247459 A perfect storm: Health care reform, state budget cuts and a crisis in rural community mental health agencies

Tuesday, November 1, 2011: 12:30 PM

Christopher R. Larrison, PhD , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Samantha Hack-Ritzo, MSW , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Benjamin David Koerner, BA , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Susan L. Schoppelrey, PhD , Waldron College of Health & Human Services, Radford University, Radford, VA
Barry Ackerson, PhD, MSW , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Wynne Korr, PhD , School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
Objective: Community mental health agencies (CMHAs) in rural communities are under significant financial stress as a result of state budget cuts. At the same time that states are announcing budget reductions to CMHAs, federal policy changes created by the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act are likely to increase the number of individuals who can afford to seek services for a mental illness.

Methods: Structured interviews were conducted with executive directors of rural CMHAs to determine the impact of federal policy changes and state budget cuts on behavioral health services. The directors represented 15 CMHAs serving 33 rural counties in southern Illinois (population 1.2 million). The counties are depressed agricultural and manufacturing locales that have been hard hit by the economic stagnation and recession in the decade between 2000 and 2010.

Results: 100% of the executive directors decided to restrict the number of patients accepted for future services, 55% have reduced current services, 91% plan to reduce services in the future, 87% have left open staff positions unfilled, 46% have laid off staff, 73% have used the agency's reserve funds, and 28% have borrowed money against future state payments.

Conclusion: The independent but inter relate trends of state funding cuts and federal health care policy changes are leading to a perfect storm at rural CMHAs. By 2014 the gap between the number of people who can access behavioral health services and the capacity of those services will reach a crisis point.

Learning Areas:
Advocacy for health and health education
Other professions or practice related to public health
Program planning
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
1) Participants will discuss the impact of state budget cuts and the scheduled implementation of the Patient Protection and Affordable Care Act on community mental health agencies (CMHAs). 2) Participants will evaluate the policy and financial factors that may impede patients in rural areas from seeking and receiving outpatient behavioral health services such as individual and group therapy, crisis services, supported employment, and assertive community treatment. 3) Participants will identify aspects of federal and state policies that offer opportunities to advocate for change that improves rural patientsí access to behavioral health services.

Keywords: Mental Health Services, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have worked with and researched community mental health agencies in rural settings for over 15 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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