Despite a decade of progress to advance mental health conversations in Oklahoma, a series of investigations, legal fights and financial concerns has begun to change the narrative among providers and policymakers advocating for better outcomes.
Most recently, the situations have spurred broad upheaval within the Department of Mental Health and Substance Abuse Services, where new Commissioner Allie Friesen announced a massive funding shortfall and then blindsided certain providers with retroactive cuts in an effort to fill a mere fraction of the gap. Meanwhile, as lawmakers also work to finalize an alternative to the stalled Donahue Behavioral Health Hospital project, the newly diagnosed disorder at ODMHSAS has fundamentally changed the Legislature’s Fiscal Year 2026 budget negotiations.
“It’s a fucking shit show over there,” one legislator said on the condition of anonymity.
After a 90-minute meeting Monday afternoon in House Speaker Kyle Hilbert’s office, lawmakers walked away with a better picture of the fiscal fiasco at hand:
- A $43 million budget shortfall for FY 25 (which ends June 30); and
- A $54 million permanent increase for FY 26 just to avoid staggering cuts to services. (A separate $17.8 million has been penciled in to execute the new consent decree mandating improved competency restoration services for pre-trial detainees.)
While the complex nature of health care budgeting means exactly how ODMHSAS reached such a deficit is confusing, House Appropriations and Budget Committee Chairman Trey Caldwell finds himself among the lawmakers digging into data and seeking solutions.
“It seems to be that former administrations at ODMHSAS essentially operated all their budgetary needs not as a budget but as one big fungible pot of money, and they would overbook contracts knowing that those contracts would not all be fully optimized, and then they could use that money on things they wanted to use it on,” said Caldwell (R-Lawton).
During the four-year tenure of former Commissioner Carrie Slatton-Hodges — which ended without ceremony in January 2024 — Caldwell said the agency found itself paying portions of last year’s bills with chunks of next year’s money.
“Essentially, in the private sector, I would equate that to almost like the concept of kiting checks,” Caldwell said. “They ran short of money probably two or three years ago, and instead of asking the Legislature for an actual fix of the problem and to fix it on a ‘going forward’ basis, they would wait until July, and they would go ahead and pay the previous two months’ bills with the new fiscal year’s money. That happened one year, but the next year instead of two months, now it’s four months.”
As new Commissioner of Mental Health Allie Friesen reached her one-year anniversary at the agency in February, the gap had reached six months. Her broad changes to leadership positions within the agency — such as pointing the longtime chief financial officer toward the door — spurred further revelation, according to a March 5 letter she sent Gov. Kevin Stitt alerting him to “the specific concerns of [a] whistleblower” who came forward Feb. 21.
“My staff has uncovered serious concerns regarding the allocation of state appropriated funds within the behavioral health program of the state Medicaid program,” Friesen wrote. “To wit, we have discovered that for at least the past five years the department has a structural budget deficiency that I believe was intentionally created by the previous administration. We cannot fulfill our financial obligations under the state Medicaid program because this department has historically paid for prior years’ debts with present years’ money — a shell game, as it were.”
The politics of coming clean
Exactly what Friesen and her team did after realizing ODMHSAS’ financial woes remains unclear, but people with first-hand knowledge of the situation said tensions heightened as the first month of the legislative session approached its end.
With the competency restoration consent decree on the Senate agenda, ODMHSAS staff alerted Sen. Paul Rosino (R-OKC) that the financial hole had been found. Worried by a clause in the decree about inadequate legislative funding levels, agency leaders wanted to avoid a future surprise for lawmakers like Rosino, who is chairman of the Senate Health and Human Services Committee.
But alerting Rosino early Thursday, Feb. 27, proved problematic. While ODMHSAS is an executive agency where the governor hires and fires the commissioner, Stitt’s team learned of the situation hours after the alarms had been sounded for Rosino and other lawmakers, who pulled the consent decree from the Senate agenda. By the time Friesen’s team met with the governor and his staff in his office around 5 p.m., frustrations were growing. Stitt peppered ODMHSAS leaders with questions about the extent and scope of the problem, drawing on a white board at times and encouraging a deeper dive into the complex arrangements of state health care funding.
