L & P Services Inc. is the Washington County Mental Health and Addiction Recovery (MHAR) board's contract agency for mental health and chemical dependency services. CEO Brent Phipps had established a small agency to accommodate the courts, the county home, and other underserved entities in the county. His intention was to serve 50 to 60 clients, but that plan changed with the closing of Washington County Recovery Alternatives (2007) and Washington County Community Mental Health Services (2009). Certified by the Ohio Department of Mental Health in October of 2005 and by the Ohio Department of Alcohol and Drug Addiction Services in May of 2006, L & P Services is now the MHAR Board's only contract agency for mental health and addiction services and serves approximately 1,500 clients. L & P Services provides a full array of services. In addition to individual therapy and case management, the agency offers a variety of therapeutic groups, including those focused on anger management, life skills, gender specific recovery issues, relapse prevention, healthy relationships and dual diagnosis.
In an interview with Phipps, he spoke of the significant changes in Washington County behavioral health services over the past five years.
Extreme funding cuts. Many Washington County residents seeking help for mental health or chemical dependency problems have seen a reduction in service availability, but none so great as those individuals without a paying source such as Medicaid or private insurance. Over the past five years, the MHAR board has lost 75 percent of its funding for non-Medicaid services, resulting in the total loss of a sliding fee scale for mental health services. At the current rate of service demand, MHAR Board dollars for a sliding fee scale for chemical dependency services will be depleted during the first quarter of 2012. This is devastating to the average citizen and negates the opportunity for lifesaving treatment services for many people in need. "While people who present at L & P or the hospital in crises can receive timely crisis intervention services, it is a Band-Aid approach and does not encompass the level of care conducive to long term recovery," Phipps explained.
Most of Ohio's 88 counties have behavioral health levies that enable them to subsidize treatment costs for non-Medicaid and under- or non-insured individuals. Washington County is one of only 14 counties without a levy and, thus, is unable to extend a lifeline to those who cannot afford services.
Treatment agencies in Ohio face an additional complication with the recent implementation of service limits for clients with Medicaid coverage. The deinstitutionalization of severely mentally disabled (SMD) clients that began in 1988 was logically accompanied by many services and supports to help these individuals live independently in the community. Service provision was based on each individual's needs as identified in a treatment service plan; allowable services are now reduced to a specific number of hours, regardless of need.
Phipps noted that locally the newly imposed service limits and the loss of a sliding fee scale have catapulted manageable problems into crises. He said that it is increasingly difficult for individuals to live independently. Hospitalizations have increased, as have the duration of hospital stays. The average hospital stay has traditionally been three to four days, but people are now so ill by the time they get help that the hospital stay is often weeks or even months.
"People have given up trying to access services," Phipps said. "They are becoming so much worse that it is nearly impossible to return to a functional state. Staff at the psychiatric hospital in Athens have said to me, 'It's been a long time since you have had people admitted this sick.' The severity of the situation in Washington County is unprecedented."
Loss of the local behavioral health hospital units. "The loss of Marietta Memorial's behavioral health units represents a huge gap in services, particularly the loss of detoxification services," Phipps stated. "This service is often a medically necessary precursor to recovery from addiction. Funding for detoxification services is sporadic and unreliable. In 2011 we only had the funding to provide detoxification services to six individuals, and then for only three to five days."
Phipps stated that though the overall outlook for behavioral health treatment in Washington County is grim, his agency is proud to have brought mental health and addiction services back under one roof. One point of entry for these services is especially critical for dually diagnosed clients and allows for better communication between the individual's service providers. The agency is determined to continue working with the MHAR Board to provide as many high quality services to as many Washington County citizens as available resources will allow.
Miriam Keith is consumer support coordinator of the Washington County Mental Health and Addiction Recovery Board. Mental Health Matters appears on the Opinion page on the first Saturday of each month.