You are the executive director of a small publicly funded behavioral health agency that serves indigent clients. After 10 years
of being able to serve all clients seeking help, your agency has just received a 20% budget cut and must prioritize which services to discontinue and which clients to turn away. The community has many suggestions: stop serving undocumented immigrants and their children; stop serving substance abuse clients, limit all clients to six sessions, discontinue providing expensive services like psychiatry, lay off professional counselors and hire non-licensed paraprofessionals, stop providing counseling and instead simply offer peer self-help groups and parenting classes, serve only the most seriously ill (or the least seriously ill), and serve only children. How would you approach the difficult task of cutting services by 20% in a manner that reflects your ethical obligations as a community counselor? Would your plan differ if you were in a private sector? If yes, how? What criteria would you consider? What theoretical or standard of care practice will you follow to make a final decision about what to cut from your program? Reference the ACA or ASCA Code of Ethics to support your answer.
When we talk about reduction of costs in a sector such as the health sector, it is paramount that the decisions taken are wisely done and also the best possible. So that every possible need is met to the best capacity.
For the needy, stopping treatment is wrong and should not be done. When there is an adjustment in budget, then a bit of prices could be put on some certain things which have high costs. A limit can be set on the frequency at which a person can visit the camp.
One criteria that can never be neglected is hiring skilled professionals and this should never be violated. The standard of care should not be limited.
In a private firm this decision could be different since funds may be high and better also advanced and better equipments may be afforded.
