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Value Options is Neither – An Open Letter to Tom Warburton, Vice President of Corporate Communications, Value Options, Inc.

Chrisa Hickey13 comments5071 views

Perhaps you read about Pickles, the eight-year-old girl with Schizoaffective Disorder that Value Options is trying to have removed from her residential treatment facility against the medical advice of her treatment team.  Adrienne Jones of No Points For Style wrote this brilliant blog post about the situation, which is still ongoing.

Adrienne and Pickle’s mom are dear friends of mine (that’s the three of us, in the picture above, in Los Angeles three weeks ago), and I have reasons to despise Value Options of my own. So I took it upon myself to add a link to Adrienne’s blog post on every posting Value Options made to their Facebook page over the past 30+ days.  They never stay.  They are removed, usually within a day, but I keep posting them anyway, hoping they will be read by the people at Value Options and anyone who thinks working there might be a great way to help their fellow man (hint: it’s not).

Today, via Facebook, I got this email:


Dear Ms. Hickey,

I’m writing regarding your active online campaign against ValueOptions. I believe your persistence comes from a place of compassion for a story you read online and after reading your own blog, it is obvious that you are very passionate about the advocacy of mental health care in the United States, especially when it comes to minors.

We hope you understand that we share this passion. Our company was founded by clinicians and many of our employees are practicing clinicians. Many of our employees have friends and/or family members who are suffering from mental illness and/or substance abuse disorders. Many even suffer themselves. Our mission as professionals and in our personal lives is to help people live their lives to the fullest. We are not in the business of denying care for those that need it. In fact, we believe it is our job to make sure that we manage resources in the most effective manner for those that need. And as I am sure you are aware, funding for mental health treatment is dramatically underserved in both the private and public sector, so resources are scarce indeed. Our goal is to advocate for more spending – public or private – when it comes to mental health and substance abuse treatment. Our goal as a company is to make behavioral health a forefront topic in the national debate, and we have made and continue to make much headway to impact the landscape for effective, accessible care.

Regarding your apparent concerns, I’m sure you know we can’t discuss the confidential facts of any particular case with you. But we do have a few questions for you to consider. Are you sure that you have all the facts in the case you reference? Are you sure that your continued postings are a benefit to others who may need and rely on ValueOptions mental health services? Are you actually driving away those potential jobseekers who share a passion for mental health care? Perhaps those job seekers might help our company become even more responsive and dedicated to the needs of individuals.

From personal experience, we would think you would agree that navigating our health care system is never as cut and dry or as black and white as we would like it to be. But we do our best to make it as seamless as possible for our members, especially those with critical needs. On a national scale, there is an enormous challenge we face, but we work hard to offer individualized services to all our members, because everyone we serve has a unique behavioral health concern.

So again, we hope that you understand that in many ways, we are fighting for exactly the same mission as you and others out there. We ask that you discontinue your repeated attacks, and let us focus on addressing the needs of the individuals we serve and building bridges with like-minded individuals such as you. Now more than ever we should link arms to help move the agenda forward for mental illness. We hope you will consider this request.

Tom Warburton
ValueOptions

Here is my answer:

Dear Mr. Warburton:

Thank you for your letter. Let me correct a few incorrect assumptions:

1) I didn’t just read the story of “Pickles” online. The author of the blog post and “Pickles” mother are personal friends. We advocate for our children with mental illness together, a fact you can witness next Wednesday, February 6, on The Ricki Lake Show, where we all appear together to discuss childhood mental illness.

2) If you read my blog, then you know I am the mother of an adolescent with an Illinois ICG, a program administrated by Value Options under the umbrella of “The Collaborative“. As such, I am subjected to a quarterly inquisition by your organization about whether my son still needs treatment for his psychotic disorder. I am also aware of Value Options current trend of issuing 30 day discharge notices to ICG kids – including my son’s roommate at ODTC  – against the medical advice of their residential clinical staff.

To answer your questions:

1) Yes. I’m sure I have all the facts, as I said, “Pickles” mother is a personal friend.

