Mental Health Parity — Meeting Topic for April 21 General Meeting

James Preis, Executive Director, and Nancy Shea, Senior Attorney, of Mental Health Advocacy Services (MHAS) will speak at our regular monthly meeting (Monday, April 21, at 7:30 p.m., First Lutheran Church, 2900 Carson in Torrance) about mental health parity in insurance. Mental health parity is a critical issue. It is the recognition of mental health conditions as equivalents to physical illnesses. Under mental health parity laws, insurance companies will not be able to limit or treat differently benefits for mental health treatment.

The Affordable Care Act potentially affects benefits of health care insurance for persons with a mental illness. You don’t want to miss this meeting.

MHAS is a private, non-profit organization established in 1977 to provide free legal services to people with mental and developmental disabilities. MHAS is sponsored by the Los Angeles County Bar Association, the Beverly Hills Bar Association, and the Mental Health Association in California. MHAS assists both children and adults, with an emphasis on obtaining WebBannerScaledgovernment benefits and services, protecting rights, and fighting discrimination. MHAS also serves as a resource to the community by providing training and technical assistance to attorneys, mental health professionals, consumer and family member groups, and other advocates. In addition, MHAS participates in impact litigation in an effort to improve the lives of people with mental and developmental disabilities. Our families have benefited greatly from their education and advocacy efforts on SSI and look forward to their support in ensuring there is mental health parity in insurance programs.

A Caring & Sharing support group for family members will be held in the Fireside Room at 6:30 p.m. before the general meeting.

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NAMI Looks Ahead to 35 Years in 2014

FROM NAMI BLOG
by Courtney Reyers, NAMI Director of Publishing

Next year marks NAMI’s 35th anniversary. Recent years have seen landmark changes in health care reform, something NAMI has steadfastly worked toward throughout its history.

In 2013, the rollout of the Affordable Care Act (ACA) and Medicaid expansion—which are still underway— were important steps forward for individuals and families affected by mental illness. But there are many more areas of growth and success that can be noted as we step into 2014.

NAMI’s signature education program, NAMI Family-to-Family, was officially declared an evidence-based practice this year, putting a seal of approval on what tens of thousands of families already knew: F2F really helps in learning to understand and cope with mental illness. NAMI also offers other education and support programs; the newest ones are NAMI Ending the Silence and NAMI Homefront, both launched since Nov. 20.

Another area of tremendous growth has been NAMI On Campus. Onset of mental illness often occurs in a person’s teens or twenties. Early intervention requires education and awareness as well as communities with resources to provide support to young people in need.

Throughout 2013, NAMI also has been engaged in the National Dialogue on Mental Health that flowed from the Sandy Hook tragedy approximately a year ago. It has included fighting for a broad agenda of initiatives. It also has included efforts to eliminate stigma and building new partnerships.

One outlet that fosters a great sense of community and inspires hope is NAMI’s story-sharing hub,You Are Not Alone. NAMI members and friends tell us regularly that the personal stories they read submitted by others who have experienced mental illness have helped them immensely. (Please feel free to share your own story if you would like!).

NAMI also offers a national, toll-free HelpLine, 1 (800) 950-NAMI (6264) which fields more than 2,000 calls and sends out more than 100 packets of information and brochures each month. It is a critical service, staffed by trained volunteers, for individuals and families seeking information about mental illness and the mental health care system.

NAMI works every day to save lives. From battling stigma to addressing cultural disparities to reaching out to youth and advocating with policymakers, NAMI is there, fighting for and alongside the millions of Americans who face mental illness in their daily lives.

For all the progress made in 2013, we know the fight will continue. We also know we depend on the support of NAMI members, friends and readers to sustain our work. Thank you for your continued help. We look forward to working with you throughout the New Year, as part of a community dedicated to hope and recovery.

Biden Announces $100 Million to Increase Mental Health Services Access

December 10, Vice President Biden announced that $100 million will soon be available to increase access to mental health services and improve mental health facilities.

“The fact that less than half of children and adults with diagnosable mental health problems receive the treatment they need is unacceptable.  The President and I have made it a priority to do everything we can to make it easier to access mental health services, and today’s announcements by the U.S. Departments of Health and Human Services and Agriculture build on that commitment.”

  • $50 Million for Mental Health Services at Community Health Centers:  The Department of Health and Human Services will issue a $50 million funding opportunity to help Community Health Centers establish or expand behavioral health services for people living with mental illness or addiction.
  • $50 Million to Improve Mental Health Facilities:  Because proximity to mental health services can be a unique challenge in rural America, the Department of Agriculture has a new goal:  finance $50 million for the construction, expansion, or improvement of mental health facilities in rural areas over the next three years.

The Affordable Care Act expands mental health and substance abuse disorder benefits and federal parity protections for approximately 60 million Americans. The law also requires most health plans to cover recommended preventive services like depression screenings for adults and behavioral assessments for children at no cost to consumers. And starting in 2014, insurers will no longer be able to deny coverage or charge individuals more due to pre-existing health conditions, including mental illnesses.

In addition, the President’s FY 2014 Budget proposes a new $130 million initiative to address several barriers that may prevent people from accessing help. The initiative proposes to train teachers to recognize signs of mental illness and refer students to mental health services when needed. It supports the training of an additional 5,000 mental health professionals.  And it would give grants to states to implement innovative strategies to help young people ages 16 to 25 with mental health or substance abuse issues. The Administration calls on Congress to appropriate funds for these important purposes.

