HOW BAZELON CENTER FOR MENTAL HEALTH LAW ISSUES STATEMENT ON MEDICAID PROPOSAL! (2177 hits)
For Immediate Release From Bazelon Center for Mental Health Law!
STATEMENT ON THE DEPARTMENT OF HEALTH AND HUMAN SERVICES’ RECENT PROPOSAL TO INCREASE INSTITUTIONALIZATION
The Judge David L. Bazelon Center condemns the Department of Health and Human Services’ (HHS) announcement earlier this week that it plans to approve new mental health Medicaid demonstration waivers to fund the institutionalization of people with psychiatric disabilities. The proposed demonstration waivers would provide federal funding for “short stays” in psychiatric institutions, but there are few limits on what counts as a “short stay.” The statewide average length of stay is expected to be 30 days —more than three times as long as the national average psychiatric hospital stay of 8 days.
The demonstration waivers will waive Medicaid’s “Institutions for Mental Disease (IMD) rule,” which bars the use of federal funds for people aged 22-64 served in large psychiatric institutions. The Medicaid law’s provisions concerning demonstration waivers do not give HHS the authority to waive this rule, which was designed in part to discourage state reliance on psychiatric institutions.
HHS’s plan to approve the new demonstration waivers ignores the real problem with mental health services systems today: an underfunded and inadequate community-based system that frequently leaves people with mental health needs cycling between hospitals, emergency rooms, shelters, and jails. Investing more money in psychiatric hospitals does nothing to address these problems, which are the root cause of pressures on psychiatric hospitals. Expanding communitybased
services such as supported housing, mobile crisis services, assertive community treatment, peer support services, and supported employment would dramatically reduce psychiatric hospital admissions and help people thrive in their communities. While the new demonstration conditions reimbursement for institutional care on some additional community investment, that investment is likely to be small. Moreover, the Centers for Medicare and Medicaid Services (CMS) has failed to hold states to similar conditions in the past.
