GUAM's mental healthcare system has lost more than $100 million in fiscal resources over the past 15 years due to the lack of political leadership by our island’s policymakers. The Department of Mental Health and Substance Abuse currently relies on taxpayer dollars and cannot bill individuals or private insurance because the territory lacks a mental health fee structure. Officials estimate that, if approved, mental health revenue could earn Guam $7.5 million annually.

While other financially challenged Guam senators have gone diving in the Mariana Trench in search of our island’s fiscal solutions, Vice Speaker Benjamin Cruz has proactively urged Gov. Eddie Calvo to implement the Department of Mental Health and Substance Abuse fee schedule. In the last several years, Cruz has put pressure on the department to facilitate the fee schedule, and he is urging the governor to do the same in light of Calvo's recent push for financial reform.

"Tens of millions of dollars in savings could have been realized had the government acted sooner," Cruz said, adding the lack of a fee schedule has burdened the government of Guam's General Fund. This is because instead of charging the insurance companies for the Mental Health Department's services, as required by the Mental Health Parity and Addiction Equity Act, the government continues to pay for the services.

The federal act presented an opportunity for DMHSA to "wean" itself off the taxpayer by charging the insurance company, Cruz said. "A decade and a half later, [DMHSA] has yet to avail itself of this opportunity," the Vice Speaker said.

In 1996, then-DMHSA Director Jeanette Tanos initiated the first proposed fee schedule. However, over the last 16 years, laws have been introduced, directors have come and gone, and the department's budget has spiked, but the fee schedule has never been promulgated.

Last week, Jeanette Tanos passed away. Her efforts to help our island’s mental health system should not have been in vain. Our island leaders need to quit arguing about things that do not matter and constructively work together to finally implement the mental health fee schedule that Jeanette Tanos started.

Jim Wotring is the director of the National Technical Assistance Center for Children’s Mental Health at Georgetown University Center for Child and Human Development. Mr. Wotring was on-island last month to encourage the government of Guam to utilize millions of dollars in untapped federal mental health funds. He urged local leaders to adopt a mental health fee schedule and begin to take advantage of recent changes to Medicaid, one of the major federal programs that funds mental health care nationwide. Wotring pointed out that previous territorial funding limitations or caps had been lifted through the Affordable Care Act. Now, approximately 30 percent more federal health dollars are available.

“Now is the time, with the cap raised, to begin billing Medicaid. You’re either going to spend all of your local money to pay for somebody to get mental health care, in the hospital or in the community, or you could get 55 percent in federal revenue. It makes no sense not to use this program,” Wotring exclaimed.

As a physician of Guam, I think our senators need to be busy with policymaking that attends to this mental health opportunity rather than flying off around the world to make themselves feel important. Better yet, I elect this year to vote for new senators who will actually give a damn about this stuff.