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Mixed news on mental health care

By Taylor Sisk
Staff Writer

With the passing of the state budget for fiscal year 2010-11, the legislature has returned $40 million that was removed from the budget last year to help communities provide mental health care services. That’s good news, as is the $29 million being provided to local management entities for inpatient beds in local and state hospitals for those suffering mental illness.

The bad news is that if the federal government fails to come through with more than $500 million in previously expected Medicaid funding, major additional cuts could be coming this winter.

And here in Orange County, though Carrboro’s Club Nova will get the same $99,000 it received last year from the state, it will be facing a $25,000 reduction in funding from other sources.

Of the effect the new budget will have on mental health care services, Rep. Verla Insko said, “I’m generally pleased. But I’m concerned about shortfalls.”

Insko represents Orange County and co-chairs a legislative oversight committee on mental health. She said that when cuts were made to the state Department of Health and Human Services’ budget last year, certain tools could have been provided that would have helped its staff meet the new targets. Some of those tools are now available.

“We’re in a better place this year to meet the targets,” Insko said, citing, for example, software that will identify, before they’re paid, providers that overbill. “We’re getting smarter about finding ways to avoid these shortfalls.”

Regarding the $500 million in Medicaid funds that may or may not be coming from Congress, Insko said, “I think it’s an election issue. I don’t think we’ll hear anything about that till after the election. But I think we’ll get at least part of that money.”

Insko is concerned, though, about the potential for further cuts in Medicaid reimbursement rates if some or all of that money doesn’t come in. “We’re in danger of losing providers,” she said.

Meanwhile, Club Nova is awaiting word from Raleigh on either of two actions that could have a significant bearing on its future. Club Nova, which operates under a clubhouse model, primarily offers psychosocial rehabilitation (PSR), helping individuals diagnosed with mental illness develop essential coping skills.

In addition to the reduction in its funding, Club Nova is dealing with several developments that have threatened its viability. Changes to be implemented later this year in how mental health care services will be provided across the state mean that Club Nova most likely will no longer be allowed to provide community support team services. These services are complementary to PSR and, because the reimbursement rate is so low for PSR, have helped Club Nova stay in business. The PSR rate was reduced in October 2009 and Club Nova has scrambled to stay in business since.

It now awaits word on bills in both the state Senate and House of Representatives that would examine and perhaps raise the rate at which clubhouses can be reimbursed for PSR services.

But executive director Karen Dunn said sources at the state mental health division have indicated to her that, independent of the outcome of the bills, the state may return reimbursement rates for those services to the previous rate or perhaps a bit higher.

As for now, Dunn said, “It’s pretty astounding that we’ve been able to stay afloat.”

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