Adminstration Looks For Savings In Mental Health Programs

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(Host) The Shumlin Administration wants to save money on mental health programs by changing how it pays non-profit providers.

The administration wants to implement a performance-based contracting system. And if that doesn’t cut costs, the state may put some of the services out to competitive bid.

VPR’s John Dillon has more:

(Dillon) The state spends $280 million a year on 17 non-profit, community mental health providers.

(Racine) "And I don’t know how well they are doing. And some may be doing well, and some may not be. They are all independent of each other, and somewhat independent of the state.

(Dillon) Human Services Secretary Doug Racine is looking for ways to rein in spending. One step, he says, is to pay the providers based on performance measures. 

(Racine) "I think we need to do our job here at the state a whole lot better, which is to ask them what kind of outcomes they’re getting, how well they’re doing with the money that they’re spending, what are the outcomes for the patients they’re seeing, the clients they’re dealing with."

(Dillon) The agencies care for people with mental illness or developmental disabilities. The community-based system evolved after the state closed the Brandon Training School, and drastically reduced the patient population at the Vermont state hospital.

But costs have been growing. And the Shumlin administration wants to cut spending by $11 million. That proposal led to a huge protest this month at the Statehouse as patients and their families said the budget cuts would decimate programs.

Paul Dupre is executive director of Washington County Mental health. He says the agencies will work with the state on performance based contracts.

(Dupre) "My belief is we’re going to be challenged to come up with some things that will give the secretary comfort that the state’s taxpayers are getting their moneys worth. And also to look at how we can keep the costs of services at as reasonable a level as possible."

(Dillon) But Racine says he may also need the flexibility to go outside the 17 agencies for services. That would require a change in state law to allow the state to contract with other providers.

(Racine) "You know, they’re non profits. I’ve heard from other non-profits who are not designated agencies who could provide high quality services at perhaps lower cost than the designated agencies."

(Dillon) The agencies strongly oppose that idea.  Dupre says non-profits like his own provide quality services – even as their budgets have been cut.

(Dupre) "The reality is that the agencies for the past four years have either taken level funding or reductions and in most cases have managed to work with the administration to provide services in alternative ways and to try to find efficiencies in all the things that they do."

(Dillon) Racine says the state has got to find more cost-effective ways to deliver mental health services. He says the budget pressures will only get worse as federal cuts come down from Washington.

For VPR News, I’m John Dillon in Montpelier.



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