Louisiana Legislative Auditor: Budget cuts leave significant gaps in treating state's mental health issues
The New Orleans AdvocateFeb 22, 2018
Hours before Gov.
"Budget cuts have affected the state's ability to provide comprehensive and appropriate specialized behavioral health services to Medicaid recipients. These challenges have resulted in gaps in services and a lack of data integration among providers, which contributes to fragmented care," Auditor
The
But the context of national debate gave auditors pause.
"There's always a risk ? because of the gaps we found ? that he would fallen through the cracks here," said Assistant Legislative Auditor
"It should certainly be on everyone's radar," said
"We work everyday to ensure that doesn't happen,"
"All I can say is that we recognize there are a lot of barriers to children and their families for getting into care and staying in care. We've tried very hard to remove as many of those barriers as we can," she said.
Since the decision to expand Medicaid under the federal Affordable Care Act, treatments are available for most people with mental health issues, Alletto said. LDH is focusing on quality of the programs offered, she said.
The primary goal of the program is keeping children out of institutional care by offering counseling and treatment to them and their families in or close to their homes. The program handles about 2,400 children, she said.
Where once the state paid doctors and clinics directly for treatments, LDH now contracts insurance companies to manage the health care for the 1.6 million
"Their role has shifted," LeBlanc said of LDH. "They can look at the data, at the statistics, but they don't have a report that can say how each individual's case managed. This is something they agree with and something they're working on."
Auditors say that 60 percent of the
Only 7.4 percent of the individuals served by the private companies had a behavioral health diagnosis. (Neither the private companies nor the state can force a person onto the "managed care" system operated by the companies, so it's hard to put that percentage into context, Alletto said.)
The report noted that
Adults with behavioral health needs often end up going to nursing homes or prisons, which don't normally provide services that address mental illness. For example, of the 4,084 individuals with a primary behavioral health diagnosis in nursing facilities, 49 percent did not receive any specialized behavioral health services.
The federal government doesn't require states to provide mental health services. Doing so is an optional expense for the state.
"Mental health is absolutely something that is vulnerable to (budget) reduction," LDH's Alletto said, adding that those programs face a 19 percent cut in funding this year. "We're trying to preserve mental health rehab care. We think it is important."