Mental Health to cut three

Mary Perham

Changes in federal funding and an ever-changing pattern of state funding will lead to the elimination of three positions in Steuben County’s mental health services.

The positions slated to be cut are now filled by people planning on retiring soon, according to county Office of Community Services Director Hank Chapman.

Chapman told the county Legislature’s special Health Services Review Committee the jobs cuts are due in part to changes in a federal program that pays for a portion of the workers salaries.

But changes expected later next year in state funding may force more dramatic changes in the office’s continuing day treatment programs, Chapman said.

State funds for the day program are now reduced 25 percent and could be eliminated all together by October of next year, he told the committee.

“In my opinion, the state is sending a message,” Chapman said. “Which is ‘You want to offer day treatment? Well, good luck, because you’ll be on your own.’”

Day treatment programs typically help people recovering from mental illnesses, substance abuse or jail develop the skills needed to function in “everyday” life.

While the office’s 2013 budget for day treatment of $1 million is level with 2012 expenses, a drop in revenues means Steuben must pick up more than $311, 000 in costs next year, according to the proposed 2013 county spending plan.

Chapman said his office will look for private therapists to pick up the slack left when the three employees retire. He expects some internal changes and is looking at ways to make services more efficient.

One key issue for all mental health clinics across the state is the number of “no-shows” – with as many as 50 percent of scheduled clients failing to show up for appointments, Chapman said.

But while his office plans on eliminating cliinical jobs, there is a growing need to fill vacant positions in the business end of the department, he said.

“We need to be sure we’re getting paid for the services, we do provide,” Chapman said. “We need to look into (denied claims). We need to keep up with our Medicaid billing.”

State policies, formulas and payments are in almost constant flux, according to the department’s business manager Karen Monroe.

During the past two years there have been several changes that have led to more paperwork and a backlog of claims the department can send to the state and private insurers, Monroe said.

The changes have added delays to claims the department had hoped to file long before now, she said.

“We still have 14 months of billing we need to get out,” Monroe told the committee.

The problem of adequate payment has bedeviled the department for years, with the state’s sometimes whimsical approach to billing. That approach includes changing rates and making those new charges retroactive, meaning clinics must go back months and re-figure charges.

The unwieldy system led the special committee to review outsourcing programs in the hopes of saving money. But a recent request for private groups to submit plans fell far short of the county’s needs.

County Administrator Mark Alger told the committee Monday Steuben received one bid to provide services for the most revenue-rich programs only and leave the costly ones to the county.