
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, May 21, 1995                   TAG: 9505220061
SECTION: VIRGINIA                    PAGE: C9   EDITION: METRO 
SOURCE: ASSOCIATED PRESS
DATELINE: NORFOLK                                 LENGTH: Medium

BOARD MEMBER RESIGNS OVER MENTAL HEALTH HMO

A member of the state board overseeing mental health and mental retardation services has resigned over a proposal to treat mentally ill people on Medicaid using a managed care organization.

``It's all smoke and mirrors,'' Doug Bevelacqua of Newport News said Friday of the proposal. ``We need to challenge the basic assumption that managed care is appropriate for mental health care in the public sector.''

Bevelacqua said a managed care company could slight patients in need of costly care in order to save money. He said the proposal also would deprive local community service boards, which now offer a wide variety of services, of Medicaid money they use to support their programs.

The proposal may produce ``a population of mentally retarded, mentally ill, street people,'' he said.

Gov. George Allen last year appointed Bevelacqua, a Republican and self-described fiscal conservative, to the Board of Mental Health, Mental Retardation and Substance Abuse Services. Bevelacqua has more than 10 years of experience on local mental health boards.

The proposal at issue is called the Tidewater Managed Care Pilot Project. Under the proposal, Medicaid recipients in need of mental health care would be referred to a managed care organization. The state would pay the managed care organization to take on patients.

The project is scheduled to begin early next year, and state officials hope it will be a model for a statewide plan.

State Mental Health Commissioner Timothy Kelly said the program will save money and, therefore, make mental health care available to some 10,000 people in Virginia now waiting for help.

``It's the most compassionate thing'' that can be done, he said. ``We want to be more efficient with what we have.''

Kelly said any savings generated by the managed care organization would be reinvested into communities to expand the types of mental health care available.

But Bevelacqua and officials with local community service boards say the proposal will leave a large number of poor patients who are not on Medicaid without help. Many of them now are treated through the community service boards.

Community-service board officials say they use some of the revenue generated by their Medicaid patients to help cover the cost of treating patients who do not receive get Medicaid.

Without that revenue, officials are unsure how they could afford to treat those patients. Charles Hall, of the Hampton-Newport News community service board, said he is skeptical.

``This is bad public policy,'' said Hall. ``It's absolutely unacceptable.''

Critics also worry that a managed care company will be less willing to provide expensive treatment for Medicaid clients. People with long-term chronic problems could be dumped onto state hospitals or community service boards, leaving those agencies stuck with the most seriously ill patients.

``The locality will have to serve them, or they'll be out on the street,'' Hall said.

by CNB