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Transportation will continue for the mentally ill despite adverse Medicaid ruling

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CANTON - Transportation for the mentally ill to day programs will continue through St. Lawrence County Community Services even if the bus is no longer driven by the county Community Development Program.

CDP has for years bused 30 to 80 mentally ill clients to Seaway House and Step-by-Step in Ogdensburg, but Medicaid recently determined it would no longer reimburse transportation costs to non-Medicaid-licensed providers even if the programs were part of a doctor’s treatment recommendation. That left a big hole in CDP’s budget.

The agency made up the gap on its own for a while, hoping that the state Department of Health, with the urging of elected representatives, would modify its ruling on Medicaid reimbursement.

“Medicaid isn’t going to change its mind,” CDP Executive Director Norma S. Cary said.

Transportation funding also comes from Community Services through the state Office of Mental Health, which recognizes the value of the day treatment services.

“Those programs are very important for socialization and emotional well-being,” Community Services Board Chairwoman Carolyn M. White said.

Community Services already was providing CDP with $112,000 for transportation for 2014 and has come up with an additional $62,000 through OMH to help CDP get through the rest of the year.

“The New York state Office of Mental Health has been wonderful,” Community Services Director Angela M. Doe said. “The additional $62,000 gives them and the Community Services board the time necessary to come up with a more proactive plan.”

The money from OMH was available in the past but has been turned back to the state because Medicaid reimbursement was more lucrative, Ms. Doe said.

“We care about what happens to our clients but we ultimately have no control over the Department of Health,” she said.

The additional funding from OMH would probably be enough to pay for the service through the end of August, Ms. Cary said.

“It would not take us to the end of the year,” she said.

The CDP board is meeting today to make a decision.

“We will lose a program if we don’t take it,” Ms. Cary said.

Without funding for mental health transports, CDP probably would have to close its bus garage and potentially lose five positions. The garage also provides maintenance service for Head Start, which then would have to outsource that work, she said.

Ms. White said she could not imagine CDP rejecting the additional money. But if it declines, the Community Services board will find an alternative provider by June 1.

“Transportation is not going to stop,” Ms. Doe said. “Our concern is that the community perception may be the Community Services Board is not providing the money or is not doing enough.”

Community Services is ready to work with CDP, Ms. White said.

“There’s a lot of creative solutions to look at,” she said. “Angela found the money through the good graces of OMH. CDP just has to take it and utilize it for its purpose and think outside the box.”

Providing the bus service is more costly than just putting a driver behind the wheel because of liability, training, and repair, Ms. Cary said.

“They don’t understand why we can’t make it on $174,000,” she said. “It’s more complicated than that.”

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