Posted by Linus on May 22, 2008, at 19:55:51
In reply to Medicaid regulations - Any Comments?, posted by SLS on May 4, 2008, at 15:25:00
Hi,
I am new to this forum, but wanted to post a follow-up to Partial Care Programs vs. Partial Hospitalization in New Jersey.
In my opinion, I think it was appropriate for Medicaid to impose the two year limit on Partial Hospitalization programs. The cost of treatment is astronomical at a Partial Hospialization Program compared to that of a Partial Care Program and the services offered are very comparable.
For example, a Partial Hospitalization Program can bill State Medicaid close to $400 a day,(maybe more) whereas a Partial Care Program offering similar services for a full 5 hour day is only reimbursed at a rate of $77 a day.
Both programs offer similar treatment:
Individual & Group therapy, ADL Skills, Social skills, Psycho-educational, Medication education/monitoring, MICA services, Anger Management, Symptom management, Case Management, Pre-vocational training...etc.
Both programs are required to have qualified Psychiatrists & Nurses on staff for medication management and comprehensive psychiatric evaluations as well as Social Workers.
I think it is unfair to say it is not the mission of the partial care programs to establish effective medical treatment. It seems to me that many partial care programs are the only entities that address the medical needs of the vulnerable population they treat.
Of course, I think it's fair to say that not all partial care programs are created equal. There are programs that are severely deficient in the services they provide and yet the State continues to allow them to remain open.
However, there are many partial care programs that go above and beyond what is required and yet the Medicaid reimbursement rate for partial care has not been increased in close to 20 years. Yet, with every passing year Partial Care programs, must creatively find ways to pay for increases in salaries, utilities, rents, insurance premiums, client transportation, meals, supplies..etc..etc..etc.
The backbone of the mental health delivery system in NJ resides with the partial care program. It is here that the patients are able to learn the necessary skills to function in the community. The learning that takes place within a partial care program is significantly easier to transfer to the real world than that in a partial hospitalization program.
> > New Jersey recently passed a regulation limiting Medicaid to pay for no more than two years of a partial hospitalization program for psychiatric patients.
> >
> > I wrote a letter to be sent to NJ politicians and other personages of influence.
>
> http://www.slschofield.com/medicine/medicaid_regulation.html
>
> Any comments?
>
> How does this compare to the Medicaid program in your state regarding partial hospitalization and partial care programs for the mentally ill?
>
>
> - Scott
poster:Linus
thread:826866
URL: http://www.dr-bob.org/babble/20080519/msgs/830592.html