Mental health providers who criticize the government for setting up an inefficient, even convoluted process for distributing the money say HHS should do right by them.
“I’m hearing everyone saying, ‘Yes we see it coming, we know increases are going to happen,’ but we’re not seeing corresponding responses at the national or state level,” said Sherry Daley, the senior government affairs director for the California Consortium of Addiction Programs and Professionals.
Advocacy groups late last week asked the Trump administration to guarantee behavioral health providers get targeted payouts. The industry sees the approach as a quicker fix than waiting for Congress to assemble another coronavirus bailout package later this summer. But the odds of getting money in the next package could be long with new Covid-19 cases spiking around the country and stretching health systems: The mental health providers struck out in April when they appealed to Congress for $50 billion in dedicated money for their centers.
The industry was bound to experience massive upheaval during the public health crisis. Treatment centers have long been underfunded and specialize in the kind of in-person care that wasn’t possible during lockdowns and stay-at-home orders.
But the pandemic has hit the centers harder and faster than expected. In California, nearly 60 percent of behavioral health providers say they have lost staff, many of whom feared going into work because of the coronavirus, according to an industry survey. In North Carolina, nearly 20 providers have already laid off employees, and even more are worried they’ll need to cut staff. One Illinois provider has lost over $1 million since the pandemic began while receiving just $6,000 in federal relief.
Almost half of mental health and addiction providers say they can only survive for six months or less in the current fiscal climate, according to a June survey of more than 660 behavioral health providers.
“It’s ridiculous considering the size and scope of behavioral health problems in the U.S., and they’re exacerbated by the pandemic,” said Andrew Kessler, the founder of Slingshot Solutions, a consulting firm specializing in behavioral health policy.
The federal government’s top mental health and addiction official said the Trump administration is committed to helping providers as millions of Americans drive an increased need for services.
“It is essential that Americans have a treatment system that remains available to meet their needs,” Elinore McCance-Katz, the assistant secretary for mental health and substance use, said in a statement to POLITICO. “Many providers report struggling with loss of revenue during this time. We will continue to work on strategies to address this revenue loss.”
Medicaid, the health insurance program for the poor, is the largest payer of behavioral health services.
But the government began paying out assistance based on the money centers make from Medicare, the health program for the elderly and disabled, which usually provides only a sliver of behavioral health revenues. HHS then sent more aid to those same providers. That confused some clinic operators, who didn’t send detailed enough financial information to a government website to be approved. Others decided to hold out until more money was targeted specifically at Medicaid providers. However, centers that received earlier rounds of funding now cannot tap that Medicaid-specific aid.
“The way information has been sent out has been piecemeal if you’re running an organization in the midst of all the craziness,” said Chuck Ingoglia, the president and CEO of the National Council for Behavioral Health. “It’s not on the top of your list to check the HHS website. It’s already confusing.”
An HHS spokesperson defended the payout system, writing in an email that “Behavioral Health Providers have not been left out of [provider relief fund] distributions.” HHS said it intentionally adjusted the funding to help get more money to those who only see a small share of Medicare patients — that that the criteria was spelled out on HHS websites.
“It is unclear why these providers did not take advantage of that opportunity … only to now want to seek funding,” the HHS spokesperson wrote.