PROCEED WITH CAUTION

Our Position: Rushing Through Massive Changes For The Mentally Ill Can Be A
Big Mistake

It takes dedicated people to devote their lives to helping the low-income
mentally ill and substance abusers. You don't get rich doing it, if you do
it right.

Now lawmakers are considering a risky plan that would place the care of
these fragile patients in the hands of managed-care companies. They would
no longer be served by the community non-profit agencies that have
dedicated themselves to this important work for more than 20 years.

This change has not been given an adequate public hearing. Yet House
Speaker Johnnie Byrd is adamantly in favor of it, and it appears that the
Senate may yield to him. All this has been happening in private meetings,
without debate.

Why the rush? Some note that Mr. Byrd, who is running for the U.S. Senate,
has received campaign donations from directors of a company that wants the
Medicaid contract.

Any action to shift the treatment of these patients to managed-care
companies would be premature because the state has a new Substance Abuse
and Mental Health Board. This issue needs study because people in crisis
may not cope well with HMO-style rules.

Tennessee tried this in 1996. The aim may have been better coordination of
care, but the results included scandals, complaints, bankruptcy and a
lawsuit by advocates for the mentally ill.

Last year, under pressure from the courts, Tennessee took over supervision
of the mess. Meanwhile, many community agencies in Tennessee merged or went
under.

The same could happen here. Give the new board time to study it.