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Pa. counties may face heavier caseload

May 22, 1998|By DON AINES

CHAMBERSBURG, Pa. - A state-mandated change in the way mental health cases are handled could greatly expand the role of counties in managing them.

Pennsylvania's HealthChoices program would shift the burden of managing many cases from Medicaid to the counties, according to a report reviewed Thursday by the Franklin County Commissioners.

Douglas Thompson of Public Consulting Group Inc., of Boston, said Franklin and Fulton counties jointly run mental health and drug and alcohol programs for about 2,000 people on an annual budget of $3.3 million.

The change in client management would bring in an additional 10,000 Medicaid-eligible people and expand the budget to about $8.6 million a year, according to Thompson. The change is supposed to go into effect by Jan. 1, 2000.

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"They're accessing through Medicaid right now or, in rural areas, they're unaware of the services available to them," County Commissioner Cheryl Plummer said of the 10,000 potential new clients in the two counties.

Most of their medical bills, however, would still be paid through medical assistance programs, according to Kelly Goshen, the director of mental health, mental retardation and drug and alcohol programs in Franklin and Fulton counties.

"We either farm it out, or we do it ourselves, or the state will do it for us," County Commissioner Bob Thomas said of the options available to the counties.

The two counties would be linked with Adams and York counties in a Behavioral Contract Unit under the proposal.

Of three options available to the counties, County Commissioner Warren Elliott predicted the choice would be a mix of county services and a private managed-care organization hired by the counties.

The counties would continue managing cases of people with chronic mental, drug and alcohol problems, while a private company would take care of those with short-term behavioral problems.

"If it costs less, we can keep the difference," Thomas said about the proposal. Goshen confirmed that any savings realized by the change could be reinvested into the region's behavioral health system.

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