Mental Health Cases In Rockland Move To Nonprofits
By Christian Wade Newsday August 1, 2012
Private nonprofit organizations are stepping in to fill the void in
services created by Rockland County’s decision to dismantle its mental
health case management program to plug budget holes.
In the most recent round of layoffs, the county eliminated 15 case
management positions from its mental health unit, a move that took apart
the state-funded program, which provides counseling and other services
for mental health patients.
Two nonprofit groups, the Rockland County Mental Health Association and
Jawonio, have since taken over responsibility for more than 180 mental
health patients from the county and are getting the state funding the
county used to receive.
Stephanie Madison, executive director of the Mental Health Association,
said her nonprofit organization is hiring five case workers — four have
already been hired — to accommodate the dozens of new clients.
“This is just an expansion of services we are already providing,” she
said. “We just had to complete the paperwork.”
She said money for hiring the new case managers will come from state
Medicaid, which had previously gone to the county. Both nonprofits
offered the case worker openings to the laid-off county workers, but
only one was hired, by Jawonio.
Madison said the process got under way before the layoffs, when county
officials reached out to the nonprofit sector to inquire if they would
be able to assume responsibility for the patients who would have been
left without services.
She said the move
<http://newyork.newsday.com/topics/The_Move_(musician)> reflects a
shift in mental health services that has been under way for several
years, as cash-strapped local governments have turned to the private
sector to provide services they can no longer afford to offer.
Several years ago, nonprofits took over Rockland County’s chemical
dependency programs after the county cut them.
“This is happening in many communities, not just Rockland,” Madison
said. “Local governments just can’t afford the cost and can’t be as
nimble as nonprofits can in terms of creating new programs and being
lean and cost-effective.”
Jawonio, located in New City, has doubled the size of its case
management program, adding four new employees to handle the caseload
from at least 97 participants from the county, according to Chief
Executive Officer Jill Warner.
“This isn’t a stretch for us, because of the relationship we have had
with the county and our existing programs,” Warner said. “People will
continue to get quality services from people who know how to deliver
those services.”
The patients in the program are people who have already been diagnosed
with a mental health condition and require additional treatment and
support, from counseling to vocational job training. Some of them are
living in group homes, others independently. Case managers typically
meet with the patients several times a month.
Mental health advocates said it remains to be seen whether nonprofits
will do a better or worse job than counties in running the programs.
“I would think that the nonprofit sector would do a better job,” said
Elaine Levin <http://newyork.newsday.com/topics/Levin,_NZ> , associate
director of The Empowerment Center, a mental health advocacy group that
works in Rockland and Westchester counties. “It’s much less
bureaucratic.”
Still, she said, it costs less for private-sector organizations to run
these kind of programs, because they don’t have to pay into state
retirement systems or provide union-negotiated benefits that county
workers traditionally receive.
“Working for the state or county is usually a more secure and
better-paying job,” Levin <http://newyork.newsday.com/topics/Levin,_NZ>
said.
Madison said that in the past two years, her organization has seen a
dramatic increase in its workload, which has doubled to more than 1,000
clients. She attributed the increase to a combination of factors, from
local government downsizing its workforces to more people seeking care
and health care providers referring more patients for mental health
services.
By far, the county’s mental health department fared the worst in the
county’s job-shedding plan, which concluded last Friday with 64
employees laid off and dozens of vacant positions eliminated.
County Executive C. Scott Vanderhoef said the layoffs were necessary to
plug a budget deficit — which at the time was estimated at $21 million
— because the county was unable to get approval from the state
Legislature to increase the sales tax and issue a deficit bond. The
county Legislature approved Vanderhoef’s job-shedding plan at a June 5
meeting.
Union leaders were critical of the layoffs, which they argued spared top
management. Some even accused Department of Mental Health Commissioner
MaryAnn Walsh-Tozer of retaliating against union members in her
department by targeting case management workers in mental health who had
been outspoken at budget hearings about previous cost-cutting
initiatives.
Walsh-Tozer didn’t return a call Wednesday seeking comment.
http://newyork.newsday.com/rockland/mental-health-cases-in-rockland-move
-to-nonprofits-1.3875534