Arkansas Department of Human Services officials told lawmakers they are close to finalizing a number of changes to the state’s Medicaid program that they say will expand care for thousands of people suffering from behavioral and mental health problems.
The changes come after more than a year of meetings by a task force dedicated to addressing the state’s mental health crisis, which it says has worsened during the Covid-19 pandemic. The new regulations aim to make it easier for people to access screening and treatment for people with behavioural, intellectual and mental health problems.
State Human Services officials are proposing numerous changes to state Medicaid guidelines and codes that govern how Medicaid pays for services and treatments. These changes will mean that health care providers will be reimbursed for more preventive care and screenings, while allowing clinicians to provide more oversight and reduce labor shortages.
During a meeting Monday, Human Services officials walked lawmakers through changes to the state’s Medicaid program for Arkansas residents with behavioral, developmental or intellectual disabilities, also known as Provider-Directed Arkansas Shared Savings, or PASSE. The PASSE program provides government-funded health care for more than 55,000 adults and children in need of specialist health care, often requiring care at home. The program, created in 2017, has been in a state of constant tweaking, DHS officials said, but the covid-19 pandemic has put more pressure on it.
The department also called for increased reimbursement rates for assertive community treatment services, care for adults with severe mental illness and intensive home care for children. The regulatory changes also will provide greater clinical oversight for home care, human services officials said.
“There [are] a lot of people are getting a service, but maybe it’s not working for them — they’re getting an unnecessary service,” said Melissa Weatherton, director of the department’s Division of Developmental Disabilities Services. “We have to be strategic about it now because we have more people, more needs and fewer workers.” The changes stem from a task force of lawmakers created in 2021 to study mental health issues in Arkansas and to issued a report. State Rep. DeAnn Vaught, the sponsor of the legislation creating the task force, told her fellow lawmakers that months of research and updates to state Medicaid regulations are just the beginning.
“We’ve made great strides, but there’s still a lot more to go,” said Vaught, a Horatio Republican.
Vaught told lawmakers the state is in a mental health crisis made worse by the covid-19 pandemic.
Depression and suicide rates among teenagers are on the rise, while prisons are full of adults suffering from a wide range of problems stemming from increased drug addiction to untreated psychiatric problems, Vaught said. The covid-19 pandemic has also exacerbated an already serious problem with drug addiction, mental health and the discontinued treatment of the elderly and people with intellectual disabilities, Vaught said.
“I heard from the providers that there wasn’t a good bridge between them and DHS, so I thought the best option was to have everyone come together in one room,” Vaught said.
The changes must still be approved by the Arkansas Legislative Council, a body of state lawmakers that provides executive oversight, which is scheduled to meet again in December.
Human services officials have also proposed changes to state regulations that would make it easier for workers in similar fields to fill behavioral health workforce shortages. Because much of the emphasis is on home care, the department will change regulations to allow lay professionals in similar areas of health care supervised by clinicians to provide care.
“We have these providers that were just taking care of clients with intellectual disabilities, and we had providers that were just providing behavioral health services, and what we’ve been working on and what this task force has really shown us is that these are the same types of personnel,” Weatherton said.
The department also wants to use state funds and federal dollars from the America’s Rescue Plan Act to retain and hire behavioral health workers.
While department officials have proposed changes to state regulations, some behavioral and mental health issues will need to be addressed through legislation. In the next session, Vaught said lawmakers will continue to work on ways to address health care workforce shortages, telemedicine and ways to provide more mental health care in schools, often where children go undiagnosed.
“If I had to guess, this would be it [addressed through] a lot of bills,” Vaught said. “Mental health will be a big priority.”