GRAND RAPIDS — “Everyone will tell you getting good access to addiction services and to mental health services is a fundamental part of having a healthy community.”
As a Grand Rapids-based emergency medical technician, Simon Gretton sees the needs firsthand when responding to calls. And mental illness and substance use factor into many of them, he said.
Simon recently joined the KAXE Morning Show to share his experiences and express concerns about the impact of an impending change to Itasca County’s public insurance program. In early September, the county said it would drop Lakeview Behavioral Health as an in-network provider for IMCare enrollees by the end of the year.
The change is expected to impact about 700 patients receiving treatment at Lakeview. IMCare is the sole provider of Medicaid and MinnesotaCare in Itasca County, meaning it serves some of the most vulnerable reliant on public health insurance. Lakeview is a for-profit mental health provider offering outpatient individual and group therapy, medication-assisted therapy, and substance use disorder treatment.
The county says it is following a transition plan approved by the state and is working with those affected to seek appropriate care elsewhere.
‘Things we don’t want to see’
Some Itasca County residents remain concerned about the continuity of care for these patients, including Simon, who also works with the unhoused population at Grace House in Grand Rapids. Simon said he worries those in need of services don’t have a voice in the conversation.
“I think generally we are considered to be an underserved area,” he said. “And it's not hard to imagine that if this happens, we'll see increases in homelessness, increases in people using the ER, increases in people calling the ambulance, increases in people calling law enforcement, you know. Maybe more suicides, maybe more murders. All the things that we don't want to see.”
Troubled by the Lakeview Behavioral Health contract news, Simon said he’s frustrated by how the Itasca County government is responding.
“Naturally you hear about something like this, you reach out to the county commissioners,” Simon said. “Unfortunately, their position has been that they can't comment on this. They've cited legal concerns."
“It's not hard to imagine that if this happens, we'll see increases in homelessness, increases in people using the ER, increases in people calling the ambulance Increases in people calling law enforcement, you know. Maybe more suicides, maybe more murders."Simon Gretton
In an earlier interview, Itasca County Commissioner Terry Snyder said, “It's important to make sure that they're not left in the cold, that there are some options given to these individuals so that they can continue the services they're receiving from Lakeview.”
Simon said it’s difficult for those with questions when there are very few answers.
“Literally everybody speculates, and people speculate all over the place,” he said, “and we know how far that gets any of us.”
What happened?
According to Zack Kahmeyer, director of clinical services of Lakeview Behavioral Health, the provider was not notified of contract violations within the IMCare termination letter.
Kahmeyer also disputed local providers' ability to absorb the IMCare patient load in an earlier interview. The sheer number of impacted enrollees, according to Kahmeyer, will put a strain on other mental health and substance use providers.
"We've talked with several different care providers in Itasca County,” said Kahmeyer, noting his conversations were with providers within reasonable driving distance. “What we're hearing is that those organizations don't really have the ability to absorb 700-plus IMCare members into their services.”
But IMCare Director Sarah Anderson disputed this, noting other network providers have said IMCare members will have access to the care they need. In a presentation to the Itasca County Board in September, she said the decision to terminate the contract came after a recent training to address concerns with Lakeview’s claims and billing practices.
Anderson stressed IMCare has an obligation to appropriately manage public taxpayer funds by following up on concerns about care as well as billing.
What’s next?
The relationship between IMCare and Lakeview is set to end Dec. 29. Lakeview Behavioral Health currently has a message on its website that reads, "We are doing all we can to reverse this decision."
It also has information on how to contact the Minnesota Department of Health to advocate for mental health services, stating, “IMCare’s rash and ill-conceived decision will create a mental health desert in our already underserved area.”
What does this mean for current and future patients?
“We are working hard to ensure that there are no gaps in care for enrollees,” stated Anderson in a September email. “There are many other mental healthcare providers in the County, and we are working to get enrollees all the information they need to select new providers. IMCare has a plan in place to make sure enrollees have continuity of care.”
In October, commissioners approved a new agreement with Compass North for substance use treatment through IMCare. This agreement expanded IMCare coverage with the Grand Rapids provider, as there was already a contract for behavioral health services.
