Continued from the Home page . . . The discussion began when Senator Allran stated that Dix had been the sited as the most responsibly managed of all the state hospitals as far as dollars go, while having its excellent reputation for model programs. He questioned why one of the less well managed hospitals had not been considered for closure instead.
For those of us who share his concern about making dollars go farther while yielding better outcomes (as many consumers I know do), we are reassured to hear such questions. However, we also realize two things. We need hospitals in the east and the western part of the state! And we need one that is in the central area. And this is what Cansler told the legislators.
The Secretary then reviewed with the LOC that there had been a mandate by the legislature early in the last decade to reduce numbers of hospitals and beds by rebuilding a new, updated hospital that would accomodate persons from the central region while closing John Umstead and Dorothea Dix hospitals, whose buildings were out of date and having multiple maintenance issues. He added that while it had been a long time in the coming, this plan was a culmination of efforts in response to a legislative mandate. The trouble was that the local community service systems were not sufficiently developed to prevent the need for the hospitals, a factor in the length of time it was taking to close Dix. And unfortunately, for almost two years, the funds for operating Dix were coming from other parts of the human services budget, including the funds that could have been paying for services in our communities that could prevent crises.
The Secretary also stated that there would be higher expectations of improved programs across all the state hospitals now (What about state-wide service and outcome standards across all state operated facilities and the LMEs?–the writer).
This vigorous discussion regarding the hospitals, fiscal responsibilty, and program integrity occupied most of the morning. Many of the legislators participated. And they publicly thanked the Secretary for finally explaining the entire scenario to them so that they actually understood the basis of the decision.
The meeting was interesting from this consumer’s standpoint. It reminded me of when I had to make copies of our local business plan to give to our LME board again because they had forgotten and abandoned what they had agreed to do in the plan. And I learned that most of them had tossed their plans or didn’t know where to find them. Time passes quickly, and people forget details.
Cansler, who is still relatively new to the administration, needed to review the legislated mandate re: the hospitals before leaders could feel comfortable with decisions of the state.
Perhaps we are entering a time that a thorough review of many things will be necessary because the economy and the outcomes indicators in our state. Something is not working effectively if we are having to hospitalize so many people or if many people are going to emergency rooms even when they are deemed not needing to be placed in a hospital bed after all. And what about the handcuffing of so many of our citizens in waiting rooms sometimes for days? I think we have at least all agreed that we should be building a broader, more solid community service infrastructure.
Hopefully, careful review of where we have been will help all of us to think, think, think. It is time for “the little gray cells” (Hercule Poirot) within multiple stakeholders, INCLUDING system customers and others who experience the complexities of living with mental illness, addicive disease, or developmental disabilities, start working for solutions. Because we need the right kinds of services now. The days of throwing money at things that aren’t truly working are over.