DEMOCRACY RUN AMOK

By Judy Arnold

             This article is adapted from a text delivered at a local anti-privatization speak out. In the article Judy Arnold demonstrates that after new initiatives to privatize/contract out mental health services are deeply flawed. Currently privatized county mental health services are awarded unilaterally by a non-elected bureaucrat. The only organization that monitors his decisions is a board made up of mostly mental health contractors who he appoints. Outsourced mental health care produces worst outcomes for the community and for the individuals it services, while public services already perform very well.

The LGU (Local Governmental Unit) has a statutory role as described in Mental Hygiene Law §41.05 and §41.07. The LGU in Broome County is the BC Commissioner of Mental Health. LGUs govern the oversight of county and local PRIVATE not-for-profit service provider funded mental health programs that receive funding from the NYS Office of Mental Health.

From the BC 2014 BUDGET Mental Health  pp 257- Quoting Commissioner Johnson:  “Over the last decade the role of this department has shifted.  Historically, the [Mental Health] dept. was a service provider only.  We now have a significant role in contract management for services provided for us by (private) not-for-profit agencies.”….. .

One of the local private nonprofits who took clients, after three years, has not complied with the ‘official’ state paperwork required. In contrast, the BCMH Clinic always had high ratings for quality assurance following State site visits for compliance.

The BC LGU has too much power that is not monitored sufficiently. He chooses what agencies to subcontract services to and unilaterally appoints members to the Community Services Board that are just rubber stamped by the County Executive and legislature. Most members are representatives of contract agencies who have a vested interest in funding.   Under New York State law, every locality must have a Community Services Board, which reviews local plans and advises the local director of community mental health services. Community Services Boards have three subcommittees–the mental health subcommittee, the mental retardation subcommittee, and the alcoholism and substance abuse subcommittee.   There is no public access to the schedule of these meetings, to minutes of this board, nor a list of the members that the public could contact in Broome County. There is not sufficient public discourse.

The NYS Office of Mental Health moved to managed care and a similar move is in the works for behavioral health. However, the managed care organizations currently responsible for medical and pharmacy benefits have limited programmatic or payment experience with the comprehensive mental health or substance abuse populations   On paper there is a plethora of services proposed. However, there is also a conflict about criteria and traditional “medical necessity”. SURPRISE!!!!, the timeline for NYS Medicaid behavioral health transformation is being delayed to January 1, 2015, for adults in New York City and July 1, 2015, for the rest of the State (children’s behavioral health services is now pushed back to January 1, 2016).

There is no waiting list at the BCMH Clinic; BC residents deserve easy access to public mental health services. The Clinic has been the gateway/single point of entry.

 

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