THE VALUED VOICE

The Assembly Committee on Health, Aging and Long-Term Care held a hearing on November 8 on Assembly Bill 616, which would address restrictions on adults enrolled in the Medicaid fee-for-service program from receiving care in freestanding psychiatric hospitals with more than 16 beds. On Nov. 9, the committee voted unanimously to approve the legislation. The full Assembly is scheduled to take up the legislation on Nov. 14 before the bill is sent to the Senate for consideration.
 
Rep. Karen Hurd (R-Fall Creek) and Sen. Howard Marklein (R-Spring Green) are lead authors of the bill, which currently has 32 co-sponsors, including Republicans and Democrats.
 
“To create additional inpatient psychiatric placement options for Medicaid patients, the Wisconsin Hospital Association supports Assembly Bill 616, which will enable Wisconsin to seek a [federal] waiver to the 1960s-era psychiatric IMD (Institute for Mental Disease) exclusion that currently excludes about half of Wisconsin’s inpatient psychiatric beds from participating in the traditional Medicaid fee-for-service program for adults,” said WHA General Counsel Matthew Stanford in testimony to the committee. 
 

Stanford said the legislation was among public policy reforms identified and developed by the WHA Mental Health and Addiction Care Forum, and “is one step Wisconsin can take to help remove public policy barriers impacting access to mental health services that do not exist for physical health services.”
 
Jessica Small, president of Aurora Psychiatric Hospital and Behavioral Health Operations, and interim administrator for the Milwaukee County Mental Health Emergency Center, joined Stanford in testimony on the bill.
 
“This is one of the most complex areas of care to navigate; as leaders in this specialty, we get questions daily from neighbors, friends, coworkers, and families on how to help people gain access to life-saving care,” said Small. “Unfortunately, the IMD exclusion is one of the greatest barriers patients can face when it comes to gaining access to care. In Milwaukee County, all but 12 of the approximately 270 inpatient mental health beds are licensed as an IMD, meaning Medicaid fee-for-service does not cover access to the vast majority of available beds.”
 
“As patients sit in emergency rooms across the state waiting for a psychiatric bed to become available, the IMD exclusion shrinks the available options even further, resulting in patients not getting timely beneficial care,” said Small. “I ask you to think about where in health care do you have these types of limitations? I cannot think of any other area.”
 

Alison Denil, Wisconsin Market CEO for Summit Behavioral Health, also came to the Capitol to testify in support of the bill. The Medicaid IMD exclusion applies to both of Summit Behavioral Health’s freestanding psychiatric hospitals in Wisconsin because they have more than 16 beds.
 
“The efforts to eliminate the stigma that is tied to mental health diseases has increased the volume of individuals who seek care,” said Denil. “We have a responsibility to ensure psychiatric care providers are available to meet this need. That is why the federal government has recognized this barrier and provided states with new mechanisms to get an exception to [the IMD] exclusion, including encouraging states to apply for a waiver that would allow Medicaid reimbursement for inpatient services in an IMD.”
 
WHA’s written testimony on Assembly Bill 616 can be found here.