Modesto Bee Article
last updated: May 16, 2008 05:47:25 AM
We commend county officials who found a way to extend mental health treatment for about 150 Stanislaus County residents who otherwise were going to slip through the safety net, with potentially dire consequences for them and others.
The issue involved medically indigent adults -- a narrowly defined group of people who didn't qualify for Medi-Cal but didn't have other insurance -- who needed psychotropic drugs and needed to be under the care of psychiatrists, but who were being seen instead by family practice physicians at county clinics. There were two problems: First, the physicians weren't comfortable evaluating these patients and writing prescriptions that needed to be monitored by specialists; and second, the county was paying about $280,000 a year for the psychotropic drugs out of its Health Services Agency budget, which is constantly bleeding red ink.
Two months ago, county supervisors voted to end that arrangement, but asked staff to come up with an alternative. Without proper treatment and medications, these patients could end up in emergency rooms or jails, ultimately costing the county more than it was spending already.
The alternative was worked out by three county departments -- the Health Services Agency, the Community Services Agency (formerly known as welfare) and Behavioral Health and Recovery Services (formerly known as mental health.) As it turns out, not all of the 150 patients require intensive psychiatric treatment; those who do will get assistance through several arrangements. Because the county is having a hard time hiring psychiatrists, some of the visits will be conducted through telemedicine -- using psychiatrists working elsewhere hooked up by video and other technology.
The county has set this up as a two-year pilot program because it will take a long time to work out the details. Some of the patients involved might qualify for Medi-Cal coverage, but the process to determine eligibility can take months.
This solution demonstrates cooperation and innovation and reflects compassion toward the individuals involved and common sense for the public. Kudos to all involved in making it happen.
