February 11, 2009

What's going on with DC DMH? (Part 2)

As I started to explain in my last mental health post, DC's Department of Mental Health (DMH) is undergoing some major changes.

In an effort to provide better services to a wider range of people, DMH has decided to close the public agencies that provide mental health treatment to severely mentally ill (known as the DC CSA) effective March 31, 2010. The plan is that the 4,174 patients who are currently receiving direct services from the DC CSA--40% of public mental health patients--will be transitioned over the next year to private providers.

This is a big deal. It will be a big undertaking with lots of room for error. I look forward to highlighting potential obstacles that DMH will need to address in future posts (and welcome comments, guest-bloggers, etc. to do a better job than I can do), but for now I will try to explain the plan from the DMH perspective.

The Implementation Plan DMH released last month provides the framework for how they expect all of these changes to take place. Here are the highlights:

  • Transition will happen in two phases: 2,500 consumers are expected to be transitioned to private providers by August 1, 2009 and then the rest by March 2010

  • Consumers will have the opportunity to choose their new provider
  • Beginning next month, there will be provider fairs, letters, ads, etc. to help educate the patients on what is happening and help them choose their new provider. Providers are encouraged to do their own outreach to the patients as well.

  • The private sector is not ready for this transition. Many private providers will need additional funding to help expand their capacity to serve these new patients--some need to hire new providers, some need bigger buildings, etc.

  • Once a consumer has chosen a new provider, then that provider will receive a pre-established "transition rate" from the District to help them increase their capacity so that they are ready to care for the patient after the transition. These extra funds are available within the current DMH budget.

  • A practice group of current DC CSA psychiatrists will continue to be employed by DMH, but will provide services at private provider offices

  • DC CSA treatment teams and outreach groups are working to ensure that care is uninterrupted and that everyone transitions smoothly

  • In the mean time, DC CSA will continue to provide needed services, especially for same day urgent care needs and for those who will only need short-term care.

Once the transition is complete, the DC CSA will be much smaller and hopefully DMH will be more effective, but given the current lack of capacity in the private sector, this will not be an easy process. There will need to be vigilant oversight, continued support for consumers and private providers, and DMH will need to be flexible on dates if private sector capacity cannot expand in time to meet the current deadlines.

Stay tuned to learn more about the end product goal and potential obstacles DMH will need to address...

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