2) Yes. I think it’s important that anyone looking to your organization to be an effective case management organization needs to realize that, your posturing aside, you are ruled by the almighty dollar, above the best interest of patients.

3) I would hope my postings are enlightening those that might apply, thinking they would be able to help, would likely just be sucked into the giant machine of for-profit mental healthcare denial that seems to be your specialty. You are correct that navigating our nation’s healthcare system is a difficult challenge. I have nearly 2,000 readers a day and I support hundreds of parents a year in navigating Social Security, Medicaid, and Special Education. And if I had an inkling that we were fighting the same battle, I’d be happy to support your efforts. But you are a for-profit enterprise whose actions betray the words you write. I hope you will consider my response and reflect on whether your organization truly has the best interest of the people you are charged with managing, or your board and investors at heart.

Regards,
Chrisa Hickey

13 Comments

  1. You go girl! although I'm in Canada, we are fighting for the same thing here in Canada and I know you 'get it' when you speak on behalf of families you have helped support and navigate. Keep doing what you do! and God Bless

  2. Excellent. God help those who try to tangle with mothers of children with mental illness…we are the fiercest breed of mama bears <3

  3. We really need more people like you advocating for children and adults with mental illnesses. I was diagnosed young, and I am greatful that I live a fulfilling life reguardless of my disorders.

  4. I have a son who is in a Therapeutic Boarding School. The accommodations charges are not covered but the Group and Individual Counseling sessions are. To get the claim for 4 months in 2012 processed required over 40 hours of my time and many, many long frustrating calls to ValueOptions. I was given advice on one call which I followed, only have the claim denied, called back in, and was given 180 degree contradictory advice. The claim for the first 4 months of 2013 was denied first for using the wrong form, which upon calling back Customer Service the agent advised was Claims Processing error. Upon resubmission the claim was denied for wrong procedure codes. When I called back the Customer Service agent advised the procedure codes were correct. So 2 months after initial submission the claim is still not paid and is in the cycle of routine and spurious denial.

    The John Grisham novel, the Rainmaker, is about a lawyer taking on one of the most powerful, corrupt, and ruthless companies in America, Great Benefit Life Insurance — and exposing a complex, multi billion-dollar insurance scam. Their business practice was to routinely deny claims for no legitimate reason. My experience with ValueOptions seems to track closely to the story told in the novel.

  5. Dave, I wish your story wasn't common. Value Options has no desire to manage care. They are very often paid for performance, and that performance, for states with horrible budget deficits, is to reduce spending to the bone. And I agree with you – my experience with Value Options is the same – deny first, review later.

    Contact your state congressman and senators. Write letters. Keep up the pressure. It's exhausting, I know. The more of us that do so, however, the more chance we have to affect change.

    Thanks for sharing your story.

  6. We reviewed sending my daughter to a residential treatment center at the recommendation of the psychiatric hospital she was sent to (her second trip to a hospital). The RTC said they contacted ValueOptions who said it would be covered 100% if medically necessary. 3 different treatment centers gave the exact same info. We felt pretty relieved and confident that insurance would take care of this and we finally found something that might actually help my daughter since my husband, myself and many different therapists and psychiatrists in outpatient programs were unable to. We had to pay the 1st month and last 2 months as a deposit that we expected to get back once the insurance company paid. After shelling out $28k we were just told ValueOptions denied the benefits and recommended an outpatient program vs inpatient (which has been attempted twice unsuccessfully). Now I am gearing up for a fight and am saddened to read this is not going to be as easy as I hoped. If forced to take my daughter out of treatment and she commits suicide can I sue ValueOptions for murder?

  7. Hello there, as someone who is considering a switch in medical plans, I found that Valueoptions was the provider for mental health. Given that I suffer from several such conditions, having seen this blog post has solidified my decision to avoid them. Thank you for posting, I do appreciate it.

    (Borderline personalities don't take kindly to denied claims, best to avoid that)

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