Changes in Medicaid funding may negatively impact mental health services offered in Kosciusko County, Bowen Center President Kurt Carlson told the county commissioners Tuesday.
Carlson said the federal Deficit Reduction Act, passed by Congress in 2006, could reduce the amount of funding his organization receives to provide mental health services to a region including Kosciusko, Allen, Huntington, Marshall, Noble, Wabash and Whitley counties.Carlson said, without further government intervention, 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, Carlson said, would put in jeopardy several residential mental health programs, which serve more than 100 people in Bowen Center's service area.
The state funds Medicaid programs and the federal government matches those funds. Carlson said the state typically spends about $1 for $2 of federal matching dollars. Carlson said the Deficit Reduction Act chokes the flow of Medicaid funding by narrowing the definition of what qualifies as matching dollars from the state for the federal assistance. Before the rule change, 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.
Carlson said Congress put a moratorium on the rule change when the Deficit Reduction Act was passed, but the rule will go into effect if the moratorium is not renewed before May 25.
For Bowen Center, Carlson said one of the most dangerous parts of the rule change affects 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 Russell House, Warsaw, Carlson said, would likely be most affected.
"If they lose those benefits, they'll be out on the street," he said. "I don't think the federal government tried to create homelessness. I think it was an unintended effect."
Carlson said, besides a renewal of the moratorium on the rule changes, Senate Bill 350, which is scheduled to go before conference committee in the Indiana legislature, could reduce the loss mental health centers face.
Senate Bill 350 would allow money the county usually contributes to Bowen Center to go directly to the state to be used to fund Bowen Center's Medicaid-funded services.
Carlson said the bill would allow the county's money to still be used to bring in federal dollars, but he admitted it's not an ideal answer.
"None of us feel comfortable relinquishing control of these dollars to the state," he told the commissioners. "There will be a reduction, this just reduces the amount of reduction."
