Budget cuts will impact community mental health centers and hospitals | New


LARAMIE –– Despite a record need for mental health and addiction services, the Wyoming Department of Health, which supports community mental health centers across the state, faces a $ 7.5 million budget cut. dollars, effective July 1.

A study by the Kaiser Family Foundation (KFF) reported that between April and May, 27.2% of people in Wyoming reported having anxiety, a depressive disorder, or both (up from 30% in the national scale); among them, 22.4% said they needed counseling or therapy, but were unable to receive it.

With the budget cuts, some centers will be forced to reduce hours or services and end some outpatient programs, especially those related to rehabilitation or substance use.

Other centers may need to reduce their mental health workforce, including psychiatrists and psychologists, psychiatric nurses and addiction counselors.

Heather Barnes, an intern at the Laramie Mental Health Wellness Clinic, spoke on behalf of a nurse practitioner who was unable to comment directly on the Boomerang.

“The way insurance currently works with Medicaid and Medicare can be very frustrating for providers,” said Barnes, adding that even without budget cuts, behavioral health patients have a limited number of insured visits. For example, a plan can cover 12 office visits in a single year.

However, if a provider feels that weekly sessions are necessary for the care and safety of a patient, public insurance will only cover the first 12 weeks.

Barnes further explained that if a patient exceeds this predetermined number of visits, accessing mental health services can become very expensive.

In some cases, providers can defend their patient’s name and request extended coverage, Barnes said, but the application process takes time.

“These are not small applications… you have to explain why (a patient) needs (long-term care),” she said.

Another impact the community could face as a result of health-related budget cuts is an increased burden on hospital emergency rooms and other first responders.

Lack of services often fosters worsening conditions and adverse consequences such as frequent emergency room visits, hospitalizations, homelessness and entanglement of young people in the juvenile or criminal justice system, according to the American Addiction Centers, National Rehab Directory.

Although the Ivinson Memorial Hospital emergency room has not seen a significant increase in acute behavioral emergency visits, ED Director Erin Rumsey said she has noticed an overall increase in the number of patients requiring immediate treatment for drug addiction, a growing problem in Wyoming.

Almost 7% of Wyoming residents reported having an alcohol-related disorder, and 0.7% of people 12 years of age or older reported opioid addiction or abuse. In 2020, drug overdose deaths fell from 12.2 per 100,000 to 16.7 per 100,000, according to the KFF.

“We are seeing a lot more patients who want to detox from alcohol or who have drug addiction and alcohol abuse issues,” Rumsey said.

She believes this is a direct result of the pandemic and the COVID restrictions.

“They’re getting to a point where they’re at their last straw and (emergencies) are where they’re coming from,” she added.

Rumsey said behavioral health is a concern in Albany County and that she has confidence in the hospital’s behavioral health unit. But she also expressed growing concern for primary care and said further cuts could lead to an increased response to the crisis from emergencies.

“We are very fortunate here that very rarely have to embark our behavioral health patients,” said Rumsey.

But she added that they only had 11 emergency room beds and about 35 patients per day on average – any increase in the number of patients with acute behavioral health could lead to a bottleneck in the wards.

She also said caring for mentally ill patients in an emergency room was not necessarily safe. Currently, the OHIM emergency room has a bed dedicated to behavioral health.

“In a sense it’s dedicated because we can make it a really safe environment for patients who might be in acute crisis or aggressive,” Rumsey said, but they need individual care, which keeps ER staff away. .

“Because of our number and beds, my maximum staffing is three nurses,” she added, and this can be difficult for other critically ill patients who also need immediate care and attention. .

The ER receives “a handful” of behavioral health patients every day, Rumsey said, and this increases during certain seasons like Christmas or college finals week. If the budget cuts continue and the volume increases, the emergency department will feel the effects and therefore have difficulty providing timely care.

“The ER isn’t the best place for (patients with acute behavior) to sit and wait (because) we can’t really provide them with an environment where they get the resources they need,” Rumsey said. , adding: “We are just here to stabilize them.

The KFF said on its website of the 30 different mental health services, only 22 are covered for “categorically needy traditional adult beneficiaries.”

Many of the uninsured services are those related to substance use disorders, including inpatient detox, residential rehabilitation, and outpatient rehabilitation.

Multi-million dollar budget cuts to the Wyoming Department of Health could potentially pose more challenges for people seeking drug addiction care.

There is, however, a silver lining, Kim Deti, media relations for WDH, mentioned in regards to community mental health centers.

“At this point, we don’t have details, but there may be additional temporary federal funding available through the most recent federal legislation passed in response to the pandemic,” Deti said, “There may be have an interest in using this funding to support mental health services.

In the meantime, community behavioral health reform may be underway as the state health department seeks public input on Wyoming’s current behavioral health system.

Through Bill 38, the WDH is required to consult relevant stakeholders when developing a publicly funded behavioral health system overhaul.

“We see this as a unique opportunity to help put this system in place for a sustainable future … by targeting those who need it most,” said Deti, adding that helping these people could reduce the burden of care. emergency hospital.

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