Tuesday, May 13, 2008

Community Support Services (12 hours/ week/ $52/ hr = $2496/ month) VERSUS Inpatient psychiatric hospitalization: $21,000/ month minimum

Community Support Services are a bargain compared to inpatient psychiatric hospitalization

by Marsha V. Hammond, PhD: Clinical Licensed Psychologist

Phil Wiggins, the 64 year old schizophrenic followed by Raleigh News & Observer reporter, Ruth Sheehan, who has been hospitalized for all of his life until NC DHHS created Community Support Services (CSS) several years ago, is assumably about to move back into the psychiatric hospital.

Why should this matter to citizens of NC? Besides the fact that his existence will consist of the same four or so walls every day of his life, what is the cost of a psychiatric hospitalization versus CSS, as made possible by Endorsed Provider companies, created by NC mental health reform?

Medicare information indicates that at a minimum, psychiatric inpatient hospitalization is $615/ day (see: October 2007 information: http://www.medpac.gov/documents/MedPAC_Payment_Basics_07_psych.pdf)

Medicare indicates that as people age, this increases, assumably as associated with other health problems.

So, let's assume that Phil Wiggins, 64 years old, is hospitalized at a NC inpatient public psychiatric hospital for $700/ day.

That's 2007 $$. A usual month consists of 30 days. That's $700 x 30 = $21,000/ month for Mr. Wiggins to stay in an impoverished environment, where there is little to do, an environment in which his mental illness undeniably worsens or at the very best, is stabilized.

Community Support Service (CSS), that bane of NC DHHS, and by default, its authorization agency, Value Options, pays approximately $52/ hour.

In April, 2007, courtesy of then DHHS Secretary Carmen Hooker Odom, appointed by Governor Easley, cut the hours of CSS to no more than 12/ week.

Beyond the 12 hours, the Endorsed Provider company would be very subject to a post payment review which would break the company. Thus, no more than 12 hours/ week/ CSS is available.

That's 12 hours/ week/ $52/ hr = $2496/ month.

Yes indeed: let's compare the very minimum of CSS hours permitted by NC DHHS per month, specifically, $2496, versus $21,000/ month for inpatient psychiatric custodial care.

The public can do math: can the Governor and NC DHHS?
Marsha V. Hammond, PhD


"....While fiscally conservative lawmakers continue to count the monetary cost of adding new beds at state mental hospitals, who will be responsible for counting the enormous social costs that come with a broken system that currently tolerates far too few beds?..." http://psychlaws.blogspot.com/2008/03/real-cost-of-psychiatric-hospital-beds.html

Psychiatrichospital servicespayment systemFor rate year (RY) 2008 (beginning July 1, 2007), the base payment rate is $615 per day. http://www.medpac.gov/documents/MedPAC_Payment_Basics_07_psych.pdf


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