Haslam administration reconsidering TennCare budget cut for chronic mental illness

In response to an outcry by mental-health providers and advocates, Gov. Bill Haslam’s administration says there will now be a closer look at a proposed budget cut that would eliminate Level 2 case management services for thousands of adults with chronic mental illness.

Further from the News Sentinel:

The Bureau of TennCare in the 2015-2016 state budget proposed the cut to the services, which are used by about 42,000 adults with “serious and persistent mental illness,” with the goal of keeping those recipients in the community rather than in institutions.

Level 2 case managers vary in the level of services they provide but might do welfare checks, drive clients to medical appointments or counseling, pick up and deliver refills of medication, or help clients with paperwork, grocery shopping and other activities needed to live independently.

But “a very small number of people” need that level of case management long-term, said Keith Gaither, TennCare’s director of managed care operations. Gaither said more intensive services might hinder clients’ abilities to live independently.

“The case managers are trying to help these people as much as they can,” he said. “I think sometimes they just try to keep helping them longer than they need to.”

The Bureau of TennCare recommends Level 2 case management be limited for 90 days after a crisis, which Gaither said could mean psychiatric hospitalization, a call to the mobile crisis unit, or arrest.

…Adult outpatient services is the largest item in TennCare’s budget, with half of that money going to case management, Gaither said. While he didn’t say how many of the 42,000 would no longer qualify for Level 2 case management, TennCare says it would save $30 million — about $10 million in state funds and $20 million in matching federal funds.

Advocates say compared to the cost of hospitalization or jail, case management is a bargain — and that if the higher level of services required for the care of the 42,000 Tennesseans is more than $10 million, or $250 per person, the cut could result in a net loss of revenue for the state.

Eliminating the services “will have dire consequences for many of these individuals and on the mental health care system,” said Paul Fuchcar, chair of the Tennessee Mental Health Planning & Policy Council, which advises the governor on mental health and substance abuse.