When Medicaid was established in 1965, it prohibited states from receiving Medicaid payments for institutions of mental disease, according to the report. Those institutions are defined as “a hospital, nursing facility or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment or care of persons with mental diseases, including medical attention, nursing care and related services.”
The rule’s intent was to discourage institutionalization of mentally ill individuals and replace it with a system of community mental healthcare, according to the report. But that system never materialized, and the exclusion has made it challenging for patients to access mental healthcare nationwide, leading many severely mentally ill individuals into homelessness.
The Los Angeles Department of Mental Health is working with U.S. Rep. Grace Napolitano, D-California, on a bill seeking to repeal the institutions of mental disease exclusion, according to the report.
“There’s no intention in this department or in this county to warehouse people, but it’s important that we have enough funding to support a network of treatment beds that’s adequate given the demand,” Los Angeles Department of Mental Health Director Jonathan Sherin, MD, told the news outlet. “We see the demand every day, certainly in our streets.”
