Doors close to mentally ill

Mental health agencies across the state are starting to cut thousands of mentally ill people from their treatment lists, and are turning away many others looking for help.

The state has until June 30 to find $41 million to help people who need mental health services but whose care can no longer be funded by federal Medicaid money.

Jennifer Buchanan / The Herald Gerri Varnes, who has bipolar disorder and has been hospitalized for her condition several times, has been denied Medicaid funding.

The state had been using Medicaid money to treat people who didn’t qualify, in violation of federal rules. Now, Medicaid is cracking down. The state originally was given a Jan. 1 deadline to cut people off, but that was pushed back to give officials time to figure out a solution.

Unless state legislators, who already face a $1.8 billion budget deficit, can find replacement funds, medical conditions could deteriorate for many who are unable to get treatment, said Terry Clark, development services director for Compass Health in Everett. Compass Health is Snohomish County’s largest mental health provider.

The people who will lose service generally earn too much money to qualify for Medicaid, but not enough to afford health insurance. For example, an adult living alone cannot earn more than $6,983 a year in order to qualify for Medicaid.

Some of the mentally ill have already ended up in mental health wards at hospitals.

“These folks aren’t going to get better on their own,” Clark said.

Cut off, turned away

The changes have forced Compass Health to cut off treatment to nearly 100 people, and the agency now is turning away about 80 potential clients each month.

Statewide, several thousand mentally ill people have lost care over the past few months, said Cathy Gaylord, chief executive officer of the Washington Community Mental Health Council.

For example, Evergreen Counseling Center in Hoquiam dropped 100 clients, and Behavioral Health Resources in Olympia dropped 65 clients.

Mental health agencies are in a quandary over whether to reinstate care or accept new clients. Officials say their clients would enter treatment only to face the possibility of being cut off again at the end of June.

Some people would benefit from short-term treatment, said John Masterson, Behavioral Health’s chief executive officer. In other cases, agencies need months to wean a mentally ill person from services. Restoring care, then yanking it away again, could severely traumatize people, Masterson said.

Gerri Varnes, 58, of Shoreline is one of those caught in limbo. She has bipolar disorder and needs treatment, but can’t afford it and doesn’t qualify for Medicaid.

Last summer, Varnes, 58, suffered a severe episode that included suicidal thoughts. She voluntarily checked into the mental health ward at Stevens Hospital in Edmonds. When she was released in July, a social worker told her to call Compass Health for follow-up outpatient treatment.

“Compass told me I didn’t qualify anymore,” Varnes said.

Her symptoms got so bad that in December she again checked into Stevens and spent eight days there.

Varnes’ deterioration over the past six months will make it difficult for her to recover fully, said Ann Allen, a mental health coordinator at Stevens Hospital.

Care is cost-effective

The federal government defends its decision to make the state follow Medicaid rules. The increased scrutiny is intended to ensure that taxpayer money is spent as intended, said Mary Kahn, a Medicaid spokeswoman.

Meanwhile, a special state legislative committee in December unanimously recommended paying the needed $41 million to restore care.

“We don’t want to harm or injure those who are most frail and vulnerable,” said state Rep. Barbara Bailey, R-Oak Harbor, a committee member. “Humanity really demands we take care of people who can’t take care of themselves.”

Helping mentally ill people is more than a moral obligation for the state, said Rep. Hans Dunshee, D-Snohomish. It’s also more cost-effective, he said.

Such help keeps many mentally ill people stable enough to work so they aren’t forced to rely on government aid. And it keeps them out of expensive hospital rooms and off the streets, Dunshee said.

The change is pushing Varnes and others to seek help at hospitals. That in turn is increasing demand on limited bed space.

Stevens Hospital sometimes has to turn away patients when its 17 psychiatric unit beds are full, said Robin Mishler, the hospital’s coordinator of mental health admissions.

And an increasing number of people suffering from mental health problems are showing up in emergency rooms, to be treated by doctors who are not fully trained to deal with mental health problems, said Jeff Uyyek, director of financial policy for the Washington State Hospital Association.

Several hundred more mentally ill patients have sought help at Community Health Center in Everett and Lynnwood, said Rita Szantay, a behavioral health specialist with the center.

The boom in patients has led to less counseling time for some, she said.

Varnes was a little luckier than many others. After her last inpatient stay at Stevens Hospital, she got six days of intensive outpatient treatment at the hospital. Stevens didn’t have the money to pay for further care, Allen said.

But with Compass and other nonprofits turning her away, Varnes doesn’t know what she’ll do now.

“I want help,” Varnes said. “I need help. I don’t want to lose my mind.”

Reporter David Olson: 425-339-3452 or dolson@heraldnet.com.