Conversations continued the next week, and the Senate gave final approval to the consent decree. Moments before he began his weekly press briefing March 5, Stitt’s office distributed a press release announcing his call for an audit of ODMHSAS.
“We just want to find out what’s going on. [Friesen] came to me and requested that we really look into this. She’s terminated some different people in their finance department,” Stitt said. “Still trying to get all the numbers, but it appears we may need to do a supplemental or some extra money to mental health. We’re really just trying to get our eyes on it, so we’re asking the auditor to go in and do a deep dive to find out exactly if there has been any type of financial mismanagement. Why do we have a gap in funding? How much have the roles grown on the Medicaid spend? Are there any contracts we need to look at? All of that stuff needs to be exposed.”
In her March 5 letter to Stitt, Friesen specifically referenced her decision to part ways with Rich Edwards, who had worked at ODMHSAS since 2013 and as the agency’s CFO since 2016. Edwards took umbrage with his identification in the letter and sent his own March 26 missive to the Legislative Office of Fiscal Transparency, which House and Senate leaders have asked to dig into the agency. Edwards met with LOFT investigators the next day, and on April 2 he discussed the situation with NonDoc.
“I was pretty shocked and upset by the letter. When I left DMH, I was happy to move on to the next part of my career. I did not begrudge the commissioner. I was not the only person who was let go at DMH. Basically all the top leadership at the department was dismissed. I totally understand that. You’re a new leader, and you want to bring in your new people and do that,” Edwards said. “But it was kind of disappointing that she was choosing to blame the department’s current financial problems on me.”
Instead, Edwards said a series of events packed the proverbial snowball as it rolled down the hill this winter.
“The department’s budget is very big and complex, and this is probably the part that I’ve had the most trouble getting across,” Edwards said. “My job was to manage the budget, and the department often encountered budget problems. And during my entire tenure there under two former commissioners, we never asked for a supplemental budget request. The department went through a lot of difficult budget times — many years of budget cuts, often mid-year budget cuts. And we always found a way to manage the budget and deal with those issues. Now, were there issues with the budget when I was there? Yes, there were, and there was a budget hole, and I was aware of it, and everyone was aware of it, and we were working to resolve those issues, and we were putting things in place to deal with those issues. But I wasn’t allowed to finish those things.”
Specifically, Edwards pointed to the FY 26 ODMHSAS “budget performance review” document submitted to the Legislature in October. On its third page, the agency’s “top five operational appropriated funding increase requests” appear, albeit in minuscule font. The first two requests included:
- Medicaid growth and utilization ($10.8 million); and
- A federal medical assistance percentage — FMAP — “savings gap” for American Rescue Plan Act funds ($23.1 million).
Edwards said those requests comprised much of the funding gap now being realized by lawmakers, and he said Friesen knew what the numbers represented.
“If you want evidence that people knew there were budget issues in the department, all you have to do is look at that on-the-record document, which is the department’s FY 26 budget request,” Edwards said. “Before I left the agency, before all of these supposed problems were public, that budget request includes [two requests] for $34 million in [Medicaid]. I prepared that budget request. The commissioner approved that budget request. That request was submitted to the Legislature and to the governor, so everyone was aware of that, and you can see that document on the Senate’s website.”
For some reason, on the House budget portal, only the $10.8 million request is listed. The $23.1 million request is listed under the portal’s change log as being “withdrawn” by the agency Feb. 7.
“Nobody is acknowledging that No. 2 one (for $23.1 million),” he said. “Everyone says that’s not real, but obviously it is real, and I was communicating that way back then.”
