MianeCare goes to work...

There is a small Mental Health agency in the Waterville area that is feeling the crunch of the recent (and I'm sure, future) cuts to the DHHS Healthcare system funding. They service nearly 100 clients with Case Management, In-home supports, a small PNMI, and a Med clinic.

This agency, until recently, served clients in need of help out of two offices in two seperate regions. With the rising costs of expenses and the waning speed of reimbursements from MaineCare and the CDC, they were forced to close one of their offices down and now work out of one. This has put a great burden on the general staff, as well as the Upper Management to try to provide the same services that are expected at the State level with less people to do it.

It also puts a fear of "abandonment" in the clients that are being served. With the recent folding of Richardson Hollow Mental Health and their subsequent absorbtion by Sweetser Mental Health followed by the closing of TWO of their main offices, we all got the chance to read in the news the reactions of some of the clients being served. It's fear. Plain and simple fear. Fear that they may not have a place to go when they need help. Fear that they may not have someone to help them tomorrow when they feel that they can't go on. Fear that they might lose what little income and financial assistance they receive to survive on. Fear that they may end up institutionalized or worse, in jail because they can't get the help they so desperately need. The one thing these people don't need added to their already (sometimes) dibilitating mental health issues is fear. I think the key word here is "people". Whether society chooses to consider them as such or not, they are "people".

A lot of these "people" have never seen the outside of an institution or jail for more than a few months at a time since their early years. They don't know what society expects of them. They don't realize what's acceptable and what's not by the standards that we, as a society, expect. These small or large Mental Health agencies provide the services needed to try to help these "people" intergrate back into society. Sometimes they succeed. Sometimes not. But, at least the attempt is made by some very caring and VERY patient persons to do just that. Still the State says, "Cut back".

Okay, then cut back. I only hope that the jails, psychiatric hospitals, and the psych wards of the general hospitals are prepared for the consequences that will follow. It's a vicious circle that gets run. Once these "people" end up in one of the three afore mentioned places, these places insist that one of these agencies pick them up as a client and "take them off their hands". Check with one of the local jails or State prisons and ask them what the percentage is of their "population" that has mental health issues. The number is staggering. Yet they get literally thrown out on the streets with no help and end up right back where they started. Same with the Psychiatric Hospitals in the State. They reach a point with some where they can't handle them anymore and will pretty much beg (and even lie) to get one of these agencies to take them.

...and here we go again. All of this expected at a rate set by the State with payment to be made at their discretion. The agencies are expected to provide more and more services for less and less money. What's going to happen to the many soldiers serving in Iraq and Afghanistan when and IF we ever manage to pull out of those countries? PTSD can be a nasty after-effect of war. Are we going to be so quick to pull the rug out from under them, too?

A lot of private practice Doctors in the State have stopped seeing or taking on anymore MaineCare patients because of the hoops that they are expected to jump through to get reimbursement. So, where do these people go? They go to the Emergency Rooms of the nearest hospital for treatment. I highly doubt that the cost of an ER visit is comparable to the cost of a Doctor's office visit. The service is usually shoddy at best and they are hurried in and out at an alarming pace. In all of this running around that is expected of these MaineCare recipients to get the medical attention they need, the hospitals are losing out, as well. Yet, they have no choice but to give them the service that they require. Do you think the hospitals are receiving reimbursment any faster than the private practice Doctors are? Not by a long shot. MaineCare is so proud to be able to say that they made a payment of $200,000 or $300,000 to one of the hospitals. Not bad. But, if you consider that that's only part of the sometimes millions of dollars that is owed, it's not such a great feat. Unfortunately for the tax-payers of Maine, that is the result of the State's own misguided and poorly thought out decision to cut back on Healthcare Provider's services. The hospitals are forced to recoup the money in other ways and that usually means an increase in cost for services rendered. Can you say "insurance hike"? I don't know about the rest of you, but I can't afford to have my taxes OR insurance costs increased to help unburden the State of the results of their own decisions.

Now don't get me wrong. I understand that a "promise" was made to the people of Maine for the State to pick up more of the tab to keep the schools in the State operating. But, I also feel that too much time and effort is being spent on that right now than the more pressing concerns at hand. If we continue to have a less "healthy" population, be it physically or mental health wise, there won't be much use for the overblown issue of "consolidation". If the State continues to pressure the schools to act at the pace they are already expected to, mistakes will be made. Mistakes that can only cost the tax-payers more money in the long run. I'm sure the people of Maine will be willing to give the State a "mulligan" and accept a minor setback for the promise from them to "get their priorities straight".