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Admissions to Lord's Ranch, other providers needs closer look, lawmakers say Wednesday, Jul 19, 2006 By Doug Thompson Arkansas News Bureau LITTLE ROCK - The state needs to take a closer look at who is getting approved for treatment at state expense at the Lord's Ranch and other mental health facilities for youth, lawmakers and state agency officials said Tuesday. If too many Medicaid clients go to the Lord's Ranch or others, then blame state "gatekeepers" who approve claims, the attorney for the ranch told lawmakers. Reforming that approval process is difficult while lobbyists from mental health providers campaign hard to "leave the system just the way it is," replied Rep. Jay Bradford, D-White Hall. Ted Suhl, chief executive officer of the Lord's Ranch, and his attorney, Bill Trice, answered questions for more than two hours from members of the House Committee on Aging, Children and Youth, Legislative & Military Affairs. The ranch is one of eight providers of mental health services that are paid by the state when, for instance, a juvenile offender is referred by a juvenile court for mental health services. It received $8.5 million from the state in 2005, up from $140,000 just five years ago. The ranch drew attention recently when Gov. Mike Huckabee, using an airplane provided by Suhl for a political trip, encountered engine trouble and had to make an emergency landing. Suhl said Tuesday that the plane is not owned by the Lord's Ranch, but that he leases aircraft for businesses besides the Lord's Ranch. Huckabee said in a recent interview that his political connections with Suhl had no influence on business the Lord's Ranch does with the state. His office does not award state contracts, the governor said. "There are a lot of people who have government contracts that if it were left up to me, they wouldn't have them. Why? Because they've supported every political opponent I've had," Huckabee said. "There are a lot of people who have business with the state that if it were as personal as (critics) want to make the Lord's Ranch, they wouldn't have business with the state because they haven't been my supporters." The cost of care to mental health providers for youth has expanded to the point that Arkansas now spends more money per capita on these services than other states, according to previous testimony to the committee. The state spent more than $112 million on in-patient child psychiatric care in 2005, serving 5,154 patients, Cliff Davis, a consultant hired by the state to study spending for mental health services, told the committee last month. "Can you provide us with something that would be evidence-based" on why Arkansas spends more per capita than other states, Rep. Sam Ledbetter, D-Little Rock, asked Trice Tuesday. "No, not today," Trice replied, but he said providers are working on compiling the information. Suhl suggested that other states have "multiple pockets of money, not just Medicaid." He and other providers are looking to see if, for instance, many of the costs borne by Medicaid in Arkansas are borne by counties or other entities in other states, he said. Trice said he would "like to hear a case when a diagnosis was not correct." Diagnoses are "still a scientific process," he said. "It's a system that a lot of people are promoting," Bradford answered. Ray Scott, deputy director of the state Department of Health and Human Services, told the committee that the agency has formed a stakeholder planning committee. The Arkansas System of Care Stakeholders Planning Committee held its first meeting Tuesday morning, Scott said. The 25-member group represents all aspects of client care, he said, and will review admission approval and many other aspects, he said. "The fundamental problem is that we don't have a system," Scott said. "We have an episodic providing of care." Those receiving the care go from one program to the other without any overall view or coordination, he said. Whatever the benefits of the programs like the Lord's Ranch, "we cannot afford to double Medicaid expense every four years," especially with a program with "very little to no accountability," said Rep. Tommy Roebuck, D-Arkadelphia. |
