Andy Wilson never shared his fear, but there were three times in the past six years when the executive director of the Carriage House crafted "catastrophe plans" to avoid closing the successful Clubhouse Model program. When the state in 2010 changed the way mental health treatment is reimbursed through Medicaid, it cut access to $70 million in funds. Carriage House lost about half its support.
Today, a relieved Wilson is looking forward to expanding programs at the Lake Avenue Clubhouse, grateful that Gov. Mike Pence’s administration agreed to change a simple code requirement and support accredited Clubhouse Model treatment, approved through community mental health centers such as Park Center.
Unfortunately, it took years of pleading with the Indiana Family and Social Services Administration. Carriage House and other Indiana Clubhouse programs enlisted local legislators and community supporters to make the case. Park Center’s Paul Wilson battled for the change, as did Judge David Avery of Allen Superior Court and other area health and public safety officials. All recognized the program’s invaluable role in helping people with serious mental illness heal.
Several times it looked as if the dispute was settled, but the funding fix never followed. Finally, top-level changes began occurring at FSSA. Wilson said Joe Moser, Pence’s state Medicaid director, spent a day visiting the Carriage House. Kevin Moore, FSSA’s director of mental health and addiction, made several visits here. Finally, a psychiatrist, John Wernert, was named FSSA secretary. The policy changed.
"This could have and should have been fixed five years ago," Wilson said. "For reasons in that current culture of mental health and FSSA, it wasn’t. I’m focusing on the big win and the support and the help we now have in FSSA."
As one of two certified Clubhouse programs in the state (the second is in Elkhart), Carriage House is immediately in position to receive funds. The New Hope Clubhouse in Kendallville begins its accreditation process this week, while programs in South Bend and Indianapolis also are preparing to become accredited. Wilson said the fact that mental health providers were embracing the model even without guarantee of Medicaid reimbursement showed "how important and valuable and effective" it is.
Clubhouse programs are exactly that. Members participate in daily activities – office and food service work, for example – that support Clubhouse operations but also build confidence and social skills. They develop relationships with staff and other members so they escape the social isolation common among adults with mental illness. All their work and experience is designed to help them get jobs in the community.
Wilson said that even with its revenue shortfall, Carriage House welcomed 100 new members in the last year. Seventy-four members started new jobs; 50 members moved to new homes; and 15 members are pursuing studies at local universities or school programs.
Carriage House survived with support from partners such as Park Center and with fundraising events like its popular "Dancing with the Fort Wayne Stars." A state grant of $250,000 is helping patch a $300,000 deficit, Wilson said.
"We had to shrink. We lost a couple of staff and we had to slow the number of members," he said. "We’re very much looking forward to seeing that no one is turned away."
Treatment is inexpensive, in health care terms. Clubhouse services cost about $3,500 per person annually. That’s about the cost of four days of inpatient behavioral health services, Wilson said.
State officials’ change of heart will help countless individuals and families. An estimated 6 percent of Hoosiers face mental health problems, but everyone benefits when effective treatment makes school, work and everyday life the norm for those affected.