Wilkes-barre

Agnes Walsh 
Jan. 11, 1994 
Agnes G. Walsh, 91, Of Wilkes-barre, Died Tuesday In The Heritage House, 
Wilkes-barre, Where She Resided.

By MITCH MORRISON; Times Leader Staff Writer
 Friday, January 14, 1994 &nbsp;&nbsp;&nbsp;&nbsp;Page: 1A QUICK WORDS: SOCIAL-SERVICE TURF WAR
MAY PIT HOSPITALS 





WILKES-BARRE -- In a few years, Luzerne County government could be out of
the social-service picture, a stark contrast to the 400-employee, $65 million
operation it now oversees. &nbsp;&nbsp;&nbsp; 
 Power is shifting from counties to "super" hospitals, which are flexing
their muscles and swallowing smaller, independent social-service agencies. &nbsp;&nbsp;&nbsp; Welcome to the health mall, where clients, both physically and mentally
ill, receive treatment at the same stop. &nbsp;&nbsp;&nbsp; 
 Hospitals aren't only fixing broken legs, they're offering outpatient
counseling services, too. &nbsp;&nbsp;&nbsp; 
 Wyoming Valley Health Care System Inc. has reached agreements, turning
Community Counseling Services, which treats the mentally ill, and the Visiting
Nurses Association into subsidiaries. &nbsp;&nbsp;&nbsp; 
 The non-profit health-care system -- formed two years ago when Nesbitt
Memorial and Wilkes-Barre General hospitals merged -- also has been courting
Wyoming Valley Alcohol &amp; Drug Services. &nbsp;&nbsp;&nbsp; 
 "I don't understand why hospitals are expanding to human services that are
not part of their mission," said Joseph Loftus-Vergari, county human-services
director. &nbsp;&nbsp;&nbsp; 
 "No one knows how to care for the chronically mentally ill," Loftus-Vergari
said. He said it's not a system that lends itself to containing costs. &nbsp;&nbsp;&nbsp; 
 Caring for the mentally ill costs big bucks. The county, using federal,
state and county funds, spends $27 million a year in Mental Health/Mental
Retardation programs to treat about 10,000 patients. &nbsp;&nbsp;&nbsp; 
 Further, it provides or contracts for counseling, housing and
transportation for the elderly and people who can't afford comprehensive
health coverage but whose higher incomes disqualify them from receiving
medical assistance. &nbsp;&nbsp;&nbsp; 
 "My concern is when clients become a drag on the system, will the system
jettison them?" Loftus-Vergari asked. &nbsp;&nbsp;&nbsp; 
 What the law says &nbsp;&nbsp;&nbsp; 
 Some local social-service agencies foresee the county standing on the
sidelines as health-care providers step in to assume control over human
services. &nbsp;&nbsp;&nbsp; 
 "That's the really frightening thing here," said John Plucenik, community
outreach coordinator at Wyoming Valley Alcohol &amp; Drug Services. &nbsp;&nbsp;&nbsp; 
 Tom Cesarini, director of the $1.5 million Luzerne/Wyoming Counties Drug &amp;
Alcohol program said, "With managed care developing the way it is ... the
state, instead of going to the county to contract for human services, may
instead contract with managed-care providers or put it out for bid." &nbsp;&nbsp;&nbsp; 
 However, the 1966 state Mental Health/Mental Retardation Act says counties
are responsible for the well-being of people with physical and mental
challenges. &nbsp;&nbsp;&nbsp; 
 To bypass the county would require lawmakers to change the law. &nbsp;&nbsp;&nbsp; 
 While advocates and critics agree large health-care providers are turning
into monopolies, they disagree on the county's future role in this change. &nbsp;&nbsp;&nbsp; 
 Counties won't be displaced as gatekeepers of millions of public dollars, a
state Public Welfare official said. &nbsp;&nbsp;&nbsp; 
 "Counties are in the best position to understand their constituencies and
understand their health-care providers," said deputy secretary Mike Breslin.
"I don't see state government ... moving human services from the county to
private providers." &nbsp;&nbsp;&nbsp; 
 But the county could be contracting with fewer providers. Breslin said
hospitals are positioning themselves by diversifying into human services in
anticipation of shrinking federal dollars and reduced inpatient care. &nbsp;&nbsp;&nbsp; 
 "Hospitals are changing in order to survive," Breslin said. &nbsp;&nbsp;&nbsp; 
 United we stand? &nbsp;&nbsp;&nbsp; 
 These changes are good for the consumer, said Ron Stern, president and CEO
at Wyoming Valley Health Care System Inc. &nbsp;&nbsp;&nbsp; 
 "When entities are separate, there are natural barriers," he said. "With
affiliations like the ones we have with Community Counseling and Visiting
Nurses Association, we're eliminating barriers and helping the patient get the
best care possible." &nbsp;&nbsp;&nbsp; 
 Both social-services providers have had longstanding relationships with
either Nesbitt Memorial or Wilkes-Barre General hospitals. &nbsp;&nbsp;&nbsp; 
 Stern emphasized Community Counseling and VNA will remain independent with
separate boards of directors, despite their affiliation with the health-care
system. &nbsp;&nbsp;&nbsp; 
 These formal relationships are putting Wyoming Valley Health Care System
Inc. on the cutting edge while ensuring the survival of many human-service
providers who might otherwise close as a result of increased competition and
fewer public dollars, Stern said. &nbsp;&nbsp;&nbsp; 
 Shadows of doubt &nbsp;&nbsp;&nbsp; 
 Even so, some fear these alliances will limit the consumer's choice. &nbsp;&nbsp;&nbsp; 
 For instance: &nbsp;&nbsp;&nbsp; 
 Because Blue Cross-Blue Shield recently picked Wyoming Valley Health Care
System Inc. as sole provider for its Health Maintenance Organization,
customers no longer will be covered going to Mercy Hospital. &nbsp;&nbsp;&nbsp; 
 The county contracts Wyoming Valley Alcohol &amp; Drug Services for about
$500,000. Now, because of its desire to remain independent of a super
health-care provider, the agency risks having its contract cut or dropped. &nbsp;&nbsp;&nbsp; 
 Luzerne County Commissioner Frank Crossin said he's cautiously optimistic
about the sudden changes. &nbsp;&nbsp;&nbsp; 
 "No matter what we want to say or do ... there are going to be changes in
the health-care-delivery system," he said. &nbsp;&nbsp;&nbsp; 
 "Our concern is that the people who are indigent and less fortunate -- the
people we are responsible for -- are going to be taken care of."

Social-service Turf War May Pit Hospitals, County 
Whose Job Is It Anyway? 
Area Hospitals Are Making 
New Strides In Mental-health 
Care, But Local Government 
Complains Its Toes Are Being 
Stepped On In The Process

Social-service Turf War May Pit Hospitals, County Whose Job Is It Anyway? Area Hospitals Are Making New Strides In Mental-health Care, But Local Government Complains Its Toes Are Being Stepped On In The Process