Regional mental health facilities must remain regional


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John Roberge


When we think about our daily routines and those of the people around us, some common themes likely emerge. Getting up in the morning, having a coffee, driving to work, coming home, eating a meal with the family, catching up on chores. These are daily tasks that have become so entrenched in our lives that we probably take them for granted or don’t think about them much.

But for the thousands of Kentuckians affected by serious mental illness, addiction and intellectual disability, such a routine may seem incredibly out of reach. For these people, some of the most vulnerable in our society, just getting through the day can present challenges that many of us cannot even imagine.

Luckily, in Kentucky, they have a place to turn to for help and support. Since the 1960s, Community Mental Health Centers (CMHCs) in Kentucky have been an integral part of our health care system, serving as the state’s behavioral health safety net. Now, important legislation – House Bill 349 – is being considered in the General Assembly to ensure that Kentuckians can continue to benefit from CMHC as intended.

CMHC was created to provide comprehensive crisis and behavioral health services to Kentuckians within their local communities, regardless of their ability to pay. Today, CMHC serves and supports approximately 175,000 people statewide, providing everything from substance use counseling and emergency services for children, to operating the helpline State’s 24-hour suicide prevention hotline. CMHC is required by law to offer a full range of services under one roof, services tailored to the most at-risk members of the community that other providers and facilities simply cannot effectively manage.

Without our trusted CMHC network, many vulnerable Kentuckians would have nowhere to turn to get the care and services they need.

One of the reasons CMHC has been able to provide these services so consistently year after year is the regional model they adhere to. CMHC operates in defined geographic regions to ensure it serves people close to home. Unfortunately, in recent years some CMHCs have decided not to follow the rules, threatening the longevity of our entire behavioral health safety net.

What happened – and why state lawmakers must now pass House Bill 349 – is that a few CMHCs chose to operate outside of the regional system that the rest of us have adhered to ever since. over 50 years old. In doing so, these dissenting CMHCs chose to provide only the most profitable services in areas outside of their designated regions. Of course, it works well for them as they are able to select preferred services and increase their profits. But it creates a level playing field for the rest of us who are required by law to provide comprehensive services in our communities.

House Bill 349 is intended solely to ensure that CMHC operates as intended, which means providing the full range of services required of CMHC in their designated areas. If a CMHC wants to move out of its designated area and set up a facility that provides only certain services, it can currently do so – and will still be able to do so under the provisions of Bill 349. But the legislation would ensure that those facilities are not operating as CMHC and instead are duly licensed as Behavioral Health Service Organizations (BHSOs), which adhere to a different set of state guidelines and a separate reimbursement structure from CMHC.

The majority of CMHCs in Kentucky are operating as they should. But the stability and future of the entire system will continue to be threatened the longer we allow a few rogue CMHCs to take advantage of the loopholes that exist today. CMHC’s system can only remain intact in the years to come if we correct this imbalance now.

As our entire country faces an unprecedented mental health crisis and record overdose deaths, the majority of CMHCs in Kentucky want nothing more than to continue serving the children, men and women who have most need our help. But without a legislative solution, our whole system could begin to crumble. This is not a scenario that any of us want to find ourselves in and why we need to pass House Bill 349 without delay.

Abbreial P. Drane is President and CEO of Seven Counties (Louisville); Jennifer Willis, CEO, Pathways Inc. (Ashland); Dr. Wanda Figueroa Peralta, President and CEO, RiverValley Behavioral Health (Owensboro).

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