Among the fiscal factors at play in recent years, Edwards cited a sudden upswing in Medicaid claims submitted by providers ahead of the state’s shift to its new managed care model in 2023. Providers can have up to six months to submit claims, and Edwards said the department ended up paying “basically double Medicaid match” for the fourth quarter of FY 24 when the state was trying to “close out” the prior model.
During his time at the agency, Edwards said former ODMHSAS Commissioners Terri White and Carrie Slatton-Hodges valued trying to avoid making supplemental budget requests of the Legislature.
“Those commissioners viewed it as their job that, the Legislature appropriates the funds to the agency, and then it is their job to manage the funds they are given and basically live within that budget. So if adjustments need to be made to programs, then those decisions fall on the commissioner to make those adjustments,” Edwards said. “Now, those decisions were not made in isolation. They were always in constant communication with the Legislature and the governor. No commissioner or any leadership team was ever doing anything without consultation with the Legislature. You’re not going to go out there and cut a bunch of programs without that communication, because then you’re immediately going to have providers contacting legislators and saying, ‘Hey, what is happening here?’ So those things were always done very carefully and with lots of communication.’”
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Addiction treatment providers ‘hurt’ by ‘retroactive’ cut
Friesen and her new executive team appear to be learning that lesson the hard way.
On the evening of March 18, ODMHSAS contracting officer Ariel Dean sent a pair of emails to “contracted treatment providers” and “contracted addiction treatment providers.” While the letters were slightly different and sent 30 minutes apart, each announced fundamental changes to how ODMHSAS will handle funding for providers with Medicaid service contracts.
For the addiction treatment providers — known as substance use disorder (SUD) providers — the message announced the end of an enhanced reimbursement program intended to drive outcomes like housing and counseling for recovery populations. The email landed among its recipients like a six-month supply of bad beef.
“Due to current financial restructuring measures, we will be implementing the following regarding value-based payments for addiction services,” the email stated. “Effective [Oct. 1, 2024] we will be ending the outpatient SUD value-based payments. As you may remember, these were instituted when federal dollars were available to fund them. These dollars are no longer available to the department, and we have continued to pay them with state dollars. Unfortunately, we are unable to continue due to this funding limitation.”
The email emphasized that “the ODMHSAS portion only of the residential SUD value-based payments will be ending.”
“At this time, the department plans to continue with the Medicaid portion of these value-based payments, which generally constitutes the majority of the paid amount,” the email stated. “The department is committed to finding avenues to continue to support quality care in our contracted treatment network. If we are able to secure funding to support these and/or similar incentive payments, we will work to implement them. We acknowledge that these changes are disappointing and appreciate your understanding as we navigate our current financial situation.”
Janet Cizek, a professional counselor who runs Community Treatment Integrations in Tulsa and Bartlesville, opened the email after arriving home from a long day at work.
“I had to read it again,” Cizek said. “And then I literally felt like I had been kicked in the stomach, because not only was it a cut, it was a six-month back-dated cut, which, with my budget hat on, I thought, ‘Oh my god, we have 90 days left in the fiscal year, and this is a $6 million cut for 26 providers.”
For months, Cizek said she has been working to open a new location in downtown Tulsa that would feature “comprehensive detox, transitional housing (and) residential treatment services.”
“And I thought, ‘Oh my god, am I not going to be able to continue this project? Am I going to have to lay off staff?’ Because those payments are 50 percent of my funding,” she said. “There’s no way to plan or prepare for that, and I also thought, ‘Oh my god, everybody is on spring break. The Legislature isn’t in.’”
Spring break aside, with 26 addiction treatment providers around the state receiving the back-dated cut notice, lawmakers suddenly heard concerns.
“We spent the weekend connecting with our local communities around this,” Rep. Suzanne Schreiber (D-Tulsa) said Monday. “Tulsa is particularly hit hard on this, so we are trying to understand what is going on and how we can ensure that services aren’t stopped within 30 days. Everybody who is a thinking person in this building has been trying to sort this out over the past couple days. I’m not sure we are at a base understanding yet, but I would say the consensus is that we need to figure out how to make sure these people are getting these services without interruption.”
