Thursday, September 29, 2016

Fight on mental health money isn't over yet

Posted By on Thu, Sep 29, 2016 at 7:16 AM

The Hutchinson administration push to cut Medicaid reimbursement for mental health treatment, thought to have been settled last week, is back on the Legislative Council agenda Friday.

The agenda shows a motion to expunge the vote that adopted a report of the Administrative Rules and Regulations Subcommittee. That vote left some in the room scratching their heads about what they'd done and a fierce lobbying campaign is underway to preserve funding for regional mental health centers that say the proposed cut could force closures.

The proposal caps spending by reducing billable group therapy from 90 minutes daily to an hour and a cap of 25 sessions per year. Medicaid Inspector General Elizabeth Smith has said the two caps could save $50 million or more a year based on past experience, about 30 percent of which is state match for federal money.

The mental health community has hotly objected in part because they insist the inspector general has made a flawed comparison of costs between Arkansas and other states. While the amount billed for group therapy is admittedly much higher here than in other states, advocates for the centers contend that centers in other states recapture more money with separate per diem charges. They acknowledge the formula for spending should be changed and that, indeed, there's a reworking of mental health services due to take effect in July. In the meanwhile, an instant cutoff of the old formula will have devastating impact on the centers and, by extension, the patients, who would be turned out on the streets where law enforcement would have to cope with mental cases.

Suspicion lingers that Gov. Asa Hutchinson is looking for an instant windfall cut in spending to shore up plans to push more tax cuts in the 2017 legislative session, but he hasn't said that is his aim. Some tax cutters in the legislature, such as Rep. Charlie Collins, have, however, been dismissive of mental health providers arguments. He's never met a program he wouldn't like to cut, no matter how beneficial.

It will take an extraordinary vote of those present Friday to overturn the earlier approval, but pledges reportedly have been gathered. Getting people in the chairs is always a problem when large votes are necessary.

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