A change in a federal Medicaid rule that has stood for 52 years is expected to allow more Ohioans to get badly needed mental-health services.
Effective July 1, Medicaid recipients ages 21 to 64 who are in a managed-care plan will be eligible for up to 15 days of inpatient mental-health treatment. The program specifically exempted that group from inpatient coverage since it was founded in 1965. Medicaid now insures 3 million poor and disabled Ohioans.
At the same time, a state agency is setting new rules to better monitor long waiting lists for people seeking drug-addiction treatment.
Greg Moody, director of the Governor’s Office of Health Transformation, said the Medicaid rule change “opens a new source of reimbursement for a critical service.”
Moody said inpatient mental-health treatment originally was banned to avoid “mental asylums,” where people were locked away in institutions for months or years. A system of home and community mental-health programs was created, although critics point out alternatives were never adequately funded.
Now, Moody said, there is a greater need for people to have longer inpatient mental-health treatment instead of being stabilized and released.
Tracy Plouck, director of the Ohio Department of Mental Health and Addiction Services, said Medicaid patients can get into treatment more quickly and closer to home rather than having to go long distances for inpatient care. Qualifying patients will be able to use some private facilities, as well as state and public hospitals.
Officials said they do not know how many additional people will be served. State hospitals are now running at a 95 percent occupancy rate.
John Corlett, former state Medicaid director, said the change will provide a new funding source for mental-health care and “take the pressure off state hospitals.”
Terry Russell, executive director of the National Alliance on Mental Illness Ohio, said his organization endorses the prospect of getting help more quickly for more people in need.
The Medicaid change will have little impact on waiting lists for treatment for opioid addiction and other addictions. However, the Department of Mental Health and Addiction Services submitted a new rule this week to the Joint Committee on Agency Rule Review in response to that problem.
The rule will require drug-treatment providers to track people put on a waiting list or who are referred to another agency. Providers will use the list to determine whether there are enough services available and to notify patients when services can be accessed. The waiting list information must be reported by the state to county agencies by the fifth day of each month.
The change is aimed at providing more statistical information and accountability for drug-treatment services in the state.