A new centralized mental health-care-management system for children and their families is accepting applications from providers in four counties. 

Mary Frances Thetford and Fred Biasini are leading UAB’s charge to develop a new centralized mental health-care-management system for the children of Alabama.

This first-of-its-kind program has been developed by UAB’s Department of Psychology and the Alabama Department of Human Resources to increase accountability of mental health-care providers statewide and improve the quality of care.

As the need for mental health services increases, additional safeguards to protect Alabama’s most vulnerable children are needed, says Psychologist Fred Biasini, Ph.D., especially given the proliferation of non-accredited online degrees and identity theft. He says the new Alabama Mental Health Management System will provide the checks and balances needed.

“Under this system UAB will collect, verify, catalog, maintain and monitor all credentialing information for mental health professionals who provide services to children and their families served by DHR within the 67 counties of Alabama,” says Biasini, director of the project and associate director of the UAB Sparks Clinics. “In addition, we propose to develop and manage a centralized system that will monitor progress, address billing discrepancies, implement standards of care and ensure that effective and appropriate services are available.” 

Biasini says if provider credentials can be verified and a fair reimbursement rate established, the number of qualified providers of mental health-care services may increase. “Then, if we can develop a standard-of-care system, we really can improve the quality of mental health services children receive,” he says. 

Improving quality of life
The credentials and competencies of the 1,433 mental health-care providers across the state have not been verified and are based largely on information provided in applications, letters of interest and fliers announcing the availability of services. DHR survey information reveals that 4,275 children were receiving some form of state-sponsored psychological counseling and an additional 1,219 children had a psychological assessment. In some cases the providers claim to offer psychological services but are not trained or qualified to provide these services or licensed as psychologists.

Psychology also has been working with the state on another endeavor — Project Heroes — in which it evaluates high-risk children. UAB staff has reviewed many psychological assessments, some of which have not met the standard the state prefers.

“We’ve read documents where the therapist actually seemed angry at the child and even reflected in their notes that they thought the child was evil; that’s not part of appropriate and quality mental health services,” Biasini says. “If we can filter out those kinds of individuals and get appropriately trained child mental health-care professionals to see these kids we possibly can make headway in helping them adjust to the trauma they’ve experienced.”

Biasini and DHR Commissioner Page Walley stress that the program, which is modeled after one used by the Georgia Department of Human Resources and in a pre-Hurricane Katrina program in Louisiana, is not an effort to reduce the amount of funding for mental health services for children. DHR already has allocated $9.8 million for services this year.

“This is strictly an effort to make the mental health services for children as good as they can be so they improve the quality of their lives long term,” Biasini says.

Thorough examination of providers follows
The first phase of the program is beginning in Jefferson, St. Clair, Walker and Mobile counties and will launch in the rest of the state during the course of the next year. Providers are required to reapply to confirm their licenses and educational attainment are legitimate, and criminal background checks will be conducted by Employment Screening Services, which is working with UAB.

“If the applicant passes the background checks then follows a review of the entire application packet by the Provider Credentialing Review Board, which includes social workers, psychologists, psychiatric nurses, counselors and psychiatrists,” says Mary Frances Thetford, the project liaison for UAB with DHR.

“Ultimately, this should result in a database of qualified professionals that will enable DHR to send clients to the right mental health professionals for their specific needs.”

In addition to Biasini and Thetford, the review board will include the following UAB faculty and staff: Alan Percy, M.D., co-director of the Civitan Center; Lee Ascherman, M.D., director of the Division of Child and Adolescent Psychiatry; Chris Walker, field director for the Social Work program; Daniel Marullo, Ph.D., clinical psychologist, Civitan Center and Sparks Clinics; and Carol Dashiff, Ph.D., Teena McGuinness, Ph.D., and Anthony Roberson, Ph.D., from the School of Nursing. Jane Lane of the Civitan International Research Center has daily oversight of the project. Mandy C. Andrews will represent DHR on the Review Board.

Equally important is the second phase of the project, which is scheduled to start in late 2009 or early 2010, Biasini says. It will develop standards of care that include policies and procedures for counties and caseworkers, creating workshops to educate workers, court personnel and providers.

“It’s certainly going to be very challenging, but it’s extremely important in what we’re trying to accomplish,” Biasini says.

“If we’re able to do this, it could be groundbreaking.”