By Debra Jasper
and Spencer Hunt
Enquirer Columbus Bureau

Ohio's mental health system is so convoluted it's easy for tax money to be wasted or misspent, officials say.

So many different agencies pay for services at centers that care for mentally ill children that two or more agencies might pay for the same treatment, says Barbara Riley, assistant director of the Ohio Department of Job and Family Services.

She says a new monitoring system to be in place this July will help keep track of tax money. But today, she says, "I can't say there is no double billing going on."

To underscore that point, the Montgomery County Prosecutor's office currently is going after an undisclosed, but "significant," amount of money that both Medicaid and the Montgomery County Juvenile Court paid for the same services to one of four treatment centers audited in 2002. Prosecutor's spokesman Greg Flannagan wouldn't be specific, citing an ongoing investigation.

Juvenile courts and Medicaid aren't the only agencies that pay a child's treatment costs, however. County child welfare agencies typically pay for a child's room and board. Local mental health boards pay for treatment and counseling. Community drug and alcohol boards pay for addiction counseling and drug testing.

County agencies also can pay vastly different rates to the same center for the same services. "One county might pay $100 for therapy, another might pay $180 for the same service, depending on the rates negotiated," Riley explains.

In many cases, county agencies don't get together to discuss a child's care or even to figure out how much tax money they are spending on one child overall. The state doesn't track spending, either, noting that local tax dollars usually cover 40 percent of the costs. Federal dollars cover the rest.

Riley says state officials need to do a better job tracking spending, ensuring that kids are actually getting the services billed to taxpayers and that those services are helping. She acknowledges her department has done "very few" random checks, but says, "We'll do more long-term."

Cheri Walter, chief executive officer of County Behavioral Health Authorities, which represents county mental health boards, also acknowledges the problems. "I'm not willing to say there is no double billing going on because we just don't know," she says.

She says kids lose if fixes aren't made. "Some mental health boards don't even know until they get the bill that a kid was even placed in a treatment center. And even then, boards have little control over how long a child stays or whether that child is getting the right services," she says.

"We tinker around the edges," Walter adds, "but nobody is biting the bullet and fixing this problem."