NORMAN — Melissa Holt and her fellow “mental health militia” members stood on a curb Monday, complete with signs and petitions.
Holt and a group of about 10 other mental health providers and advocates, donning “Mental Health Militia” T-shirts, started their protest at noon Monday outside a children’s behavioral conference, which was hosted by the Oklahoma Department of Mental Health and Substance Abuse Services.
The group spent the next five hours protesting a proposed Medicaid policy change that would change which Oklahomans were eligible for psychosocial rehabilitation services, which Holt said includes helping teach people life skills that complement the talk therapy they receive from counselors.
Under the proposed rule change, adults and children would qualify to receive psychosocial rehab services only if they have been hospitalized at a psychiatric inpatient facility; have been admitted to a crisis center; or have been determined disabled by the Social Security Administration for mental health reasons.
Additionally under the changes, children might also qualify if they’ve been identified as having emotional disturbances and have related education plans, such as an individualized education program plan, for those mental health needs. Adults also may qualify if they live in a residential care facility.
Holt, who owns Elite Counseling in Kingston, said the proposed rule change will largely affect small private mental health agencies like the agency she runs in southern Oklahoma.
“It is going to be detrimental to children, families and individuals that need mental health counseling services,” Holt said.
The state’s mental health agency proposed the policy change after the Oklahoma Legislature did not allocate the agency all of the additional $20 million that its leaders said it needed to maintain the services it provides.
The Oklahoma Health Care Authority board will discuss and potentially approve the proposed changes at 1 p.m. Thursday at the agency’s meeting room.
Oklahoma has the second-highest rate of serious mental illness in the nation, and the majority of adults — about 70 percent — go without services, according to state and federal data.
To refrain from cutting funding that goes to inpatient and crisis beds, mental health officials proposed, among other things, changing the eligibility requirements for psychosocial rehab. The proposed change would save the department about $20 million.
Carrie Slatton-Hodges, the agency’s deputy commissioner of recovery and treatment, said the number of providers billing for psychosocial rehab services over the past few years has exploded.
Between the 2011 and 2013 fiscal years, there was an almost $70 million increase in outpatient behavioral health services paid by Oklahoma’s Medicaid program, and about 43 percent of that increase was in psychosocial rehab billing, she said. Also, there are 123 more agencies that are primarily rehab agencies in 2014 than there were in 2011, she said.
“It has been a tremendous increase,” Slatton-Hodges said. “We’ve seen more growth in this than any other service by far.”
Previously, about 57,000 Oklahoma adults and children received psychosocial rehab, she said. After the proposed rule change, that number would decrease to about 20,000 Oklahomans.
Holt said she worries about those Oklahomans who are no longer eligible. Psychosocial rehab provides children and adults with life skills, such as how to better control their anger, Holt said.
Without the service, clients will be left with only psychotherapy, the traditional talk therapy that a person receives during counseling, which they generally don’t receive as often as rehab, Holt said. Additionally, people learn more about their emotions and behaviors in therapy, not life skills like what behavioral health rehab specialists provide, she said.
Additionally, behavioral health rehab specialists might be left without jobs to do as the number of people who qualify for psychosocial rehab dwindles, Holt said.
“Basically, what that service is, it’s educational services — we can teach kids how to deal with ADHD, we can teach on domestic violence, we can teach on parenting. We can teach on communication,” Holt said. “Without that service, these kids will go without those services. These parents will go without these services.”