House Speaker Kyle Hilbert expressed similar frustration at his March 27 press availability.
“We’re continuing to monitor this mental health situation, where we were first told somewhere in the mid-$50 million range of a shortfall. Then the shortfall was north of $60 million, then it was less than $10 million. Then it was, ‘Well, there’s not a shortfall, we’re just going to eat it,’” said Hilbert (R-Bristow). “Well, over the course of the last week, the Legislature has been hearing from providers throughout the state who have been getting letters and notifications from the Department of Mental Health that they are retroactively getting cut on some of the contracts that have already been agreed to, which of course is concerning to the Legislature. So we’re going to continue to dig into this. If there are bad contracts that the Department of Mental Health has made, absolutely we should dig into those and look at those bad contracts, but if there are providers who are providing core critical services for Oklahomans, we should not be revising those contracts in the middle. We already have mental health problems in the state of Oklahoma. The last thing we need to do is be making the job of those providers more difficult than it needs to be.”
The ambush announcement of contract cuts spurred meetings among stakeholders. Monday morning in Tulsa, city officials and mental health leaders met to discuss the potential impact. Monday afternoon, ODMHSAS executives were in Hilbert’s conference room with Caldwell and other House members.
By noon Tuesday, Friesen and her deputies were hosting representatives of the addiction treatment providers for a discussion at ODMHSAS headquarters — a gesture that arrived too late to ease the emotional impact among the frontlines of addiction treatment. Even as Friesen outlined the dire budget dilemma and said she hoped the change might last only 90 days until the fiscal year ends, frustration in the room grew palpable.
“I think the biggest hit right now is the retroactive nature back to October, where many of us have been in a position where we’ve tried to budget because we’ve had a what seemed [to be] a secure revenue stream pulled out and pulled back all the way back to October,” one provider told Friesen. “That extremely hurt. The idea of being told, ‘OK, moving forward, this is the new reality, absorb it,’ it still would have been detrimental both to to our organization, as well as to a number of providers across the state. But to go backwards, it seems like we’re trying to fight from the bottom of a well at this point.”
Another provider was even more blunt, referencing rumors that Friesen has grown ODMHSAS’ number of full-time employees significantly.
“It’s devastating to know that you’re continuing to hire people while we are going to have to turn away people. We are laying off staff. We are doing all of those things,” the woman said. “I will have to likely evict people from my sober living. I will have to do all of those things that you don’t, and if you’re talking about 90 days, people will close. They’re already closing satellite offices. They’re already doing all of those things. But to find that out in an email at eight o’clock at night is, I think, almost unforgivable, honestly. So I’ll say it, because I think that’s what we’re all saying. And honestly, commissioner, I have been here long term, like most of these people — 20 [years] we’ve been contracted providers. Had you called us, had you pulled us all together and gotten everybody on the Zoom call, we would follow you. Had you led, we would follow you into anywhere. We’d be down at the Capitol advocating for whatever you need. But it feels like we didn’t get an opportunity.”
Speaking before the meeting Tuesday, Cizek emphasized how the enhanced value-based payment model was designed to drive outcomes among and meet benchmarks for treating vulnerable patient populations. Functionally, she said the money lets providers cover sober living houses, the hiring of peer recovery support specialists and medications for “so many people with fentanyl and methamphetamine addiction.”
“Those were the things we were utilizing the value-based payments for. Not fluff, but legitimate care for patients,” Cizek said.
Friesen, who teared up during Tuesday’s meeting with SUD providers, spoke to the dire nature of ODMHSAS’ fiscal situation.
