Updated: Stakeholder Meeting for Analysis of Public Behavioral Health System

We have a wonderful opportunity for grassroots advocacy in December and January. As a result of legislation, HHSC and DSHS is undertaking a comprehensive analysis of the public behavioral health system. There will be 6 stakeholder meetings to gather input, and we strongly encourage you to attend and express your opinion. The first hearing was held December 14, 2011 in Austin. The other meetings are scheduled for January, at times found below. The locations are El Paso, Harlingen, Lubbock, Dallas and Houston. The website listed below will provide updated information, and you can subscribe and receive updates automatically. PLEASE take the time to participate in these very important hearings. If you cannot attend, you can submit comments via email. Please see below for how to do this.

If you have any questions regarding the public stakeholder forums, please contact Joey Longley at jlongley@civicinitiatives.com or Public Consulting Group at txbhstudy@pcgus.com. If you are not able to attend, you can also submit input to the Public Consulting Group at txbhstudy@pcgus.com.

 

Date	Time	Location	Address
December 14, 2011	10 AM – 1 PM	Austin	Brown Heatly Building – Public Hearing Room 4900 N. Lamar Blvd Austin, TX 78751
January 11, 2012	4 PM – 8 PM – New Time	Lubbock	Texas Tech Health Sciences Center – Academic Classroom Bldg Room ACB 110 3601 4th Street Lubbock, TX 79430 Google Map of 3601 4th Street • Texas Tech Health Sciences Center – Lubbock Campus Map (PDF)
January 13, 2012	10 AM – 1 PM	Dallas	Center for Community Cooperation 2900 Live Oak Street Dallas, TX 75204 Google Map of 2900 Live Oak Street
January 17, 2012 – New Date	1 PM – 4 PM	Harlingen	Rio Grande State Center Auditorium 1401 Rangerville Rd Harlingen, TX 78551 Google Map of 1401 Rangerville Road
January 19, 2012 – New Date	4 PM – 7 PM	El Paso	El Paso First Health Plans, Inc. 1145 Westmoreland El Paso, Texas 79925 Google Map of 1145 Westmoreland
January, 25 2012 – Date, Time, Location Announced	4:30 PM – 7:30 PM	Houston	DePelchin Children’s Center (Driving Directions from DePelchin.org) 4950 Memorial Drive Houston, Texas 77007 Google Map of 4950 Memorial

 

Stakeholder Forums Begin December 14 in Austin

The Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) would like to announce the scheduling of six (6) public stakeholder forums to be conducted by Public Consulting Group (PCG) as part of the comprehensive analysis of the public behavioral health system. The study of the public behavioral health system is required by DSHS Rider 71, General Appropriations Act, 82^nd Texas Legislature, 2011. PCG’s efforts will focus on two major components: (1) a comprehensive study of the current public behavioral health system in Texas and (2) short and long term recommendations for the Texas behavioral health system.

The six (6) stakeholder meetings will be used by PCG to provide stakeholders with an overview of the engagement and to gather stakeholder input on the current behavioral health system. Stakeholders will be encouraged to provide feedback on topics including, but not limited to, access to services, service delivery models, current service array, and funding for services. Attendees will also have an opportunity to provide input on general strengths and weaknesses of the current behavioral health system and thoughts on the future direction of behavioral health services in Texas.

For complete information, please visit the Comprehensive Analysis web page: http://www.dshs.state.tx.us/mhsa/mhsa-analysis.aspx. As the time and location of other forums around the state are confirmed, details will be posted to the Comprehensive Analysis page and announced via email to subscribers of the MHSA News and Announcements and Comprehensive Analysis web pages. 

You can view or update your subscriptions, password or e-mail address at any time on your User Profile Page. All you will need are your e-mail address and your password (if you selected one).

This service is provided to you at no charge by the Texas Department of State Health Services.

Visit us on the web at http://www.dshs.state.tx.us/.

If you have any problems with the subscription service e-mail support@govdelivery.com for assistance.

Lawsuit Over the Forensic Waiting List

A lawsuit has been filed against the Department of State Health Services (DSHS) on behalf of individuals in county jails who are awaiting access to State Hospitals for competency restoration treatment was scheduled for a hearing on Thursday, November 10, 2011 at 9:00 a.m.

The Plaintiffs claim that they have been placed on a Clearinghouse Waiting List maintained by DSHS, which causes them to endure prolonged and unneccessary confinement in the county jails in violation of their right to treatment under Texas law. Currently there are approximately 300 inmates on the waiting list.

Plantiffs requested that the Court enter an injunction requiring DSHS to comply with the orders of the criminal courts and promptly accept physical custody of those persons currently or in the future who have been found incompetent to stand trial and provide them with competency restoration treatment either at a state mental health facility or other treatment location within a reasonable period of time, not to exceed three days.

