Wednesday, October 09, 2013

Lehigh County Spends $75 MM Per Year On Mental Health

I know everyone in Lehigh County is crazy, but did you know that the County spends $75 million every year on behavioral health services for the mentally ill? That's a lot of straight jackets. It's all pass through money that comes in the form of federal and state subsidies, but it's 1/5 of the budget. Tonight, Commissioners will consider a no-bid contract that will allow Magellan Health Services to continue to provide these health services. What's more, all of their fees have been redacted from public view. As a third-party administrator, Magellan will walk away with about $4.5 million as Executive Matt Croslis fades away.

This is great for Magellan. Nothing like a no-bid contract in the waning days of what is really a caretaker administration. But is it good government?

Commissioner Vic Mazziotti has his doubts. He does not like to see contract provisions redacted from public inspection, despite Magellan's concerns that competitors get to see what it charges. "Id vote against it just for that reason," he told me last night. "The public has a right to know every word in a public contract."

He's also concerned that this is the "wrong time" for such a major contract, which could last up to four years.

Mazziotti tells me that these mental health services are offered to low income residents, and that about 50,000-60,000 people meet the income guidelines. But how many of these are actually consumers?

In a day and age where senseless gun violence is perpetrated by people with serious mental health issues and state hospitals are closing, I'm all for spending what we need to spend on mental health. But No Bid? Is this the most effective way to do it? How many consumers are actually benefited by this annual payment of $75 million?

I'll try to get answers tonight.

Incidentally, Northampton County uses Magellan, too.

22 comments:

Anonymous said...

yet another bs program of givemes. this is insanity

prove it works

this country is turning into nothing but one big sob story

John Blankstein said...

Bernie, if the goal of this is to streamline delivery of services and foster competitive bidding I'm all for it. If its an attempt to dodge legitimate responsibiity to treat troubled people properly it's a big problem.

And anon 1:08 if you want to see what doesnt work just have a look at the Navy yard or Newtown Connecticut.

Even the NRA's president supports improved mental health services as part of keeping our gun rights in place.

Anonymous said...

Bernie lots of people will want to know if you use this service

Anonymous said...

If I understand this correctly, the Counties contract with Magellan to manage their capitated Medicaid Managed Care funds. In other words, the State has removed the Medicaid consumers' abilities to go wherever they want for services and must go where Magellan says for an amount of time that Magellan approves. The Counties could perform this function themselves, but assume all risk. If they have $75M, but residents use $80m, the counties pay the difference. By contracting with Magellan, the Counties pass that risk to Magellan.

It appears that Magellan has done this well for over a decade and changing managed care companies could create havoc in the system.

I'm not advocating for an automatic approval of magellan's contract, just pointing out a couple of important pieces of information

Bill said...

There are several other companies that provide this service around the state. Competition was supposed to be one of the major reasons for enacting the Healthchoices program. As citizens, we should be able to observe and see the deals and plans that are made in respect to our Human Service System.

Anonymous said...

I agree with Bill's points, but how would we like it if our health insurance was put out for bid every 3 years and new contractors, unfamiliar with the region and providers came in and told us we could no longer see the health professional we've be seeing for years.

On one side of the argument, you have a Tea Party member trying to make government "right". On the other side you have a component of fragmented behavioral health system that seems to be working ok.

Of all the places to fix govt and mental health, I'm not sure this is our next move.

Anonymous said...

6:55 -

So the answer is keeping Magellan and not investigating whether there are better options for the taxpayers?

What about patients who might want a provider that Magellan doesn't deal with? Or are the providers Magellan deals with the only ones who are qualified? Likely not, but the way you get all those answers is by bidding the contract out.

That seems like common sense and good government to me.

Bill said...

I just renegotiated my electric bill. It involved indicating that I saw that other companies were willing to provide the same service for less money. I asked for a lower rate from the company in order to keep my business they reduced my rate on the spot.

At minimum, open it up. I think it is probable that Magellan will offer the county (us taxpayers) a better offer to keep our business. I suspect that while this may involve more effort for the county which is as usual strained to meet the needs of our residents, even the threat of competition would result in a better deal from Magellan and serve us better for less money.

Shielding all this from public view only reduces efficiency and the ability of the public to participate in how these services are planned and implemented. Much of this type of thing happens behind closed doors in rooms that the county has indicated that its citizens are not welcomed and behind which they claim the sunshine act does not apply.

Anonymous said...

As of 11:00 a.m. yesterday (Tuesday) Magellan agreed to allow its financial terms to be released to the public. The un-redacted contract amendment was up on the County's website yesterday.

Anonymous said...

4:06 AM - isolated incidents always turns bleeding heart liberals into crazed fanatics who want to throw away even more money

John Blankstein said...

4:57: The NRA are "bleeding heart liberals"? Seriously?

Bernie O'Hare said...

"Bernie, if the goal of this is to streamline delivery of services and foster competitive bidding I'm all for it. If its an attempt to dodge legitimate responsibiity to treat troubled people properly it's a big problem."

It's the former. In fact, I question the true motives of many people behind a lot of these contracts. Are they trying to help people or line their own pockets? If we spend $75 MM in each county on mental health services, and cRaZies are still out there shooting people, something is wrong. i want people helped as much as they can be, but when you have a no-bid contract at the end of an administration, it is clear to me that someone is not doing his job.

Bernie O'Hare said...

"It appears that Magellan has done this well for over a decade and changing managed care companies could create havoc in the system. "

It probably does well at what it does, but i would not give a no-bod contract to the Pope at the end of an administration.

Bernie O'Hare said...

" but how would we like it if our health insurance was put out for bid every 3 years"

I'd c all it good government. I know it's inconvenient for you.

Bernie O'Hare said...

"As of 11:00 a.m. yesterday (Tuesday) Magellan agreed to allow its financial terms to be released to the public. The un-redacted contract amendment was up on the County's website yesterday."

I see. The day before the voter, magellan makes this magnanimous gesture. This gives the public one day. This is simply bad government. It is a no-bid contract at the end of a caretaker administration. This needs to wait for a new Eexec.

Bernie O'Hare said...

"At minimum, open it up. I think it is probable that Magellan will offer the county (us taxpayers) a better offer to keep our business"

I agree completely.

Anonymous said...

It is less than a month to election. I wonder if we should expect some grandstanding?

Bernie O'Hare said...

"Bernie lots of people will want to know if you use this service "

I use Northampton County.

Anonymous said...

This is all about managing the system. Don't blame the company blame the county. They negotiate the rates. So you have a political hack with zero experience running Human Services in Lehigh County and an old "give a pal a job", Marcus who ran it in Northampton county.

Everyone knows that neither of these guys were qualified for their jobs and couldn't negotiate their way out of a paper bag.

Again the company can only get what the county is willing to give. Wait till Stoffa is gone and the new executive sees how screwed up it is on Northampton County.

Stupid is as stupid does.

Anonymous said...

It is opened during enrollment by law. The County screwed this up with poor management of funds.

Anonymous said...

Better mental health care delivery might have helped Jim Gregory before he went off the deep end and landed in ass pounding prison.

Anonymous said...

Wouldn't mind if all the money spent was helping people get well instead of keeping them sick!
I personally believe in choices and that is with Insurers as well. Other counties offer better service and the proof is in the service. That is to say that is effective in getting the most people well for the least amount of money...Not Providing Cadillac services for the least amount of people...