Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, November 16, 1995 TAG: 9511160056
SECTION: VIRGINIA PAGE: C-5 EDITION: METRO
SOURCE: LESLIE TAYLOR STAFF WRITER
DATELINE: LENGTH: Medium
He'd suffered a severe head injury and was in a coma for six weeks. Rehabilitation was slow, hard, "like being reborn," said Austin, of Galax.
As his brain and body healed, Austin wanted to talk with others about the frustrations of being able to remember what happened decades ago - but not what happened two weeks ago.
For nearly five years, he has leaned on the services of Powerhouse Clubhouse, where he belongs to a support group of people with a range of mental disabilities.
"You find you're not in it by yourself, not trying to fight a battle you feel you're not going to win," said Austin, 28.
Clubhouses across Virginia - defined as "psychosocial" programs - are funded primarily by the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services. A proposal to shift the delivery of those services to a managed care plan has been developed by the department, endorsed by its board of directors and forwarded to Health and Human Resources Secretary Kay Coles James.
Austin and other mental health clients and advocates who met in Roanoke this week fear that proposal could eliminate clubhouses, the support programs they offer and other publicly funded mental health services. There are 14 such support groups in the Roanoke Valley alone.
The proposal "could change the whole philosophy of how we deliver services," said Lankford Blair, president of the Virginia International Association of Psychosocial Rehabilitation Services. The association ended its three-day conference in Roanoke on Wednesday.
"We can't stop this from happening," said Blair, who is program administrator for the Portsmouth Community Services Board. "But we can make sure integrity is maintained to make sure our voices are heard."
Fred Roessel, executive director of Blue Ridge Community Services in Roanoke - one of the state's 40 Community Services Boards that provide services to people with mental disabilities and substance abuse problems - said there is much concern among clients and advocates on what the future has in store.
"A lot of the concern on their part is that the commonwealth is moving quickly ... and they aren't sure what's at the end of the path," Roessel said. "They're definitely wanting some reassurances."
Medicaid - federal-state health coverage for the needy, aged, blind and disabled - was the primary stimulus for Virginia's mental health department to develop a proposal to change the framework for publicly financed mental health, mental retardation and substance abuse services, Roessel said.
Virginia already has moved 370,000 Medicaid clients into its Medicaid managed care plan for physical health coverage. Now Medicaid managed care is moving to mental health. Many of the state's mentally disabled receive Medicaid benefits.
"One of the main objectives of managed care is cost containment and to reduce or eliminate programs that they view as being not entirely essential," Roessel said. "There are concerns on the part of people at clubhouses as to how they would fit in."
The purpose of community-based services such as clubhouses and support groups is to keep people out of state mental hospitals, Blair said. Eliminate those services, and the state could have more people committed to state mental health facilities, he said.
by CNB