Minutes - 20021008 - Laserfiche WebLink

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determination, use of"best practice" methods, outcome driven, and client choice and competition. The major changes of reform are that the Local Management Entity (LME) will be directly controlled by County Government, the State chooses "priority populations" (The priority population aspect has more exclusions in the area of substance abuse because the resources are so inadequate), State payment methods change — more restrictive, LME's must consolidate by 2006, and LME's are not permitted to deliver services. This is a major change. The idea is that if they are going to have person centered service, then the public agent responsible for administering such a system has a conflict of interest if it is also the service provider. In the event that no alternatives can be found in a particular community, there are provisions for an LME to continue filling the gap until a suitable arrangement can be made. One of the main issues in reform is how to manage the fact that there are not enough resources to go around. The funds available are not sufficient to meet the need. The main idea of the reform effort is that the decisions of how to ration care should be local decisions, with more citizen input and increased scrutiny. This forum is an opportunity for public input on these issues. An independent consultant administered questionnaires and public information has been circulated. The idea of reform is to have daily feedback. The Board of County Commissioners can oversee the operation and hold them accountable. This is not the last time for the public to speak on this issue. There has been an agreement on governance and the three counties have decided to stay together and keep the reform strong and commissioner driven. The County Commissioners have recommended a strong LME structure, which means that OPC would like to have more control over the local expenditure of funds. The County Commissioners have instructed OPC to keep an eye on a number of local guiding principles as we go forward with implementing a plan. The principles are as follows: assure services are not interrupted, assure fair treatment for all staff, strengthen services for citizens, assure county level integration of services, and meaningful input and involvement of the consumers/stakeholders. Regarding how the LME would work, it would not provide services, it would manage the local public process for assessing needs and deploying resources, the resources would not be tied up in fixed programs, and the money would follow the client and the purchase of services would be individualized. There are some choices to be made in this process and questions need to be answered as follows: How should citizens, families, and consumers monitor and influence decisions? How can County Commissioners best discharge their responsibility? In what ways is divestiture a good thing, an opportunity, or a threat? How can we best maximize the good and limit the negative? What services would you most want to see more of? What services are of lesser importance? What features of the service system need to change/not change? Tom Maynard said that tonight's discussion should focus on what the public would like to see addressed and what improvements are needed. Also, how the public would prioritize services and consumers. The information from the small group discussions will be submitted to the County Commissioners at the work session tomorrow night. Cassandra Brown spoke about a study quoted that the University of Pennsylvania did on the cost of taking care of the mentally ill. They followed people and took the homeless off the street and gave them food, clothing, services, etc. and compared them to the plain homeless and there was only a $100 difference per person. She said that we were spending the money one way or another.