A potentially harmful contract has been let for bid to health service organizations by the U.S. Government on behalf of the Department of Defense (DoD). Health care organizations are attempting to assume the contract from the present contract holder for the Military and Family Life Counseling Program.
Magellan Behavioral Health, Inc., has been the clearing house for Tri Care’s mental health component for a number of years. Often they have been adequate in performing their duties and other times, impossible for active duty military, retirees and family members to understand and resolve differences. More often than not, mental health providers have refused to accept Tri Care because they are burdensome in the amount of paperwork required and take even longer to pay once services have been approved and provided.
Unfortunately, multiple deployments over the past ten years have left not only active duty military members with unresolved problems, but spouses and children who are baffled by what happened to the loved one they used to know.
1) a 6 month rotation in the United States
2) a 6 month rotation overseas
3) on demand services
A major concern of mine is that a mental health practitioner with real life experience in treating complex mental problems will already have in existence a full-time practice and ethics that will not allow them to leave their practice for six-month rotation periods. They will have office space rented and they cannot abandon their existing patients. Further, some of the patients may already be Tri Care patients. Tri Care pays more for a 50 minute appointment than they would earn under the proposed contract of $40/hour with no benefits (for a six-month contract that might roll over into another six months).
The proposal by Magellan reads, “You will make yourself available to accept assignments to locations within the United Sates and/or outside the United States designated by Magellan, which will involve full-time designation of your time for a rotation of one to six months or a short-term on demand or military surge assignment of one to thirty days, to provide the following services:
a) Face-to-face assessment, short-term counseling addressing the stressors of military life and other problems in living, and referral for treatment (“non-medical counseling services”) to military personnel and their family members (“clients”) at locations at military installations and/or communities in which military families live. You will use a walk around/just-in-time approach to deliver non-medical counseling services in addition to making appointments available as requested. The duration of counseling sessions may range from several minutes to two hours, depending on the circumstances.
b) This section pertains to services under the Child and Youth Behavioral program. It is straight-forward in its discussion.
c) Presentations to military personnel appear to be of routine matter.
The remainder of the proposed contract is what one might expect in any medical proposal.
This proposal might be an exciting opportunity for a young, inexperienced therapist who’s a recent graduate. It’s an opportunity to travel and have an immediate peer group to associate with. Additionally, the new graduate would incur no cost of doing business expenses.
A therapist in an unhappy practice, but one that’s already on the Tri Care approved list could easily drop into this contract. The therapist wouldn’t have to find a new practice to work within or set up a private practice.
Today, more than ever, our men and women in uniform need competent and experienced health care. In my opinion, we’ve never had such mental and emotional fragility among our armed services. Vietnam provided a mental health crisis but our country as a whole turned its back. We cannot afford to make that mistake again.
We continue pretending that it’s okay to seek help for lives out-of-control due to multiple deployments but seeking help from a mental health care provider can still end a promising career in today’s armed forces. Nothing much has changed—those that can afford out-of-pocket expenses discreetly seek help in the private sector.
The current proposed contract doesn’t qualify for a band-aid fix and certainly doesn’t come close to adequate mental health care. The Veterans Affairs Administration cannot meet the demands of returning veterans and our active duty service members have no place to turn.
The Sounds of Silence will continue the debate of diminishing health care afforded both active duty and retired military along with the announced drawdown, hazardous materials clean-up attempts on closed bases, and other subjects of interest to the military/defense community.