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Cuts to mental health services spark action
Georgia Senate President Pro Tempore Eric Johnson (R-Savannah), far right, and state Rep. Al Williams (D-Midway), center, listen as Department of Human Resources Regional Coordinator Charles Ringling discusses finding support within the local community. - photo by Photo by Andrea Washington
A population that commonly goes unnoticed by the public had the attention of Georgia lawmakers and agency directors Monday night.
After months of problems with services at Gateway Behavioral Health Services, a treatment center for people with mental and physical disabilities, members of the Liberty County Association of Retarded Citizens met with officials to discuss concerns they believe have been ignored.
“We hope tonight we can get some of the questions that we’ve asked over and over and over again and haven’t gotten a direct answer...this population of the county, all the counties in Georgia, are human beings just like everybody else,” LCARC vice president and treasurer Martha Grice said. “They may not vote and they may mot pay taxes, but their guardians, their parents, their caregivers do and I’m hoping tonight this meeting will be the start to finding out some answers.”
With state Rep. Al Williams (D-Midway) and state Senate President Pro Tempore Eric Johnson (R-Savannah) in attendance, caregivers voiced their distress over Gateway officials’ recent decisions to halt its lunch program and temporarily stop transporting clients.
According to Gateway Chief Executive Officer Dr. Frank Bonati, the cuts are related to a debt the company accrued nearly four years ago “as a result of an advance on future Medicaid billing.” He said Gateway has paid back about $22 million of debt, but still owes “a few million dollars more to the Department of Human Resources.”
The state’s switch to Medicaid managed care and the fee-for-service payment format caused an additional financial hardship that eventually led to the laying off of 100 employees, closing its Long County office and cutting services, Bonati said.
“The first thing we did, in addition to looking at our assets, was look at our employees and what jobs we could eliminate,” the CEO said, explaining the company’s rationale for finding revenue to cover its increasing costs. “The next thing we did was say what unfunded services are out there. In other words, what’s Gateway spending money on that we’re not getting paid for?”
And much to the chagrin of clients’ parents and guardians, transportation fell into the “unfunded services” category.
Transportation, however, was reinstated after the Georgia Department of Community Health “made it clear...transportation is part of the bucket of services” Gateway is reimbursed for, DCH director for the Division of Medical Assistance Mark Trail said.
Nevertheless, Bonati said the Medicaid reimbursement system does not foot the bill because of  a flaw in its rates.
“The cost analysis that was done to determine how much money they’re going to give us for Medicaid to pay for a particular service was made in 1998, give or take a year,” he said. “What if you were living today on the paycheck you got in 1998?”
In regards to the lunch program, Bonati said Gateway saves money by not preparing meals, but money was not the reason the program was scrapped. He said the company was one of five organizations selected to participate in a program called “From Good to Great,” an initiative to show good programs what they can do to be better.
Bonati said board members felt in order provide better care, they would require consumers to bring their own lunches to the center to create more independence for those with less severe disabilities.
“The idea that people should come with their own brown bag lunch has everything to do with moving people towards independence,” he said. “It’s really not a budget issue.”
Following the CEO’s lengthy explanation of Gateway’s fiscal problems, most of the parents and guardians in attendance said they understood the company was in a money crunch, but questioned what officials were doing besides cutting programs.
“We don’t feel that Gateway is providing what the clients need. But Gateway just made it very clear to me that they’re doing the best they can with what they have to do it with,” Dennis Grice Sr. said. “But if they’re expected to do today what they were in 1998 with a dollar, I feel like Gateway should be doing the same thing we’re doing tonight with somebody in D.C. or something.”
According to DHR Region Five Regional Coordinator Charles Ringling, Gateway and similar organizations have been very vocal about their money concerns, especially in the area of increasing the Medicare reimbursement rates.
He said the state is in better economic standing to possibly increase the rate scale next year, but suggested parents and guardians look to more community resources to fill-in where Gateway falls off.
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