Support Grants for Community Crisis Response Teams

Last summer, advocates for reform of Dane County’s criminal justice system argued for more community crisis response teams.   Teams help divert persons with mental illness into treatment before arrests that are costly to them and the taxpayers.

The Mental Health Reform Act of 2016 (S 2680 ) would provide grants to support those efforts by strengthening community crisis response systems.  The bill was passed out of the appropriate Senate committee with strong bipartisan support and will be voted upon by the full Senate.  Passage would be a victory for mental health services and bipartisan cooperation.

NAMI-WI posted an excellent analysis of the proposed legislation.  The bill would also strengthen enforcement of parity laws, provide grants for early intervention and suicide prevention, and support an enhanced mental health workforce.

Contact Senator Ron Johnson to urge his support.  He will be listening to voters.



Next Steps for Criminal Justice Reform in Dane County

In late April, Dane County sent a five-person team to the Stepping Up Summit in Washington, D.C..  Our team consisted of representatives from the county board, police department, county department of social services, NAMI-Dane County, and the sheriff’s department.

The team spent two days learning how to design and implement a successful plan to move more people with mental illness from jails into treatment.  Members will share what they  learned and respond to questions and feedback from audience members.

Join them on June 29 from 5:30 to 7:00 at the United Way Building, 2059 Atwood Ave.

Making Medicaid Work for Mental Health Services

More financial support for mental health services comes from the Medicaid program than any other source.  Private insurance is a close second with state/local funds in third place.

A recent publication from the Center on Budget and Policy Priorities “States are using flexibility to create successful innovative Medicaid programs” offers an optimistic take on what can be a discouraging topic.  Often, Medicaid’s complexity and requirements for  coordination and approvals are daunting enough to stop even the most determined advocate from finding ways to use the dollars more effectively.

The publication describes two state programs that are succeeding in providing improved services to people with mental illness and saving the states money.  Wisconsin and one other state are praised for innovative approaches to other populations.

Missouri’s Medicaid and mental health agencies established “health homes” that integrate behavioral health care and primary health care with the aim of decreasing hospital stays.  A team of providers identifies people in need of help and connects them with the appropriate medical, social, and mental health care services.  Data show a significant decline in emergency room visits and hospitalizations and a savings in Medicaid dollars.

Oregon has taken a more ambitious approach.  Central to its effort is a move from “fee for service” to capitation.  Although fee for service appears to be a logical approach to funding medical care, it has resulted in escalating health care costs because practitioners are rewarded for the number of procedures they perform instead of the outcomes for their patients.

Oregon created coordinated care organizations (CCOs), which are integrated community-care organizations that are responsible for providing all medical, mental health, and dental care services for their members in a specific part of the state.  They receive a capitation payment or amount per enrollee that is to cover all services.  It is to the advantage of the CCO to provide services that prevent unnecessary hospitalizations and other expensive care.  The largest CCO in Oregon has cut emergency department visits by 18 percent and met all of the quality measures by which it is judged.








Discouraged about National Politics?

Check out what’s happening with mental health legislation and cheer up.  Republicans and Democrats are working together to address problems that have been simmering on congressional back burners for decades.

Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT) hosted a Senate Summit on Mental Health on May 26, where they were joined by Senators Patty Murray (D-WA) and Lamar Alexander (R-TN) to enlist support for the Mental Health Reform Act of 2016 (S 2680).  That bill represents the joint work of all four senators and was voted out of the appropriate Senate committee on March 16. It has the best chance of passage.

“Mental Health Reform: A Patchwork of Care” reports highlights of the bill.  Among them are: increased access to care for veterans, women and children; efforts to move people from jails and prisons into mental health treatment programs; promotion of evidence-based treatment; and grant money to treat mental illness on colleges and universities.  See also the analysis by NAMI-WI of the bill.  The related House bill (2646) has controversial provisions that are impeding its progress.

“Transforming and Modernizing our Nation’s Mental Health and Addiction System” offers a description of 16 mental health bills introduced in the House and Senate.  The bills are categorized under 10 topics such as integrated care, early intervention, and workforce issues.  You can follow the progress of any bill by clicking on and entering the number of the bill.

Senator Ron Johnson (R) is facing a strong challenge from Russ Feingold (D).   Johnson should be listening to voters about mental health legislation, particularly since it has become a bipartisan issue.  Send him an email.  I did and received a generic response saying that he would keep my views in mind.







Join the Battle for Mental Health Parity

With less than a year left of Obama’s presidency, the federal government is beginning to show some determination to implement parity requirements of the Affordable Health Care Act.  On June 10, HHS’s head Sylvia Burwell will host a listening session to learn about problems experienced by practitioners and patients.

You can provide valuable feedback about violations, state enforcement, and support needed for effective implementation.  Click here for an opportunity to sent an email to the National Council for Behavioral Health about your experiences.  The Council will use the information to develop talking points.   Click here to send your comments directly to the President’s Task Force in charge of implementing parity.

Click here for an excellent article by Lloyd Sederer, M.D.,chief medical officer of the New York State Office of Mental Health, offering stories about the human impact when parity is not enforced and examples of how insurance companies evade the law.

Sederer argues for the importance of federal action writing, “Individuals are too overwhelmed and outgunned by insurers to solve the problem, as are doctors.  State insurance agencies are generally very underresourced…legal remedies…are generally too small to attract plaintiff’s attorneys…”

Click here for “Know Your Rights,” a brochure available from SAMHSA that offers simple explanations of the law, common problems and methods of appeal.