JACKSON – Leaders of Northeast Mississippi’s mental health centers expect to meet their Medicaid obligation for the rest of this fiscal year, but after that, services could be affected unless the state can provide some help.

“If we have to, we will scrimp by in order to pay it,” said Region 3 Executive Director Robert Smith, whose center serves Lee County and six other Northeast Mississippi counties.

Region 3, Smith said, will be able to cover the projected $700,000 Medicaid match owed for the rest of the current fiscal year, which ends June 30.

But without substantial changes to services, it will be difficult to pay the projected $1.2 million that will be owed as its portion of the Medicaid match for the upcoming fiscal year, he said.

The 15 community mental health centers operate independently and provide services for the mentally ill, people suffering from drug addictions, people dealing with intellectual disabilities and others.

The Department of Mental Health also contracts with the centers to provide community-based treatments, including people who have been discharged from state institutions.

The centers receive funding from a tax levy in the counties in their service region. Smith said Region 3 receives some money from treating patients with private insurance, and some funds from patients with no health insurance – based on their ability to pay.

A large percentage of the patients the centers treat are eligible for Medicaid. The federal government currently pays 84 cents of each $1 spent treating a Medicaid recipient in Mississippi.

For the centers, the problem is coming up with the funds to provide the match to the federal government for treating Medicaid recipients.

During the current state budget crunch, no state funds have been appropriated to help the centers with their Medicaid match this year or the next, according to a statement from the Department of Mental Health.

The department has provided some funds to the centers to help pay the Medicaid match. But facing budget cuts of its own, the department says the centers will be responsible for paying the rest of their Medicaid debt for this year, which is estimated to be around $15 million, and for the coming year, estimated to be $35 million.

Centers that cannot pay their debt will no longer be certified by the Department of Mental Health as an approved provider and will lose grants.

That action could place some of the centers in danger of closing. The statement adds that boards of supervisors in the regions where their centers cannot pay their debt can contract with other centers.

The statement said the Department of Mental Health Medicaid could not continue to pay the centers’ Medicaid match “without severely negatively impacting the programs which are the responsibility of DMH to operate, including the thousands of individuals those programs serve.

“Our priority is to provide quality services to the citizens of this state who have a mental illness, intellectual or developmental disability, substance abuse problems, Alzheimer’s disease and other dementia.”

Corinth-based Region IV Community Mental Health Center is in no danger of closing.

“We’ve always kept our Medicaid match paid up,” said Charlie Spearman, executive director of the center, which currently serves four counties and will expand in September to handle DeSoto County. “That hurts because it takes a lot out of our budget.”

Michael Roberts, executive director of Region 2, which serves Lafayette and six surrounding counties, said his center will not have any Medicaid debt for the rest of the current fiscal year.

But for the coming year, if no state help is coming, “we will be in very serious difficulty, very serious.”

He said the community centers are being cut off by the state at a time when the national trend is to move away from institutional care for the mentally ill and toward community care.

“But the truth is, for good, comprehensive services, you really need both,” Roberts said.

House Public Health Chairman Steve Holland, D-Plantersville, said he believes the responsibility for paying the Medicaid match for the 15 community mental health facilities will be decided in court.

“I think the state will wind up having to pay, and I wouldn’t be surprised if it had to pay it all,” Holland said.

Holland called funding of community mental health centers “a major crisis.”

“If you close down the community mental health centers, there is no safety net out there,” Holland said. “The jails will fill up. You will have people shooting people in the street. I am not exaggerating. The mentally ill are the mentally ill. They don’t need to be put in the jail, but they need care.”

Daily Journal staff writer Michaela Gibson Morris contributed to this report.