Private providers plan for 500 mental patients Groups work toward June 30 deadline when health bureau closes

Private mental health providers in Carroll County are gearing up to absorb more than 500 patients who will need to arrange for psychiatric care before June 30, when the county Health Department plans to close its mental health bureau.

The transition process, which began this month, is expected to be complete by the middle of May.


Meanwhile, mental health providers are competing for patients and scrambling to have services in place for their new clients.

"It's a very changing marketplace," said Fred Chanteau, president and chief executive officer of Affiliated Sante Group of Montgomery County. The provider of outpatient psychiatric services is planning to open a clinic in Carroll next month.


ADAPT Counseling, a private, outpatient mental health clinic with offices in Eldersburg and Westminster, and Granite House, which provides residential and rehabilitation services to psychiatric clients, are joining to offer services to mental health bureau patients. The two local providers plan to provide comprehensive outpatient treatment and rehabilitation services to the county's mentally ill.

ADAPT has hired three psychiatrists from the county's mental health bureau, including the clinical director, under the assumption that most former bureau patients will follow their treatment providers, said Dr. Eduardo de la Cruz, president of ADAPT and a psychiatrist at Springfield Hospital Center in Sykesville.

"We are expecting that the vast majority of them will simply change addresses and come over to us," said de la Cruz. "The care is not disrupted; there will be continuity. The patients need not be involved in all the bureaucratic goings-on."

Although officials at ADAPT/Granite House assume that most Health Department patients will choose treatment at their clinic, Chanteau said that the final choice rests with the patient.

"I think what's real important is that people not get the impression there's only one resource," Chanteau said. "Our concern is to ensure that clients are well-informed about the choices and providers available to them."

Closing of bureau

Carroll's Health Department announced the closing of its mental health bureau last month in anticipation of the state's efforts to privatize mental health services. The bureau's 40 employees are gradually being laid off as services are phased out.

Bureau Director Howard Held said the process of transferring patients to new treatment providers is "going smoothly," and that about 120 referrals have been made. The number of patient transfers is lower than the referrals because, in some cases, a patient may require more than one provider. For example, a patient might go to one therapist for case management and a psychiatrist for medication monitoring, Held said.


Patients have been given a list of private providers. Health officials said therapists will work with them to secure new treatment before the bureau closes.

The shutdown comes at a time when Maryland's publicly funded mental health delivery system is undergoing fundamental changes. By July 1, the system will be overseen by Maryland Health Partners, a partnership between Green Spring Health Services Inc. of Columbia and CMG Health Care of Owings Mills.

The two companies will form the new Administrative Services Organization, which will determine who is eligible for care under the new system, process billing claims and set reimbursement rates to mental health providers.

The impending overhaul has created widespread confusion among patients and health providers about how the new mental health care system will function.

Providers such as Affiliated Sante Group, ADAPT and Granite House are aware of the uncertainty surrounding the delivery of mental health care.

"I think people are upset and, quite frankly, scared, about what's going to happen to mental health services in the state," Chanteau said.


Affiliated Sante -- which has offices in Prince George's, St. Mary's and Charles counties -- and the Adapt/Granite partnership have received "clinic status" from the state Mental Hygiene Administration. The clinics must meet criteria on therapists' credentials and office hours to receive the ranking, which makes them eligible to receive higher Medicaid reimbursement rates than other providers.

New Medicaid rates

However, the new Medicaid rates, released recently under the new state public mental health system, are lower than expected, said officials with the two clinics. Final rates are under negotiation.

"We hope we're going to be able to hang in there and not go bankrupt," said de la Cruz.

A Health Department psychiatric nurse, who asked that her name not be used, said she's not optimistic about the transition to a new mental health care system. Unless the Medicaid reimbursement rates are substantially increased, patients are likely to go untreated, she said.

"How do you provide the same level of care with less money?" she asked.


Pub Date: 3/18/97