[BlackCanary]

I live in a big metropolitan area. My HMO is closing the mental health center where I go, and take my son. All of the staff will move to a suburban center that is 10 miles further from our home, 30-40 minutes further depending on traffic. It takes 25 min. to get to the existing center from home or work or my son's school. 55-65 min to the new center, each way. For a 45 min session or 1 hr 15min group, or 20 min medication appt.

I talked to the chief of psychiatry about how this will impact getting care for my son - his ADHD group meets at 4 PM, so he misses 30 mins of language arts each week as it is, his teacher is not likely to be tolerant of missing over an hour. The chief says "Well, I know you have to do what is best for your family".

There are no plans to replace the lost services in our part of the county. The HMO will open a gleaming new center 3 miles from my home, with no mental health care providers in that center.

I lost my first therapist in June last year, when he left the HMO. I will lose my second therapist this June, when she is moved to the suburban center, and my psychiatrist moves to a different center on the far edge of the county, 40 miles (for a 20 min medication management appt???). My son's practitioners will move to the suburban center too.

So, I am mainly venting my frustration , but also want to know if you think it's worth a letter of complaint? I'm not entirely comfortable with "coming out" as a complainer nor in having to share my status as a consumer of mental health services. My letter of complaint won't be confidential. If I lived in a rural area, an hr each way might be typical for most things. I live in an area where I can likely find 100 therapists within 5 miles of home. Time to complain? Get new insurance?

[Elli-Beth]

I have to drive 2 hours each way for my appts, so an hour's drive would be a dream!

Would a letter do any good, or just become a confidentiality issue? Is new insurance a viable option? Sounds like a lot of factors to think over...

[BlackCanary]

Thanks E-B -- Yeah, I am a bit of an insensitive jerk about the drive when I know that plenty of folks, esp in rural areas, have to go a long way to see a provider. My in-laws go 3 hr for a decent hospital. Since I live in a busy, populated area it's counter-intuitive to have a stress-filled hour long drive in traffic for a 45 min therapy appt. followed by another hour in traffic. There are likely 30 providers within 1 mile of my home, both adult and child therapists (but I can't use them because they are not in the HMO).
But, since it's an HMO, I'd have to find all new doctors for my whole family if I switch. ANd I'd have to wait until open season.

A letter might increase the odds of getting more mental health care at a close by medical center. Having NONE is so silly, I wish that the medical care and mental health care providers worked side-by-side.

[ladyjrnlist]

I am so lucky my T is 15 minute drive away and pdoc 25. Sorry you have to mess with this. I can't believe 10 miles adds that much time to your drive. Must be sucky traffic!

Oh gosh that is SO frustrating especially when your son already has to miss some school and you already have a drive as it is!!! I always have a drive too... my T (if I see her after work) is 35 minutes, and if I go from home its about a 60 minute drive. But, I have an hour drive to work every day so I am used to driving a lot. Its so frustrating, isn't it? Especially with the price of gas these days?
I think it would be worth it to speak up for yourself-- that would certainly be good, and probably make you feel better. But I wonder, what if what you wrote wasn't necessarily a letter of COMPLAINT, per se, but just a letter that was straight forward about how this was affecting you and your son, how these issues are a problem. You don't necessarily have to come across as "look what you're doing, this is pissing me off and i am so angry about it!!!" but as "this is what has been happening, and this is how it is affecting my family-- is there anything that can be done. i am thinking of changing providers/therapists/etc." That way it gets the issue out there, you get heard, and it comes across as straightforward, but not in a complainy way, just in a i need some assistance here kind of way.
Does that make sense?

[EvilPopTart]

I don't think a single letter of complaint will be of any use. You could try getting other people from the center to vent their anger on this. Maybe a letter of complaint signed by those who it affects, like a petition and send it to a higher up. It's worth a try.

[nannypat]

I also drive an hour and fifteen minutes one way on a good traffic day for my mental health care because of quality issues in my area. I was also a teacher, however, and I realize how much that time your son has to miss from language arts can effect him and now you are talking about more time.
I don't know if a letter of complaint will fix anything, other than give you a voice which may be what you want. Your options are difficult no matter which way you turn. I hope what every you decide to do, you will be happy with the care you find for yourself and your family.

[sunrise]

Originally Posted by BlackCanary

Time to complain? Get new insurance?

I don't think complaining to them will help. Yes, I do think it is time to get new insurance. Can you get out of that HMO? Then you can choose from quite a wide range of providers who won't have to relocate at the whim of the HMO.

The whole scenario you've described is so discouraging BlackCanary. The only thing I can think of to do is to change insurance, as you suggested.

[Snakebit]

Instead of a letter of complaint, try calling the HMO and see what they can do for you. Taking your son out of class is a large issue.

Good luck.

[BlackCanary]

Thanks all!
I definitely think that my approach to the HMO will probably be: OK, when will you be offering the services I need in my area? vs. telling them how stupid the move is because most of them likely know that! If they don't have near-term plans to offer the services, then I can make a decision about changing insurance.

For my son, the work-around will be to connect with another child psychiatrist who will be in our medical center 1-2 days per week. She can help us with medication monitoring - since he's growing it's very important. For a kid therapist, we will find someone in our neighborhood, may end up just paying out of pocket.

For me, I've got a great therapist now and don't want to start again. Also, I feel like we are near to a stopping point. So, I'll probably make the drive out to the new center once a month, maybe have a phone session, try to get to the point where I'm ready to stop. I'm going to wait and see. She's also hopeful that she'll get to move to the medical center where I go, esp. if members (like me) demand services in that area. The family practice team there has just one therapist.

What we all know, and our therapists know, is that the personal relationship is so essential, and so core to the care - you just cannot substitute one therapist for another. The higher-up administrators SHOULD know this - the bean counters only care about the beans.

[imapatient]

I, too, don't think a letter will help.

Two things to suggest:

As Sunrise already suggested, try to get a different HMO. That's hard to do because your son and you will have "pre-existing" conditions that very well might make any other HMO reject you.

The other thing to do is see if the HMO will let you go out of network--and still cover the care--to somewhere in a more convenient location for you. It's not unheard of. Since you're in a big metro area, I'm assuming you could find something closer--outisde your own HMO network--that provides the services you need. There should be some appeal policy on that. Don't do it on your own, this is the time to enlist the various providers you work with to help you identify other places to go, and have them "recommend" them to you, i.e. have them write something--as part of your appeal for out-of-network coverage--on your behalf to convince the HMO that they can't meet your needs in-network due to the location issues and that what you need is to go to specific alternatives that theywill say will be best for you and your son's (mental) health. Start with a discussion about this possibility with your pdoc.