Monday, March 30, 2009

GA Depart Hum. Resources taking bids on privatizing mental health hospitals: WE'RE GONNA TELL YOU, 'WE TOLD YOU SO'

Its better to watch a wreck from afar than it is to be the recipient---as a mental health provider. Maybe it will get the Dems back into the Govna's office.

Its as if they lived on the other side of the planet instead of literally next door.

So, GA: here is what we can predict:

1. privatization won't work. Why? Because these are indigent clients and they have no money and therefore there will be no money to be made and therefore they will simply get sicker and sicker, people will get murdered by untreated people, etc.

2. NC only privatized the mental health outpt services but did it in such a way that every citizen was supposed to receive mental health services as associated w/ a term 'state funded client.' Why hasn't that worked better than the state legislature proposed that it would? Because the LME's---the authorizing entity for the state funded mental health and the overseers of Community Support Services (CSS), the people who had been the community mental health centers-----managed the state funded client mental health services in keeping w/ the demands by NC DHHS which continues to create poorly written memos which set up the private providers to crach and burn as they cannot be paid on a reliable basis.

3. NC state psychiatric hospitals have not been privatized. The Centers for Medicaid and Medicare Services (CMS), this being the federal funding that even GA will have to pay attention to----has the matter of the IMD exclusion rule which means that you cannot have more than 14% Medicaid beds in a private, psychiatric, for-profit, free standing hospital. And that is what the GA psychiatric hospitals will be if they are privatized. So, HOW does the GA State legislature think that they are going to get around the IMD exclusion rule?

Read it and laugh (or weep):

"Still, the Georgia Department of Human Resources is pressing forward with a proposal to turn over one of the state’s seven mental hospitals to a private company as early as next year. DHR’s longer-range plan is to close four of the institutions and privatize most of what remains of the state’s mental health services by 2012, according to a report by The Atlanta Journal-Constitution’s Alan Judd and Andy Miller.

....State mental hospitals can hardly be seen as potential profit centers for private companies — one of the reasons there has been so little private or public investment in that market over the last two decades. Patients who are sent to state institutions have usually exhausted all private insurance coverage.

And unlike regular hospitals, there is no way to cost-shift the burden of caring for indigent patients by treating insured patients. Private practice psychiatrists rarely admit insured patients to state institutions. Given this, corporations don’t have many ways to make a profit from running state hospitals. They’ll probably resort to reducing staff and services — the very things that have gotten Georgia in trouble in the first place.

It’s hard to tell whether DHR officials believe privatizing mental health services will really work or whether they have become ideological slaves to the notion that the private sector always delivers higher-quality and lower-cost services than the government can.

“This is the most exciting thing I have seen, conceptually, that helps us get to real, positive change in mental health,” DHR Commissioner B.J. Walker breathlessly announced last month. In an e-mail obtained by the AJC through the Georgia Open Records Act, Walker told a consultant: “I find myself with a strategic opportunity, given budget cuts, to do what is unthinkable here.”


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