Sunday, March 9, 2008

Psychosocial Rehabilitation Reimbursements

Yeah, say that one three times fast. It's been a pet peeve of mine for over a decade, and I started thinking about it during a slow period at work today. In Virginia, facilities providing psychosocial rehabilitation for the mentally ill have no incentive to help their clients get jobs, but actually have a disincentive for doing it. Let me explain.

Psychosocial rehabilitation facilities can bill Medicaid (a state program) for the minutes that each client spends at such a facility. The clients have to sign in and out, with the time records kept for billing.

At the same time such facilities receive no payments or credits for a client going to work. In addition, if a client is at work, those are hours that Medicaid can't be billed for since the client isn't in the facility.

Therefore, the way the reimbursement system is set up, Community Service Boards (CSBs) lose money by their clients going to work, but profit by having them sit around a facility all day doing nothing meaningful. Am I the only one who sees what's so backwards about that?

With Medicaid payments one of the fastest growing areas in the state budget, Richmond could curb spending and improve the lives of the mentally ill in one swoop by fixing this absurdity. With the statewide races next year, will any candidates have the guts to take on the mental health bureaucrats? It's obscene that CSBs win by their clients losing.

1 comment:

Michael Ragsdale said...

There's a good idea. Hmm...wonder why Richmond's never thought of that before? ;)