Part of cost-cutting at Monadnock Family Services
Published April 21, 2008 in the Keene Sentinel
By Casey Farrar
Monadnock Family Services CEO Kenneth Jue said he met Friday with Matthew P. Haas, board president of the cooperative, to discuss ending cleaning services at Monadnock Family Services’ offices at 64 Main St. in Keene.
The cooperative, which is a nonprofit organization aimed at rehabilitating people with mental illnesses, emotional disturbances and substance-abuse problems, will continue to clean Monadnock Family Services’ offices on 93rd Street, Jue said.
With devastating deficits statewide, Monadnock Family Services might be only the first of the state’s 10 community mental-health centers forced to make cuts, according to according to Roland P. Lamy Jr., executive director of the New Hampshire Community Behavioral Health Association, a group formed by the state’s centers.
Jue estimates Family Services will save $10,000 per year by hiring another cleaning company to provide the service on Main Street.
James P. Noyes, general manager of the cooperative, said the the contract brings in $2,700 per month.
The cooperative, which employs 19 people, is making plans to place affected employees in other jobs in the community, including cleaning, grounds keeping and painting, according to Haas.
Haas said he doesn’t yet know what the financial effect of the contract loss will be.
“It’s a very big contract,” he said. “If anything, this is kind of a good time of year to have the contract cut, if there is a good time, only because had it been winter time it would be very difficult to find jobs to do indoors.”
Haas said the board of the cooperative had been informed that cutbacks were coming before the announcement last Monday that Monadnock Family Services was dealing with a $500,000 deficit this year.
The cooperative also offers moving services and is considering expanding a service providing transportation to people for medical appointments, such as doctor visits and prescription pick-ups, Haas said.
“Our income is going to be very different for a while, but knowing (about the changes) ahead of time helps,” Haas said. “We need to see how it plays out and probably we’ll get a better picture of things in November and December, when the summer rush ends.”
Last week, Monadnock Family Services announced major employee and service cutbacks in response to its budget deficit.
Jue said the contract with the cooperative won’t be cancelled until after a new contract is negotiated with another company, adding that he doesn’t know how long it will take to make the change.
A contract with the cooperative costs more than other cleaning services because members of the cooperative often work together on jobs and sometimes require additional time or training to complete tasks, Jue said.
“I hate to do it,” Jue said. “It’s purely a financial decision.”
Other mental-health centers in the state feel the pinch
Losses from unmet Medicaid deductibles have cost the 10 centers across the state nearly $4.5 million this fiscal year, leaving all of them grappling with budget deficits, Lamy said.
Lamy said the amount each center has lost varies by the population served, but Monadnock Family Services falls in the middle of the group, having lost $436,000 this year.
Other centers are located in Derry, Nashua, Dover, Laconia, Manchester, Conway, Concord, Portsmouth and Lebanon.
The 10 centers served 41,353 people in 2006, according to the New Hampshire Community Behavioral Health Association’s Web site.
The association was formed in 2001 to coordinate efforts to inform the state Legislature and Department of Health and Human Services about the issues and financial difficulties faced by the centers, Lamy said.
Lamy said financial shortfalls have been gradually building at centers all over the state, stemming mostly from unmet Medicaid and commercial health insurance deductibles.
With Medicaid reimbursement rates, set by the state and matched by the federal government, holding steady and health-care costs climbing, the centers are absorbing more expenses for services, Lamy said.
“It’s a dramatic issue and I think we’ll see more strain and stress on the centers all over the state,” Lamy said. “Across the board, they are looking at what they have to do to remain financially viable.”
So far, Monadnock Family Services is the only center in the state to make cuts this year, according to Lamy.
“It’s a very difficult decision to make, but when you reach the threat of having to close your doors or make these decisions you have to take care of the most needy,” Lamy said.
Changes implemented this month in federal case-management regulations may compound the financial difficulties the centers face, Lamy said.
As a requirement of Medicaid regulations, the centers create plans for treatment for all patients covered by Medicaid. The centers are then paid by Medicaid for providing these services.
The regulation changes will affect the type of treatment covered under the plans, as well as how the centers are paid for these services, Lamy said.
New York, Tennessee, Kentucky, Maine, Maryland, Oklahoma and New Jersey have filed a lawsuit seeking to block the Medicaid regulation changes, according to a report by the Associated Press.
The association of community mental health centers is working with the Department of Health and Human Services to define the changes to the regulations, but the full financial effect on the centers probably won’t be clear until after mid-May, according to Lamy.
“This rule came upon us pretty suddenly and it has a significant impact on the system of care,” Lamy said.
Monadnock Family Services is overhauling its computer coding system to meet the new regulations, Jue said.
Jue said he fears the changes will only add to the growing financial strain on the organization.
“We’re just going to have to wait and see what happens,” Jue said.
Casey Farrar can be reached at 352-1234, extension 1435, or firstname.lastname@example.org.