Fourth patient dies after Idaho cut Medicaid mental health service
Published at
Kyle Pfannenstiel, Idaho Capital Sun
BOISE (Idaho Capital Sun) — Last week, one of Meredith Sievers’ patients missed an appointment.
The patient — in his late 40s — had gone down to once-a-week visits, Sievers said, after an Idaho Medicaid contractor cut a mobile treatment program for people with severe mental illness. The program was designed for people who have struggled in routine treatment settings.
He used to see providers several times a week, and was improving, Sievers said.
“He was actually doing really well,” Sievers told the Idaho Capital Sun. “Had achieved sobriety in the last couple of years. Was starting to go back to work. And was working toward becoming a recovery coach for people with other substance use disorders.”
After she asked around more, she learned he had died. But she doesn’t know how or why, she said.
Providers say it marks the fourth death among patients who were receiving mobile, specialized treatment in less than four months since an Idaho Medicaid contractor cut the service, called Assertive Community Treatment, or ACT. In the year and a half before the cut, only one patient on the program died, providers say.
“There’s a special place in my heart for these people,” said Sievers, who is a nurse practitioner and was the provider for the ACT team for a region in southwest Idaho. “And they’re really some of the nicest people you’ll meet, but the most mentally ill. … To have that funding pulled from us was heartbreaking, because now we don’t have a way to help those people.”
RELATED | After state cut a critical Medicaid mental health service, 2 eastern Idaho patients died
RELATED | A third patient has died after Idaho cut a Medicaid mental health service
RELATED | Despite recent cuts, Idaho is facing a projected state budget deficit, says report
Magellan, the contractor that runs Idaho Medicaid mental health benefits, and the Idaho Department of Health and Welfare were not immediately available for comment.
State health officials have denied the entire ACT program was cut, saying services are still available. But some providers say the services that are still available aren’t what the evidence-based program was like, because providers aren’t paid to staff mobile treatment teams.
About 200 people in Idaho are on the ACT program, Magellan Healthcare’s Idaho Executive Director David Welsh wrote in a December declaration in response to a federal lawsuit by patients.
Idaho doesn’t need more deaths ‘that could have been avoided,’ lawmaker says
A bill to reinstate the program, introduced last month as House Bill 753, hasn’t had a full committee hearing — which is when it can advance to the full House.
Rep. Ben Fuhriman, a Shelley Republican who’s sponsoring the bill, told the Idaho Capital Sun that securing funding for the program is still a work in progress. His bill estimates the program would cost the state general fund $1.3 million to run for the next few months of this fiscal year, and nearly $4 million for next fiscal year.
“I will reiterate that we need ACT, Peer Support, and the other mental health programs that were cut in December last year and there are some really good people working behind the scenes to try and make it happen,” Fuhriman told the Sun in a text message Thursday. “Once we have identified funding, I hope ACT gets our full attention. The State of Idaho doesn’t need any more patient deaths that could have been avoided.”
Sievers said she believes her patient’s death might have been preventable.
“I don’t know the circumstances around his death, so I don’t know. Potentially it could have been prevented if we knew more,” she told the Sun. “Say it was medical, we could have been assisting him with getting to a doctor’s appointment or whatever preventive medication he would need.”
Other providers have said at least two of the first three patient deaths were preventable.
That’s what Ric Boyce, the owner of Chubbuck-based clinic Mental Health Specialists, wrote in a federal court declaration about the first patient death. The patient, also in his 40s, died after complications following a minor surgical procedure — after declining follow-up care or sticking to a treatment plan, Boyce wrote.
How we got here: State had few options for cuts, official said
Soon after the cuts were announced, providers and the Idaho Sheriffs’ Association warned the cuts would risk public safety, and providers said the cuts would drive up other costs even more. Eastern Idaho crisis centers saw demand spike after the cuts, which also ended peer support services that help people navigate mental health treatment.
The governor’s budget chief, Lori Wolff, previously told the Sun that preventive services are often the first to go when the state faces a budget crunch — because they are one of few options the state has.
Magellan’s pay rate was reduced by the Department of Health and Welfare as part of Medicaid provider pay cuts last year, after Gov. Brad Little ordered state budget cuts.
In December, the state’s Medicaid director told lawmakers that health officials aren’t sure the cuts will save the state money long-term. Fuhriman’s bill estimates reinstating the program would save the state up to $9 million each year.
RELATED | Idaho House to consider $22M cuts to Medicaid disability provider pay rates
RELATED | Idaho families defend disability services amid Republicans’ Medicaid budget cuts
Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com.