WATERBURY -- Dozens of representatives from mental health care providers throughout Greater Waterbury packed a small conference room Wellmore Behavioral Health on East Main Street Monday for the opportunity to air their concerns with U.S. Sen. Chris Murphy, D-Conn.
The roundtable discussion was organized by Murphy to seek input for a mental and behavioral health he said he hopes to submit within the next month.
“Our behavioral health system nationally is fundamentally broken and is held tog by the miracles that the people around this table perform every day, despite reimbursement schemes, and rules and regulations, and funding levels that make your job harder,” Murphy said at the opening of the forum.
He asked attendees to each name one thing they would like to see changed in federal policy toward mental and behavioral health services.
Gary Steck, chief executive officer of Wellmore, told Murphy the antiquated system requiring mental health patients visit multiple care providers is based on funding rather than in taking the full recovery of the patient into account.
“We need a restart, because its not just inefficient, it's not how real people in the real world act. People shouldn't have top go to this provider because they're 18, and this provider because they're 20,” he said. “They shouldn't have to go to a different provider because of some arcane, financially driven mechanism.”
Deborah Borzellino, program officer at Community Mental Health Affiliates, complained Medicaid reimbursement rates are so low, agencies need to seek outside funding in order to pay physicians and other care providers.
Others in the discussion agreed. Pamela Pratt, manager of outpatient behavioral health at Saint Mary's Hospital, said the hospital is reimbursed as little as 52 for a behavioral health medical doctor appointment, and even less of that amount goes directly to the doctor. For that reimbursement, a doctor is required to provide a three-point examination for at least 20 minutes, she said.
“I want to sustain top quality that is fiscally responsible. I do not want to be the albatross to any system of care,” Pratt said. “I have no capacity to serve more people. Because of those kinds of rates, I can't afford to offer a doctor compensatory earnings.”
Professionals at the roundtable told Murphy that issue results in longer wait times for appointments, more people with mental and behavioral health issues crowding hospital emergency rooms, or troubled people being discouraged from seeking care at all.
“When Sandy Hook went down...one of my first thoughts was, 'Oh, dear God, don't have this be someone who tried to call me yesterday,' because I couldn't have gotten to him,” Pratt said.
“That's the impact you're having on the system, when people who do need care cannot get in.”
One answer, Borzellino suggested, is to create a “level playing field” bringing Medicaid reimbursements up to the levels provided by private insurance companies.
“When it comes to private insurers, they are for-profit. We are non-profit, so we get squeezed on a regular basis because sort of the implication of non-profit means well you don't need to make any money,” Borzellino said. “Well, that's not true. You want us to provide all of these services for our clients; we do need to have some sort of financial reimbursement.”
Marcia Geddes, chief financial officer at Wellmore, said the providers stand the most financial risk because they still see patients even if the funding to reimburse for those services is uncertain.
“I've been in this business a very long time, and we are at a critical point now, especially with the state pulling our grants that help subsidize those Medicare, Medicaid rates,” she said. “You know we're going to be hurting bad.”
Murphy, who said he had a full plate of meetings Monday, acknowledged the one-our panel was too short to do much more than “keep the conversation going” about the issues discussed.
“I am determined to get something done. Maybe it's not this year, maybe it's not next year, but I am determined to answer your challenge,” Murphy said. “I hear your frustration and I do these roundtables repeatedly because it's also inspiration to me.”
Steck, the Wellmore CEO, said afterward the forum effectively communication mental and behavioral health care providers' concerns to the senator.
“I think he understands very much from the consumers' perspective how difficult it is for people to access care,” he said.