Should PA ‘carve out’ behavioral health from physical health or shift to a ‘whole person’ model? – PublicSource


Should PA 'carve out' behavioral health from physical health or shift to a 'whole person' model? - PublicSource

Two legislators are promoting a proposal to change the way thousands of the state’s most vulnerable people get services for mental illness and addiction treatment across the Commonwealth.

At issue is how the state delivers health services to Medicaid recipients, and whether they should merge the program offering behavioral health services with a larger one that also offers physical healthcare services.

Complementary bills in state House and Senate committees aim to eliminate Behavioral HealthChoices — a program led by the state but delivered at the county level in Pennsylvania.

“We have to have a common payment system to drive integration in the Commonwealth,” said state Rep. Seth Grove, a York Republican and sponsor of the House legislation. “You can’t treat two things separately. There has to be communication between mental health physician and primary care provider. It’s a medical whole model versus what we have today.”

Grove said the goal is to better help people by coordinating treatment through fewer programs. The carve-out approach does not engage providers in whole-person care, he said.

A spokesperson for state Rep. Kathy Rapp, chair of the House Health Committee, said the proposal will not be run through committee because Rapp does not support it.

The Senate bill, proposed earlier this year, advanced to the Health and Human Services Committee before the Legislature adjourned for the summer. It wasn’t immediately clear when and if the bill would advance in the Senate when the Legislature reconvenes in September.

“There are discussions ongoing, but there is nothing definitive at this time,” state Sen. Michele Brooks (R-50) said in July of a hearing. Brooks chairs the committee. State Sen. Kristin Phillips-Hill, also a York Republican, is sponsor of the Senate legislation.

Gov. Tom Wolf has not taken a position on the proposed legislation, according to Erin James, press secretary for the Pennsylvania Department of Human Services.

The state’s program offering behavioral health services to those on medical assistance was phased in at the county level in starting in 1997. Today, several but not all counties contract with healthcare providers to deliver behavioral health services to the state’s nearly 2.8 million Medicaid recipients who qualify.

Pennsylvania is one of fewer than a dozen states that uses a carve-out model.




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