The Nebraska Department of Health and Human Services has seen a $15 million cut to its Behavioral Health Division this year and more cuts are being proposed, despite soaring demand for mental health and addiction treatment programs.
DHHS now faces a $25 million cut to help fund property tax relief.
Behavioral Health Specialists in Norfolk provides short-term residential treatment for substance use disorders.
Neil Broders, executive director, said the COVID pandemic may have contributed to the mistaken assumption any unspent funding must not be needed.
"Really, why a lot of places weren't able to pull down their funding and use it, it wasn't because the demand wasn't there," Broders pointed out. "It's because trying to find staff the last four to five years -- it was a difficult period."
Some Nebraska agencies have spent years rebuilding their staff following COVID. Broders explained they have had to compete with national companies who can pay more and allow people to work remotely. He pointed out employers, especially in smaller communities, have had to increase wages and work harder to recruit and retain staff.
Broders added their residential program only recently became fully staffed for the first time in four years.
"We now have the staff to be at 58 beds and are full," Broders reported. "We receive over 100 referrals a month for those 58 beds. So, we have the staffing now to serve the clients, and the clients are there."
The multi-program CenterPointe, based in Lincoln, has seen a similar increase in demand in the past year.
Topher Hansen, JD, president and CEO of the nonprofit, said their primary care clinic served 500 more people, and they provided over 2,000 additional hours of outpatient clinic care, at least partly because they were able to fill some open positions.
"But the more staff we get, the more availability we have, the more people that come in the door," Hansen observed.
More than half the people CenterPointe served in the last fiscal year reported annual incomes of less than $1,000.
Hansen acknowledged funding for mental health and addiction recovery is not always politically popular, but he stressed it is often a fiscally sound move. He pointed to their "Alternative Response" program, which works with the Lincoln Police Department to send a CenterPointe team, rather than a uniformed officer, for nonviolent welfare checks.
"We have done over a thousand of those in the last year and saved officer time every single time," Hansen emphasized. "We've cut the emergency protective custody incidents in half. We've housed a dozen people, and decriminalized being unsheltered."
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Researchers have announced a new blood test that will predict whether someone has Alzheimer's disease far better than current tests can. A new law in Iowa will make sure it's covered by insurance.
The Alzheimer's Association says the blood test is 90% accurate in informing people showing signs of cognitive impairment if they have the disease.
Iowa Chapter Communications Director Lauren Livingston said it's a huge step beyond the memory tests doctors currently use.
"Very good news," said Livingston. "It was about 30% to 40% higher accuracy rate with the blood test, versus just the physicians using a memory screening."
Livingston said patients must have a certain amount of "tau" in the brain, a protein that is an Alzheimer's precursor, to qualify for the test.
Iowa passed a law this year that requires state-funded health insurance companies to cover tests for dementia biomarkers, like tau in the blood.
Livingston said positive blood tests could boost recruitment for Alzheimer's clinical trials and reduce wait times for assessment.
There is no cure for the disease, but Livingston said early detection means a person can take drugs to slow its progression.
She said the test can be especially helpful outside Iowa's metro areas that have larger health care centers.
"Especially to rural Iowans who don't have as much access to specialists and these tests," said Livingston. "It would be much, much easier for them to be able to get a diagnosis if there was a simple blood test available."
Some 62,000 Iowans suffer from Alzheimer's disease. Nationwide, the number is close to 7 million, although the Alzheimer's Association says the disease is underdiagnosed.
Livingston is hopeful the test is available in health care settings in the near future.
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Montana is spending $300 million to improve mental health services in the state.
Experts are focusing on six key areas.
Montana's mental health care services took a hit in 2017 during an economic downturn, and Matt Kuntz - executive director of the National Alliance on Mental Illness, Montana - said the state is trying to come back from that.
New data released by what's known as the 872 Commission recommends the state bolster services in key areas - including investing in more mental health crisis beds, securing more funding sources, and getting more resources into Montana classrooms.
"It's important because it's a really great place for the kids to be able to access the care without disrupting their schooling," said Kuntz, "and it also gives the schools the ability to help their students get the care that they need."
The 872 Commission will make its recommendations to state legislators when they convene in January.
Kuntz said some of the commission's recommendations will require ongoing funding.
He said the state is already working to re-establish the mental health services the state needs, which suffered dramatically during the 2017 budget shortfall.
"And it was really heavily impacted in ways that we haven't quite dug out from yet," said Kuntz, "and they were only compounded during COVID."
The 872 Commission also recommends funding for forensic mental health evaluations and expanding group homes. Its report and recommendations are open for public comment.
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July is National Minority Mental Health Awareness Month, a time to raise awareness about the challenges ethnic and racial minorities face when it comes to mental health care.
The Food and Drug Administration says barriers include a lack of health insurance and less access to treatment.
Lisa Pion-Berlin, president and CEO of Parents Anonymous, which runs both the California and National Parent and Youth Helplines, said society must fight to eliminate the stigma around mental health.
"We don't talk about those things in their families, which may be tied to your cultural values," Pion-Berlin observed. "The history of oppression, where people say, 'If I express a problem, I'm seen as weak and as incapable.'"
She said 80% of callers to the California helpline are people of color. People can call or text the free helpline at 855-427-2736 to be connected with a trained counselor. Or you can live-chat through the websites, CAParentYouthHelpline.org or NationalParentYouthHelpline.org, 24/7. Parents Anonymous also offers free weekly support groups in California.
Sen. Alex Padilla, D-Calif., has called on the feds to finalize a rule proposed last year, requiring insurance companies nationwide to cover mental health and substance use disorders the same way they cover physical health.
Pion-Berlin argued many health plans are woefully inadequate, covering only a few therapy sessions. She added it can be hard to find a therapist who takes insurance because of extremely low reimbursement rates.
"They're saying two-thirds of the people actually experiencing mental health problems are not receiving any treatment, even though insurance companies claim that they have mental health coverage," Pion-Berlin noted.
Federal data show as of 2020, fewer than 50% of African American adults got care for mental health. And in 2018, Asian Americans were 60% less likely to receive mental health treatment than non-Hispanic whites.
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