The Oklahoma Legislature is on the cusp of combining the state Department of Mental Health and Substance Abuse Services into the Oklahoma Health Care Authority.
The idea of House Bill 4064 — part of Gov. Kevin Stitt’s legislative program — makes sense on a certain surface level: Both agencies are involved in health services and do a lot of business with Medicaid.
But the idea is setting off alarms among those who know more about the issues than is visible at the surface.
Mike Brose, Mental Health Association Oklahoma chief engagement officer and the most trusted voice for mental health advocacy in Oklahoma, called the plan “wildly irresponsible,” and we think he has cause.
The Health Care Authority is a federal Medicaid pass-through agency, essentially an office responsible for accounting and federal compliance. The Mental Health Department is a specialized health care supervisory office with technical expertise, direct supervision of seven psychiatric hospitals and responsibility for thousands of patients. The expertise of the two functions — all lumped together in one director by HB 4064 — are not really complementary at all.
The nonpartisan Healthy Minds Policy Initiative looked at similar efforts in other states and found the unanimous advice in those states was not to rush into a Medicaid-mental health merger.
We feel the issue is very much being rushed. In a matter of weeks really, the plan has gone from a state Capitol brainstorm to the verge of implementation. Brose says he met with a large group of leading mental health care professionals recently and not one of them had been consulted. That sounds like the kind of top-down management that leads to havoc and regret.
If merging mental health and Medicaid processing is a good idea — and we’re less than convinced of that — it will be a good idea after the issue is fully vetted, a process we can’t see happening in the remainder of one legislative year.
We urge the Legislature to drop HB 4064 in favor of further study to make sure this is the best course for the state.