Medicaid waiver proposed to treat mental illness

To provide help to those without coverage

The Missouri Department of Mental Health introduced a Medicaid waiver program Tuesday designed to treat those in early stages of mental illness.

Director Mark Stringer and Rick Gowdy, director of the behavioral health and substance abuse division, presented the proposal to the House appropriations committee for health, mental health and social services.

In 2013, the state established the Strengthening Mental Health Initiative following the Sandy Hook Elementary School shooting. The initiative created the emergency room enhancement project, which promotes intervention in the emergency room, and community mental health liaisons, people statewide who refer mentally ill to services. Referrals often come from police who are the first to interact with the individuals in crisis.

Through those programs, the department has found those in early stages of mental illness are ages 25-31, whose life course can change if they receive treatment. In many cases, however, Gowdy said they fall in the health coverage gap - they don't qualify for Medicaid and can't afford their own insurance.

Typically, they receive charity care or none at all.

The waiver program would allow these individuals, an estimated 1,400, to receive two years of treatment through Medicaid. Employment is a condition of the program, as it is viewed as prevention therapy.

"If you get them to work, you can have much better outcomes," Gowdy said.

Ultimately, the goal is to halt the onset of irreversible mental illness or substance abuse disorders.

"We really believe that this first episode of psychosis intervention ... there are individuals that we can divert from becoming permanently mentally disabled by the time they turn 30, 40 years old," Gowdy said.

Stringer said the early intervention will keep people out of jail, court and the emergency room, and eventually save the state money. He said the waiver program is budget neutral at federal and state level, and the department will redirect certain existing funds from other programs that will be sustained by increased federal dollars.