Select Page

By Evelyn Amodovar

For many individuals seeking mental health care, finding a mental health provider and treatment is as quick and easy as a Google search and a phone call. For Medicare recipients, however, it is neither quick nor easy. Results from the 2016 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration, an agency within the U.S. Department of Health & Human Services, indicates that only 1 in 5 recipients receive needed care. Beneficiaries are often at the highest risk for mental health problems, such as depression and suicide, yet they are the least likely to receive mental health services.

Although there is a general shortage of qualified mental health and substance abuse counselors, one of the reasons why Medicare recipients are unable to access timely care is because relatively few licensed providers can bill Medicare. Also, many facilities do not have sufficient numbers of counselors credentialed for billing Medicare, and this creates long waiting lists for treatment.

Prompted by the national debate regarding gun violence and mental health, this year the U.S. House of Representatives introduced the Mental Health Access Improvement Act of 2019 (H.R. 945). Designed to expand the list of professionals authorized to treat and receive payment for services to Medicare patients, the bill provides Medicare coverage for marriage and family therapist services and mental health counseling services. It also authorizes marriage and family therapists and mental health counselors to develop discharge plans for post-acute services. Currently, Medicare does reimbursement for these services.

Some local governments have taken steps to increase prevention and outreach programs in their communities. For instance, Manatee County, Florida recently approved funding for a home visitation program called the Community Health Improvement Plan. This program will focus on case management for people who are at risk of preventable emergency room visits and for those who are either uninsured or are Medicare/Medicaid recipients. Specifically, the plan is to train staff to identify and work with potential mental health patients to reduce emergency department visits.

One of the program’s goals is to move clients into post-acute treatment as soon as possible by addressing known and potential barriers to treatment. For instance, a case manager might arrange transportation for a client or call with a reminder. This program helps ensure that clients are connected with the resources they need to get the care they need. Manatee County is also developing community partnerships between law enforcement and behavioral health providers. Mental health professionals are now involved in threat assessments conducted by law enforcement and the implementation of so-called “red flag” laws.

The Mental Health Access Improvement Act of 2019 and the efforts of Manatee County are hopeful signs of progress and improvement. While more needs to be done, these efforts, generated by inspired public policymakers, provide real benefits to people who desperately need them.

Evelyn Amodovar is an MPA student who has worked as a treatment consultant for a federal and state-funded Behavioral Health and Addictions hospital. She has a B.S. from Post University in Human Services with a concentration in counseling.