“Our team is trying to figure out a way that we can continue to exist as a department, and that’s where we’re at. So I am not someone that’s interested in histrionics. That’s just the black and white of the situation,” Friesen said. “So for our entire state, for obvious reasons, we have a lot of obligations to a lot of human beings, and that’s my primary obligation, is to ensure that we can continue functioning our safety net system, and make sure that the doors stay open and that people that need access to care have access to care. So it is horrifically upsetting what we’re having to navigate through. And I came here to try to optimize the system, but what we’re faced with is truly trying to pick up the pieces that are left and try to put them back together.”
Through a spokesperson, Friesen declined to do an interview about the situation, offering to answer written questions instead. But when questions were sent regarding the document shared with the Legislature and whether Friesen would reverse the retroactive SUD cut decision if lawmakers provide supplemental funding, the spokesperson did not respond.
Members of the Legislature, meanwhile, remain frustrated by the sudden and retroactive cuts.
“First and foremost, I am concerned about the people receiving these services. Putting the burden on these providers to stop services within a very short amount of time or even pay back from services that have been provided is just unacceptable,” Schreiber said.
Senate Appropriations and Budget Committee Chairman Chuck Hall agreed.
“My frustration is that all those notices went out before the Legislature was told about it,” said Hall (R-Perry). “I can’t unilaterally tell you that we would have immediately addressed a supplemental request, but what I can tell you is we certainly would have talked about it before we heard from providers who are constituents of ours that they are getting cuts. It’s very disappointing that we didn’t know anything about providers being cut until we heard from the providers.”
Rosino, who chairs the Senate’s health committees, said he is also hearing from providers.
“It’s problematic, but I can’t comment further until we get all the facts aligned,” he said.
ODMHSAS crisis highlights ‘bifurcated’ Medicaid management
Beyond the budget shortfall and the subsequent rushed announcement of backdated addiction treatment cuts, the situation at ODMHSAS has also highlighted a broader peculiarity about Oklahoma’s Medicaid system, which some stakeholders believe should change.
While the Oklahoma Health Care Authority is the sole state agency with which the federal Centers for Medicare & Medicaid Services will contract, lawmakers have historically divided the authority for handling the state’s matching portion of Medicaid dollars among a dozen agencies, including ODMHSAS.
Proponents of that arrangement argue the mental health agency must have control of state Medicaid dollars to ensure that mental health decisions are made by mental health experts. But critics say having a variety of agencies involved in Medicaid reimbursement creates an overly complicated system bloated by bureaucracy.
“There are ongoing conversations for the most effective, appropriate way to deliver Medicaid dollars and whether having it in the bifurcated manner we have now makes sense,” said Caldwell, the House budget chairman.
Alex Yaffe, who has served on the Health Care Authority Board since 2018, referenced a Medicaid debacle where CMS clawed back funds when the state’s teaching hospitals improperly took supplemental payments.
“Ensuring the state share of Medicaid dollars flows through the Oklahoma Health Care Authority is critical to maintaining transparency, accountability, and strategic oversight of how these funds are used,” Yaffe said. “With more than a dozen agencies receiving portions of the state match — despite having no authority to interact with CMS — significant structural and statutory inefficiencies remain within our Medicaid funding system that risk repeating financial and governance challenges from recent years.”
Edwards, the former CFO, joined ODMHSAS in 2013 around the same time the Legislature agreed to send ODMHSAS the state portion of Medicaid for mental health claims.
“The reason you give the money to the various state agencies is that when you control the money you control the policy, and if you don’t control the money, you only have so much say over the policy,” Edwards said. “And when [ODMHSAS] did not have the money, they had trouble getting a seat at the table when it came to behavioral health policy in the Medicaid program. The Health Care Authority would say they were listening to the mental health agency, but they often were not. What you saw was behavioral health expenditures in the Medicaid program increasing at a dramatic rate year over year over year. And when DMH took over, the behavioral health portion of the Medicaid program — that rate of growth was much more controlled.”
