Mental health

Denton County mental health services could take a multi-million-dollar hit if a funding extension isn’t granted in the coming months.

Pam Gutierrez, executive director of Denton County MHMR, said the center has made use of the 1115 Delivery System Reform Incentive Payment (DSRIP) Waiver programs since 2011. The DSRIP is part of a healthcare funding program approved by the U.S. Centers for Medicare and Medicaid Services (CMS) in 2011.

That year Denton County MHMR applied for and received funding for three DSRIP programs – a crisis residential program, a psychiatric triage facility and an integrated care facility. It received funding for those programs in partnership with UT Southwestern.

Gutierrez said the CMS in January approved a 10-year extension for the DSRIP program, but in April the CMS rescinded the waiver, meaning it would expire Sept. 30, 2021, as originally planned.

Gutierrez said if it expires without an extension Denton County MHMR could lose $4.6 million in funding.

“The problem is ongoing services,” Gutierrez said. “We need more money for ongoing services.”

Gutierrez said the waiver extension helps underinsured and Medicaid recipients.

“That’s tremendous for us because we have three Medicaid waiver programs in Denton County,” Gutierrez said.

Gutierrez said the crisis residential facility helps individuals who have been in a psychiatric hospital, who have been in jail or who have been homeless and need help transitioning into everyday life.

“It gives them a fresh outlook on life,” Gutierrez said. “It teaches them the skills they don’t have and teaches them things they don’t have in life but need to know, like how to survive on the outside.”

It has 12 beds for males or females and includes a transgender room.

Gutierrez said the psychiatric triage facility provides mental health services to people who go to the emergency room and need the help.

“People go to ERs,” she said. “They spend hours and hours at the ERs, and they don’t get appropriate services. When they go to psych triages they get appropriate services for their mental health conditions because we can help them. When they go to ERs it’s not appropriate services.”

She said the integrated care clinic treats people holistically who have comorbid diseases.

“For example, if someone has schizophrenia and diabetes the doctor provides treatment for the diabetes and a nurse practitioner sees the patient for schizophrenia,” Gutierrez said. They’re in the same building, they communicate with each other and they share information.”

Tuesday, Gutierrez asked the Denton County Commissioners Court to approve a resolution that encourages the Department of Health and Human Services and CMS to approve the DSRIP program to at least Sept. 30, 2022. The resolution also encourages the Texas Legislature to make funds available to cover the loss if the extension isn’t granted. The court unanimously approved the resolution.

“We need to be getting as much mental services as we can get during these times,” said Commissioner Bobbie Mitchell. “Because we’re seeing this pandemic has brought to light all of the areas that was hidden.”

Gutierrez agreed.

“It’s increasing. It’s not stopping,” Gutierrez said. “And for this to happen was so damaging to us.”

Gutierrez said the resolution will go to the Texas Legislature, which would then send it to the federal government.

Gutierrez said the Texas Council is asking for these types of resolutions from counties across the state, and many, including Tarrant and Collin, have jumped on board.

Gutierrez said MHMR has applied for multiple grants to help cover the losses, but she said Denton County’s center isn’t the only one needing help.

“Right now everyone is in limbo,” she said. “There are 39 community centers. They all have programs similar to ours.”

She said if MHMR doesn’t receive that funding elsewhere the programs will have to close.

Gutierrez said there are also programs within Denton County Public Health that would be impacted by the extension not being granted.

“So this will hurt your constituents exponentially,” Gutierrez said to the Commissioners Court.

This isn’t the only time Denton County MHMR has faced funding challenges. Gutierrez said Denton County MHMR was recently the lowest-funded mental health facility in the state. She said the Legislature gave Denton County MHMR money to take people off its waitlist, but it’s still 29th out of 34 facilities in terms of funding.

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