Many Utahns to lose mental health services

Nearly 10 percent of poor Utahns who receive government mental health services could lose them because of changes in the federal rule over how Medicaid dollars are spent.

In the next six months, a projected 4,332 residents — 825 of them children — will not receive treatment at the 11 public mental health centers across the state, administrators say.

At Central Utah Counseling, 300 people who have received services for years have already been turned away because the center can only afford to treat those who are eligible under the joint state/federal Medicaid insurance plan.

"Really, it is a safety net. . . . We are the very thin blue line sometimes between insanity and someone taking their own life," said executive director Doug Ford. "Our services have already been stretched thin, and in the rural areas it is just impossible to keep pace with the demand."

The funding shortfalls stem from a federal rule that went into effect as a result of the Federal Balanced Budget Act. The rule altered the formula for how mental health centers are reimbursed with Medicaid dollars.

Previously, the centers could collect one Medicaid dollar for services to Medicaid patients, even though the actual costs were only 93 cents. The remaining seven cents of "profit" could then be used to expand services in the community, including offering help to those who are non-Medicaid eligible.

Lawmakers and ultimately taxpayers will be asked to stem the crisis brought on by a shortfall approaching close to $8 million across the state, a funding blow that means fewer treatment options for those with mental illness.

The state Department of Human Services, whose top leaders met with the governor Monday, is expected to ask lawmakers for a supplemental appropriation of $2.4 million in the 2005 general session of the Legislature to see it through the rest of the fiscal year that ends June 30. Another $6.4 million request is on the table for the coming year to assist providers across the state.

State officials are also seeking a waiver from the federal government because the state has failed to maintain its funding levels in mental health and substance abuse over a two-year period. Because it did not meet the "maintenance of effort" requirement, the state is in jeopardy of losing $700,000 in federal money if the waiver isn't granted.

Ford said before the rule change, the extra money allowed centers to subsidize services for those who aren't on the Medicaid rolls but certainly couldn't afford a $150-an-hour mental health assessment.