BOISE, ID – A committee of the Idaho Legislature recommended using legal settlement funds to attempt to restore Medicaid programs that the state has cut.
That would include a mobile treatment program that cared for people with severe mental illness who have struggled in routine treatment settings. In less than four months after an Idaho Medicaid contractor cut the program, called Assertive Community Treatment, four patients have died, the Idaho Capital Sun reported. That’s a sharp uptick for the program, which only had one patient death in the 18 months before the cut, providers say.
The Legislature’s Joint Millennium Fund Committee on Monday night voted to restore funding for the program and peer support services on a unanimous voice vote.
The one-time funding would come from legal settlements Idaho reached with tobacco manufacturers. The funds are typically meant to reduce smoking.
The committee allowed spending $6 million of the tobacco settlement funds next fiscal year, which starts in July. That’s only if the state can use $5.8 million from the state’s legal settlement funds from opioid manufacturers to cover the program’s other costs.
The committee’s co-chair, Sen. Van Burtenshaw, R-Terreton, said if the opioid funds don’t come through, that isn’t the committee’s responsibility. The Legislature’s budget committee, the Joint Finance-Appropriations Committee, decides whether to appropriate funding to specific programs.
“I really feel like we need to stop being the stopgap, safety net,” Burtenshaw said.
Two Democrats, Rep. Brooke Green and Sen. Janie Ward-Engelking, worried about making the tobacco funds’ availability contingent on the opioid funds. If the opioid funds didn’t come through, they said they wanted to make sure the Assertive Community Treatment program would be funded.
“It’s just critical. We’re seeing deaths here in the state, and that’s problematic for me,” Ward-Engelking said.
The committee’s decision doesn’t officially fund the program. The Legislature still needs to officially appropriate the funds.
In a statement, Ric Boyce, the owner of Chubbuck-based clinic Mental Health Specialists, said it isn’t clear if the Legislature had settled on a funding mechanism to reinstate the program.
“We are immensely grateful to the Millennium Fund Committee for their unanimous vote to support ACT funding. At the same time, we worry that Idaho has not yet aligned on a stable, ongoing funding mechanism,” Boyce wrote. “Until that happens the death toll will continue to rise.”
Why a contractor cut the Medicaid programs
State health officials have denied the entire ACT program was cut, saying services are still available. But some providers say the services that are still available aren’t what the evidence-based program was like, because providers aren’t paid to staff mobile treatment teams.
Fourth patient dies after Idaho cut Medicaid mental health service
The contractor, Magellan, had its pay rate reduced by the Department of Health and Welfare as part of Medicaid provider pay cuts last year, after Gov. Brad Little ordered state budget cuts. Magellan cut the services in December.
The governor’s budget chief, Lori Wolff, previously told the Sun that preventive services are often the first to go when the state faces a budget crunch — because they are one of few options the state has.
In December, the state’s Medicaid director told lawmakers that health officials aren’t sure the cuts will save the state money long-term.
About 200 people in Idaho are on the ACT program, Magellan Healthcare’s Idaho Executive Director David Welsh wrote in a December declaration in response to a federal lawsuit by patients.
A bill to reinstate the Assertive Community Treatment Program, House Bill 753, was introduced in the House Health and Welfare Committee last month. But it still hasn’t had a full committee hearing — which is when it can advance to the full House.
Asked about that last week, bill sponsor Rep. Ben Fuhriman, a Shelley Republican, said securing funding for the program was still a work in progress.
“I will reiterate that we need ACT, Peer Support, and the other mental health programs that were cut in December last year and there are some really good people working behind the scenes to try and make it happen,” Fuhriman told the Idaho Capital Sun last week. “Once we have identified funding, I hope ACT gets our full attention. The state of Idaho doesn’t need any more patient deaths that could have been avoided.”
Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com.