Three county departments are proposing a plan for 157 patients who, as a last resort, have gone to Stanislaus County health clinics for medication to treat mental disorders.
Under what's billed as a pilot program, county Behavioral Health and Recovery Services would retain the services of a psychiatrist to evaluate the patients and consult with health clinic physicians. County staff also are weighing options for obtaining low-cost or free medications for the patients.
Management staff with Behavioral Health and Recovery Services, the Health Services Agency and Community Services Agency will bring the proposal to the Board of Supervisors on Tuesday for board approval.
The Stanislaus County Mental Health Board endorsed the proposal after hearing the details from county staff at its meeting Thursday.
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"I am satisfied with the plan they presented," said Chip Langman, a Mental Health Board member. "I will be more satisfied if the board looks at it the same way and continues the funding."
The patients are in the county's medically indigent adult health program. Most of them resorted to the county health clinics because they didn't have access to psychiatrists for conditions ranging from bipolar disorder and schizophrenia to milder forms of depression.
In March, county supervisors voted to exclude mental health from the list of services in the medically indigent adult program. The county's primary care doctors are not qualified to manage psychiatric patients. Cutting the service was going to save the cash-strapped Health Services Agency about $280,000 annually in pharmacy costs.
The county board gave the departments 60 days to work out another arrangement for the patients.
Supervisor Dick Monteith said Friday he likes the proposal.
"The former situation put our doctors in a very bad position, because that is not their field," he said. "We have people who need the service, and I knew if the departments worked together they could come up with a solution."
If the board approves, the patients will be screened and evaluated to determine the appropriate level of treatment they need, said Madelyn Schlaepfer, associate director of county behavioral health.
The county will need to retain the services of a psychiatrist to evaluate patients and consult with their doctors at the county clinics. Because there is a shortage of psychiatrists, the county might have to buy telemedicine equipment for evaluations via videoconference.
Some patients may need to have their dosages adjusted. The psychiatrist also might recommend lower-cost generic drugs that work just as well, staff said.
"There are some who are not seriously mentally ill, and they may not need ongoing medication or may benefit from shorter-term medication," Schlaepfer said.
The plan still would involve the Health Services Agency pharmacy in obtaining drugs for some patients and the clinic doctors in treating patients who also receive care for medical issues.
The agency expects to spend less on drugs for the patients, said Mary Ann Lee, HSA director. The county clinics are eligible for discounted drugs through the federal government. Patients also may qualify for free drugs from pharmaceutical companies or buy certain drugs from Wal-Mart or other retailers offering $4-a-bottle prices.
The county agencies also will help eligible patients in obtaining Social Security and Medi-Cal benefits. Under the plan, the county is expected to save $10,000 to $75,000 the first year, depending on whether it needs to buy telemedicine equipment. The savings could be $140,000 in the second year.
The Board of Supervisors meets at 9 a.m. Tuesday in the basement chamber of Tenth Street Place, 1010 10th St., Modesto.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or 578-2321.