Mental Health Takes a Hit

Last week’s House budget had great news for many concerned with state funding and programs.  This was particularly true in areas like child welfare, which traditionally has had a limited group of advocates able to work to secure funding.  However, after cuts proposed by the governor of up to 20% to some key programs at DSHS, many services fared pretty well.

Not so in mental health, which after getting hit repeatedly in previous budget chops, got hit with another $40m cut.  From the House budget, agency detail, page 74:

1. RSN Medicaid Rates – The Department contracts with Regional Support Networks (RSNs) to provide state plan community mental health services to individuals enrolled in the state Medicaid program. Effective May 1, 2012, RSN Medicaid capitation rates are reduced to the bottom of the rate ranges that are certified as actuarially sound. In accordance with a corrective action from the Center for Medicaid and Medicare Services on the Department’s 1915(b) waiver, effective July 1, 2012, RSN capitation rates are further reduced to reflect the elimination of optional 1915(b)(3) waiver services which consist of supported employment, clubhouse, and respite. (General Fund-State, General Fund-Federal)

2. RSN Non-Medicaid Funding – The Department contracts with RSNs to provide crisis, involuntary treatment and other mental health services that are not reimbursed under the Medicaid program. Reductions of 5.2 percent are made to RSN non-Medicaid funding effective May 1, 2012.

While yesterday’s Senate version makes much smaller cuts of about $20m versus $40m, the toll adds up.  And, like vaccines, there is a clear public health risk associated with underfunding mental health.  If you’re wondering what that looks like, look no further than a link I saw at Crosscut this morning.  This story from Bloomberg highlights a Seattle story to demonstrate the weakness of mental health care in our system today.

Adam had U-turned directly into oncoming traffic. On impact with his car, Elisa’s side of the Explorer crumbled like a candy wrapper. Once his car came to a halt, Adam climbed out, jumped over a guardrail into traffic and was hit by five vehicles, police reports say. He died at the scene. Elisa succumbed to injuries three weeks later.

Their deaths lay bare continuing failures of the U.S. health care system in treating the seriously mentally ill, and in protecting the public from their disturbed behavior. Adam’s parents say he died because a series of hospitals sent him home too soon in the turbulent final months of his life.