Behavioral health advocates, providers and patients rallied at the state Capitol on Thursday afternoon to protest state spending cuts they say are forcing providers out of business and reducing services for people in need.
Changes implemented by the state Department of Human Services and the legislature have led to an 11 percent across-the-board cut for providers, according to Luke Kramer. Kramer is the director of the STARR Coalition, the advocacy group which organized the event.
He said DHS has also reduced the scope of practice for certain types of professional licensure in the mental health field, threatening providers that have a difficult time finding licensed clinical social workers. LCSWs are in short supply in Arkansas, especially in rural areas.
DHS has been instituting major changes in the state’s behavioral health system and plans to begin reimbursing providers through a new quasi-managed care model in 2019. But other cuts are hitting now, and some providers are already closing their doors, Kramer and other advocates said.
The rally occurred too late in the day to get a response from DHS, but earlier on Thursday, the agency issued a statement that maintained its reforms would increase access to services and improve outcomes for patients. The number of behavioral health agency sites in Arkansas has increased over the past year, the email said — from 253 in July 2017 to 264 as of this month. DHS said it is in the process of enrolling 27 more.
The Thursday event was headlined by former U.S. Rep. Patrick Kennedy of Rhode Island. Kennedy, a national mental health advocate, sponsored a 2008 bill intended to provide parity between insurers’ coverage of mental and physical ailments. (He’s had his own well-publicized struggles with addiction and mental illness, and he spoke on Thursday of his “recovery.”) He also drew on the civil rights legacy of his uncle, President Kennedy, to compare racial discrimination with the disparate treatment of mental health and physical health today.
“They are being treated in a separate and unequal fashion. … They are told, when they go into our health care system, to go down the hall and drink from the colored water fountain,” Kennedy said.
Patients with mental illness are told they’re not in the same category as patients with cancer, diabetes or cardiovascular disease, he added “Somehow they’re made to believe that their illness is their moral failing. Do you know where that attitude comes from? From the same place that racism comes from. It comes from mythology; it comes from ignorance; it comes from flat-out bigotry,” Kennedy said. (The crowd, which was about half African-American, applauded at the parallel.) He urged the state attorney general to look into the parity issue.
The rally came amid tumult of a different kind in the state’s behavioral health system as Arkansas’s largest behavioral health provider, Preferred Family Healthcare, prepares to withdraw from the state. Former PFH executives are at the center of multiple federal criminal investigations into alleged bribery schemes that implicate several state legislators, four of whom have pleaded guilty. (PFH, which was formerly called Alternative Opportunities, does business in Arkansas under the names Dayspring, Decision Point and Health Resources of Arkansas; it is based in Springfield, Missouri.) On September 12, one of its former top leaders, Keith Noble, admitted to various schemes to embezzle millions of dollars from the nonprofit, most of which originated from public funds. Other leaders are implicated but remain uncharged.
But while PFH’s former leaders may have engineered a way to unduly profit from the system, advocates said after Thursday’s rally, other providers have been operating on a shoestring for years and now face a crisis.