MANAGED CARE...KILLER OF QUALITY TREATMENT

As I've already said, TTC was an amazing place. It provided effective treatment for kids heading back out into the world. The team was dedicated and focused and effective.
It was also a time when managed care was in full swing, and it was increasingly difficult to secure funding for our type of population. And, because of the increase in more "difficult" kids, it was slim pickin's for us. The kids that could get the funding weren't appropriate for placement and we weren't equipped to deal with kids, that needed another year on a locked unit but managed care said it was time to move on and they did.
We tried to hold our ground on admissions, but a few ended up coming and they didn't stay long before they decompensated in some form or fashion and we would begin the hunt for alternative placement.
And we weren't shy about saying I told you so when this happened.This flippancy would come back to bite us in the end.
So, you put all this together and what you end up with is a class A treatment program running at 50% capacity for several months and they finally shut us down.They moved us out into the hill country to another facility CLCW that provided treatment for a wide range of patients, adults and minors. the adults were predominantly chronic schizophrenics and most of the kids had organic brain disorders.
So, here we were, the cream of the crop kids thrown into a dangerous mix of no impulse control whack job kids with brain damage and a bunch of delusional adults. Oh yeah, I forgot the sexual predators, they had those too.
If I remember correctly, our clinicians got 30 days, our mental health workers retained their jobs, as did I. I was a milieu coordinator with no milieu to coordinate.
But thanks to the combustible mix of minors,adults and sexual predators a situation would arise that would cause all those 18 and under to be moved back to the facility where I had been on the CSO team. You see, managed care was doing such a good job, there were empty units available. We got one, I was chosen to lead the team, it evolved into the nightmare that would finally cause me to leave the field. That nightmare was called ATC or adult transitional center.
The answer to managed care was marketing...and the best way I can describe the marketing for ATC is...LIES.LIES.AND MORE DAMN LIES...Now,give us your money.I had nothing to do with this marketing.
We had also developed a relationship with the state of Illinois called an interstate compact...if they sent us a kid, they paid and we could keep them until they were 21.
And send us kids they did...the absolute dregs of their system all dressed up in their clinical sunday best...
At one point, I had two rival gang members from the vice lords and the gangsta disciples on my unit...talk about your good times!
Speaking of good times, this was around the time I broke up with "Jill" and hooked up with Ann.
More on that later.