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Yahoo
07-05-2025
- Health
- Yahoo
Oklahoma mental health providers say they're owed nearly $150M in reimbursements
Mental Health Commissioner Allie Friesen speaks at a meeting April 17 at the state Capitol with House lawmakers reviewing her agency's finances. (Photo by Emma Murphy/Oklahoma Voice) OKLAHOMA CITY — Behavioral health providers contracted with Oklahoma's mental health department are no longer being reimbursed for some services provided and can't sustain the cost, an industry advocate said. Green Country Behavioral Health Services has not been reimbursed by the Oklahoma Department of Mental Health and Substance Abuse Services for some specific services this fiscal year, said Joy Sloan, its chief executive officer. Sloan said Green Country has inexplicably not been paid for $5.2 million in requests since the 2024 fiscal year. She said these are costs that have been 'historically' reimbursed to help cover additional costs related to caring for indigent patients. Sloan operates a certified community behavioral health center, known as a CCBHC, which provides comprehensive substance abuse and mental health treatment to vulnerable people. Those health centers are supposed to receive enhanced Medicaid reimbursement rates. An analysis provided by Sloan shows that eight Oklahoma providers have claimed almost $150 million in reimbursements in budget year 2024. The analysis shows the providers received $8.7 million in reimbursements in that time, but were owed about $62.3 million. In the current budget year, they've sought $86.7 million, but have received nothing. While providers weren't historically reimbursed for 100% of these requests, Sloan said there was a drop in what was reimbursed last fiscal year. A graph from a fact sheet created by an Oklahoma behavioral health provider shows changes over time in reimbursements from the Oklahoma Department of Mental Health and Substance Abuse Services for services provided by eight certified community behavioral health centers operated by members of the Alliance of Mental Health Providers of Oklahoma . (Provided and created by Family and Children's Services) Mental Health Commissioner Allie Friesen, said the agency is investigating why the payments have not been distributed. She said her agency has been in contact with a few partners since Monday afternoon and is actively working with the Oklahoma Health Care Authority to investigate. 'We are not currently aware of any reason why these payments should not have been distributed and are committed to resolving the issue swiftly,' she said in a statement. Friesen's agency is facing several investigations following reports of financial disarray and a $43 million shortfall. Friesen admitted to lawmakers Monday that her agency needs help finding answers on the agency's finances and budget. Traditionally, certified community behavioral health centers have been eligible for additional compensation beyond their contracted monthly rate. For example, Sloan said, a provider with a $2 million annual contract receives one-twelfth of that amount every month and any expense for additional services beyond that falls into a 'pended services' category, which is submitted for reimbursement. Sloan said she had not been contacted by the mental health department as of Tuesday afternoon. She said she's worked at Green Country for 34 years and has been in the CEO role for 15 of those. Heather Helberg, CEO of HOPE Community Services in Oklahoma County, also said Tuesday afternoon that she hadn't been contacted about the reimbursements for services, but had been in contact with Friesen on Monday about a separate payment issue, outcome-based payments. Helberg said she's worked at HOPE for seven years. 'We have done so much to divert clients from jails and hospitals,' she said. 'No one wants to go back.' SUPPORT: YOU MAKE OUR WORK POSSIBLE Between the 2020 and 2023 fiscal years, HOPE was reimbursed 85% to 95% by the state, Helberg said. In the 2024 fiscal year, its reimbursement rate dropped to 23%. This lack of payment equates to $2 million in the 2024 fiscal year and '$1.7 million and counting' for the current fiscal year, she said. 'I would just love to ask the question, 'Would we expect any other field to absorb several million dollars in free care and services?'' she said. 'Even if we are charities or nonprofits, we have to get paid for services rendered. It's not sustainable for us to keep absorbing these costs. We are the safety net, and if it continues, it will break us and our clients are the ones that suffer without care.' Sloan also serves as the president of Alliance of Mental Health Providers of Oklahoma, a coalition of eight certified community behavioral health centers. She said the other members are also experiencing issues receiving payments. Family and Children's Services, a Tulsa area provider, is another member of the group. Without the pended payments, reimbursement is unbalanced and results in 'overwhelming deficit,' according to a fact sheet from the agency provided to Oklahoma Voice. Between the 2023 and the 2025 fiscal year, the number of community behavioral health center clients grew 13%, and the number of uninsured clients grew 102%, the document shows. Historically, about 55% of those reimbursement costs were covered by the mental health department on average. Those reimbursements dropped to 14% last fiscal year. An increase in Medicaid clients would be needed for the centers to break even if the state does not contribute, the document said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Sloan said her operations have been able to continue because Green Country has been 'good stewards' of its funds, but she's spent time at the state Capitol talking to legislators about the problem. She said under previous administrations at the mental health department, there used to be more regular, monthly meetings with agency leadership. Demand for the services is growing, but payments are not, she said. Green Country, which serves Muskogee and McIntosh counties, serves 5,000 Oklahomans every year, Sloan said. 'I sure expect to give away services to the community, which historically has been anywhere between $300,000 and $600,000,' she said. 'Millions is too much to bear.' Most of these services are for uninsured, indigent populations. Without payment, Sloan said her agency might have to halt these services. 'The last thing I want to do is have to lay off staff and quit serving people because it affects my friends in the community,' she said.
