Department of Mental Health caseworkers in Southeast Missouri will remain on the state payroll and will not be privatized, DMH director Keith Schafer wrote in a letter to state legislators late last month.

Plans to transition case managers to local control were met by an onslaught of concerns raised by parents, who worried they would lose services, and caseworkers, who feared they would lose their jobs. The caseworkers assist people with developmental disabilities such as mental retardation, cerebral palsy, head injuries, autism, epilepsy and certain learning disabilities.

A town hall meeting was held Nov. 14 in Poplar Bluff to discuss the plan, which would have left 484 caseworkers in Missouri out of state jobs. After the meeting, DMH officials decided Poplar Bluff and Sikeston Regional Center caseworkers would not be outsourced.

Instead, the 35 caseworkers will continue to be part of the regional centers. Any new positions that become available will be transitioned to local control.

"The voice of the people was heard. I'm very pleased that they've decided to back off it, and that the trained case managers will be able to keep their positions," said Susan Wallis, the assistant secretary of Mentally Retarded Citizens of Missouri.

News of the DMH's decision has not filtered down to many parents and mental health organizations, who said they have consistently been provided sketchy details.

Uncertainty and unanswered questions have led some casemanagers to leave the profession, said Mike Sciortino, the founder of the autism support group Ethan & Friends.

"There's several good people that have left because they didn't know what was going to happen," Sciortino said.

The state says that privatizing workers costs less, so more could be hired and caseloads would decrease. In Southeast Missouri, one casemanager works with about 66 people. Ideally, the number would be 40, according to Bob Bax, a DMH spokesman.

"In the current budget year, we got funding for 40 new positions. By going through SB40 Boards, we were able to generate funds to support 53 positions," Bax said. Privatizing caseworkers is cheaper, in part, because there are fewer employee benefits.

About 167 casemanagers throughout Missouri are already managed by SB40 Boards, which distribute county tax money to agencies that provide services for people with mental disabilities.

In Cape Girardeau County, money from SB40 Boards currently goes, in part, toward providing transportation for those with disabilities and to a sheltered workshop, a service shop that employs adults with physical or mental disabilities.

Robert Landgraf, chairman of the Cape Girardeau County SB40 Board, said the board has not yet discussed the DMH's proposal.

Outside of Southeast Missouri, the plan to outsource casemanagers will continue and must be approved by legislators.

Six state representatives and senators were present at the meeting in Poplar Bluff. State senator Rob Mayer, R-Dexter, was pleased to receive the letter from Schafer, he said, but wants to know who will take over case management if SB40 boards don't want to, how many people currently don't receive services because of a backlog of clients and how private companies will avoid conflicts of interest.

Some parents have expressed concern that private companies would "cherry pick" clients, only providing services to easy consumers and not the severely disabled.

"For now, they have not answered my questions. Until that happens, that transition is still uncertain," Mayer said.

lbavolek@semissourian.com

335-6611, extension 123