The state health department is figuring out how to restore funding to health care providers who take Medicaid, but it may be too late for people in Libby and Eureka who need help with mental health.
"I don’t think we’ll be able to keep those offices open," Megan Bailey, a therapist with Sunburst Mental Health told a legislative committee Monday.
Sunburst offers case management for people who need help with daily living and other tasks in order to stay out of institutions. Bailey said her board meets later this week to consider closing the Libby and Eureka offices in the wake of state budget cuts made in January.
Those cuts were made because revenue forecasts said the state was facing a $227 million budget shortfall. New revenue numbers now say the state has enough money to restore cuts to payment rates for Medicaid service providers like Sunburst, but Bailey says it might be too late.
"From a business perspective, if we lose those offices, and rates do come back up, I highly doubt within the next decade I’ll be able to convince my board to leverage the quarter-of-a-million dollars necessary just to open in a rural community," Bailey said. "The money needed to do that is pretty extreme, and from a business perspective it really doesn’t make a lot of financial sense."
Bailey testified in front of a subcommittee with oversight of Montana’s Department of Public Health and Human Services, which made deep cuts at the direction of the state legislature and Governor Steve Bullock in the face of the projected budget shortfall. She was one of many who spent hours telling lawmakers about how the cuts affected their work, and who said that restoring the cuts alone isn’t enough. They said mental health care providers in Montana are asked to do too much in return for what they get paid.
Lisa Leon is a case manager for Sunburst.
"The reimbursement rates going down has made me have to have more productivity, the productivity goes up means more billing, the more billing that goes up means more I’m at my computer, not being able get productivity with clients that I can bill for, and it becomes this vicious cycle of me working an incredible amount of overtime off the books," Leon said.
Leon told the committee that case managers save the state money because they help their clients keep their lives on track and living at home, but budget cuts have meant case managers have had to take on vastly more clients. Too many, she says.
"I’m trying to keep this person out of the hospital, and this person out of jail, and this person’s not getting food, and this person just got their Medicaid cancelled or their housing cancelled because the case management was slaughtered," she said. "It’s becoming this just perpetual wheel of exhaustion, and we need case managers, we really do. I don’t even want to know how many people are being lost because of this and may die because of this."
Representative Kathy Kelker of Billings said she’s been encouraged by the work the Children, Families, Health and Human Services Committee has done lately to study the needs of people with developmental disabilities, and that could lead to new legislation to address their needs, but, "mental health seems to be more complicated than that, and I’m just wondering how we can begin to have an oversight role there."
The state health department is currently taking public comment on how to restore funding cuts made in January. Money to do so is expected to start going to Medicaid contractors in September.