It’s been a topsy-turvy year for mental health advocates in Chicago.
Having fought to stop the city from closing four mental health centers, they’re now worried that a series of discussions with mental health stakeholders are paving the way to privatize the city’s services.
Advocates wonder just how long the city can maintain a dozen mental health centers with a shaky budget, dwindling staff and state grants that keep shrinking.
“I think that is a concern,” says Anne Irving, public policy director for AFSCME Council 31, which represents some clinic employees. “The city centers are there when people need them, and that is an important public service and that should not go away.”
Badonna Reingold, a member of the Woodlawn clinic’s board of directors, says advocates are glad discussions are taking place, “but we’re not pleased that so far they’re not really oriented for new solutions. It sounds as if they’re looking for ways to privatize, if possible.”
Tim Hadac, CDPH spokesman, says the meetings have focused on finding solutions to ensure health care access for Chicagoans, while sharing ideas from different stakeholders. The mental health task force, comprised of city and state officials, mental health advocates and private operators, was convened to discuss how to make the services in Chicago viable.
Hadac says the city is committed to keeping the 12 centers open – they are safely funded in the mayor’s 2010 budget recommendations - but that all mental health providers are struggling with the economy.
“While neither we nor anyone can predict the future of the economy or of the availability of resources, we can say that we are looking for creative solutions – short-term and long-term – that will result in Chicagoans have access to quality mental health services,” Hadac said in an e-mail.
Private operators argue they provide more comprehensive services, which, in the end, would better serve patients and the city.
Carl Bell, CEO of the Community Mental Health Council & Foundation, says the city clinics are underused, understaffed and don’t offer enough services. Patients, he says, could be better served with the larger array of services offered by private operations.
“City clinics are clinics. They’re not well-resourced in terms of their being comprehensive,” he says.
While mental health advocates are staunchly against the idea of privatizing the services, Bell says the word privatization is unfairly aligned with greed and graft, deflecting from the increased volume of services private operators offer.
“If the city sort of wanted to maintain it was doing something, they could contract with organizations like mine,” says Tony Kopera, president and CEO of Community Counseling Centers of Chicago. “My recommendation is they just get out of it and save themselves the trouble.”
Advocates who briefly occupied Daley’s office in April to protest the clinic closures say privatizing the centers would harm many patients who rely on the city’s services and have forged relationships with city therapists.
“We have no problem with cooperating and sharing services with other agencies, and other agencies talking about efficiency and better service,” says Darryl Gumm, chairman of the Community Mental Health Board, “but I think we’re looking for a deeper commitment from the city to maintain the centers.”
While the mental health centers are funded for the next fiscal year, Reingold worries the potential loss of more state funding in June could cripple the system. State grants have routinely diminished in recent years. It gave just $4.3 million for the current fiscal year, a drop of $2.5 million from the previous year. In all, the city has lost about $4 million because of faulty billing practices.
Before any decisions are made, Hadac says the task force wants more data on the need for mental health services, and will hash out more concrete goals. It next meets in December.
Another issue for the centers is staffing. The Tribune reported last week that mental health staff will be cut 50 percent, from 216 to 108. Some centers already work with a skeleton staff. The North River clinic, for example, is budgeted for just two staff members in 2010.
The city continues to grapple with billing issues, and Tom Green, spokesman for the Illinois Department of Human Services, says the city has billed just $400,000 for services since July 2008.
To rectify the billing issues the city encountered in the last year with an electronic system created by Cerner, the city has turned to a new program made by Custom Information Systems, used concurrently with the Cerner system.
An internal memo, obtained by the Current, notes mental health staff will bill through the CIS program, and also maintain hard copy records that will be put into the program.