Edwards said that flexibility enabled ODMHSAS to facilitate the certified community behavioral health center (CCBHC) network that serves specific catchment areas based on agreements to see uninsured patients in addition to those on Medicaid. Over the last two years as pandemic-era Medicaid rules ended and tens of thousands of Oklahomans lost their insurance, the CCBHCs have seen higher percentages of patients without direct reimbursement.
“If you were starting from scratch and you were trying to design a safety net to provide behavioral health care for the entire state, you would want a system where you had providers that were required to serve everyone, and you’d want those providers to be able to be reimbursed (for Medicaid) in a way where they could actually provide that care (for the uninsured),” he said. “The only way to do that is the CCBHC system and the current kind of market incentives and reimbursement structure that we have available.”
Still, as the CCBHC model has grown, so has competition for dollars and criticism that those entities lack necessary oversight and outcome measurement. To that end, annual compensation for the CEO of CREOKS has topped $1.1 million, and the salaries of Grand Mental Health’s former CEO and CFO topped $1.2 million in 2023. (By comparison, the compensation for Grand Mental Health’s medical director was $457,000, and one of its psychiatrists earned $359,000.)
“All the criticism (…) 100 percent valid,” Edwards said. “What we need is better regulation over the CCBHCs and better oversight. (…) Should a CCBHC have total dominion over their catchment area until the end of time? No. Every catchment area should be up for bid over whatever period of time. That might cause some disruption for consumers receiving care, because maybe they have to move from Red Rock to CREOKS or from CREOKS to wherever, but that makes it a much more fair and even playing field when you put those out for bid, especially in metro areas.”
Stitt and Friesen chimed in on CCBHCs themselves Wednesday. Friesen announced a freeze on “additional state funds” for CCBHCs, although the bulk of the nonprofits’ Medicaid revenue would be unaffected. Stitt, meanwhile, voiced “100 percent” support of Friesen during his weekly press briefing and brought up the seven-figure Grand Mental Health executive salaries.
“I think Oklahomans would be very interested to know that we have nonprofit CEOs in the mental health space at Grand Lake Mental Health making $1.3 million,” Stitt said. “That is a lot of money for Oklahoma that they are making off of the taxpayer. So we should be asking questions. Are those dollars going on target and actually helping folks? Or are they being spent at the top level of the bureaucracy, so to speak.”
Even before Stitt’s and Friesen’s remarks Wednesday, drama surrounding CCBHCs had been percolating. After catchment lines were recently redrawn in the Tulsa area, Family and Children’s Services has protested the ODMHSAS request for proposal that opened part of FCS’ boundaries to Grand Mental Health and other CCBHCs.
“It was moved — not by us — to an administrative law judge where the process continues,” said Adam Andreassen, CEO of FCS. “We have not filed a lawsuit against the state. Ideally, we hope this will be resolved in the near future.”
Andreassen said changing CCBHC catchment areas or opening them for bid would dissuade such nonprofits from pursuing growth strategies that involve buying buildings or adding infrastructure.
“We have to know the parameters under which we are investing, because we are building a safety net,” he said. “You wouldn’t go to a fire department and say you’re going to introduce a new fire department every five years to keep you honest. People think CCBHCs are out here competing, but we’re part of the safety net, just like first responders.”
Andreassen said Oklahoma’s bigger problem is that local Medicaid reimbursement rates for behavioral health providers are below regional and national averages “to the point that it makes it hard for practices and other agencies to compete.”
“When one system — CCBHC — finally gets adequately funded to the point that it can compete for provider pay with nonprofit and for-profit sectors, this exacerbates the overarching problem in Oklahoma because other providers get left behind,” Andreassen said. “But in the event that CCBHC reimbursement structures were diminished or went away, the vast majority of providers would be forced to either take massive pay cuts or leave the state to remain competitive with what is available to them nationally.”
