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Publicly Funded Community Behavioral Health System Hit Hard by Low Rates and COVID Impacts

By May 19, 2020April 20th, 2021Home Page, News

The Washington Council for Behavioral Health has been working hard throughout 2020 and 2021 to ensure that our essential safety-net providers remain able to serve people living with serious mental illness and/or substance use disorder in the face of COVID-19. A recent survey of our members provided startling data on the impacts of the pandemic; a summary of that data can be found HERE. Chronically low Medicaid rates exacerbated by COVID pandemic costs and lost revenue have left community behavioral health agencies in crisis, struggling to recruit and retain the essential workforce needed to maintain treatment access and capacity. In the past year we have seen the community behavioral health workforce shrink by over 11%, and at least eight treatment facilities and branch clinics have closed so far. Provider agencies report unacceptable vacancy and turnover rates, which result in ballooning caseloads.

Our members responded quickly to the healthcare crisis like every other healthcare provider system, such as nursing homes, assisted living facilities, hospitals, and primary care clinics. Behavioral health agencies pivoted swiftly to activate and expand telehealth services where possible, while maintaining access to essential in-person care for a vulnerable population. They have spent, and continue to spend, significant amounts of money on PPE for staff working in clinic or community settings, sanitizing equipment, upgrading HVAC systems, and other measures to ensure our locations are sanitary and safe.

Unlike other healthcare providers, however, community behavioral health has not received COVID-19 specific rate increases to offset the high costs we assumed. Reimbursement rates were already extremely low before the pandemic.

The Washington Council has asked the Legislature to address these impacts through three main actions:

  • Including in the biennial operating budget a Medicaid rate increase of 7% for rates paid to behavioral health agencies to support competitive salaries and stabilize system capacity;
  • Providing immediate and flexible COVID stabilization stipends to behavioral health agencies to address COVID costs and related loss of revenue; and
  • Giving proactive guidance to state agencies to ensure an equitable share of any new federal COVID relief funds are directed to the community behavioral health system.