September 11, 2005

Testimony Urges Congress to Stop Medicaid Cuts

Robert Sheehan, chief executive of a community mental health center in Michigan and a member of the National Council for Community Behavioral Healthcare, testified before the House Energy and Commerce Committee on September 8, 2005. He made a powerful appeal to Congress to stop proposed cuts to Medicaid funding for services which help people with serious mental illnesses recover and live full lives in their communities.

The testimony was delivered in the context of proposed Medicaid cuts to the tune of $10 billion that the House Committee on Energy and Commerce and the Senate Committee on Finance are expected to clear in the week of September 12 as part of budget reconciliation legislation. These cuts will seriously impact public mental health services in the United States, more than half of which are funded by Medicaid, according to the Substance Abuse and Mental Health Services Administration. Two essential types of community mental health services that the proposed cuts will practically wipe out are targeted case management and rehabilitation.

“Ironically, these threatened services—case management and rehabilitation—lie at the center of our nation’s community-based approach to treating mental illnesses. It is these very services that are focused on engaging Medicaid beneficiaries in self-care activities that effectively improve clinical outcomes and reduce the use of costly hospital-based care,” explained Sheehan.

Self-care or empowerment of consumers with mental health illness is the goal and the proven outcome of Medicaid-funded case management services provided by community mental health centers across the nation. A typical example is the services provided by the Community Mental Health Authority of Clinton-Eaton-Ingham Counties in Michigan, which Sheehan heads. This center provides case management services to over 1,800 people with serious illnesses such as schizophrenia and bipolar disorder. Case management workers teach consumers illness management and medication use skills. They also link consumers to a full range of needed healthcare, rehabilitative, and social services and supports to help them regain an optimal level of functioning and live successfully in the community.

Empowering mental health consumers for self-care and independent living helps to avoid a drain on public dollars from potential negative consequences such as hospitalizations, jail sentences and even suicide.

Mental health rehabilitation services, which are threatened by the proposed Medicaid cuts, are also widely recognized as important in achieving good clinical outcomes and restoring functioning to consumers with mental illnesses.

Sheehan commented that it is ironic that Congress is considering measures that would result in a catastrophic loss of funding for case management and rehabilitation services, when the President’s New Freedom Commission on Mental Health has established recovery from mental illness as the goal of the U.S. mental health system. The commission calls for the expanded use of case management and rehabilitation services under Medicaid to help accomplish this goal.

“I urge you to preserve and support services such as case management and rehabilitation that focus squarely on developing the skills of mental health consumers so they can participate in their treatment, experience recovery from psychiatric disability, and live full lives in their communities,” Sheehan appealed in his testimony.

Sheehan also urged against other harmful Medicaid reform proposals such as increasing co-payment and cost-sharing requirements for beneficiaries. He pointed out that such measures have been proven to disrupt access to critical services and medications for the most vulnerable populations with mental illnesses. Consumers who have lost access to regular psychiatric treatment or medications because they cannot afford co-pays have lost their jobs, housing and sometimes their lives. Loss of regular care also drives up overall costs in the healthcare system as these consumers end up in the emergency room or have to be hospitalized.

Source: National Council for Community Behavioral Healthcare (NCCBH)
Contact: Meena Dayak or 301-984-6200 ext. 228 (office)/301-602-8474 (cell)


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