NAMI Texas will keep you posted as more details arise.

NAMI Texas Voices Concern over Medicare Part D Cuts

NAMI Texas sent a letter to the Honorable Jeb Hensarling regarding our concerns about possible cuts to Medicare Part D by the “Super Committee”. We worked with NAMI National to develop the letter you see below:

Dear Congressman Hensarling:

On behalf of NAMI Texas, we are writing to you in your capacity as Co-Chair of the Joint Committee on Deficit Reduction.  NAMI Texas and our coalition partners across the state  that advocate for Medicare beneficiaries, patient advocates, family caregivers and health professional organizations are committed to improving access to prescription medications and safeguarding the well-being of beneficiaries with chronic diseases and disabilities under the Medicare prescription drug benefit (Part D).

On behalf of the thousands of Texans eligible for Medicare that are living with chronic conditions and rely on Part D for essential medications, we urge you and fellow members of the joint deficit panel, or “supercommittee,” to protect the Part D program as you examine ways to reduce federal spending.  We are cognizant of the fiscal situation facing the nation.  Furthermore, we recognize the enormity of the challenge the Committee faces.  However, we are concerned that, in the effort to find savings in the Medicare program, Part D beneficiaries will be negatively impacted both financially and in terms of health outcomes.  Proposals such as increasing Medicare beneficiary cost-sharing, raising coinsurance and freezing income thresholds have the potential to affect Part D beneficiaries in these ways.

When looking at federal spending to find greater efficiencies and areas to reduce spending, we ask that you keep this in mind when looking at Part D: it has been and continues to be extremely successful.  The program has provided a lifeline to millions of beneficiaries by providing them with access to prescription drugs that were previously unaffordable.  This, in turn, has improved health outcomes, which ultimately saves money in other parts of Medicare by reducing doctor and hospital visits, preventing acute illness, and avoiding other costly health problems.  Finally, the Part D program has proven to cost far less than projected.

All of these factors amply demonstrate that Part D is working well – for beneficiaries and the federal government.  Imposing policies that place greater financial burdens on beneficiaries has the potential to undermine much of this success. As noted in a recent report by the Kaiser Family Foundation, half of the total Medicare population has an income below twice the federal poverty level – $22,000 for an individual – and “even those with higher incomes often struggle to make ends meet.”  Even with the benefits of Part D, many still struggle to afford needed prescription drugs.

Increasing cost-sharing or raising co-insurance may cause many – particularly those with chronic conditions that require high-cost drugs or biologics – to face severe financial hardship and/or forego necessary treatment, which will ultimately drive up costs in other parts of the Medicare program.  We ask that you carefully consider the impact on beneficiaries of any changes to the Part D program.  As additional people enter the Medicare program over time, Part D will become even more essential in maintaining health and reducing costs.  Making significant changes that create obstacles to beneficiaries’ access to prescription drugs will render the program less effective.  This would be unfortunate – and unnecessary – for the Medicare population, the entire Medicare program, and the entire nation.  NAMI Texas urges you and your colleagues on the Joint Committee to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies.

If you share our concern please contact his office at andrew.duke@mail.house.gov.

NAMI National Releases Report on State Budgets

NAMI released a report on state budgets today, ranking all the states. The link to the complete report is:
 
http://www.nami.org/Template.cfm?Section=state_budget_cuts_report
 
Texas ranks 50th in the nation for state per capita public mental health spending! We are moving in the wrong direction, and this approach to funding mental health services touches our lives in a very real way, every day.
 
This report presents a powerful opportunity for grassroots advocacy. Below is an e-alert that we are providing to you, so that you can contact your legislators and policy makers to educate them about the impact of this level of funding. Please take the time to raise your voice and express your opinion. 
 _________________________________________________________________________
HOW YOU CAN HELP!
Give a little time to make a big difference.  Take a few moments right now to urge your state legislators to do right by mental health.  Pass it on.  More noise = bigger impact!
 
INSTRUCTIONS:
1. Copy the message below into the body of an email
2. Insert a sentence or two of your personal viewpoint
3. Email the message to Governor Perry and your state legislator  
 
POSSIBLE TOPICS:
o     Why mental health services are important to you and people you care about. 
o     A personal success story about the effectiveness of mental health services and/or access to treatment and medications.
 

Subject line:  Mental Health Budget – Move Back from the Edge
As a member of NAMI, the National Alliance on Mental Illness [insert your personal message].
In a nationwide report, NAMI research found that Texas had a modest increase of 4.3% in state mental health funding from 2009 – 2012 (www.nami.org/budgetcuts).  I commend you and your colleagues for maintaining mental health funding in a very tough budget year, rolling back deep cuts proposed in the governors recommended budget.   You heard the Texas Association of Counties, Texas Sheriffs Association and mental health stakeholders when they warned that cuts to our dangerously eroded mental health system risks total collapse.  
 
