Monday, September 29, 2008

Letter to the Editor

Director backs local mental health services


A great deal has recently been written and debated about how best to fix the state system that provides services and supports for individuals with mental illness, addictions and developmental disabilities. Much of the discussion often seems very detached from actually providing services to the people who need it. On the surface, the discussion about whether to have a statewide vendor for "utilization management" of services or to return that authority to the local management entity seems to be that type of esoteric, detached and academic discussion. In reality, it has a great deal to do with improving the care, quality and coordination of the services being provided.

Utilization management simply means that someone is reviewing requests for services, seeing if the request meets the identified needs of a person, and approving (or not) those services for payment. With a statewide vendor such as Value Options, that process is essentially a paper review. But individuals served by our public system often have very complex needs and many will need some level of support in our communities for an extended period of time. A paper review is insufficient to fully understand the individual and his or her circumstances, much less understand the types of services and expertise available at the local level that might best support that individual.

Local management entities such as The Durham Center have an intimate knowledge of the individuals we serve, the providers in our community, and the natural supports available. As reported in The Herald-Sun in recent days, Durham providers recognize that offering the best services to an individual often requires not a paper review, but a conversation about how best to meet the needs and preferences of the individual. At the local level, being aware of and staying involved in the care of the individuals we serve is easier because it is closer to home -- our home as well as the homes of the ones we serve and the agencies we partner with.

We strongly support the efforts to move the management of services, in a way that is thoughtful and well-planned, back to the local level.

September 20, 2008
The writer is area director of the Durham Center. The length rule was waived.

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