By Emma Murphy, Oklahoma Voice
OKLAHOMA CITY — Behavioral health providers contracted with Oklahoma’s mental health department are no longer being reimbursed for some services provided and can’t sustain the cost, an industry advocate said.
Green Country Behavioral Health Services has not been reimbursed by the Oklahoma Department of Mental Health and Substance Abuse Services for some specific services this fiscal year, said Joy Sloan, its chief executive officer. Sloan said Green Country has inexplicably not been paid for $5.2 million in requests since the 2024 fiscal year. She said these are costs that have been “historically” reimbursed to help cover additional costs related to caring for indigent patients.
Sloan operates a certified community behavioral health center, known as a CCBHC, which provides comprehensive substance abuse and mental health treatment to vulnerable people. Those health centers are supposed to receive enhanced Medicaid reimbursement rates.
An analysis provided by Sloan shows that eight Oklahoma providers have claimed almost $150 million in reimbursements in budget years 2024 and 2025. The analysis shows the providers received $8.7 million in reimbursements in fiscal year 2024, but were owed about $62.3 million. In the current budget year, they’ve sought $86.7 million, but have received nothing.
While providers weren’t historically reimbursed for 100% of these requests, Sloan said there was a drop in what was reimbursed last fiscal year.
Mental Health Commissioner Allie Friesen, said the agency is investigating why the payments have not been distributed. She said her agency has been in contact with a few partners since Monday afternoon and is actively working with the Oklahoma Health Care Authority to investigate.
“We are not currently aware of any reason why these payments should not have been distributed and are committed to resolving the issue swiftly,” she said in a statement.
Friesen’s agency is facing several investigations following reports of financial disarray and a $43 million shortfall. Friesen admitted to lawmakers Monday that her agency needs help finding answers on the agency’s finances and budget.
Traditionally, certified community behavioral health centers have been eligible for additional compensation beyond their contracted monthly rate. For example, Sloan said, a provider with a $2 million annual contract receives one-twelfth of that amount every month and any expense for additional services beyond that falls into a “pended services” category, which is submitted for reimbursement.
Sloan said she had not been contacted by the mental health department as of Tuesday afternoon. She said she’s worked at Green Country for 34 years and has been in the CEO role for 15 of those.
Heather Helberg, CEO of HOPE Community Services in Oklahoma County, also said Tuesday afternoon that she hadn’t been contacted about the reimbursements for services, but had been in contact with Friesen on Monday about a separate payment issue, outcome-based payments.
Helberg said she’s worked at HOPE for seven years.
“We have done so much to divert clients from jails and hospitals,” she said. “No one wants to go back.”
Between the 2020 and 2023 fiscal years, HOPE was reimbursed 85% to 95% by the state, Helberg said. In the 2024 fiscal year, its reimbursement rate dropped to 23%.
This lack of payment equates to $2 million in the 2024 fiscal year and “$1.7 million and counting” for the current fiscal year, she said.
“I would just love to ask the question, ‘Would we expect any other field to absorb several million dollars in free care and services?’” she said. “Even if we are charities or nonprofits, we have to get paid for services rendered. It’s not sustainable for us to keep absorbing these costs. We are the safety net, and if it continues, it will break us and our clients are the ones that suffer without care.”
Sloan also serves as the president of Alliance of Mental Health Providers of Oklahoma, a coalition of eight certified community behavioral health centers. She said the other members are also experiencing issues receiving payments.
Family and Children’s Services, a Tulsa area provider, is another member of the group. Without the pended payments, reimbursement is unbalanced and results in “overwhelming deficit,” according to a fact sheet from the agency provided to Oklahoma Voice.
Between the 2023 and the 2025 fiscal year, the number of community behavioral health center clients grew 13%, and the number of uninsured clients grew 102%, the document shows. Historically, about 55% of those reimbursement costs were covered by the mental health department on average. Those reimbursements dropped to 14% last fiscal year.
An increase in Medicaid clients would be needed for the centers to break even if the state does not contribute, the document said.
Sloan said her operations have been able to continue because Green Country has been “good stewards” of its funds, but she’s spent time at the state Capitol talking to legislators about the problem. She said under previous administrations at the mental health department, there used to be more regular, monthly meetings with agency leadership.
Demand for the services is growing, but payments are not, she said. Green Country, which serves Muskogee and McIntosh counties, serves 5,000 Oklahomans every year, Sloan said.
“I sure expect to give away services to the community, which historically has been anywhere between $300,000 and $600,000,” she said. “Millions is too much to bear.”
Most of these services are for uninsured, indigent populations. Without payment, Sloan said her agency might have to halt these services.
“The last thing I want to do is have to lay off staff and quit serving people because it affects my friends in the community,” she said.
