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Topic: Medicaid expansion

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June 11, 2013 at 6:16 AM

Will state budget make mental health ‘boarding’ crisis worse?

Corrected version

The state Legislature’s embrace of Medicaid expansion has the potential to revolutionize mental health care in Washington State.

But the transition into Medicaid expansion will be rocky. Exhibit A & B are the House and Senate budgets now pending in Olympia. Each assumes Medicaid expansion will reduce the need for so-called “state only” mental health funding. For King County, the House Democrats’ budget reduces state-only funding by about $5 million in the 2013-15 biennium; the Senate assumes closer to $8 million.

State-only money covers services that Medicaid will not, including short-term psychiatric hospitalizations in facilities with more than 16 beds. That’s a particular problem in King County, because it depends heavily on Navos in West Seattle and Fairfax Hospital, which are too big to get Medicaid reimbursement.

And access to inpatient psychiatric care is already disastrous in King County. As I’ve written, and the Times has editorialized about, each night dozens of patients are “boarded” in emergency rooms because there’s no place else for them to go. The numbers are staggering – 2,160 patients in King County alone were boarded – in conditions a Pierce County Superior Court judge recently ruled were unconstitutional.

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Comments | Topics: Medicaid expansion, mental health