State must renew attention to funding behavioral health services

I recently testified in support of the Illinois Department of Healthcare and Family Services Section 1115 Research and Demonstration Waiver application.

As Illinois considers the future transformation plan, it should be cautioned that the capacity for behavioral health services must be restored or rebuilt in order to adequately address the needs of the population. The failure in the past to care for individuals with behavioral health issues has affected our education, criminal justice and local health systems. Our economy has suffered, as resources have been diverted to treat the consequences rather than the cause of the problem.

The DuPage County Health Department is one of many local organizations providing behavioral health care services. We have successfully implemented programs that seek to provide integrated care in the most efficient manner for the taxpayers. The primary effort, called MYCARE, to integrate physical and behavioral health services has demonstrated significant improvement in participants' physical and mental health status. It is vitally important that coordination of services focus on the patient's needs rather than independent funding streams.

Our behavioral health services treat 6,000 adults and an additional 6,000 children and teenagers monthly. Clearly, in mental health, as in all chronic health care conditions, the concept of disease prevention and early intervention are key to successfully mitigating the impact of the illness.

To that point, the proposal of this waiver to invest in early childhood mental health support is a wise one. Early intervention can reduce behavioral issues that disrupt schools and families, taxing both financially and emotionally and often leading to increased mental illness and even interaction with the criminal justice system. The failure to provide behavioral health services only exacerbates the problem, delaying the inevitable while causing other problems in society that must be addressed.

The sobering statistics from the Urban Institute in 2015 estimated that 56 percent of individuals in state prisons suffer from mental health issues. Each year, over 10,000 inmates are released into society. Improved access to behavioral health care can reduce the number of people who end up in the criminal justice system while suffering from mental illness.

The estimate of 90 percent of the prison population qualifying for Medicaid sets forth a potential to connect funding to this unserved population. Screenings, assessments and services to those upon re-entry into the public should reduce the number of individuals returning to the system, and provide communities with a greater sense of security.

Individuals suffering from mental illness also need stable work and living accommodations. In DuPage, we have dedicated our own resources as well as developed partnerships with other agencies to assist clients with both of these necessary components of a rewarding life. We support plans at the state level that continue this trend toward treating the individual, both clinically and socially.

The identification of current state services and enhanced services that qualify for federal funding matches is an excellent way to increase funding without increasing the burden on taxpayers. Shifting the incentive for providers to address client issues in the most effective, community-based setting rather than inefficient, stigmatizing environments is key to integrated treatment. Society in general, and the individuals specifically, benefit from a plan that not only can treat the crisis situations but also can stabilize the individual's treatment while reducing the need for impatient or emergency care at local hospitals.

Substance abuse problems and a lack of treatment options affect all communities. Increasing the capacity of outpatient methadone programs, decreasing the incidence of emergency room admissions and reducing overdoses are all positive points of the plan. Lifting the restriction on beds for residential programs allows for billing Medicaid for increased reimbursements. Again, the plan shines a light toward a more efficient manner of treatment with reimbursement at the federal level.

This plan is an excellent first step in the transformation process. The details in the implementation, once the plan is approved, will determine if the plan can provide real improvements in the delivery of service while developing funding models that don't overly burden the taxpaying public. The development of this plan has been acutely needed for years in Illinois.

Karen Ayala is executive director of the DuPage County Health Department