A simple error causes a big deficit for mental health care.
North Carolina is home to nearly 10.5 million people. According to the National Alliance on Mental Illness (NAMI), 20% of adults in North Carolina experience mental illness each year. The state has been grappling with a shortage of mental health professionals and a rise in mental health-related incidents. In 2018, North Carolina’s Division of Health Benefits (DHB) implemented a new policy intended to improve mental health services for the state’s Medicaid beneficiaries. However, a math error in the policy has led to a shortage of services, leaving those in need without proper care.
The new policy implemented by the DHB was aimed at ensuring that Medicaid beneficiaries in need of mental health services receive them within a reasonable timeframe. The policy required health care providers to conduct an assessment of the patient’s condition within three business days of the request for service. The providers were also required to provide services to the patient within ten business days of the assessment.
However, the DHB made a critical error in the formula used to calculate the timeframe for providing services. The policy did not account for weekends and holidays, which meant that the ten-day deadline could stretch out to as much as sixteen days. This error caused a significant backlog of Medicaid beneficiaries waiting for mental health services, as providers were not able to meet the requirements of the policy within the stipulated period of time.
The failure of the DHB policy has had significant consequences for those in need of mental health services in North Carolina. According to a report by PBS Frontline, the number of Medicaid beneficiaries who received mental health services in North Carolina dropped from 290,399 in 2018 to 274,768 in 2019. Additionally, the number of Medicaid beneficiaries with mental health needs waiting for services increased from 4,245 in 2018 to 5,048 in 2019.
The math error in the policy also led to the closure of several mental health practices, as they were unable to keep up with the increased demand for services. Many providers could not afford to hire additional staff to meet the requirements of the policy, leading to reduced services and longer wait times for patients.
North Carolina’s mental health system needs a solution that addresses the shortage of mental health professionals and the backlog of Medicaid beneficiaries waiting for services. One possible solution is to revise the policy to account for weekends and holidays, which would help ensure that providers can meet the ten-day deadline for providing services.
Another solution is to increase funding for mental health services. According to NAMI, North Carolina ranks 43rd in the nation in per capita spending on mental health services. Increasing funding for these important services would help attract more mental health professionals to the state and ensure that providers can hire additional staff to meet the demand for services.
The math error in North Carolina’s mental health policy has led to a shortage of mental health services for Medicaid beneficiaries in the state. The error has caused a backlog of patients waiting for services and the closure of several mental health providers. North Carolina’s mental health system needs a solution that addresses the shortage of mental health professionals in a sustainable manner as well as the backlog of Medicaid beneficiaries waiting for services. This can be achieved through a revision of the policy to account for weekends and holidays and an increase in funding for mental health services.
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