Our Voice: Unrealistic deadline to fix state's mental health system hurts patients

August 13, 2013 

The state and the feds are at odds about the best way to deliver mental health care.

Rather than side with either agency, we align ourselves with those who need the care.

The federal government is threatening to pull hundreds of millions of dollars from the state's programs if Washington does not comply within 90 days.

On a bureaucratic calendar, three months is not much more than the blink of an eye.

Supposing the money gets pulled, who does that hurt? Some people -- possibly administrators -- will lose their jobs, but the real gouge will be to the patients receiving services.

The net effect always hits the bottom wrung the hardest.

Large agencies often are the target (and in some cases rightly so) to trim costs and eliminate waste. The federal government has blanket rules. It's how it manages large systems.

But blanket rules don't always meet local needs -- or any needs for that matter.

The broken rule in question here requires a proper bidding process for the regional networks that make decisions on spending federal money for mental health care.

A competitive bidding process, when administered the way the federal government requires, likely would lower the cost of services, but may also lower the quality of services.

The regional networks know they are not in compliance with federal regulations, but officials say their approach results in better care for their clients.

The state claims that when mental health care is administered at a local level, clients benefit. The networks bring the major players -- counties, hospitals and jails -- closer together to pursue a unified approach to treatment.

We all know that as a country, we cannot continue to deliver mental health care the way we have in the past.

It's just not working.

We need to save money. We need to do things in a smarter way.

But we also must care for our communities -- as a whole and the individual members. We can't lose sight of the person while we are watching the dollars.

It's reasonable for the feds to examine the counties' mental health delivery system. If local networks are providing better care at a similar cost, they should be able to prove it.

If they are showing favoritism to local providers and bilking the government, that must stop.

This is an excellent opportunity for the state's networks to prove their value.

We support the quest to curb federal spending and to make sure that our money is wisely spent, but we have doubts about the 90-day deadline the feds gave state officials to produce a plan for bringing the state into compliance with federal rules.

Bureaucracies don't make wise decisions quickly. Sometimes it's like trying to steer an ocean liner.

A quick deadline leads to quick actions, and mistakes are made that could have been avoided with a little more planning.

Yes, the feds should oversee how local governments spend federal dollars. Yes, the counties should comply with the rules -- or prove that what they are doing is a superior approach.

No, we can't expect this to happen in 90 days. The feds and the state should work together to create a system that satisfies not only government requirements but offers the mentally ill the best chance for treatment.

Pulling federal dollars only will make things worse.

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