Gazette opinion: Mentally ill Montanans struggle without Medicaid

2013-11-27T00:00:00Z Gazette opinion: Mentally ill Montanans struggle without Medicaid The Billings Gazette
November 27, 2013 12:00 am

On Jan. 1, this column called attention to the urgent need for affordable, accessible, high-quality mental health care for all Montanans.

So it is a great concern that the 11th month of the year is ending with our regional Mental Health Center out of money to care for indigent Montanans who don’t qualify for Medicaid. The Mental Health Center has been unable to accept new Mental Health Service Plan clients for several weeks.

The state Department of Public Health and Human Services and the center are struggling with a program that has more demand for indigent care than dollars to provide care. Barbara Mettler, Mental Health Center executive director, said Tuesday that it may be possible to speed up state reimbursements, but the total dollars available won’t change. The cash crunch may just be postponed a few months.

Meanwhile, the U.S. Department of Veterans Affairs finally has started paying on the $230,000 in bills it had backlogged since January 2013.

This month, VA paid more than $50,000 owed to the center from previous months, Mettler said.

“They are starting to get caught up,” Mettler said.

Tester prods VA

The VA payments started coming in after Sen. Jon Tester intervened. Tester, a member of the Senate Veterans Affairs Committee, brought up the Billings payment backlog with a VA nominee, and the senator’s staff has been in close communication with the Mental Health Center.

“They were instrumental,” Mettler said of Tester’s staff. No layoffs or cutbacks are planned with the VA reimbursements coming in, she said.

Through all this financial turmoil, the private, nonprofit center has still been seeing clients. There has been no interruption in services to veterans, which are provided on contract with the VA to veterans in Yellowstone and 10 neighboring counties. The Hub, Rainbow House and satellite offices in neighboring counties still provide regular, daily care.

Although the center is out of money for non-Medicaid clients’ therapy, case management and most other services, there is funding for people to see psychiatrists. Mettler has instructed her staff to continue evaluating and enrolling non-Medicaid clients, although they will be on a waiting list.

After the 2013 Legislature refused to expand Medicaid, the problem of indigent care remained. The need is in Billings, it is statewide, and it is getting worse as our population grows.

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

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