CHARLESTON, W.Va. - Along with expanding Medicaid to the working poor, West Virginia will change billing rules to provide more behavioral health services though the program.

The Department of Health and Human Resources is preparing to accept Medicaid billing from independent, licensed, masters-level clinical social workers. The West Virginia Center on Budget and Policy studied the availability of these services, and health-policy analyst Erin Snyder said the change should help ease a problem.

"There's a limited number of psychiatrists and psychologists as it is, and most areas of the state are considered mental-health professional shortage areas," she said. "With Medicaid expansion, there's an additional 150,000 individuals who will need access to health care."

According to the DHHR, the details are still being worked out but the change should be in effect for the next fiscal year, which begins July 1, and should result in a very limited increase in costs for the program. Providers point out that behavioral health care saves money in the long run by reducing a lot of other costs.

Snyder said it should be a boost for the state's physical health and economy.

"Having effective behavioral-health treatment will increase productivity, decrease the burden on the criminal justice system and decrease health costs," she said. "It's a real benefit to the state."

Snyder said the billing rules had been a barrier to some people getting the care they need, adding that most neighboring states already have removed similar barriers. In many cases in West Virginia, Snyder said, independent providers have had to have a psychologist or psychiatrist review their treatment notes, which she calls an unnecessary step.

"In reality," she said, "when their supervisors review these notes, it's just cursory, in order to bill Medicaid."

Medicaid covers treatment for behavioral-health issues such as depression and substance abuse, both of which are serious problems in the state. By expanding Medicaid to cover families with incomes up to one-and-one-third of the federal poverty level, behavioral health professionals predict a lot more West Virginians should gain access to the help they need.


get more stories like this via email

Columbia County, New York, is developing a new center to help people with mental illness and substance use disorder.

The Wellness Hub stems from a county study showing the best ways to fill gaps in care for people. It will provide emergency housing for people with mental health and substance use disorders.

Cheryl Roberts, executive director of the Greenburger Center for Social and Criminal Justice, said not many places offer services for populations in need.

"A lot of the emergency housing is nothing more than motels that are often located far from services," Roberts pointed out. "No food in the area, no other services, and that's the case in Columbia County. There's one hotel that provides services, but most do not."

The hub will have a ground flood-safe haven shelter with 25 single-room occupancy units. The hub will also have 35 units of permanent supportive housing and up to 14 120-day supportive housing units staffed with clinicians. Additional funding would be spent on a welcome center with space for peer-support services, a commercial kitchen to train people in culinary arts and other amenities for homeless people in the area not staying at the hub.

Early feedback has been overwhelmingly positive. The hub has become more necessary since the pandemic exacerbated mental health issues and homelessness. Roberts notes the Wellness Hub will work hand-in-hand with the county's mental health court. She said the 35 units of permanent housing can provide added resources for people in the criminal justice system.

"Half of it will be set aside for people with serious mental illness," Roberts outlined. "A quarter of it will be for people who are justice-involved, so coming out of incarceration or may be in the midst of the justice process where they might be taking a plea in the treatment court and being required to follow a treatment protocol."

One of the biggest challenges for maintaining the Wellness Hub is the ongoing shortage of mental health professionals. Reports show the number of New Yorkers with a mental illness has grown since the pandemic. The Health Resources and Services Administration found there are 192 designated mental health professional shortage areas, leaving more than 3.5 million people without access to mental health services.


get more stories like this via email

As the school year begins, experts are advising schools on how to preserve students' mental health but politics in states such as Wyoming limit policies that could help.

The youth suicide rate in Wyoming is increasing and has led the national rate for at least the past decade, according to Wyoming Department of Health data. Experts said K-12 schools can be good points of contact for student mental health but there are barriers for schools.

Rep. Dan Zwonitzer, R-Cheyenne, is on the state's Mental Health Task Force and said suicide prevention and mental health treatment can be challenging in rural areas.

"Just due to our lack of population and the rural nature, it's really tough to recruit and find individuals in this space to come in and work with the kids in many of our areas," Zwonitzer pointed out.

He and other members of the state Legislature tried to change it this year with House Bill 119, which would have made funding available for school districts to supply additional mental health providers for students. In a break from typical practice for interim session bills, it was voted down for introduction to the House.

Gov. Mark Gordon has prioritized the expansion of mental health services while in office. But Zwonitzer pointed out there is a lot of ideological diversity across the state.

"There's just a large segment of Wyoming, at least in their legislative representatives, don't believe that we need to be spending more money for the schools to deal with mental health challenges; that should be in the churches or nonprofits or within the family," Zwonitzer explained.

Zwonitzer and experts agreed schools are a critical place to identify student mental health problems or patterns.

A school checklist from the mental health advocacy organization Inseparable includes age-appropriate mental health education for students, engagement with families and community partners and a recommended professional ratio of one social worker and one counselor for every 250 students.

Caitlin Hochul, vice president of public policy for Inseparable, said schools provide the best opportunity to reach students in need of help.

"When we talk about access issues, we know that most kids are not receiving the care that they need. Schools are such a critical component to improving youth mental health because that is where students spend most of their time."

As Ohio students prepare for the new school year, mental health experts are highlighting the importance of belonging in the classroom.

A national poll from the Kids Mental Health Foundation revealed nearly half of parents are concerned excessive screen time might be preventing kids from forming meaningful connections at school.

Ariana Hoet, executive clinical director of The Kids Mental Health Foundation and a pediatric psychologist at Nationwide Children's Hospital, said the start of a new school year is different for every child. Some may be really excited, while others may be really nervous.

"As kids head back to school, what really matters is this feeling of fitting in, of belonging, of being connected to their school culture and community," Hoet explained.

Hoet pointed out as students face challenges, from social anxiety to post-pandemic adjustments, creating a classroom environment where they feel safe and connected is vital. Open communication between parents and teachers about a child's strengths and concerns can provide the support they will need to thrive.

Tyanna Snider, a pediatric psychologist at Nationwide Children's Hospital, said it is important to notice symptoms of mental health concerns in children and adolescents, especially during the back-to-school season when increased stressors may arise.

"Watching out for changes in functioning -- their child's mood, stomachaches or headaches or feeling nauseous, difficulty sleeping -- changes in behavior," Snider outlined. "All those things might happen every now and then but when those things are starting to get in the way of everyday life, that's when we really want to make sure that we're seeking out some additional help."

Hoet noted teachers play a pivotal role in shaping the classroom environment. Their relationships with their students and their overall influence can significantly affect students' mental health and sense of connection.

"The teacher has the power to change dynamics in the class," Hoet emphasized. "Create activities so that kids can connect with others to teach about empathy, kindness."

She added collaboration between parents and teachers is crucial for creating a supportive environment to enhance academic success and students' well-being.


get more stories like this via email