Minnesota lawmakers cut back reimbursement rate reforms amid mental health care crisis
There’s a growing need for mental health treatment programs in Minnesota, but patient advocates and providers are warning that care will become even harder to find after lawmakers cut portions of a bill that would have significantly increased funding.
Most programs rely on reimbursements from medical assistance programs, like Medicaid. The state legislature sets the reimbursement rates.
A study released in January by the Minnesota Department of Human Services (DHS) showed the state’s medical assistance reimbursement rates for mental health coverage are far below the current market demands.
5 INVESTIGATES has previously reported on providers who are scaling back or closing completely, blaming low rates and lack of staff.
Providers say, on average, the gap between what it costs to do business and what they receive in reimbursement is nearly 40%.
With the rate study in hand, lawmakers proposed significant reforms to help close that gap.
But earlier this month, the House Health Finance and Policy Committee voted to remove the portions of a bill that would have increased rates in line with DHS’ proposed framework.
“We’re not meeting the need.”
Rep. Tina Liebling (DFL-Rochester), who chairs the committee, acknowledged they are unable to meet the needs of the mental health treatment provider community.
“When you have to put together the budget, you never meet all the needs,” she told her colleagues earlier this month. You always feel like there are people you’re disappointing and more importantly, that you’re leaving their needs — their critical needs — unmet. This is just part of our job, folks.”
Several Republicans on the committee argued that the funding gaps are due, in part, to the DFL majority’s budget, which was passed last year.
“We had an unaffordable, irresponsible, $30 billion budget last year, and this is what means: that we do not have adequate funding now to fund these essential services,” said Rep. Anne Neu Brindley (R-North Branch).
While the committee did include some funding for mental health programs and policies, patient advocates and providers expressed their disappointment in the cutbacks and said the most vulnerable individuals in the system would pay the price.
“Without a rate solution, we are stuck in crisis response, with consequences felt by the children and adults who rely on hospital boarding, juvenile detention and jail because they get sicker waiting weeks or months for care,” said Kirsten Anderson, executive director of AspireMN, an advocacy organization based in the Twin Cities.
Stuck in crisis
Dysfunctional. Impossible.
Those are the words Pat and Karen use to describe Minnesota’s mental health care system.
For the last six years, they’ve struggled to find and keep their daughter in treatment for her severe mental illness.
The 14-year-old girl has been admitted to Twin Cities’ emergency rooms a dozen of times, her parents say, often spending the night on a gurney in the hallway because there are no beds available for adolescents.
Pat and Karen have called dozens of programs, ranging from intensive inpatient hospitalization to agencies that provide at-home care.
But each time, they run into barriers. Programs often have waiting lists of six months to a year. They won’t take clients with complex needs because they don’t have enough qualified workers. Insurance won’t cover the care of the stay.
“It’s just kind of this rinse and repeat cycle, over and over again,” Karen said during a recent interview.
The couple worries that if the state doesn’t boost reimbursement rates, their fight will only get harder, and treatment programs will continue to close.
“There’s not one [provider] who’s ever said, ‘Yeah, this is a great system. Everything’s working the way it should,'” said Pat. “They all acknowledge that it’s a broken system.”