‘Expanded Choice’

Medi-Cal has a pilot capitation plan, farcically labeled “Expanded Choice”, which will go into effect in the San Fernando Valley in December. The plan will be criminally disadvantageous to many beneficiaries. Those who receive Medi-Cal in conjunction with SSI because they are significantly handicapped and therefore cannot provide for themselves financially will not, in most cases, be able to get to those few facilities where services will be available by contract with the state. Their disabilities interfere with traveling (getting from home to anywhere) as much as with working and making money.

I provide psychological services to about 15 mentally ill adults in the residential facility where they live. Many other mental-health providers work in a similar fashion. When we can no longer go to them, most of them will be without those services, lacking the will and the wherewithal to get to a clinic or HMO facility, and also being afraid to see a strange provider for these personal kinds of treatment. For example, one man whom I have been seeing for five years will not talk to any stranger; another will not travel by bus because he is afraid of being arrested for hallucinating.

This program will certainly save the state money but at great cost to the sick for whom Medi-Cal benefits were intended. It’s so obviously a sneaky way of taking away their benefits. And how bizarre to call this “Expanded Choice”!

LINDA WATERS

Encino