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Change could cut funding for mental health services

Peninsula Daily News - 4/22/2019

PORT ANGELESClallam, Jefferson and Kitsap counties could lose more than $1 million in funding per year for people without insurance who need to access mental health services.

Stephanie Lewis, Salish Behavioral Health Organization director, told the Clallam CountyBoard of Health the shortfall would be the result of a change in state law that works to integrate behavioral and physical health services by Jan. 1, 2020. The law dissolves Behavioral Health Organizations and creates Behavioral Health Administrative Services Organizations (BH-ASO).

"There's additional administrative burden, additional entities needing to withhold administrative funding and less dollars to serve the people that needs the care," Lewis said.

"There isn't additional funding available at this point that I'm aware of being put into the system … so it has to come from somewhere and it's coming from the communities."

The Salish Behavioral Health Organization has overseen the administration of $55 million in Medicaid funds and $10 million in state General Fund and Block Grand funds for publicly funded mental health and substance use disorder treatment services for Medicaid and unfunded people since 2016.

The BH-ASO will be responsible for managing the regional crisis system and is charged with ensuring equal access to crisis services for all people.

Required services include crisis services, evaluation and treatment services for people ineligible for Medicaid and services related to involuntary treatment.

"The state wanted to ensure there be equal crisis services for all individuals regardless of their insurance status," Lewis said.

She said among the services she believes would not be funded is voluntary inpatient psychiatric care.

"It is still early to project what the budget and resources will look like in 2020, but voluntary inpatient are will not be as readily available," she said.

Last year, the Salish Behavioral Health Organization paid for 188 hospital claims for unfunded voluntary patients that totaled $1.5 million.

The BHO paid for about 1,200 people to get outpatient mental health care who didn't have insurance and paid for about 700 people to receive outpatient substance use disorder treatment.

"Unless individuals are approaching a crisis, unfunded individuals are not going to have access to care like they do now," she said.

She said the state released a request for proposals for organizations to take the role of the BH-ASO and that Beacon Health Options was selected.

Counties have the first right of refusal to become the BH-ASO.

"We are working to meet the requirements to be deemed a BH-ASO," she said. "If we are unsuccessful than Beacon Health Options immediately gets the region because they won the state bid."

The level or services the state requires the BH-ASO to offer unfunded individuals is far less than what the SBHO offers now, she said.

"The $1 million shortfall per year is if we were to continue to make sure all those services remain intact as they are now," she said. "And whether it is the county-run ASO or Beacon Health Options, I do not think that having Beacon Health Options would result in more services being available."