Wait times: A difficult question.

Robbin Miller, also known as "Advocate" on this blog, asked some difficult questions on the comment section below, that I thought merited some discussion:

What is the average wait list for your clients to receive counseling services in their area? I am wondering if the new law will be monitoring wait times and assessing what the reasons are for these waiting lists.

I know in the Worcester area, the waiting list for counseling services are between one to three months. I know some agencies have a 30 day waiting period for Family Stabilization Services (FST).

Do counseling agencies have to report their waiting lists to the state on a monthly basis? For private practitioners, some take Mass Health Clients while others don't for a variety of reasons.

I was glad to hear that Fallon is now paying for coordinated/collateral services their clients on Mass Health. However, Network Health has not stepped up to the plate yet.

How come commercial insurances such as Blue Cross and Fallon won't be pay for the above services?

Robbin Miller
Advocate/Private Practitioner

The answer to the "waiting question" is difficult, because of my uncertainty as to when to start the count.  Does the wait time start from when I suggest the referral (ie Day of the Annual Physical?)  If so, I would say 1 to 3 months is accurate.  Or does it start from the day that the parent makes the initial phone call, which may be up to 3-4 weeks after we see the child in the office (and actually may never happen?  Or is it from when the agency calls back?  (Which may be days, weeks or never after the initial call)  Agencies to report this stuff monthly and I was getting reports from Elizabeth O'Brien, LICSW, the Regional Director of MBHP, Central Mass for a long time.   Last one I got last winter reported that the wait times for an initial evaluation were 0-5 weeks, with additional times for initiation of therapy and initial consultation with a psychiatrist.  The data apparently is from agency information, and is not verified independently.

I'd post one of the reports, but it is 18 pages long and would fill the blogosphere.

FST, I haven't had long waits with, on the 5 or so patients that I have referred.  My biggest problem has been families that don't want FST in the house.

As to why insurers don't cover collaterals and FST, the answer is always "money" and "because they don't have to".

I am interested if others have thoughts on this.