The Indiana General Assembly passed a bill which is expected to soften the blow of federal Medicaid changes on local mental health services.According to Bowen Center President/CEO Kurt Carlson, the legislature passed Senate Bill 350, which will allow money counties contribute annually to local mental health organizations to be sent directly to the state to help bring in federal Medicaid dollars. The state funds Medicaid programs and the federal government matches those funds. Carlson said the state typically spends about $1 for $2 of federal Medicaid funding.
The changes to Medicaid came in the form of the Deficit Reduction Act of 2006. The federal bill slows the flow of Medicaid funding by narrowing the definition of what types of funding may be used as matching dollars from the state for Medicaid. Before the rule change, Carlson said, Bowen Center was allowed to contribute directly to the state's side of funds for Medicaid dollars. Some of the money Bowen Center contributed was annual funding from Kosciusko County.
When the Deficit Reduction Act was passed, Congress put a moratorium on the bill, but that moratorium is set to expire on May 25 if it is not renewed.
On March 4, before SB 350 passed, Carlson told the Kosciusko County Commissioners the Deficit Reduction Act could reduce the amount of funding his organization receives for mental health services to a region including Kosciusko, Allen, Huntington, Marshall, Noble, Wabash and Whitley counties. As a result, Carlson told the commissioners, Bowen Center would have to reduce Medicaid expenditures by about $3.5 million per year and eliminate approximately 35 case manager positions organization-wide by May. The changes would put in jeopardy several residential mental health programs serving more than 100 people in the region.
This morning, Carlson said the passing of SB 350 would reduce those cuts. He said Bowen Center will still have to cut about 23 positions if Congress does not renew the moratorium on the Deficit Reduction Act.
"We're still going to have to shrink a little bit, but not as much as if [SB 350] didn't pass," he said. "It reduces the severity of it."
Carlson said only a few of the 23 cut positions will come from Kosciusko County.
The state bill does not completely eliminate the threat the Deficit Reduction Act poses to clients living in residential mental health facilities. If left unchanged, the federal legislation would affect when residential mental health services can be billed through Medicaid. If the rule change goes into effect, not-for-profit mental health centers like Bowen Center would not be able to continue billing Medicaid for case management services after a client stabilizes through treatment.
Carlson said mental health clients almost always need continued case management to maintain their mental health after they stabilize. Without Medicaid funding, Carlson said most residential clients could not pay for the services. The residential programming Bowen Center provides at Shady Rest Home, Plymouth, and Russel House, Warsaw, Carlson said, would likely be the most affected.
Carlson said, if that happens, some clients could face homelessness.
