Proposed changes to Medicaid rules could “decimate” funding for Bert Nash Community Mental Health Center and 700 of its clients, CEO David Johnson said Monday.

Bert Nash gets roughly 40 percent of its $8.5 million budget from Medicaid, Johnson said. He said legislation proposed by U.S. Health and Human Services Secretary Mike Leavitt would set the bar impossibly high for Medicaid reimbursements.

“There’s little question that the implementation of these rules would decimate the community mental health system across the country,” Johnson said.

Gary Karr, chief Medicaid spokesman in Washington, D.C., said Monday he wasn’t familiar with the details of proposed changes in funding for mental health programs.

“I do know that the administration believes that the Medicaid reform proposals will not have any direct impact on any Medicaid beneficiary,” Karr told the Journal-World.

The National Council for Community Behavioral Healthcare last week sent an alert to community mental health centers, detailing the proposed changes.

According to the council, those changes would affect two kinds of programs:

¢ Case-management services, under which mental health specialists help clients find services that help them get medical help, housing assistance, jobs and other social services.

¢ Rehabilitation services, under which a variety of physical, psychosocial and addiction treatment services can be offered.

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The National Council said the proposed changes include a provision that Medicaid won’t reimburse programs like Bert Nash if similar management or rehabilitation services are provided elsewhere in the community without the use of federal dollars.

Practically, the council warned, that means that Medicaid wouldn’t pay for “medication management” if a county jail in the same state provided that service to its inmates.

Johnson said 700 clients of Bert Nash receive case management or rehabilitation services. “Almost all” of those services are paid with Medicaid dollars.

“They’re trying to cut the budget,” Johnson said. “They’re trying to cut the Medicaid budget.”

But Karr said the Medicaid budget was growing too fast, otherwise.

Even with cuts, federal Medicaid spending would grow from $184 billion this year to $250 billion, as rosters swell with population growth and the working poor are dropped from employer-provided health plans.

Such skyrocketing expenses, Karr said, show the clear need for Medicaid budget reform.

“It’s an unsustainable system,” he told the Journal-World.