Fearing that mental-health provisions for children may be discontinued in their home state, U.S. Rep. Erik Paulsen (R-MN) and U.S. Sen. Al Franken (D-MN) wrote a letter recently to the Centers for Medicare and Medicaid Services (CMS), the agency in charge of providing Medicaid, asking the agency to preserve these services.
A recent statement from CMS, which outlines questions regarding the state’s compliance with federal regulations for psychiatric residential treatment facilities (PRTFs), raised concerns that federal funding could be cut off immediately. In a letter to CMS, members of the state delegation asked the agency to allow the Minnesota Department of Health and Human Services to maintain current practices for mental-health care, retroactive to 2001.
“The recent letter from CMS raises the concern that Federal Financial Participation (FFP) could be immediately cut off, leaving children in need of services with few options,” the legislators said in the letter. “Minnesota has had an effective array and continuum of care and services for children with mental illnesses for over a decade. These services have been developed over many years to effectively meet the individual and unique needs of children, adolescents and their families in the state.”
The letter — also signed by other Minnesota lawmakers, including Sen. Amy Klobuchar (D) and Reps. Tim Walz (D), John Kline (R), Betty McCollum (D), Keith Ellison (D), Tom Emmer (R), Collin Peterson (D) and Rick Nolan (D) — requests that Minnesota be allowed to maintain its current practice of funding mental-health services the way it’s been done since 2001. The group refers to a number of critical issues supporting their case, including:
• When the Medicaid program was established in 1965, federal payments were excluded for Institutions for Mental Diseases (IMD), defined as facilities with over 16 beds. However, in 1972, an exception to the IMD exclusion was established for individuals under age 21 in certain larger settings, including psychiatric residential treatment facilities.
• The Secretary of Health and Human Services has the authority to determine what large, other settings are allowed under the in-patient service benefit.
• In 2001, Minnesota, in consultation with CMS, designed a rehabilitation model that fell under the other setting option. This model allows for any medical service that has been recommended by a physician or other licensed practitioner for maximum reduction of a disability to be provided in a residential treatment center.
• Despite approving the state plan in 2001, CMS recently sent a letter to the Minnesota Department of Health and Human Services, expressing concerns about the use of federal Medicaid dollars for treatment services provided to children in residential treatment centers under the rehab option. The letter implies that federal funding could be at risk.
Paulsen and Franken have each worked hard to support the plight of small-business owners, particularly in regard to health care coverage, as well as those facing mental-health challenges. Paulsen serves on the House Ways and Means Committee and the bicameral Joint Economic Committee, and is co-chairman of both the Congressional Medical Technology Caucus and House Wellness Caucus. Franken, a member of the Senate Health Committee and co-chairman of the bipartisan Senate Rural Health Caucus, is known for his groundbreaking mental-health policy.