SAN DIEGO: County’s Managed Mental Health System On The Fritz

      San Diego County's venture to hire a private firm to manage its $65 million mental health system is "crumbling," the San Diego Union-Tribune reports. Earlier this spring, the county awarded United Behavioral Health a three-year, $13.2 million contract to run its adult mental health system (see CHL 3/18). UBH's attempt "to increase revenues by enrolling more Medi-Cal patients" and "raise money to stretch scarce mental health service dollars" has not worked. "Right now, we're having aggressive discussions with UBH about their performance or lack thereof, and we're in the process of sending them a 'you'd-better-get-well' notice," said Larry Prior, chief administrative officer for the county. In a letter to UBH, the county says UBH has limited patient access by failing to sign up enough psychiatrists, has "failed to implement its billing and information system" and "has not raised the money to provide sufficient services." UBH Chair Saul Feldman said, "We have every motivation here to make it work with county help," but "it's a two-way street." According to county officials, doctors have been reluctant to sign up with UBH because the company was slow in payments and heavy in record-keeping requirements. But Feldman said the main reason psychiatrists were averse to contracting with UBH was due to their "antipathy" toward managed care in general. Another obstacle was the influx of some 10,000 clients who "swelled the waiting lists," according to Dr. Robert Ross, director of the county's Health and Human Services Agency. Dr. Loren Mosher, former clinical director of the county's mental health system, said UBH had about 140 psychiatrists but needed about 70 more. Ross said UBH's contract could be put back out for bid if it does not correct operations. Of the move to privatize the county's mental health system, Feldman said, "This is the most difficult and most complex project UBH has ever tried" (Brooks/Rother, 11/29).