Parity Gets Another Boost from the Federal Government

Federal officials are taking new steps to address unfinished business with the Affordable Health Care Act of 2010.  The AHCA mandated conformity with earlier legislation that requires insurance companies to provide parity between mental health and medical/surgical services and reimbursement for them.

Those in need of mental health services found many obstacles to implementation of the law.   Categorized as “quantitative” issues are higher co-payments and deductibles and shorter periods of coverage for episodes of mental illness.  Among “non-quantitative” problems are prior approval requirements, lack of enough mental health personnel in insurance networks, and lower reimbursement to psychiatrists and other mental health personnel for comparable treatment.

A new guide will help consumers determine if an insurance company has unfairly denied mental health or substance abuse services.  A set of Frequently Asked Questions will also help them understand parity requirements.  Click here for the official report.  Click here for a summary from the Kaiser Health Network.

Prison Reform Saves Money and Cuts Crime

Wisconsin’s crime rate increased 12 percent from 2009 to 2014, while Minnesota’s rate decreased by 6 percent.  Consider those figures along with the fact that state and local governments in Wisconsin spend nearly twice as much per capita on corrections as those in Minnesota.  In FY 2013, the figures were $259 for each resident of Wisconsin and $163 for each Minnesota resident.

WISDOM, a network of faith-based organizations in Wisconsin, used those figures and other analysis to make a strong case that criminal justice reform saves money and reduces crime. Their representatives spoke before the state’s Legislative Council Study Committee on Reducing Recidivism on October 17.

The bad news: Wisconsin is the only state during the last decade to have moved backwards in terms of reform. Eighteen states have enacted “big and comprehensive reform” and 15 states have enacted “significant reform.”  A “driving motivation of reform is the crippling cost of incarceration.”

The good news: Several common sense steps could be taken quickly that would move the state towards a more humane, effective system and save taxpayer dollars.  Fully fund the Treatment Alternatives and Diversion (TAD) program that has reduced recidivism and costs of incarceration; review the status of 2,800 parole eligible prisoners, many of whom are caught in administrative limbo, and reinstate a successful early release program.

Even better news: The Council of State Governments Justice Center and the Pew Charitable Trusts have worked with 23 states to promote “justice reinvestment,” intended to reduce corrections spending and reinvest the savings in strategies that reduce recidivism.  Technical assistance is available free of charge if a state is selected for help.

For resources and more information about WISDOM’s Restore our Community project, click here.

UPDATE:  Click here for a letter from Sen. Lena Taylor published in the Milwaukee Courier describing outcomes of the hearing.

Tell Rep. Mark Pocan to Support Mental Health/Criminal Justice Reform

Rep. Mark Pocan (D) published a statement yesterday in Cap Times telling readers why they should vote to re-elect him to Congress.  He called himself a “strong progressive voice” who fought for higher wages, better public education funding, help for low-income college students, prevention of gun violence, and stronger labor unions.  Here is his statement.

Conspicuous by its absence is any mention of efforts to address criminal justice reform.  That issue captured national attention and continues to be very important to many of Pocan’s constituents in Dane County.  In the summer of 2015, three work  groups appointed by the Dane County Board of Supervisors came up with an extensive report, “Investigating Solutions to Racial Disparities and Mental Health Challenges in the Dane County Jail and Throughout Dane County’s Criminal Justice System.”  Board members are working to implement its 30 recommendations.

Moses, an interfaith organization concerned with criminal justice reform, hosts monthly meetings, develops policy and informational materials, testifies, and works with the county board and state legislators to bring about change.  Dane County was one of 50 applicants selected to send representatives to the Stepping Up Summit in Washington, D.C.  The Stepping Up Initiative is a multi-year effort by three national organizations to reduce the number of people with mental illness in jails and prisons.

Pocan has had nearly a year to take a simple and obvious step in support of the work of his constituents. He could join 59 Democrats and 43 Republicans as a co-sponsor of the Comprehensive Justice and Mental Health Act of 2015 (HR 1854).  An identical bill, originally sponsored by Sen. Al Franken, passed the Senate in December of 2015 with strong bipartisan support.  It was reported out of committee to the full House the next month.  Representatives continue to join as co-sponsors, with the most recent addition in September.

