U.S. Sen. Charles Grassley, R-Iowa, said he intends to co-sponsor bipartisan legislation that Quad-Cities officials say will enhance access to local mental health services.
Grassley toured and spoke with employees at Vera French Community Mental Health Center on Friday.
Vera French CEO Richard Whitaker urged Grassley, chairman of the Senate Finance Committee, to support a bill that would include licensed mental health counselors (LMHCs) as well as licensed marriage and family therapists as Medicare providers.
The bill, introduced in the Senate by Sen. John Barrasso, R-Wyoming, and Sen. Debbie Stabenow, D-Michigan, would require Medicare to finally recognize LMHCs as Medicare-eligible providers of covered behavioral health services to older adults and other Medicare beneficiaries.
Whitaker mentioned a 10-year-old study by White House's Office of Management and Budget that determined if Medicare were to make such a change to allow other providers that it would cost $100 million over four years. The study, Whitaker argued, failed to take into account the savings from "increasing access to a low-cost, low-level service" similar to primary care.
"When you open up access and incentivize people to go and get that primary care visit (from a physician), you're going to save money on emergency room visits and hospitalizations and other expensive procedures that you headed off," Whitaker said.
The same, he said, holds true for mental health therapy by a counselor, marriage and family therapist or a social worker.
"If we open up access to those folks, yes, there may be those costs, but in a real way they pale in comparison to the savings you see from" helping local hospitals, ERs, jails and nursing homes from becoming overburdened with Medicare beneficiaries with severe, chronic mental illness, substance abuse and other conditions, Whitaker said.
It also means patients who have seen mental health counselors for years are forced to find another therapist when they age into Medicare, because providers are no longer able to be reimbursed, Whitaker said.
"We also see a shortage of providers coming," Whitaker said. "We have a shortage now. We're not able to serve everyone we can serve in a timely way, because we are short on therapists. And as Baby Boomers start to age up into Medicare, and we're starting to see that now, we're seeing more and more people coming in and that shortage gets more acute."
Grassley said he will support the bill and work to get it passed in the Senate "so we can broaden the base beyond just licensed social workers of the people who can help them deliver the services."
Whitaker and Vera French employees also spoke of the need to address the loss of mental health services paid for by Medicaid when older adults age into Medicare.
"They're chronically mentally ill folks that weren't expected to live into Medicare age past (age) 65, and, yet, we are," Whitaker said. "We are seeing lots of our patients well beyond 65 with a chronic mental illness," who could benefit from the community mental health center's assertive community treatment to keep them out of the emergency room and hospital beds.
Grassley says mental health is a frequent, recurring concern he hears about across Iowa.
"It's coming up a little more often now ... with people being isolated" leading to increased anxiety, depression, substance abuse and other emotional, behavioral and mental health conditions arising "from a change of life style because of the pandemic," Grassley said."Hopefully, we're coming out of that now and you'll see less of that."