Regarding the July 25 Point of View “Medicaid reform plan a disastrous mistake”: David Horowitz is correct that mental health reform was seriously flawed, especially in its implementation, but some of the facts in his article are incorrect.
Local Management Entities are multi-county public-sector agencies created under Chapter 122C of the General Statutes as “area authorities.” The participating counties in each LME appoint their governing boards. LMEs manage the Medicaid, state and local dollars for mental health, developmental disabilities and substance addiction services. They contract with private sector providers to deliver the services.
Two early decisions hampered reform. The goal was to increase community-based services and decrease the number of patients inappropriately referred to state institutions. To start the process, legislators established a $35 million trust fund to expand local services and close state hospital beds. The funds saved from bed closures would replenish the trust fund to build more community services.
The plan started to unravel when the General Assembly used the $35 million trust fund to address the 2001 downturn and budget shortfall. In 2004, state legislators did further and irreparable damage when they took the savings from closing state hospital beds for debt payment for the new Central Regional Hospital.
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