CHOICE issue, continued from Home . . .
The survey, which was addressed to people who use mental health or substance abuse services in the public system, reveals so far that while 90 % of its respondents highly value their right to choose their service providers, more than 35% of them state that they did not choose the services they currently receive (pre-CABHA changes), but that they were selected for them by their LME.
This was already not a good sign. But as we are beginning to hear from people across the state, we are learning that some people are telling their providers they do not want to be moved to another one. Further, we know that at least one staff of a Local Management Entity (LME) has said that “if people can have quality, they don’t need choice.”
We beg pardon, but we should have both a right to choice AND to quality. And unfortunately, if the provider system is trimmed to so few providers that there is not much competition and if clients are assigned to them anyway, how will we leverage quality out of our providers?
We as consumers had thought since early in the mental health reform that choice and quality were what service divestiture was supposed to be all about! It was to reduce conflicts of interests and develop a market where providers would have to compete based on the quality of their services! (And oh, yes–let’s not forget that the Reform was also to be about saving money.)
Our survey still has a little more time for consumer participation. We hope that while we await responses and develop our report for state leadership, the Department of Human Services will remember the human elements of human services. Because without choice, we have less Voice in what happens to us.