Clients worry who will fill gap when city drops mental health services

Changes raise questions over how treatment will be paid for

Posted: Tuesday, March 07, 2000

Ellen Martinson weighed in with her concerns Monday night that the city is ridding itself of its mental health responsibilities without providing answers to questions about what will happen to people who need help.

With two siblings and a parent receiving treatment for schizophrenia, Martinson told Juneau Assembly members that ``Juneau Mental Health handled all aspects of taking care of my family. I've dealt with private, nonprofit organizations in Juneau. They acted as if I was a burden. JMH was caring.''

Martinson was among 10 city Health and Social Services mental health services providers, clients and patients who addressed the assembly and city staff in a packed assembly chamber.

The testimony centered around the lack of details or timetable for plans to phase out city participation in mental health and chemical dependency services, announced by the city manager last week.

Mental health clinician Sylvia Kidd expressed her worry that the transmittal of services to the private sector could mean the disappearance of Access, a program for severely emotionally disturbed children.

``There is no equivalent among the (private) agencies,'' she said.

But with new funding from state grants the city is no longer applying for, those agencies will grow and change to accommodate such programs, countered Deputy City Manager Donna Pierce.

``Those agencies will be stronger than they are today,'' Pierce said.

Louise Seligman, identifying herself as a ``concerned, private citizen,'' addressed the costs and affordability of private care.

``Can these agencies commit to Medicaid?'' she said. ``Can they commit to a sliding scale'' for low-income patients?

Bemoaning what she said was a very political process of transition, Seligman called for the formation of a nonpartisan panel of clients,

providers and citizens to help come to terms with the transfer.

``You need to appoint a committee,'' she said to the assembly. ``And you need to get it out of this room.''

According to a Pierce memo addressing city mental health workers' questions, the state Division of Mental Health and Developmental Disabilities is in fact contemplating the formation of a ``transition team which would include representatives of the state, CBJ and receiving agencies.''

The proposal recommends inclusion of ``members with clinical expertise'' on the team.

The memo also deals with a transition timetable, of sorts. ``The practical answer to how long a transition should take is `as long as it needs to take,''' Pierce stated. ``However, some kind of guideline is needed, and the state has established one (fiscal) quarter as a reasonable timeframe to implement a transition plan.''

All department workers are funded through June and the end of the fiscal year, said City Manager Dave Palmer. ``Some people are going to be moving around, but there will be no official layoffs until the end of June,'' he said.

Palmer was to meet this afternoon with department workers and representatives of their union, the Marine Engineers Beneficial Association.

The city manager's office has scheduled a public meeting for 7 p.m. Wednesday in the assembly chambers to discuss the transition with the public and with clients in particular.

``I will be attending that meeting,'' Martinson said. ``I have to - I have no other choice. It's a part of my life. I've learned: If I don't do it, who will?

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