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February 23, 2010 | A Matter of Opinion
 

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Tuesday, February 23, 2010

Editorial: Twin Valley sale won’t fill void

A for-profit company is buying the old Twin Valley state mental hospital on Dayton’s Wayne Avenue, but it’s too soon to know whether that’s a good or a bad thing for people who need mental health care and can’t get it in the Dayton community.

The state closed Twin Valley in June 2008 as part of a cost-saving move.

Now individuals who need inpatient mental health care are being sent to a state facility in Cincinnati; admitted to local hospitals, which aren’t designed to keep psychiatric patients beyond a few days; or they’re given their meds and sent on their way.

It’s not a good situation, and the problem is compounded by the fact that psychiatrists at the county mental health agency and psychiatrists at local hospitals are at each others’ throats.

Psychiatrists at ADAMHS — the Alcohol, Drug Addiction and Mental Health Services agency — get to decide who’s admitted to the Cincinnati state hospital. In the case of people without insurance, this means they decide who will get treatment at state expense.

When that agency won’t OK treatment at a state facility, a local hospital often is in the position of keeping a patient who may not belong in a general hospital. More than likely, the hospital also will take a financial hit for providing the treatment.

A local study is being done by area hospitals that shows a small number of chronically mentally ill patients — many of whom also have drug or alcohol addictions — are responsible for big bills that the hospitals turn around and submit to Montgomery County for repayment under the Human Services Levy.

Amamata LLC is the newly created company that is buying the old Twin Valley from the state for $1.7 million. The state is eager to trumpet the sale because there is still much bitterness aimed at the Strickland administration for closing Twin Valley in the first place.

But the sale itself is not what matters. What counts are the services that will be offered and for whom. If the facility only takes those who have insurance, that’ll leave area hospitals caring for those patients who can’t pay and possibly losing those who can pay.

Some psychiatrists say that what’s needed locally are psychiatric services for children, developmentally disabled individuals, older adults and those who are both mentally ill and addicted to drugs or alcohol. These are subspecialities that general psychiatrists may not be expert enough at dealing with.

There’s some understandable local skepticism about a for-profit business model being viable. A for-profit operation was slated to go into Elizabeth Place, but that effort fizzled.

Generally speaking, it’s hard to turn a profit at psychiatric facilities because Medicaid and Medicare reimbursements are low, and reimbursements by traditional insurers aren’t exactly lucrative either. That’s why states so often end up running psych facilities or why they’re non-profit.

Dr. John A. Johnson, who is president of Amamata, told reporters he wants to offer speciality services, the sort Dayton needs. He has big plans, including putting $6 million into the aged Twin Valley facility, and he imagines hiring 150 people.

There is no doubt that there are gaps in the local psychiatric offerings. Whether Amamata can help fill them remains to be seen. What’s certain is that Twin Valley’s absence is still being felt.

Permalink | Comments (0) | Post your comment | Categories: Editorials, Ellen Belcher, Health Care, Local Business, Ohio government, Social Services

Editorial: Early college cut now has Ohio out of step

The Obama administration wants to pilot a promising high school reform effort. Too bad Ohio is moving in the wrong direction, having junked funding for an effective program that is perfectly in step with the administration’s goals.

The federal pilot in eight states (Ohio is not one of them, but Kentucky is) would create an avenue for high-achieving high school students to skip two years of high school and jump straight to attending a community college.

Specifically, if students can perform well on challenging coursework early in high school and pass college-level exams at the end of their sophomore year, they can move ahead with a college education.

It just so happens that Ohio has pioneered an excellent test program build on this concept. Nine “early college” high schools in Ohio are part of a national experiment with the same regimen.

Dayton has one of the best performing, the Dayton Early College Academy. That charter school began as a joint venture of the University of Dayton and Dayton Public Schools. It now relies heavily on UD’s financial support.

In part, that’s because of a huge mistake by the state legislature in the midst of last year’s budget wheeling-and-dealing. In the effort to fill a massive shortfall, money for the early college was among a host of programs that lawmakers axed, costing DECA about a quarter of its funding.

Ohio is now out of step with the national trend.

Under President George W. Bush, almost all school reform efforts were focused on kindergarten to eighth grade. The faulty logic of No Child Left Behind was that better prepared younger children would naturally make high schools more rigorous. Belated efforts by President Bush to get serious about changing high schools never really got off the ground.

President Obama’s hope is that high schools will respond to the opportunity for their students to move quickly ahead by ratcheting up their own expectations and offerings. The plan also maps the way for kids to see the practical value of their school work: put in the effort, and you can get out of school early.

Critics have argued for more than a decade that U.S. high schools need a makeover. In too many schools, the work is just not challenging enough. Sometimes the bar is set so low that high-performers complete the toughest courses early and end up filling their senior years with frivolous electives and study halls.

Bit by bit, efforts have been made to give kids who want to move on a way out. Allowing high school students to earn university credit by taking college courses has been a huge success.

There’s also been an explosion of college-level courses at quality high schools through programs like Advanced Placement and International Baccalaureate. Early-college high schools are another successful move in this direction. The Obama plan takes some of the lessons of schools like DECA and tries to apply them more widely.

Before it’s too late, the state should reverse course. Ohio should not only keep its fledgling early-college program, it should expand it.

Permalink | Comments (2) | Post your comment | Categories: Editorials, Education, Scott Elliott

 
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