Cuts for Mental Health care for Poor in Massachusetts

The October 15 issue of the AMERICAN HEALTH
LINE features a BOSTON GLOBE report about cuts in mental health care for poor
Massachusetts residents. BOSTON GLOBE reports that further cuts to what is
already being called a "...strained mental health system..." for the state's
poor are "...raising fears that many children and adults with serious
illnesses will not receive the hospital or outpatient care they need."
According to a recent study of Massachusetts' new Medicaid contract by a
coalition of 90 mental health care providers, mental health spending for
Medicaid patients will be cut 15% this year, a $26 million reduction from last year's $175
million budget.

The new contractor for the program, Massachusetts Behavioral
Health Partnership, plans to halt reimbursement next March to "
hospitals across the state for providing care to acutely mentally ill
patients who have no insurance." Hospital officials said that the cuts will
"...lead to more fragmented hospital care for poor people with mental
illness..." because they will have to "...try to get compensation from the
state's already overburdened free-care pool."

Behavioral Health Partnership assumed management of the state's
Medicaid mental healthcare recipients from Mental Health Management of
America July 1. The contract includes 30,000 acutely ill and emergency
patients "...previously served by the state Department of Mental Health,"
BOSTON GLOBE reports. In addition, enrollment in the state's Mental
Health/Substance Abuse program is expected to grow as a result of the state's new healthcare
access law. Currently, the program serves 378,000 Medicaid recipients;
another 40,000 to 60,000 people are expected to join this year.

State officials said the new cuts to the system "...will onlybe between..."
6.3% and 8.6%. Sherral Crown, head of the Mental Health/Substance Abuse
program at the state Division of Medical Assistance, said that the number of
uninsured will diminish because of the new healthcare access law.

Crown and Behavioral Health Partnership CEO Richard Sheola said that
"innovative programs" intended to reduce expensive hospitalizations would
lead to savings. Also, the state raised the cigarette tax to help pay for the
new enrollees.

Consumer advocates argue, however, that hospital lengths of
stay "...have already been pared to the bone." According to state figures,
the average monthly stay for adult mental illness patients dropped from 13
days in 1992 to about 12 days in 1993. Stays for recipients under age
21 fell from an average of 24 days in 1992 to 17 days in 1994. Bonnie Gorman
of the Massachusetts chapter of the Federation of Families for Children
Mental Health, said, "At some point, I think we are going to be talking
about drive-through psychiatric care, and that really disturbs us."
Advocates said that, due to Weld administration cutbacks, "
mental health programs are overwhelmed and ill-equipped to handle the
additional load." Thomas Barker, director of specialty hospital policy at
the Massachusetts

Hospital Association, said the cutbacks will put " additional burden on
the health safety net that people have proven already is torn." Betsy Wright,
executive director of the Massachusetts Human Services Coalition, commented,
"It is ironic that an administration that wants to get people off welfare
and into work would try to save money by cutting back on the services that help
families become ready for the workforce"

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