Highlight on Tennessee: Governor proposes 10% cut to mental health case management

Mental health funding through Tennessee’s Medicaid program, TennCare, would be cut under budget changes proposed by Governor Bill Haslam (R). These cuts would reduce funding for Level 2 Case Management Services by 10 percent.

Level 2 Case Management

Level 2 Case Management Services fund outpatient care for Tennessee’s mentally ill patients. Case managers working under Level 2 aid mental health patients in their daily lives by monitoring medication intake, assisting in employment searches, and coordinating everyday activities, such as buying groceries.

“It’s about quality of life,” said Frontier Health CEO and President Dr. Teresa Kidd. “Mental illness is one of those diseases . . . where you have periods of stability, you’re prone to relapse, and you may do well again. But helping people access the systems that they need to really be the most they can be is what case management does.” Frontier provided data showing that in 2014, approximately 2,200 people in Tennessee used Level 2 Case Management to cope with mental illness, and 92 percent of these people meet the state’s definition for serious, persistent mental illness.

Effect of proposed changes

The budget cuts proposed by Governor Haslam would not eliminate Level 2 case management completely, but it would limit case management services to 90 days after being hospitalized for mental illness, rather than allowing years of services if necessary. Kidd said that, not only is 90 days insufficient for these types of services, hospitalization is too costly a treatment method for how ineffective it can be.

“[I]t’s terrible for the person to have to wait until they get to crisis,” Kidd said. “The case management movement has been one of the most successful things that we have used in this state to actually decrease hospitalization.”

Others are concerned that the drop in the number of case managers will result in fewer patients receiving any necessary treatment for their mental illnesses, increasing interactions between law enforcement and the mentally ill.