The Los Angeles County Board of Supervisors Tuesday voted to urge state officials to apply for a Medicaid waiver that would expand coverage for inpatient mental health treatment at residential facilities.
Supervisor Kathryn Barger recommended pushing for the expansion.
"Medicaid is the largest payer of mental health services and expansion of this coverage would be critical to those who are in need of treatment," Barger said. "It is imperative that we use this opportunity to demonstrate that mental health treatment should be a permanent and ongoing priority that is worthy of both federal and state investments."
The federally funded health program has always excluded reimbursement for residential mental health care, with the exception of treatment for minors and seniors.
The Centers for Medicaid and Medicare Services announced in November they would consider state applications for an exclusion waiver, which would make coverage available to those suffering from a severe mental illness. CMS said it is looking for innovative programs.
If accepted, the waiver would free up funding to help the county deal with a decades-long shortage of mental health beds.
The wait time for a bed in one of California's five state psychiatric hospitals is a year or more, leaving severely ill patients without the care they need and tying up resources in hospital emergency rooms, according to county officials.
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Last week, the board asked for a plan to expand the number of inpatient and "step-down" mental health beds for patients transitioning out of hospital care.
"Today's motion is complementary to our existing efforts, and will allow us to right-size our network of hospital beds to ensure that the right level of care is delivered to those in need -- including not just mental health services, but also services for addictions and medical co-morbidities," said Dr. Jonathan Sherin, who runs the county's Department of Mental Health.
California moved to de-institutionalize mental health care in the 1970s over concerns about abusive treatment and mental health advocates support the expansion of community-based care.
The board voted to send a letter to Gov. Gavin Newsom and state legislators urging the state to apply for the waiver.
Newsom's proposed budget includes a number of investments in mental health care, including:
- expediting the allocation of bonds and streamlining the permit process for permanent supportive housing for mentally ill individuals;
- $100 million for intensive supportive services; and
- $70 million related to early detection of mental illness in young people.
