OP-ED: Central Illinois Medicaid Managed Care Crisis Shuts Out Mental Health Inpatient Care

OP-ED: – The collapse of the Central Illinois Medicaid Managed network has, effectively, shuttered inpatient psychiatric services for people with schizophrenia, bi-polar disorder and other mental illnesses at regional hospitals.

The January announcement by Decatur Memorial Hospital that it will terminate its contract with Molina Healthcare of Illinois on March 23, 2017 brings the number to four hospitals (St. Mary’s, Decatur; St. John’s, and Memorial, Springfield) that will no longer accept individuals with Molina Medicaid insurance.

This is a crisis.

Molina patients who are now receiving mental health care in community mental health centers or persons in the area in need of inpatient psychiatric care will now loose that access to care.

Gone.

The hobbled network of inpatient psychiatric beds in Central Illinois threatens individuals who have been diagnosed with schizophrenia, bi-polar disorder or co-occurring mental health/substance use disorder and who need immediate, emergency stabilizing care. That’s why Decatur Memorial’s decision has a created a crisis. Hospital doors are shutting on people with severe mental illness.

What’s the impact?

Community mental health providers in the area have been left to scramble around to find an inpatient placement for someone who is in crisis or on the verge of crisis. The nearest state operated psychiatric hospital, the Jacksonville Developmental Center, has a waiting list. A waiting list for psychiatric crisis. Admittance into Jacksonville can consume days because the Medicaid certified individuals who are provided state psychiatric hospital care receive do not trigger managed care organization reimbursement to the Department of Human Services for the cost of this care.

Because no inpatient psychiatric care is available, individuals often are detained in emergency rooms or other non-psychiatric units for extended periods. Sometimes days. This situation will worsen in this region if the Department of Human Services fails to find a solution. Period.

Failure on the part of the state is not an option.

CBHA urgently recommends that the state act expeditiously on its own announcement rolled last September to allow Meridian Health Plan to begin covering persons with Medicaid in central Illinois. We agree with Health & Family Services Director Felicia Norwood who is on the record stating that the expansion of Meridian into the central Illinois region “will assure that our clients have access to managed care options in Central Illinois and the Quad Cities.”

Once Meridian is in operation in the region, we also recommend that the state implement an open enrollment period to allow persons on Medicaid the choice of health plans that will meet their healthcare needs.

We recommend that the state act.

Swiftly.

Marvin Lindsey, CEO, Community Behavioral Healthcare Association of Illinois

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