ANNAPOLIS – After a recent wave of cuts to reduce a potential $30 million deficit, the Mental Hygiene Administration froze some mental health services for new uninsured patients in Maryland.
As of April 9, psychiatric rehabilitation services, such as counseling and social skills training, are on a temporary freeze while the administration recalculates budget figures to make sure it has enough money to cover care for this population.
The administration could not comment on how much money it projected to save with this freeze, but spokeswoman Jean Smith said the administration wants to ensure it has funds to cover the population being served.
“We don’t have enough money . . . to serve everyone in the entire world,” Smith said.
Services for patients already in the system and for residential treatment are not affected by the freeze.
Providers are projecting that this move will only degrade the system into a revolving door of crisis care management with no preventive care.
“It creates a demand for crisis services by not having preemptive services,” said Jeff Richardson, executive director of Dulaney Station, a treatment center in Timonium.
Without maintenance care, mental health patients can deteriorate to the point where hospitalization is needed for them to recover, Richardson said. Once they’re released and cannot get regular care, the deterioration cycle restarts.
“We’ve heard that clearly if the state has to make other reductions, health care in general and mental health will have to absorb a good portion of that, and I think that will devastate the system,” Richardson said.
The state’s projected $800 million deficit is going to squeeze more than just the uninsured out of the public mental health system, said Lori Doyle, director of public policy for Community Behavioral Health Association.
“Medicaid stands out there like a target every time,” Doyle said.
Though Gov. Robert Ehrlich increased mental health funding for 2005, the Legislature recessed without finding new revenue streams to fund these programs that perpetually run large deficits, so future funding hopes are bleak, Doyle said.
“I think it comes down to an $800 million hole,” Doyle said.
The administration instituted a new payment structure on Feb. 1 that paid providers a monthly rate for these services rather than a fee for each individual service. Authorization criteria have also become more stringent over the last several months.
These moves have already stretched providers to maintain quality care with very limited funds, Richardson said. Providers were not warned to prepare for this freeze on top of the other cuts.
“To get this surprise effect . . . throws a curveball for everything you’re trying to do,” Richardson said. “Because someone is grey zone (uninsured) doesn’t mean the person doesn’t need services.” – 30 – CNS-4-23-04