Mentally ill no longer flooding Vegas emergency rooms
CARSON CITY — Southern Nevada’s mental health treatment crisis has largely disappeared because of the state’s decision to participate in the Affordable Care Act expansion in Medicaid and because of a significant increase in the reimbursement rate for inpatient mental health treatment.
But the good news that mentally ill people are no longer flooding the region’s emergency rooms seeking treatment has produced a funding issue for the Southern Nevada Adult Mental Health Services budget.
The agency “has seen a dramatic reduction in the number of both inpatient and outpatient clients with Medicaid insurance as community providers have stepped in to provide services to these patients,” a budget document prepared for state lawmakers says.
Statistics show that since May 2014, the state agency has experienced a 44 percent decline in the number of outpatient managed care patients, with a 73 percent decrease in the number of inpatient managed care patients since October.
The decision by Gov. Brian Sandoval to participate in Obamacare for the Medicaid program increased the number of behavioral health clients eligible for Medicaid from 27 percent in December 2013 to 77 percent in February of this year.
And with an increase in the Medicare and Medicaid reimbursement rate for inpatient mental health treatment from $460 a day to $944 a day, private-sector community providers have now entered the market.
“According to the agency, emergency rooms that were once flooded with patients in need of behavioral health services are now visited regularly by community providers willing to assist Medicaid eligible clients,” the report to lawmakers said.
In October, there were 162 people in hospital emergency rooms in Southern Nevada awaiting a bed in a mental health facility. On April 10 of this year, the count was 39.
The changes have affected the delivery of state mental health services statewide but are particularly noticeable in Southern Nevada. Total Medicaid reimbursements to the state mental health agencies have been revised downward from nearly $41 million over the coming two years to just under $20 million, creating a $21 million shortfall.
Lawmakers are proposing to reduce personnel and services totaling $16 million at the Southern Nevada agency to address the shortfall. The Northern Nevada agency probably will see a nearly $6 million reduction.
A joint Senate Finance and Assembly Ways and Means subcommittee signed off on the budget recommendations on Wednesday.
But Richard Whitley, interim director of the Department of Health and Human Services, said the funding reductions are good news. They mean the state no longer needs to provide the level of services initially contemplated when the budget was first prepared because of the growth in the private sector.
“The beds have always been available; it was payment,” he said of the growth in services provided by the private sector. “Within weeks there was a turnaround in the ER.”
Contact Sean Whaley at swhaley@reviewjournal.com or 775-687-3900. Find him on Twitter: @seanw801