But Texas has a long way to go.  Our mental health system is at the bottom of the barrel, with the highest uninsured rate in the nation (26%) and the lowest per capita spending on mental health – less than a third per capita ($38.38) compared to a national average of $122.90. 
 
Although the population with mental illness is growing along with the general Texas population, the Department of State Health Services is not able to serve more people because most of the modest increase of $39.8 million (4.3%) since 2009 pays for expensive psychiatric crisis services.  As vital as crisis care is, once the crisis is managed, far too many Texans have to go on a waiting list for ongoing community based care, with the exception of those living in the 7 county NorthSTAR area. The result is a high priced revolving door of crisis teams, emergency rooms and hospitals. And the costs and damage spreads to the criminal justice system through preventable, unnecessary arrests and incarceration. 
 
As your constituent, I call on you to preserve mental health funding and encourage wise use of scarce state dollars.   Help individuals and families stay independent of intensive high-cost services through timely and appropriate community treatment, housing and employment supports, and peer/family education.  Help us help ourselves.

Please visit our website at www.namitexas.org.
Donate to our cause at www.namitexas.org/donate/savingminds.html.

Federally Proposed Rules for Establishment of Exchanges and Qualified Health Plans – Open for Comment!

The Federal Health and Human Services Administration is proposing regulations regarding Health Insurance Exchanges. The proposed rule would implement standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care
Act as amended by the Health Care and Education Reconciliation Act of
2010, referred to collectively as the Affordable Care Act.

 View the proposed regulations at http://www.regulations.gov/#!documentDetail;D=HHS-OS-2011-0022-0001

To have your voice heard – submit comments by Monday, Oct. 31 before 5 p.m. Eastern. 

To submit comments, visit http://www.regulations.gov/#%21submitComment;D=HHS-OS-2011-0020-0001.

 

Centers for Medicare & Medicare Services Announce New Coverage for Alcohol Misuse & Depression Screening

See below for the news release:

 

MEDICARE NEWS

FOR IMMEDIATE RELEASE

Contact: CMS Media Relations Group

October 14, 2011 (202) 690-6145

Medicare covers screening and counseling for alcohol misuse and screening for depression

The new coverage policies add new preventive services for Medicare beneficiaries

The Centers for Medicare & Medicaid Services (CMS) today announced two new national coverage determinations that cover alcohol misuse screening and behavioral counseling for Medicare beneficiaries as well as screening for depression. These new coverage policies add to the existing portfolio of covered preventive services, most of which are now available to people with Medicare at no additional cost.

“Preventive services bring relief to Medicare beneficiaries for whom preventive care means early identification of disease and greater opportunity for treatment and recovery,” said CMS Administrator Donald M. Berwick, MD. “It’s just as important for our elderly beneficiaries to enjoy access to preventive services as it is for any American.”

Alcohol misuse puts individuals at risk for ill health as misuse is linked to diseases such as cancer, liver disease and cardiac disease, as well as mental and emotional problems. For society at large, alcohol-related problems include economic losses from illness and injury, and disruption of family and social relationships.

Annual alcohol misuse screening by primary care providers, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices are covered under CMS’ new policies. The benefit also includes four behavioral counseling sessions per year furnished by the primary care provider, if beneficiaries screen positive for alcohol misuse.

Depression is a medical disorder characterized by feeling sad, diminished interest in pleasurable activities, feelings of guilt, decreased ability to concentrate and other symptoms experienced nearly every day. Depression may also include thoughts of suicide. Among people 65 years and older one in six suffers from depression.

Annual screening for depression for Medicare beneficiaries is now covered in primary care settings that have staff resources to follow up with appropriate treatment and referrals. The purpose of this screening is to assure accurate diagnosis, effective treatment and follow-up.

“These new coverage policies address important issues related to mental health and prevention of substance abuse,” said Patrick Conway, MD, CMS chief medical officer and director of the agency’s Office of Clinical Standards and Quality. “We at CMS continue to carefully and systematically review the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible for as long as possible.”

The coverage decision on alcohol misuse screening is online at

http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=249 and the decision on depression screening is online at http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=251

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Institute of Medicines Releases Essential Health Benefits Report to the Department of State Health Services

On October 7, 2011 the Institute of Medicine released its Essential Health Benefits Report to the Department of State Health Services. The report details criteria and methods for DSHS to use in determining which benefits should take priority for coverage in the Essential Health Benefits Package that is required by the Affordable Care Act. Mental Health and substance use disorder services, and behavioral health are included in the priorities. Click the link to view the full report: http://www.iom.edu/EHB.