« Ind Decisions - Is Purdue subject to the age discrimination law? | Main | Ind. Courts - Vanderburgh County plan to put records on line is stalled »

Sunday, October 09, 2005

Ind. Gov't. - FSSA urges "localization," not "privatization," at Richmond State Hospital

The Richmond Paladium-Item has this story today wherein Mitch Roob, FSSA secretary, makes the distinction. Some quotes:

FSSA Secretary Mitch Roob wants to make clear that plans for the Richmond State Hospital involve localization, not privatization, and that there is, he insists, an important difference.

"It is something of a euphemism that I made up," Roob said in a Friday telephone interview about the localization term. He also argues in a guest column on today's Viewpoints page that in privatization, an organization is brought in to make changes that government couldn't make.

"You bring in new people to radically alter what you're doing today to save money," Roob said about privatization. "It's not the right answer here."

He said the decision is not being made to save money and the state hospital's employees' jobs are not in danger.

FSSA Media Specialist Brian Carnes said the FSSA would negotiate for state hospital employees to receive the same or better salary and benefits as they receive currently.

What Roob wants to see at Richmond State Hospital is a local not-for-profit organization contracting with the state to care for the needs of patients. He said he doesn't think the state hospital needs radical change, but that keeping FSSA as the service provider is, he contends, the wrong way to go for the long run. Mental health, he emphasizes, is the only area where the FSSA itself provides direct services to Hoosiers. Other services are contracted out, he said.

The Richmond paper today also carries an opinion piece by Secretary Roob, that begins with the question: "Should state government make or buy inpatient mental health care?" Some quotes:
Last year, FSSA funded treatments for more than 100,000 Hoosiers for out-patient mental health care and substance abuse, yet none of those people were treated by FSSA employees. In addition, FSSA pays for long term care for the elderly, training for the developmentally disabled and well-baby care. FSSA is truly a health care financing agency -- we buy health care, we don't provide it.

The only exception is inpatient mental health care.

FSSA currently owns and operates several state mental health hospitals. Indiana, like many states, has gradually reduced the number of those hospitals thanks to the outstanding progress in mental health care in the last 20 years. New treatments and drug therapies allow millions of people to live less painful and more productive lives that may not require long-term hospitalization. Because of this, Indiana has chosen to transfer a substantial amount of patients and dollars to community-based not-for-profit healthcare providers.

However, government models of care tend to stagnate. They are overseen in Indianapolis while the actual care is often delivered far away. Our state hospitals should be free from the shackles of a bureaucracy cumbersome and benignly neglectful at best, and at worst meddling and contradictory.

When state government decides a hospital's care model has so clearly stagnated it has become politically or financially embarrassing, someone in Indianapolis becomes responsible for downsizing or closing the hospital. This is typically done with little regard for the effect such action has upon the local community, not to mention the trauma to the families, and most importantly, to the patients. Frankly, this is the history of the closure at Central State and Muscatatuck. Now, sadly, Fort Wayne may face a similar future.

But I believe we have a unique opportunity to stop this devastating cycle. Currently, FSSA's state hospitals in Madison, Richmond and Evansville are needed and likely to be relevant for the foreseeable future. These facilities have recently been rebuilt and the model of care they employ is current.

The communities housing these facilities, along with the employees who operate them, should be given -- or better yet, have a role in developing -- a governance model that keeps pace with clinical and operating changes. Hospitals that stay current stay in operation, and therefore, remain a vital part of the local economy.

This is why I have proposed "localizing" state mental health facilities. By this I mean that locally chartered not-for-profit providers are awarded the contracts to run/operate the facilities. It is also my intention that current employees will be offered jobs at or even above their current wages and with retirement and healthcare benefits equal to state government.

Posted by Marcia Oddi on October 9, 2005 11:58 AM
Posted to Indiana Government