Treasure Valley mental health agency cutting rehab, cites Optum changes

Meridian mental-health agency A New Leaf is halting its community-based rehabilitation services on June 1.

The cuts, according to a letter sent to clients, are the result of changes implemented by Medicaid managed-care contractor Optum Idaho.

Optum took over the administration of Idaho Medicaid’s outpatient mental health services in September 2013. Since then, Optum has cut back on authorizations, saying community-based rehabilitation does not always meet standards for “evidence based” treatment.

Optum Idaho Executive Director Becky diVittorio told the Statesman that her company’s goal is “helping individuals achieve their goals” and “using active therapies that have measured, repeatable results.”

Many patients who received the skills-based community-based rehabilitation services, or CBRS — previously known as psychosocial rehabilitation, or PSR — through Idaho Medicaid were children. Optum says there is inadequate evidence that CBRS is an effective therapy for children, while many providers and parents say the services are a key part of patients’ mental health care.

Optum has increased access to family and individual therapy, diVittorio said.

A New Leaf was providing 136 clients with CBRS when Optum took over, but the number of clients Optum authorized for CBRS declined to 23 by early April, the letter said.

“With [the previous number of] clients, we were able to meet the program’s financial obligations, including hiring enough qualified staff to manage the amount of paperwork and therapy required by Medicaid,” the letter said.

At the same time, Optum required more paperwork but would not reimburse for the time spent on it, A New Leaf said.

“So, it has become necessary to face the fact that it is no longer financially feasible to continue providing CBRS services as of June 1, 2015,” the letter said.

A New Leaf will continue to offer some non-CBRS services, such as counseling, the letter said.

Marilyn Sears, director of mental health services for A New Leaf, said the agency would lay off all staff who lack certification to provide a non-CBRS service. A New Leaf had reduced staff by 13 employees as of early April.