How the Affordable Care Act Changes Mental Health Coverage

from The Fiscal Times: The passage of Affordable Care Act has brought sweeping changes that will make coverage of mental health and drug treatment one of the “10 essential health benefits” that all insurers must offer. Insurers, patient advocates and state regulators are still hammering out specifics, but critics contend it will lead to an even greater shortage of services and that it doesn’t do enough to address issues specific to treating the mentally ill. Many industry experts also aren’t sure what changes in the field of mental health will even be needed as new challenges arise.

According to Ron Honberg, the national director for policy and legal affairs at the National Alliance on Mental Illness:

“The reality is that the ACA is not going to solve all of our health care problems, either for physical or mental health. People are still going to struggle to get everything covered that they need to, but the inclusion of mental health care in this law is a huge step forward.”

Read the whole story.

Kennedy: Release of Parity Rule Is Only Part of the Battle

From Psychiatric News Alert: Speaking to the APA Assembly the day after Friday’s release of the final rule implementing the federal mental health parity law, the law’s chief sponsor, Patrick Kennedy, emphasized that “while the final rule may have been written, the final word on mental health is not yet written.” It will have to be written by psychiatrists “on the front lines” who battle to make mental health care as routine as the rest of medical care, he told Assembly members. He lamented the stubborn stigma that still attaches to mental illness as well as the thousands of suicide deaths that could be prevented every year if people weren’t ashamed of having an illness affecting the brain rather than other parts of the body. He added that it was appropriate to use the slogan that AIDS activists used in their fight against stigma a couple of decades ago: “Silence = Death.”

Kennedy, a former member of Congress who fought for 12 years to get the mental health parity law passed, said that the battle against mental illness discrimination “is part of the march toward progress embodied in the civil rights movement in our country and in the historic human rights movement that occurred in South Africa.”

“What you’re fighting for at APA,” he said, “is giving a connection to human beings who feel marginalized because their illness is so shamed and stigmatized, much like Americans who are marginalized because of the color of their skin, their gender, their sexual orientation, or their religious ethnicity.”

He ended by describing how receiving mental health treatment changed his life for the better, allowing him to experience the joy of seeing the parity law enacted, its final rule issued, and of being a father able to give his children the foundation in life that all children need. Kennedy now serves as a senior advisor to APA.

Administration issues final mental health parity rule

Administration says final rules break down financial barriers and provide consumer protections

The Departments of Health and Human Services, Labor and the Treasury today jointly issued a final rule they say increases parity between mental health/substance use disorder benefits and medical/surgical benefits in group and individual health plans.

The final rule issued today implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, and ensures that health plans features like co-pays, deductibles and visit limits are generally not more restrictive for mental health/substance abuse disorders benefits than they are for medical/surgical benefits.

The Administration states that today’s action also includes specific additional consumer protections, such as:

  • Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings;
  • Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law;
  • Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits and network adequacy; and
  • Eliminating the provision that allowed insurance companies to make an exception to parity requirements for certain benefits based on “clinically appropriate standards of care,” which clinical experts advised was not necessary and which is confusing and open to potential abuse.

In January, as part of the President and Vice President’s plan to reduce gun violence, the Administration committed to finalize this rule as part of a larger effort to increase access to affordable mental health services and reduce the misinformation associated with mental illness. The President and Vice President state that:

mental illness should no longer be treated by our society – or covered by insurance companies – differently from other illnesses.

“Americans deserve access to coverage for mental health and substance use disorders that is on par with medical and surgical care,” said Treasury Secretary Jacob J. Lew.  “These rules mark an important step in ending the disparities that exist in insurance plans, and will provide families nationwide with critical coverage and protections that fulfill their health needs.”

“New efforts are underway to expand coverage to the millions of Americans who have lacked access to affordable treatment for mental and substance use disorders,” said Labor Secretary Thomas E. Perez. “These rules will increase access to mental health and substance abuse treatment, prohibit discriminatory practices, and increase health plan transparency. Ultimately, they’ll provide greater opportunities for affordable, accessible, effective treatment to Americans who need it.”

The final Mental Health Parity and Addiction Equity Act rule was developed based on the departments’ review of more than 5,400 public comments on the interim final rules issued in 2010. The final rules may be viewed at https://www.federalregister.gov.

A fact sheet on the rules is available here: http://cms.hhs.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet.html.

JFK on Mental Health: Still a Timely Concern

From Psychiatric News Alert: President John F. Kennedy’s 1963 Community Mental Health Act was signed 50 years ago, but it resonates with contemporary federal policy on mental health. Kennedy’s messages to Congress included references to financing mental health care in the same way as other medical services, the need to overcome mental health care disparities, a nod towards what would be called “recovery” today, and references to social determinants of health, said Substance Abuse and Mental Health Services Administrator Pamela Hyde, J.D., at the Kennedy Forum Inaugural Conference in Boston October 24.

The conference coincided with other current policy developments in the care of people with mental illness, added APA President Jeffrey Lieberman, M.D. “We have the Affordable Care Act being rolled out, the final rule on the mental health parity act being issued soon, and the symbolic inspirational power of the 1963 act, which was the first legislation to truly envision how mental health care could be provided in a much more humane and much more effective way in our society,” said Lieberman.

The Kennedy Forum’s event on the 50th anniversary of the Community Mental Health Act was a major step, but not the last, said former member of Congress Patrick Kennedy, the late president’s nephew, who convened the conference and who has spent his post-congressional career leading efforts to improve mental health and substance use research and services. To follow up, scientific, advocacy, and professional organizations are likely to unite to refine and clarify future directions for the public and Congress. “We need to determine what the policy priorities are, so we spend our time working on the things that have the greatest leverage to improve the whole world of mental health,” Kennedy stated.

To read more in about the work of Patrick Kennedy, see the Psychiatric News article “Kennedy Makes Suicide Concerns Focus of National Media Tour.”