The bill would authorize funds for a “sequential intercept” model, which provides interventions for dealing with people with mental illness at various stages of the criminal justice process.  It would also provide grants for emergency and crisis services, alternatives to jail, and training for police.

Contact Pocan here and tell him to join other “progressives” such as Elijah Cummings, Charlie Rangel and Joseph Kennedy, and work with his constituents to bring about criminal justice reform.

How Would the Republican and Democratic Nominees Bring about Mental Health Care Reform?

Republican nominee Donald Trump, according to his campaign website, believes that reform is necessary and families need tools to help them with the mental health problems of their loved ones.  He offers few specific proposals except for increased funding to provide services for veterans with PTSD and for suicide prevention.

Trump’s primary goal in terms of health care is repeal of the Affordable Health Care Act, which he would replace with an unspecified improved program.  He proposes making Medicaid a block grant program to offer states greater flexibility in allocating funds by eliminating mandated services.

Democratic nominee Hillary Clinton would host a White House Conference on Mental Health during the first year of her presidency.  Her 12-page plan calls for better enforcement of parity regulations, integration of treatment systems for physical and mental health, improved efforts at early diagnosis and supports for college students, and alternatives to jail whenever possible for those with mental illness.  She would also fund an expansion of community-based housing and employment programs.

Click here for an article with more detail on these proposals.  Clinton’s full plan appears on this blog in the category federal mental health legislation.


How Would the Third Party Candidates Bring about Mental Health Care Reform?

It’s difficult to know, judging from their campaign websites.  Jill Stein, nominee of the Green Party, promises a “mental health system that safeguards human dignity, respects individual autonomy, and protects informed consent.”  She advocates for a single payer universal health care system.

Here is how the Green Party describes the merits of the system. ” Under a universal, comprehensive, national single-payer health care system, the administrative waste of private insurance corporations would be redirected to patient care. If the United States were to shift to a system of universal coverage and a single payer plan, as in Canada and many European countries, the savings in administrative costs would be more than enough to offset the cost of additional care. Expenses for businesses currently providing coverage would be reduced, while state and local governments would pay less because they would receive reimbursement for services provided to the previously uninsured, and because public programs would cease to be the “dumping ground” for high-risk patients and those rejected by health maintenance organizations (HMOs) when they become disabled and unemployed.”

There were strong and knowledgeable advocates for “single payer” during the discussions and lobbying that led up to the Affordable Health Care Act.  Medicare is a good example of a successful single payer plan.  However, opening that battle again would require abandoning the gains of the AHCA without much likelihood that single payer legislation could pass.  Click here for the Green Party platform.

Gary Johnson, nominee of the Libertarian Party, takes the opposite position.  He favors a free market health care system, which would “get the federal government out of the health care business.”

Unfortunately, he means what he says.  Johnson would “privatize all federally funded medical research…end all regulatory powers of the Food and Drug Administration…end all coverage mandates and restrictions on health insurance… end all state mandates and regulations on medical care.”   Click here for the Libertarian Party platform.



Help Wisconsin Officials Decide How to Use its Mental Health Block Grant Funds

The federal government requires that each state establish a council to advise on use of its mental health block grant funds.  According to its website, the Wisconsin Council on Mental Health has taken that requirement several steps further.  It “evaluates and reviews the mental health system’s programs toward improved client outcomes and the adequacy of mental health services in the state.”

The WCMH provides several opportunities to make your voice heard.  Advocates may apply to serve on the council.  According to the website, 50 percent of members are consumers and/or family members.  All meetings are open to the public and each provides an opportunity for public comment.

In September, members took an annual tour of county mental health programs.  Minutes of each meeting are posted.  Among topics covered recently were school-based mental health programs, suicide prevention, and use of peer specialists.  Members were preparing  to consider how to advocate for mental health programs in the state budget.

Next meeting is November 16 from 10-3 at Division of Vocational Rehabilitation, 1801 Aberg Street.  For more information, click here.

SAMHSA offers grant opportunity to improve mental health of children

The federal Substance Abuse and Mental Health Services Administration (SAMHSA) posted an announcement of funds available to help treat children with serious mental illness.  The deadline for application is January 3, 2017.  Funds for this effort have been granted in previous years.  See here for more information.