DMH presentations continue in House

JEFFERSON CITY- Missouri Department of Mental Health’s presentation to the House Committee continued this week with a focus on how funding reductions will effect Missourians access to Mental Health care funding.

The Department of Mental Health Director, Dorn Schuffman and Diane McFarland, Director of the Division of Comprehensive Psychiatric Services, provided the stark figures on the impact budget reductions have for those with or caring for someone with a brain disorder.

Medical Assistance for Workers with Disabilities (MAWD) is being eliminated. MAWD was implemented in July 2002, for individuals ages 16 to 64 who are disabled and work. Fifty-four percent of workers currently receiving MAWD would become ineligible.

Medical assistance to families eligibility is reduced from 100 percent of the Federal Poverty Level ($776 per month) to 30 percent of the Federal Poverty Level ($233 per month).

Dental and podiatry services would be eliminated for adults in Fiscal Year 2006.

Rehabilitation and Specialty Services, including hearing aides and associated testing, diabetic supplies and equipment, eyeglasses, manual and power wheelchairs, therapies, and hospice, would also be eliminated.

Medicaid would require a co-payment for all services. Consumers will be required to pay $.50 to $1.00 per unit of service. Providers are responsible for collecting the co-payment and are required to provide services regardless of whether they are able to collect the co-payment.

Psycho-social rehabilitation (PSR) consumers would pay for 24 units of service provided per day for a total co-payment of $24 a day, $120 a week, or $480 month.

“There are no alternative providers outside our system [for PSR],” McFarland said.

The general revenue reductions proposed by Gov. Matt Blunt would eliminate all state funding for community services for adults with serious mental illness who are not eligible for Medicaid. These community services include medication management, psycho-social rehabilitation, case management, and therapies.

The reductions eliminate current treatment capacity for more than 8200 adults, including community services for 50 percent (218 individuals) of the forensic clients who have been conditionally released from state psychiatric hospitals by the courts. Without this capacity, these clients could not meet the conditions for release set by the courts and would likely remain hospitalized.

Aftercare services for 35 percent (3600) of the individuals discharged from state psychiatric hospitals each year would also be eliminated.

The Community Mental Health (CMH) Block grant requires the DMH maintain its level of funding for community mental health services. A reduction in DMH funding results in a dollar for dollar reduction in federal funding in the following year.

Because 10 percent of CMH Block Grant funds must be spent on children, reduction in Block Grant funding will affect services for both children and adults.

Budget reductions will result in the loss of over $6.7 million in federal funds and eliminate all CMH Block Grant funding, current treatment capacity for more than 5,400 additional adults, and more than 600 children, and eliminate funding for suicide prevention activities.

The Neosho school district recently held a suicide prevention seminar from funding to be cut.

Approximately 5,800 Medicaid-eligible adults with serious mental illness will lose access to support employment, individual and group therapies, adult respite care, and transportation assistance.

McFarland said there has been a loss of more than 500 private psychiatric beds since 1998, a 23 percent reduction.

The Springfield region has had 172 beds close since 1996, a 46 percent reduction.

The number of state operated beds has remained relatively constant, however, admission to state operated acute care rose by 14 percent during the same period discharges of non-forensic long-term care clients declined by 40 percent.

The decline in discharges is the result of a shortage of available community support, said McFarland. Patients are not discharged unless there is support available.

Presentations by the Department of Mental Health will continue next Thursday.