Maryland Mental Heath Clinic Closures Are a ‘Matter of Money,’ Washington Post Editorial Says

The planned closure of three Montgomery County, Md., mental health clinics is not a "complex policy question; it's almost entirely a matter of money," a Washington Post editorial says (Washington Post, 1/17). The problem stems in part from how the state pays for treatment of residents with mental illnesses. Patients who have illnesses severe enough to qualify as a disability are eligible for coverage under Medicare, which covers half of a psychiatrist's bill and not medications. Low-income patients may qualify for coverage under Medicaid, which covers all needed care and medications. Remaining patients either have private coverage or are uninsured. In 1996, Maryland ceased covering the remaining 50% of bills for Medicare beneficiaries who were dually eligible for Medicaid. Although the state in 1997 initiated a program to cover more people at lower cost, officials underestimated by half the number of people who would access the services. (Kaiser Daily Health Policy Report, 1/15). The underfunding is causing federal, state, and local programs that help those with mental illnesses to be "whittled down, closed out, disbanded ... one by one," the editorial states. Without those programs, "many will end up, by default, on the streets, in jails or in mental hospitals," the Post continues. According to the editorial, a Montgomery County health official said that to "adequately serve" those "at risk" in the state, $26 million would have to be added to the governor's budget. "For perspective on that figure, consult ... Tuesday's front page; it tells about the Redskins' new coach" and his $25 million contract, the Post says, concluding, "How much is to be directed to making life better for some of the most helpless and tormented people in the society -- and how much to other things?" (Washington Post, 1/17).