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dialogue
30
NOV / DEC 2013
I
Healthcare Journal of NEW ORLEANS
type services that we want available. It’s great
to have increased institutional beds when
we need them and it’s also good that we are
using more community-based services but
we have to have the right types of services
available, which means again, working with
providers for them to become the types of
providers we need.
For instance, part of the Behavioral Health
Partnership is working with the Department
of Children and Family Services, Office of
Juvenile Justice, and the problemwe’ve had
with the high risk adolescents and children.
Typically they’ve been in residential homes
and we want therapeutic group homes,
which is a different type of service than just
a residential home. It’s much more intense
in terms of treatment, provides more short
term stays, so again, people can get back out
and live with their families. It provides more
services to families at home in addition to the
child in the institution. It’s a different model
though, and getting providers to switch from
a residential group home model where they
were paid by contract to amodel that is now
under the managed care system and paid
throughMedicaid, is a challenge. We’ve had
some real difficulties in getting enough pro-
viders to provide that service.
That said, we havemore than doubled the
number of providers through the Behavioral
Health Partnership. That had a lot to do with
the fact that previouslymany of our provid-
ers like social workers, marriage and family
counselors, some of our therapeutic services,
couldn’t be paid for byMedicaid. It was never
a billable service. We would payMedicaid for
them to see a psychiatrist for medication,
and the cost was significant, but you couldn’t
see a social worker for counseling. We now
pay for those services and that’s primarily by
adding thosemental health practitioners. But
more importantly it allowed us to provide
the right level of service at the right time at
the right place. Now they don’t need to go
see a psychiatrist if what they really need is
amarriage and family therapist or an addic-
tion counselor.
Focus for the next year is making sure we
have those kinds of outcomes happen and
that we actually do havemore of those com-
munity-based services for those individuals
who are at risk.
Editor:
How do the public private partnerships
with the LSU hospitals figure into the Depart-
ment’s health outcomes goals?
Kathy Kliebert:
I mentioned the areas that we
have worked really hard on, Bayou Health,
the Behavioral Health Partnership, but I
think the public/private partnerships with
LSU are going to be significant in terms of
increasing access of services to uninsured.
We’ve had a good safety net system, but I
think these partnerships are probably one of
themost exciting things I’ve been involved in.
The fact that you now have Our Lady of the
Lakemanaging these services and being able
to staff up and staff down as a private pro-
vider can do, as well as re-open clinics they
know are needed and take care of backlogs
of services.Those are significant changes and
those have been in this area, since that’s been
the longest partnership, but we are already
seeing changes in other areas where hospi-
tals have taken over and are staffing ortho-
pedic clinics back up and offering OB/GYN
services they didn’t have previously. They
were lost due to budget cuts and now, with
these partnerships, they are changing cost
structures and providing the same level of
service and standards that they have in their
private system. It’s no longer a two-tiered
system. Whether you are uninsured or you
have insurance, you are going to get a similar
level of service, a similar kind of wait time, all
those things that truly weren’t there whenwe
had that separate state-operated system.
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