Advocates, lawmakers and state bureaucrats hope regulatory changes that will increase Medicaid reimbursement rates for mental health services and cut red tape for clinicians will help calm a growing mental health crisis in Arkansas.
For 18 months, a task force of mental health clinicians, lawmakers and Department of Human Services officials worked on a report on how to modestly reform mental and behavioral health care in the state. The Legislative Council of Arkansas, December 2. 16 endorsed the report, which served as a guide for DHS rule changes and will serve as a roadmap for lawmakers in future sessions. The state will increase Medicaid reimbursement rates to encourage more providers to support Medicaid patients.
“I hope this is a big step in the right direction. That’s my hope,” the state representative said. DeAnn Vaught, who sponsored the legislation creating the task force. “Do I think that’s going to make it all okay? No, because I think mental health is always changing.”
Teenage depression and suicide rates are on the rise while jails and jails are overflowing with adults suffering from a wide range of problems, from increased substance abuse to untreated psychiatric issues, Vaught said, a Republican from Horatio.
Those with behavioral health issues also need care, with a dwindling number of people on the ground able to provide it. Department of Human Services officials have proposed changes to state regulations that make it easier for workers in similar fields to fill behavioral health workforce shortages. Since much of the focus is on home care, the ministry will change regulations to allow non-professionals in similar health care fields, supervised by clinicians, to provide care.
Gavin Lesnick, spokesman for the Department of Human Services, said the agency had also finalized a list of rule changes that would reduce regulations for mental health care providers, known as the handbooks. The state Medicaid handbooks are a set of regulations about how the state pays for services and the rules providers must follow.
Some mental health providers said the current list of regulations is cumbersome, making it difficult to bill patients who participate in the state Medicaid plan.
“The manuals that DHS followed were old,” Vaught said.
The Certified Independent Practitioner Certification Handbook, which is only required for health care providers who accept Medicaid, contains 17 pages of rules that require clinicians to be online 24/7 with a 15 minute response time, identifying nearby law enforcement or medical facilities. a 50 mile radius and pass an annual fire safety inspection.
These regulations, which will be repeated from 1 January. 1, only applies to mental health providers treating Arkansas Medicaid clients, leading some to only accept private insurance to avoid red tape.
“There are hundreds and hundreds of private practices in the state and I would say the majority of them choose not to bother with Medicaid because they blame themselves for not following the rules because that there are too many rules,” said Thomas Ritchie, a licensed professional counselor practicing in White and Lonoke counties.
For mental health professionals, a big part of the challenge is finding a way to provide more care with fewer clinicians. Since the covid-19 pandemic and subsequent isolation, cases of mental illness have skyrocketed across the country, particularly with cases of depression and suicide.
Many mental health professionals reported having month-long waiting lists for outpatient treatment that overwhelmed their practices and led to burnout.
“The burnout rate for therapists in the mental health world is high because we are chronically inundated with stories of trauma,” said Shawna Burns, licensed mental health counselor at Harrison.
Burns said state Medicaid regulations requiring independent clinics to be available 24/7 for emergencies with 15-minute phone response times and two-hour call response times. face-to-face was difficult for small suppliers like her.
“They’re reducing the amount of regulation and the barriers that it takes for providers to actually access Medicaid benefits, and that’s a really big deal that’s not talked about a lot either because it really only applies. independent contractors,” Ritchie said. “They removed a huge hurdle in the amount of intricate detail we have to go into to even have an office that can treat Medicaid recipients.”
The Department of Human Services said it would increase Medicaid reimbursement rates for many mental health services, including psychotherapy, which for many services, but not all, pays 80% of what Medicare pays. The new rates will not match private insurance rates, but are intended to encourage more providers to accept patients covered by the state Medicaid plan.
“Just raising the rate alone was huge,” Burns said. “We need more providers to bill Arkansas Medicaid.”
The task force also recommended legislation in its report, which could serve as a guide for lawmakers in the next session. The report specifically calls on lawmakers to draft legislation to increase the number of psychological examiners, reimburse screenings for early childhood autism and maternal depression, require screening for depression and anxiety to be covered by insurance and review the safe storage of firearms and chemicals.
The task force also highlighted the need for more mental health screenings in schools, as rates of depression and suicide have increased.
Vaught said the General Assembly is unlikely to adopt all the recommendations in the next session, but the working group will meet again after the session ends.
“You can’t eat the whole elephant in one sitting,” Vaught said. “It’s going to take us several sessions to really work through these issues.”
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