More from Mark "Drastic and Worse"
The mental health reform debacle demonstrates one thing very clearly: blind adherence to the ideology of privatization is misguided. Some services and some programs should not be privatized at the expense of quality care. I'll save my rant about the Bush administration's ideology of privatization for another day, but suffice it to say that I believe Democrats, like Governor Easley, have been misguided in pursuing privatization programs --particularly for health care.
Drastic and worse (this one was printed on 4/22)
"In response to Health and Human Services Secretary Carmen Hooker Odom's April 14 letter:
Community Support was designed to be a key component of the new mental health system, replacing Case Management and Community Based Services. Under the new regimen, high school graduate workers can perform essentially the same functions as graduate-level practitioners, and their agencies can bill at the same rate.
Architects of the new system aimed to reduce dependence on state hospitals by strengthening the infrastructure of community-based services. One of their strategies was to bring market forces to bear. By untying reimbursement rates and credentials, allowing workers with GEDs to bill at the same rate as those with master's degrees, an obvious financial incentive to employ lower-skilled workers was created. Some of us pointed out this glaring problem when the original definitions and rates were introduced.
Now DHHS has confirmed the predictable outcome: Lower credentialed workers are providing the vast majority of these services.
Rather than taking a sensible approach like tying credentials to reimbursement rates, the department has taken drastic action, which only guarantees that the problem gets worse. By slashing reimbursement rates, it is ensuring that lower-skilled workers will increasingly provide this important service. It is pulling the rug out from under an already shaky and insufficient network of providers."
Mark D. Sullivan, MSW
Mental Health Association in Orange County, NC