Gazette opinion: Community will suffer with new gap in mental care

2013-10-07T00:00:00Z Gazette opinion: Community will suffer with new gap in mental care The Billings Gazette
October 07, 2013 12:00 am

Need for mental health care of indigent Montanans has grown faster than funding.

As a result, the Mental Health Center in Billings has stopped taking on new clients for the Mental Health Services Plan, according to Executive Director Barbara Mettler. That state-funded program was created to help low-income Montanans with serious mental illnesses who don’t qualify for Medicaid. The plan has never been an entitlement; it is limited to the amount of money appropriated by the biennial Legislature.

“We are going to have waiting lists,” said Yellowstone County Commissioner Bill Kennedy, who chairs the Mental Health Center Board. “We are in dire straits again. We have had growth in the community, but the dollars have not grown with the community.”

The Montana Department of Public Health and Human Services makes quarterly block grants to the four regional community health centers for most of the Mental Health Services Plan care they provide. That pool of money has come up short for the Billings center, which serves 11 south-central counties.

There are remedies for this mental health care gap. Unfortunately, none will be fast enough to help needy people this fall.

- The Mental Health Center should assist clients whose income is above poverty level with signing up for federally subsidized private health insurance on the new exchange. Coverage won’t start until Jan. 1.

- The Montana Legislature should adopt the Medicaid expansion proposal Gov. Steve Bullock backed in the 2013 session. The Medicaid expansion rejected by the 2013 Legislature would have covered people with incomes up to 138 percent of poverty level, including about 90 percent of those now eligible for the Mental Health Services Plan, according to DPHHS. The Legislature is scheduled to reconvene in January 2015.

- DPHHS is working on a federal Medicaid waiver that would cover a limited number of Montanans who have major depression. If that effort is successful, some people who have been eligible for the Mental Health Services Plan would shift to Medicaid.

- The U.S. Department of Veterans Affairs needs to pay up. As of last week, VA was $220,000 in arrears with some bills dating back to January. The center has a contract with VA to provide outpatient services to veterans in the 11-county region. Services to veterans will continue despite the VA’s slow payment, said Mettler.

Much of the Mental Health Center cash crunch appears to be a symptom of insufficient communication between community mental health centers and state officials.

We call on Gov. Steve Bullock and DPHHS Director Richard Opper to work collaboratively with the mental health centers based in Billings, Miles City, Missoula and Great Falls.

Mental health access is a taxpayer issue. When the Mental Health Center doesn’t have money to see needy outpatients, we all pay. Those who don’t get help when needed get worse and are more likely to wind up in the state psychiatric hospital at Warm Springs.

Nearly every week, The Gazette reports on efforts to reduce the state’s terribly high suicide rate. One of the reasons why our state has one of the worst suicide rates is lack of timely access to affordable mental health care.

This gap in the mental health safety net is a life-or-death matter for Montanans.

Copyright 2014 The Billings Gazette. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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