Early in the process HPU met with QA coordinators to establish uniform standards for collecting and reporting to set benchmarks for performance across the state. Because this effort was not successful, a requirement was put into the contracts for establishment of goals, objectives and benchmarks for their own areas. This was met with a arying degree of success across the programs. The HPU has been providing a substantial amount of help to organizations. The HPU also found a lack of psychiatric services and expertise in speciality areas.
Some areas have difficulty in attracting psychiatrists and other medical staff to their area.
Several organizations had their board of directors composed entirely of providers which makes it difficult to impose standards. Changing to a managed care philosophy was difficult for some. Anne Potter stressed that for some people more intensive and frequent therapy is more beneficial that brief therapy sessions. Kathryn Ross noted that they hope to see more flexibility and individualized treatment plans. Madeline noted that if systems set up group programs for therapy then there are no individualized goals.