MDH officials question PEER report, reform legislation calls

Published 6:00 am Monday, February 9, 2009

Mississippi Department of Mental Health officials arequestioning the accuracy of a legislative report and somelegislators who generated reform-minded legislation and a publichearing in a House subcommittee.

MDMH Director of Public Information Wendy Bailey pointed outseveral discrepancies in the Legislature’s Performance Evaluationand Expenditure Review, a critical report on the department’soperations released last summer that inspired several bills seekingto reform the department this session. Most of those bills diedTuesday in committee, but at least three bills authorizingconstruction bonds for the department are still alive.

Bailey said the department has largely embraced the report asconstructive, but some of the criticism is unfounded. She contestedthe report’s findings and some legislators’ charges that thedepartment has no long-term goals, spends too much money and hasnot conformed to national standards of mental health care.

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“It’s misleading to say we didn’t have an long-term goals,because from the beginning we’ve had four state plans, and each oneoutlines different long-term goals,” Bailey said.

Since PEER was released in June 2008, Bailey said the StateBoard of Mental Health has concurred and formed a strategicplanning committee to create a singular strategic plan.

The report’s claim the MDMH operates institution-based servicesat a per capita cost that is 152 percent higher than neighboringstates is also misleading, Bailey said. She said other departmentsof mental health operating at lower costs might only be treatingmental health patients, while MDMH encompasses mental health andother forms of treatment.

“It’s kind of like apples and oranges,” she said. “It isinteresting to go online and look at the different ways departmentsof mental health are set up.”

According to their respective Web sites, the mental healthdepartments of Alabama, Arkansas, Louisiana and Tennessee all claimto oversee the same types of treatment as MDMH – mental illness,retardation and substance abuse.

MDMH Bureau of Administration Director Glenn Kegley said thestate’s per capita mental health expenditure is $108 – $8 more thanthe national average and almost double the South Central U.S.average.

“That’s not necessarily a bad thing, because the other statesare not doing enough,” he said.

Kegley admitted that of the state’s $108 per capita expenditureon mental health services, $60 is spent on institutional serviceswhile $48 is allocated to community services. Of the nation’s $100figure, $26 goes to institutional services while $74 is invested incommunity services. Kegley said MDMH is moving toward parity withthe national standard for community-based care.

Kegley also addressed some legislators’ calls for thereformation of MDMH by implementing new requirements for thedirector and canceling state-provided homes for its employees.

Some bills this session have called for the department’sexecutive director, Ed LeGrand, to be replaced with a qualifiedpsychiatrist, but Kelgley said being a good psychiatrist does notequate to being a good administrator in charge of a $632 millionbudget.

The department’s numerous state-provided homes are necessary asincentives to recruit qualified personnel away from the privatesector, Kegley said.

There are 59 such homes in Mississippi, he said, most built inthe 1970s. MDMH directors and other administrators occupy thelargest of these homes, some as large as four-bedroom, three-bathhouses. Those officials are required by the department to live onfacility grounds, he said.

The department last reported spending approximately $300,000annually to maintain the homes, but Kegley said it’s probablycloser to $60,000-$70,000. Until last year, employees were notrequired to pay utilities on those homes.

Kegley pointed out the department no longer builds new homes forits employees, recalling LeGrand’s statement at the subcommitteehearing that the homes should be “bulldozed or filled withphysicians” upon vacancy.

“Every facility we have built since 1974 has only had one housewith it,” he said.

District 39 Sen. Cindy Hyde-Smith, D-Brookhaven, said thedepartment was simply challenging the PEER report, which she helpedcraft last year. She challenged the department’s challenge.

“I have full faith in the PEER staff, and I would put Dr. MaxArinder (PEER executive director) and his staff up against in thenation when it comes to investigating state agencies,” Hyde-Smithsaid.

District 92 Rep. Becky Currie, R-Brookhaven, is also wary of thedepartment’s explanations. It was Currie who requested the publichearing, only to afterward see her legislation expire incommittee.

“They miss the boat, and they’ve been missing it for 20 years,”Currie said of MDMH. “How can I vote on that budget this year? Iknow it’s not for taking care of patients. I can’t waste thetaxpayers’ dollars until MDMH puts the money where it’s supposed tobe going.”