Health policy panel proposes more money for behavioral health homes

Behavioral health homes are a model of care that can provide a variety of services for people with mental health illness or emotional disturbances. But the costs of delivering an integrated approach offering primary care, mental health and social services can be high.

The problem behavioral health home providers in Minnesota say they are facing is that reimbursements for services provided are inconsistent and too low. Many are losing money despite the need people have for this type of care and the success providers have seen it produce.

Julie Bluhm, CEO of Guild Services, a nonprofit that provides integrated behavioral health homes services to people living with mental illnesses and/or experiencing chronic homelessness, told the House Behavioral Health Policy Division Wednesday that her organization served 226 people last year.

“At the same time we lost $114,000 in providing this service in 2021,” Bluhm said. “We keep this service despite the fact that it does not break even because it’s a critical need in our community.”

Rep. Kelly Morrison

Rep. Kelly Morrison (DFL-Deephaven) sponsors HF3737, which seeks to help behavioral health home providers by establishing a single statewide reimbursement rate for people covered under Medical Assistance. It would also require the Department of Human Services to allow the reimbursement rate to be adjusted annually based on the Medicare Economic Index.

“Behavioral health homes are a critical part of the continuum of care for people with mental illness,” Morrison said. “I hope that you will all support this bill so that a reimbursement rate reflective of the true cost of providing this service can become reality.”

Division members voted 12-0 to approve the bill and refer it to the House Human Services Finance and Policy Committee. The companion, SF3010, is sponsored by Sen. Carla Nelson (R-Rochester) and awaits action by the Senate Human Services Reform Finance and Policy Committee.

Bluhm said she believes if the bill does result in a “sustainable” reimbursement rate, more providers will begin offering behavioral health home services helping people who “represent a very high risk, very high needs, very high cost population in our state” get the assistance they need before ending up in a crisis, or the criminal justice system.

“We have found that the people we are serving in our behavioral health homes are those who have very high needs who have fallen through the cracks of our mental health system as it is now,” Bluhm said.

A number of organizations also submitted testimony in support of the bill, including the Minnesota Association of Mental Health Programs, which represents 35 community-based mental health providers and agencies around the state and collectively serves over 200,000 Minnesotans.

“We know the model of care works well and helps address and improve clients’ needs in a holistic way,” the association wrote. “But we need the payment for BHH to be more accurate to the cost of providing the service.”

Rep. Dave Baker (R-Willmar) said that although he supports the bill and believes it should get bipartisan support, tying the reimbursement rate to an economic index gives him “heartburn” and he urged caution in holding future legislators to decisions made today.

“We just need to make sure that we keep looking at this,” Baker said.