BOISE, ID – An Idaho judge on Wednesday denied a request to pause a Medicaid contractor’s budget cuts to a critical mental health service.

Idaho mental health clinics sue state over Medicaid contractor’s cuts

The decision clears a legal hurdle for an Idaho Medicaid contractor, Magellan of Idaho, to proceed with its plan to cut specialized mobile teams that treat patients with severe mental illness who have struggled in routine settings. The cut took effect Monday, Magellan spokesperson Kristen Durocher told the Idaho Capital Sun in a statement.

Since the contractor announced the decision — which is part of a series of cuts meant to help the state avoid a budget deficit — mental health providers and even the Idaho Sheriffs’ Association have warned that the cuts could risk public safety, as people with severe mental illness lose accessible treatment through the program. In attempts to block the cuts, some mental health clinics and patients on the program sued the Idaho Department of Health and Welfare and top state health officials.

Idaho 4th District Judge Derrick O’Neill on Wednesday denied a request by four mental health clinics to pause the cuts, saying he didn’t believe he’d received enough information to suggest their case would succeed on its legal merits.

“Appreciating the fact that everybody involved is burdened by a difficult reality, I do not believe there is sufficient evidence before the court at this time to upset that reality,” the judge said at a Wednesday court hearing.

Federal judge Amanda Brailsford on Monday denied patients’ request for a temporary restraining order that could have required the state to continue offering the service.

The Idaho Department of Health and Welfare could not be immediately reached for comment. Magellan is a private company that runs Idaho Medicaid mental health benefits.

Patients will go to homeless shelters, jails, if program is cut, mental health clinics say

The clinics asked the state court to pause Magellan’s plan to end the program, called Assertive Community Treatment, until the cuts’ legality is determined. An attorney for the clinics, Preston Carter of Givens Pursley, argued that the state health agency didn’t adequately notify providers about the cuts. Last week, the Department of Health and Welfare published a notice of the cuts and announced public comment opportunities for Tribal representatives, weeks after Magellan first announced the cuts in late October.

“The patients will disperse among homeless shelters, in jail, in institutions, in hospitalizations, and the providers will not be able to relocate them because of the characteristics of this population,” Carter told the judge Wednesday. “And the trust that has been built up between providers and their patients will evaporate and will be very difficult, if not impossible, to reestablish.”

An attorney for the Department of Health and Welfare, Deputy Attorney General Anita Moore, said the agency has few options for cuts because many Medicaid services are protected by federal and state law. But if the department’s cuts were delayed, she said future cuts could be more drastic.

“It’s tempting to look at the Department of Health and Welfare as a bunch of faceless bureaucrats, heartless and cold, just cutting stuff left and right just because. …. That’s a cartoonish depiction or idea of how the department operates,” she told the judge Wednesday. “A lot of careful deliberation of what services have to be given priority over others or which amongst its myriad of services can be paired back with the least amount of negative impact on beneficiaries, or with the least amount of ripple effect across services, goes into these decisions.”

The judge, O’Neill, said later in the case attorneys will debate whether the department adequately notified the public about the cuts.

Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com.