Yahoo
07-03-2025
- Health
- Yahoo
Agencies collaborate to close gaps in care for Newport County children. Here's how
In October, the Rhode Island Coalition for Children and Families (RICCF) released a report titled 'Children in Crisis Can't Wait: The Case for System Transformation.' The report highlighted the increasing demand for behavioral health services for children in crisis, along with the growing gaps in the state's ability to meet these needs. At the time, children were being sent to out-of-state psychiatric facilities for care, and the situation was dire. Around the same time the report was released, Rhode Island was accepted into the federal Certified Community Behavioral Health Clinic (CCBHC) program. Newport Mental Health serves as the CCBHC for Newport County, offering a wide range of services for children and families (see our January 2025 column for more details). Today, the state, along with many partner agencies, including Newport Mental Health, is actively working to address the problems and close the gaps identified by RICCF. 'The Department of Children, Youth and Families (DCYF) is working very hard to bring back the children placed out of state' says Stephanie Lujan Rickerman, division director of children's services at Newport Mental Health. 'They are trying to get them out of hospitals and into treatment in the community, and we are partnering to help them do that.' In Rhode Island, DCYF is responsible for the well-being of children, regardless of whether they are in the department's care. With a dynamic new leadership and an ambitious strategic plan for 2025-2030, the agency recognizes Newport Mental Health, and all of Rhode Island's CCBHCs, as key partners in providing the right behavioral health services at the right time, ensuring the 'least restrictive' care possible (i.e., keeping children out of hospitals unless necessary). Rickerman participates in biweekly meetings at DCYF's Providence office, where agencies that provide children's services, including CCBHCs, come together to discuss complex cases and find collaborative solutions. She cited an example of how CCBHCs provide essential wraparound services. In one case, a parent was ready to be reunited with their child, but housing was the only barrier to reunification. CCBHCs helped by connecting the family to housing assistance resources. Newport Mental Health's newly introduced Intensive In-Home Child & Adolescent Psychiatric Services (IICAPS) program (developed by Yale University and operating in Connecticut) is also playing an important role. Newport Mental Health is working to take the program statewide through partnership expansion. Since its launch, DCYF has referred seven children to the program at NMH. Rickerman recalls a recent case where IICAPS was combined with services from Child & Family, a family-focused nonprofit based in Middletown. One sibling enrolled in IICAPS, while another continued treatment with Child & Family. 'Our families are incredibly complex,' explains Marty Sinnott, president & CEO of Child & Family. 'It takes a well-integrated system of care – of which Newport Mental Health is an essential part – to meet the diverse needs of these families.' Newport Mental Health and Child & Family collaborate through the Family Care Community Partnership (FCCP), a program that wraps services around families experiencing stress, whether related to finances, behavioral health, substance use, housing security, or other challenges, and develops a comprehensive support plan. 'We need to look at how all these pieces fit together,' Sinnott says, referencing IICAPS, FCCP, and other services, including hospitalization. 'Newport Hospital is taking steps to increase capacity for adolescent inpatient care. The IICAPS program can help prevent some kids from needing that level of care. We have to find the best ways to maximize our resources and create the biggest impact.' 'It's so important to have Newport Hospital here,' adds Rickerman. 'Sending a child to Providence for treatment can put a huge strain on the family. There are transportation challenges, and parents often have to take time off work. Having a facility on the island makes it easier for families – kids get the care they need, and parents can keep their jobs and participate in family therapy.' Newport Mental Health has also partnered with Aquidneck Pediatrics to enhance care coordination. A nurse from Newport Mental Health's children's team regularly attends meetings to share information, discuss client needs and review referrals. Recently, one of our school-based clinicians spoke with a pediatrician about concerns regarding a child's eating habits. In another case, a young client with eczema was found to also have asthma, prompting our nurse to coordinate care through the East Bay Community Action Program (EBCAP), a nonprofit providing health and human services support such as medical and dental care. Integrated care like this is crucial to a child's – and family's – overall well-being. We also collaborate with many Newport County schools and organizations, including Looking Upwards, the Newport County YMCA, the Boys & Girls Club, and the Bradley School in Portsmouth. Some initiatives are already in place, while others are in the planning stages. 'The partnerships between Newport Mental Health and state and local agencies offer several important benefits for Rhode Island,' says Richard Leclerc, director, RI Department of Behavioral Healthcare, Developmental Disabilities & Hospitals. 'These collaborations help improve the efficiency and effectiveness of behavioral health services, which can lead to a range of positive outcomes and benefits for the individual, the community, and the state. Some of these improvements include stronger community support networks, such as the collaboration between Newport Mental Health and state and local agencies to ensure individuals have access to a wide range of services. This would include counseling, psychotherapy, care coordination with primary care and other services, medications, and assistance with supported housing and employment. When we improve the access and effectiveness of services, we improve the quality of life. Access to care allows individuals to maintain employment and become more self-sufficient, reducing stress and fear.' As the first CCBHC in the state (a designation we first received in 2018), Newport Mental Health has a head start in developing our programs, all of which are replicable, and science based. Because CCBHCs operate statewide, every community has the potential to access these lifesaving, client-centered services like IICAPS — if the state continues to support behavioral health. Children and families represent the future of Rhode Island, and it is essential that we invest in their well-being. Supporting children is our top priority. A healthier Rhode Island means stronger economic growth and improved quality of life for all. By focusing on the needs of children today, we can make a lasting, positive impact on the future of our state. Newport Mental Health is actively collecting and tracking data to show the outcomes of the high standard of care being delivered, and we look forward to sharing the results. Dayna Gladstein is president & CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Kristan McClintock, appears monthly in The Newport Daily News and online at Newport Mental Health is a 501(c)3, charitable nonprofit and a Certified Community Behavioral Health Clinic (CCBHC) that provides mental health and substance use treatment to those who live, work, and study in Newport County, regardless of their income, insurance, or ability to pay. Newport Mental Health offers programs and services for children and adults; immediate access to care is available by calling 401-846-1213. For more information, please visit This article originally appeared on Newport Daily News: Newport Mental Health partners with agencies to improve child care
