By Jennifer Fiorillo
Mental Health
Jennifer Fiorillo
I have been encouraged by the outcome of recent past legislative sessions that have helped to support and build upon the critical safety net of community mental health and substance use services for some of our most vulnerable residents in Connecticut. Providers have seen some cost of living increases in state service contracts that have enabled them to adjust salaries for staff who provide trauma-informed, evidenced-based treatment that is necessary to promote positive outcomes and successful recovery.
The unfortunate reality is that the nonprofit sector still functions 30 percent behind inflation dating back to 2007. This statistic, published by the CT Community Nonprofit Alliance, places safety net services at risk for shutting down vital programs and services because of high staff turnover, burnout and the inability to pay a competitive salary that meets market standards. Compounded by this statistic of agencies operating behind inflation, those that are supported through the Medicaid/Husky program for behavioral health services have been struggling to meet program needs and demands because the reimbursement rates for services are lagging behind significantly.
The results of phase 1 of a Medicaid rate study that was initiated by the state Department of Social Services in 2023 showed concerning disparities between expenditures in specific behavioral health services in comparison with five benchmark states including New York, New Jersey, Maine, Oregon and Massachusetts. The total behavioral health Medicaid/Husky expenditures for Connecticut for the study period were $39.1 million compared to an average of $81.5 million for each of these benchmark states. Nearly 92 percent of the rates for the services analyzed in Connecticut fell below the reimbursement for these comparisons.
Agencies providing outpatient mental health services in Connecticut are not nearly able to cover the cost of services through Medicaid/Husky reimbursement alone. Individuals who seek care at community-based mental health organizations are typically on Medicaid/Husky. The reimbursement for an individual therapy session does not even cover 50 percent of the cost in an outpatient clinic. Those organizations that receive support from state contracts to supplement reimbursement struggle to meet the demand for service, retain clinicians and provide consistent treatment because of staff turnover and ever-increasing costs to provide quality care.
Community-based outpatient clinics are also required to meet rigorous licensing and accreditation standards, service thresholds, quality monitoring and data reporting that need to be supported by adequate infrastructure and technology. These requirements not only cost money, but they add to the complexity of providing treatment and recovery services to people who so heavily rely on this support.
I had a sense of hope at the start of this year’s legislative session that we would continue to see progress toward making non-profits more whole. There is nothing more meaningful to community nonprofit providers than to do their best work and meet the needs of those who put their lives in our hands. In order to do our best work, we need to continue to advocate and push for the funding we need and deserve to bring about hope and healing.
Jennifer Fiorillo, MBA, MPH is the president and CEO of Bridges Healthcare in Milford, and may be reached at Jfiorillo@bridgesmilford.org.