Daytime mental-health programs shrink, citing problems with managed-care Medicaid; pastoral counselors to be licensed

Access to daytime mental-health care “is on a steep decline in Kentucky, leaving what some fear is a gap in care that isolates the mentally ill at home or drives them out into the streets, hospitals or jail,” Mike Wynn of The Courier-Journal‘s Frankfort Bureau reports. The Kentucky Association of Regional Programs, the lobby for community mental-health centers, “reports that 33 of the roughly 50 programs offered across the state have closed in the past 18 months while four others have reduced their hours by half,” affecting an estimated 1,000 people.

The state Department for Behavioral Health, Developmental and Intellectual Disabilities says these community mental-health centers should embrace “a shift away from using day programs,” Wynn writes, but mental-health advocates “say the centers have struggled to get enough coverage authorized under Kentucky’s Medicaid managed-care system to keep the services operating. That has forced programs to close before new services are available to replace them, they argue.”

The advocates say that among companies that manage care in Kentucky under Medicaid, Coventry Cares and its subsidiary MHNet “are by
far the worst about denying coverage or reducing hours for therapeutic
day programs. Coventry and MHNet are owned by insurance provider
Aetna,” which “says complaints are off target and that it is committed to
providing patients with high-quality care. MHNet has approved
two-thirds of the requests it received for therapeutic rehabilitation
since January 2013, Aetna said in a statement.”

Steve Shannon, executive director of the centers’ lobbying group, “said
that even mild reductions — such as approving services for three days a
week rather than five — can wreak havoc on a program’s financial
viability,” Wynn writes. “He also argues that centers may have stopped requesting services once they realized that MHNet would not approve them.” (Read more)

Meanwhile, Kentucky has become the sixth state to license pastoral counselors under a new law that will also allow them to be paid for their services. The sponsor of Senate Bill 61, Sen. Alice Forgy Kerr of Lexington, told Jack Brammer of the Lexington Herald-Leader that the counselors must have a master of pastoral
counseling degree, in addition to the same qualifications as other
licensed counselors, and must also pass a written examination. (Read more)