Last week, I was fortunate enough to attend the NC Providers Council 2012 Conference, Strategies for Success in Uncertain Times: Keeping People First. Many thanks to Bob Hedrick and the Providers Council Board for hosting this event.
The agenda was appropriately relevant to NC’s transition under the 1915 b/c Medicaid Waiver. It was encouraging to hear presentations from Representative Nelson Dollar (R), DHHS Secretary Albert Delia, Jim Jarrard (NC DMH/DD/SAS Acting Director) and Tara Larson (NC DMA Chief Clinical Operating Officer), as well as MCO representatives from Cardinal Innovations Healthcare Solutions and East Carolina Behavioral Health.
Much of what was discussed centered around MCOs and providers working together as partners in Keeping People First. The message became clear that there are only a finite amount of Medicaid dollars in each MCO pot, and a tremendous amount of pressure on MCO leadership to avoid budget over-runs. As a leader of a private company, I respect this message. At the same time, it is important to not only have a fiscal year budget to guide operations, but also a long range plan for growth and efficiency.
I heard a number of individuals speak about “right-sizing” Psychiatric Residential Treatment Facilities, specifically citing the cost of this type of long-term care. Some PRTFs do not provide quality care and their outcomes are poor… at a high price to taxpayers, consumers and their families. I think there is truth in this statement; however, you cannot throw out the baby with the bath water.
New Hope consistently looks for ways to improve both our performance and consumer outcomes. Through our evidence-based practices and validated regulatory compliance, our outcome data has proven our success with adolescents (and their families) who have been unsuccessful in other levels of care. With the mental health, safety and trauma/attachment issues that these youth present, quality PRTFs serve as a very important spoke in the mental health wheel (and with our partnership with Carolina Choice, a CABHA, together we can serve many more spokes in the wheel – Therapeutic Foster Care, Day Treatment, Intensive In-Home Services, Medication Management and Outpatient Therapy).
By denying this level of care to individuals who need it (a small percentage of the population), or forcing them to leave prematurely, the state could incur even greater costs. Over the life of the individual, this may well lead to multiple short-term placements, hospitalizations, or time in state prisons. All of these services are more costly than PRTF treatment.
We often hear the expression “Invest in our children’s future.” Now is the time to invest all possible resources in helping children (and their families) work through core issues to a resolution. If we do not, many of these children will struggle for rest of their lives. They will incur high dollar claims over a protracted period that could have been confined and abated if addressed sufficiently in childhood.
I hope when we meet for next year’s conference, we can all hold our heads high and say with confidence, “We kept people first.”