, which necessitates diligent monitoring; and (5) privatization ideology is a powerful force that is external to the public interest but one that can be challenged by “good government” coalitions.

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Nonprofits: More privatization can save state $1.3 billion

Source: Susan Haigh, Associated Press, January 18, 2017

Nonprofit human services providers say they can help solve Connecticut’s budget problems by taking over more state-operated programs, an idea that appears to be gaining steam among some legislative Democrats as well as Republicans. The Connecticut Community Nonprofit Alliance on Wednesday unveiled a proposal to shift developmental disability residential services and mental health and substance abuse treatment programs from the state to the private sector. The group says its plan would save $1.3 billion over three years. The proposal comes as Connecticut faces a projected $1.5 billion deficit in the fiscal year beginning July 1. Connecticut has a system where both state employees and private nonprofit providers deliver state services. While many Republicans have pushed to privatize those programs, more Democrats, including Gov. Dannel P. Malloy, support the idea.

Emanuel’s privatizing mental health clinic in Roseland raises concerns

Source: Curtis Black, Chicago Reporter, November 3, 2016

When Mayor Rahm Emanuel closed six of the city’s 12 mental health clinics four years ago, the decision sparked sustained protest.  With his announcement last month that the city’s Roseland clinic will be privatized, it looks like the mayor has decided it is now safe to go after the remaining clinics. This move should not happen without public discussion, according to the Mental Health Movement, a coalition of clinic clients, grassroots groups and unions, has called for hearings on the Roseland clinic’s fate. The Health Movement initially withheld judgment when the city announced on Oct. 7 that the Cook County Health and Hospital System would take over management of mental health services at the Roseland Neighborhood Health Center, one of the remaining Chicago Department of Public Health clinics. In fact, the county seems to have a stronger commitment than the city to providing public health services, an organizer said. … Activists are concerned because last year, C4 announced that it was closing its doors due to billing problems, sending its 10,000 patients elsewhere.  A few weeks later, C4 announced it was joining CountyCare and would stay open. … The city describes C4’s takeover as an “increase [in] service options,” since the nonprofit would extend mental health services to children.   Again, Carter points out that activists have long called on the city to expand services. …

California counties look to private firm to run new state psychiatric hospital

Source: Annie Gilbertson, SCPR, October 27, 2016

A statewide consortium of county mental health officials is planning to create California’s first privately-run state mental health hospital. It says it’s the fastest way to address the persistent shortage of beds for the state’s most dangerously and severely mentally ill. But critics of prison privatization worry care will worsen, pointing to past problems with the contractor, Correct Care Recovery Solutions, a spinoff of the private prison giant GEO Group. The proposed facility would serve around 250 civilly-committed patients – those hospitalized because they’re deemed a danger to themselves or others. That would allow the current network of state hospitals to continue to house people who are charged with crimes but found mentally incompetent to stand trial or not guilty by reason of insanity. … In June, the list of people waiting to get in reached a five-year high of 700. On average, patients found incompetent to stand trial waited two months to get a hospital bed, but some can wait several months. Many are waiting in county jails, predominately in Los Angeles County, where they are entitled to basic mental health care, but long-term psychiatric treatment can be delayed. Civilly-committed patients are housed in local psychiatric hospitals, which can charge between $600 to $1,300 a day in Los Angeles County. … Graziani points to South Florida State Hospital as an example. The facility was one of the first state mental health hospitals in the U.S. to be privatized. It was managed by a division of GEO Group until 2014, when Correct Care Solutions bought the unit. In 2011, Florida’s Department of Children and Families, which oversees adult protective services, launched an investigation into the facility after three patient deaths that year.  In one case, a heavily-medicated man was found dead in a bathtub. The water was so hot, staff reported, the patient’s skin sloughed off his body. Florida investigators determined Correct Care staff was fixing the problems, yet adult protective services continued to find abuse and neglect at the hospital. Between 2011 and 2015, investigators verified 19 claims that staff abused, neglected or poorly supervised those in their care, records show. …