HOSPITAL CLOSURES
THE MEDICAID IMD EXCLUSION
"Across the
country, 40 mental health hospitals have closed in the past decade, according to the U.S.
Department of Justice. During the same period, 400 new prisons have opened."
The Olympian (Washington), October 9, 2003
Resources
Articles
Contact Congress
In 1965, Congress
excluded most payments to state psychiatric hospitals and other "institutions for the
treatment of mental disease" (IMDs) from Medicaid because the Federal Government did
not intend to take over what historically had been a state responsibility, and because it
intended to implement a system of community mental health centers that would replace the
state psychiatric hospital systems.
Largely as a result of the IMD Exclusion, hundreds of thousands of patients have been
deinstitutionalized to the streets or transinstitutionalized to nursing homes, general
hospitals and other similar institutions where federal funds pay most of the costs.
Hundreds of thousands more are incarcerated in prisons and jails -- institutions ill-equipped to handle their special needs. In
the past four decades, America has lost effectively 93 percent of its much needed state
psychiatric hospital beds, resulting in increased rates of homelessness, incarceration,
suicide, victimization and violence.
The Treatment
Advocacy Center is working to abolish the IMD Exclusion and to encourage a broad federal and state
re-evaluation of how mental health services are funded. So long as there remains an
enormous financial incentive for states to discharge patients with severe mental
illnesses, but no financial incentive to provide aftercare, America’s jails and
streets will continue to be the de facto asylums for the mentally ill.
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The Treatment Advocacy Center's report on the shortage of public psychiatric hospital beds
The report - released in 2008- shows a national shortage of nearly 100,000 beds
Make your opinion heard!
( Find
out how to contact your Senators and Representatives )
- Report: "The Shortage of Public Hosptial Beds for Mentally Ill Persons"
- Fact Sheet: Medicaid Discrimination Against the Severely Mentally Ill
- NAMI Policy Paper -- IMD Exclusion: Implications of Repeal
- NAMI Public Policy on IMD Repeal
- NASMHPD Position Statement on Repeal of the Medicaid IMD Exclusion
- Briefing Paper: Repeal of the
Institutions for Mental Disease Exclusion
(Click here for the HTML version: 119K)
(Or click here for the PDF version: 186K, see note below about PDFs) - The Outdated Institutions for Mental Disease
Exclusion: A Call to Re-Examine and Repeal the Medicaid IMD Exclusion
(Click here for the HTML version: 571 K)
(Or click here for the PDF version: 277K, see note below about PDFs)
- 'No vacancy' faces mentally ill (The Daily Oklahoman, October 6, 2000)
- True Parity Means Eliminating Medicaid's IMD Exclusion (Catalyst, by Bruce Rheinstein, J.D.)
- Dix's Bind Begins in Washington (The Raleigh News and Observer, April 2, 2000)
- Florida's Mentally Ill Left Out in the Cold (The Orlando Sentinel, March 23, 2000)
- Federal Neglect of the Mentally Ill (The Washington Post, December 30, 1999)
- Half a Million Liberated from Institutions to Community Settings Without Provisions for Long-term Care (Catalyst, by Curtis Flory MBA and Rose Marie Friedrich RN, MA)
- Deinstitutionalization of the Mentally Ill (Sen. Daniel P. Moynihan in the Congressional Record, July 12, 1999)
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Reprinted with permission of Bob Englehart and The Hartford Courant.
Copyright 2000, The Hartford Courant. All rights reserved.
