(Sept. 25, 2014) Next time Maria Cepeda tries to kill herself, she will succeed, she told the Press Democrat (“Mental health patients forced to seek treatment outside of Sonoma County,” Sept. 23).
“My last way, my final out, will be a hanging,” said Cepeda. “There will be no more suicide attempts. There will be one more and I will succeed.”
Cepeda, who has been diagnosed with severe depression and bipolar disorder, has checked herself into psychiatric hospitals over a dozen times in just as many years.
But because she is on Medicaid, she is not eligible to stay at Aurora Santa Rosa Hospital, a 95-bed, inpatient-psychiatric hospital. For Cepeda, and many low-income people with a mental illness, Medicaid is essentially meaningless when it comes to getting treatment in a psychiatric hospital.
The federal government's Institution for Mental Diseases (IMD) exclusion bans Medicaid from paying for psychiatric hospitalizations in facilities with more than 16 beds. Because Aurora Santa Rosa Hospital has 95 beds, Medicaid recipients with mental illness in Sonoma County, like Cepeda, have nowhere to go. (Read about the IMD exclusion). “The IMD exclusion ensures that adult, low-income patients will usually be sent out of the county,” according to the Press Democrat.
Ken Meibert, Aurora’s CEO, said the IMD exclusion amounts to discrimination. “Just because they have a different type of insurance should not preclude them from the type of care everybody else gets,” he said.
Some states are beginning to apply for a waiver to sidestep the IMD exclusion. In mid-September, Washington received approval to allow reimbursement for 30-day psychiatric hospital stays in facilities with more than 16 beds.
We can only hope, for Cepeda’s sake, that other states follow suit.
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