By Andy Metzger
STATE HOUSE NEWS SERVICE
SPRINGFIELD — The MBTA isn’t the only place where state officials are looking to privatize government services.
Democratic legislative leaders in the House last week proposed relaxing privatization laws at the transit authority, which appears in store for a major overhaul following this winter’s service failures.
In the Senate, where the privatization law’s namesake Marc Pacheco was elevated this term to Senate President Pro Tempore, the idea was less than warmly received.
A day after the governor’s MBTA task force gathered in Boston to recommend suspension of a law detailing requirements for privatization, Baker administration officials were testifying before a legislative panel about privatizing mental health services.
Under the plan, which seeks to save $4.7 million on the treatment of mental illness, the Baker administration would need to convince the state auditor that its plan to privatize emergency mental health services in southeastern Massachusetts will save money without diminishing services.
“We believe this will have no impact on client services. The staff who have worked in those emergency service programs are dedicated professionals,” Interim Commissioner of Mental Health Joan Mikula told members of the House and Senate Ways and Means committees.
The House Ways and Means Committee’s budget would facilitate the Baker administration’s privatization plans, according to DMH. Rep. Carole Fiola, a Fall River Democrat, filed an amendment with a bipartisan group of lawmakers from around the state that DMH said would require DMH to maintain state-operated emergency services in the southeast.
Throughout most of the state, mental health emergency services are handled by the Massachusetts Behavioral Health Partnership, which is managed by MassHealth, according to DMH. The southeast is the only region where the department operates the emergency mental health services, and it has four programs in five locations in the region.
A 2013 guide to services offered by the department shows emergency services in the southeast available on Cape Cod, the South Coast and Brockton.
If the state follows through on the privatization plan, Mikula said the department would follow the current procedures for privatization of state services. It could become the Baker administration’s first attempt to move a privatization plan through the process mandated by the Pacheco law, a controversial measure that requires government to show savings and no decline in service before privatizing services. Viewed by some as an unnecessary hurdle for seeking efficiency through privatization, the law over the years has been regularly subjected to attempts to repeal it or reduce its scope.
Pacheco, a Taunton Democrat, prefers to call it the Taxpayer Protection Act, and said the law is a safeguard against contracts that diminish service or increase government spending.
“The law works,” Pacheco told the News Service. He said, “You want to make sure there is a process.”
The Council of State Governments Director of Health Policy Debra Miller said it is important to monitor contracts after a state service has been privatized.
“The trend seems to be toward privatization because of the feelings of policymakers that it’s a way to potentially save money,” Miller told the News Service. She said, “It’s always a good managerial process to look at the data behind a decision to privatize services.”
Ellen Andrews, a health policy consultant to The Council of State Governments Eastern Region, said evaluations of a planned privatization are usually ad hoc and “heavily lobbied,” often occurring at the end of a budget cycle.
“I think it’s a really cool thing that Massachusetts is looking at it in a formal way,” said Andrews, who said privatization of state health services is a “growing trend.”
The process mandated by the 1993 law has been used over the years, resulting in some objections – as when the MBTA sought to privatize the operation and maintenance of bus routes in 1997 – and other approvals.
In September 2010, former Auditor Joe DeNucci objected to the Department of Mental Health’s actions, laying off employees while contracting new service without using the Pacheco law’s process.
In early 2009, DMH began moving away from its own case-management system to a new model that it said resulted in more efficient service while around the same time the department reduced the number of case managers from a high of 311 to 230 by the fall of 2009, according to DeNucci’s report
The matter is still in litigation, according to a spokesman for Auditor Suzanne Bump.
Though the Department of Mental Health will receive a 1.7 percent increase in Baker’s budget, bringing spending up to $727.6 million, Mikula said fiscal constraints will require DMH to trim $29 million in spending. Privatizing emergency mental health in the southeast is one of the department’s tactics to rein in costs.
Already the union that represents the affected workers has said the plan will result in job losses and diminished service.
“The only thing this budget tells us is the emergency mental health teams are being eliminated,” Jason Stephany, a spokesman for SEIU Local 509, said in March.
Pacheco said state officials should be cautious making changes to mental health emergency services. The Baker administration said the southeastern service-delivery model is anomalous.
“Only in the southeast of Massachusetts are the emergency services programs state-operated,” Health and Human Services Secretary Marylou Sudders told the News Service. “In the rest of the Commonwealth of Massachusetts the emergency services programs are operated by contracted agencies.”