Hospital project problems highlight further upheaval
If those meaty mental health questions aren’t enough for lawmakers’ pecuniary plate, the Oklahoma Legislature has been trying to fund a new 330-bed mental health hospital in Oklahoma City for three years. Despite the commitment of $147 million in ARPA money, the project has languished after its ceremonial groundbreaking in March 2024.
A year later, it’s an open secret at the State Capitol that cost overruns, design delays and the stalled sale of the Griffin Memorial Hospital property in Norman mean the Donahue Behavioral Health Hospital could be scrapped for an alternate option. As ODMHSAS and the Legislature consider buying and renovating a different facility to bring beds online much faster than new construction would, fallout from the situation has only added layers to complicated conversations.
“I think the Oklahoma Legislature has done exactly what Oklahomans expect us to do,” Hall said of a potential “Plan B” to the Donahue project. “With this series of unfortunate events, I think it’s prudent to realize that, if there’s a better option that is more fiscally responsible and gets beds online faster, we ought to look at it.”
Exacerbating public perception, Heath Hayes, the former chief of staff to commissioner Carrie Slatton-Hodges, is still facing embezzlement charges for allegedly stealing from the Healthy Minds, Healthy Lives Foundation, a nebulous 501(c)(3) nonprofit established by ODMHSAS in 2015 to advocate for improved mental health care. While the money allegedly taken by Hayes is rumored to have constituted program dollars, the foundation has also played a role in fundraising for the Donahue project. More than $7.5 million was raised from some of the largest philanthropic organizations in Oklahoma, and a total of $10 million was transferred to OSU-OKC to facilitate a land swap for the Donahue hospital.
As philanthropic leaders wonder where their money went, OSU is in the precarious position of explaining how it spent much of it preparing the site as instructed when the Donahue was on course.
Mack Burke, associate director of media relations for OSU, said that “$10 million of (the) $13 million (total price) has been inter-agency transferred from ODMHSAS to OSU-OKC.”
“About $6.8 million has been spent on relocation and necessary improvements to campus facilities, including moving programs from the south campus to the north campus and related remodeling,” Burke said. “We are holding the remaining funds and awaiting further direction.”
All in all, the complicated and concerning situations with Oklahoma’s mental health agency represent the newest narrative in a state that has finally recognized its mental health needs but now must ensure functional, effective systems and services for citizens.
When Friesen became mental health commissioner in early 2024, Edwards said she articulated that ODMHSAS faces a sort of “identity crisis” because the agency is simultaneously a provider of mental health care, a regulator of mental health care and a payer of mental health care.
“We have made a lot of investments in behavioral health care in Oklahoma, and there’s a lot of money out there. So what you see in some of these other states that have heavily invested in behavioral health care is, unfortunately, you do start to get maybe some bad actors out there, and you have to start focusing on some of that regulation to make sure that the money is going to where it needs to be and providing the actual care that needs to be provided,” Edwards said. “That is a bit of a new position for Oklahoma to be in. Before, the only thing we needed to worry about is putting our foot on the gas and getting more money, more money and more money into the system. But I think we do need to have a little change in mindset where we need to think about, ‘OK, are we putting the money in the right places, and do we have the right oversight and regulation of those areas?’”
Edwards noted the January report from the U.S. Department of Justice, which said the state “unnecessarily institutionalizes, or puts at serious risk of unnecessary institutionalization, adults with behavioral health disabilities in the Oklahoma County area, in violation of Title II of the Americans with Disabilities Act.”
“The key for the department going forward is finding a balance between the various levels of care in the behavioral health system,” Edwards said. “This is highlighted by the three big challenges in front of the department: the consent decree, the construction of the new ARPA hospitals and the implementation of the new Olmstead plan under DOJ review. These challenges are sometimes pulling in opposite directions, so it’s important that the department is building the right type of capacity for the right service levels.”
(Clarification: This article was updated at 11:05 a.m. Thursday, April 3, to clarify requests listed on the House budget portal.)
