A bill that aims to expand access to subacute mental health care, which is one step below hospitalization, is on its way to the governor’s desk.
It would remove the current 10-day time limit on subacute mental health care, establish new deadlines for Medicaid officials to respond to preauthorization requests and direct state agencies to eliminate rules that may impede access to subacute care.
The bill that passed the Iowa House unanimously Monday was a scaled-back version of what the House initially proposed. The Senate removed provisions that would have required health insurance companies to cover subacute mental health services and end preauthorization requirements.
Key supporters said they preferred the original bill, including mental health advocate Mary Neubauer.
“This bill today still makes meaningful changes that I hope will make the way easier for families and patients as we move ahead,” Neubauer said.
But she said help that isn't readily available isn't help at all. Neubauer said she tried everything to find care for her son when he was at the height of a mental health crisis, but it was a four to five month wait for an emergency assessment. Her son died by suicide before that day came.
“The longer that it takes for an insurance company or a managed care organization to make a decision about whether someone should receive care, the harder it may be for that person to recover their health or for them to avoid something more catastrophic that would happen in the meantime,” Neubauer said.
Rep. Beth Wessel-Kroeschell, D-Ames, said she also preferred the original bill, but she still asked lawmakers to vote yes.
“It seems that this leans on the side in favor of private insurance and the [Medicaid Managed Care Organizations],” she said. “I would prefer that we leaned toward the needs of people who need subacute care, the people who are suffering with mental health.”
Rep. Ann Meyer, R-Fort Dodge, managed the bill’s passage. She said she agreed with Wessel-Kroeschell.
“I’ve also reached out to private insurance and MCOs and will have the providers watching over the interim, and we will definitely make changes if those promises are not kept,” Meyer said.
Lawmakers and advocates said they will be watching how insurance companies handle requests for coverage of subacute mental health care and if Iowans are able to stay in facilities as long as they need to get better.
The bill that passed also requires the state to establish an electronic system to track the availability of beds at each psychiatric medical institution for children.
It directs the Iowa Department of Health and Human Services to review its capability to establish subacute mental health services at the state-run mental health institute in Independence, and allows the department to start those services if it can be done within its budget.
