WA: Mental Health Integration Takes Center Stage in Senate

The Senate Ways & Means Committee held a work session today on the question of integration of medical and mental health purchasing.

The two-hour session included a presentation from committee staff.  The presentation highlighted how clients from the DSHS/RSN mental health system are also often clients in the HCA/medical system.  Although the impacts on each system are high, they are broadly uncoordinated.

Mental Health HCA slideIn fact, across all sectors of Health Care Authority (HCA) medical benefits, Medicaid beneficiaries who receive mental health services are more costly than non-mental health patients.

A number of panels were presented to testify on the issue.

Jean Robertson, director of the King County Regional Support Networks (RSN), said during her comments that she’d like to see the RSN allowed to provide primary care services.

Gordon Bopp, president of the Washington chapter of the National Alliance on Mental Illness (NAMI), expressed concern at length about managed care entities taking over decisions about mental health illness, specifically citing the potential for decisions about psychotropic medications to be driven by cost rather than effectiveness.

Medicaid health plans Molina, Coordinated Care, and Community Health Plan of Washington (CHPW) spoke from the medical perspective.

Molina’s vice president of behavioral health plans, Dr. Taft Parsons, testified. Molina Healthcare of Washington has been without a plan president since the recent resignation of Bela Biro. Dr. Parsons flew in from California to fill in.

Mental Health HCA slide 2

This was interesting given that Molina has significant integration experience in Washington State.  Apparently, however, they don’t have anyone in the state to speak to the issue.

Dr. Jay Fathi, President of Coordinated Care, spoke next.  He called the separation of mental and physical health funding a “business construct” rather than a function of good care delivery.  He said the current model “does not logically or optimally integrate these funding streams.”

While not out of the ordinary, the fact that this topic was taken up in the Ways & Means Committee is noteworthy.  Both the Health Care Committee and the Human Services and Corrections Committee have some jurisdiction on the issue.  However, both committee chairs have been reluctant to bring up the integration issue.