Washington hospitals ask state to expand behavioral health care access

When Abby Baker was pulled out of a youth treatment center in Montana due to traumatizing conditions, she still needed mental health care.

The teenager, diagnosed with bipolar disorder, hadn't received any during her short time at the residential facility called Acadia Montana, as the Inlander wrote in August. When she got out, she asked for intensive outpatient treatment through the Providence RISE program.

It turned out to be exactly what she needed.

"Without programs like RISE, I would probably be in a different residential program, dead, or at the least, incredibly unstable," says Baker, 15, in a letter provided to the Inlander meant to raise awareness for more mental health services in the state.

Currently, however, partial hospitalization or intensive outpatient programs like RISE aren't covered by Medicaid. But that could change soon. The Washington State Hospital Association has asked the state Legislature to fund access to such programs through Medicaid. The state Senate's budget proposal includes funding for intensive outpatient and partial hospitalization.

"When people talk about the behavioral health crisis, a lot of attention is paid on the inpatient side," says Shirley Prasad, policy director of government affairs for WSHA. "If we want to move the needle in behavioral health, we have to look at the entire continuum."

Programs like RISE serve as a bridge in that continuum — more structured than typical outpatient treatment but not quite an inpatient stay. WSHA says these programs can prevent hospitalizations and facilitate quicker discharges from psychiatric units. Kolbi Peach, the behavioral health practice manager for RISE, says they help people stay in touch with their communities while receiving intensive services.

"A lot of the individuals who attend are individuals who have kids and jobs and really need to stay connected," Peach says.

The hospital association is asking for $2.2 million to add intensive outpatient programs to Medicaid coverage and an additional $2.4 million for partial hospitalization programs. That would fund benefits starting Jan. 1, 2021, through June 30, 2021. (Intensive outpatient programs are usually attended for three hours a day a couple of times a week, and partial hospitalization programs are up to eight hours a day and five days a week.)

Most commercial health insurance plans, along with Medicare, cover these programs. But Washington is one of 21 states where Medicaid doesn't cover it, according to WSHA.

Besides Providence's RISE program, and another Providence program that provides outpatient care for young children, there are few options locally for those looking for similar treatment. Peach says the RISE program generally has a waitlist.

"We're hoping that this will encourage other facilities to expand programs or start offering partial hospitalization or intensive outpatient services," Prasad says.

In her letter shared with the hospital association, Baker says if RISE had been available to her years ago, she could have avoided therapists, psychiatrists, hospitals and "so much unnecessary trauma."

"There are so many children and adults in Washington state, in the United States, and in the world who have miraculous futures if we would just give them the chance to get help," Baker says.

This story has been updated.