President, Fountain House
All over the country, programs like Fountain House face a serious funding crisis, as state governments dramatically slash these organizations’ budget lines. Medicaid dollars are being reduced nationally, and many community mental health programs are finding the current Medicaid funding mechanisms extremely cumbersome and, ultimately, unworkable.
New York State developed a new funding stream called Personal Recovery Oriented Services (PROS) in an attempt to create a more recovery-oriented Medicaid program. This mean that, in contrast to the traditional medical model of treating sickness that Medicaid was designed to pay for, the state is encouraging recovery programs – programs that integrate treatment, support, and rehabilitation at the level of the individual – to qualify for Medicaid funding.
The state promoted this approach, but the majority of early adopters are really struggling to make their programs financially viable. Funding is now creating the programming, and that’s always detrimental.
The disconnect between the rhetoric of recovery and the current nature of Medicaid funding demands new thinking about the issue. Most disturbing to me is the fact that the advocacy groups who should be crying the loudest, can’t, because they receive too much funding from the state. Rather than make believe that PROS is working, we should admit the obvious and search for a better way.