Category Archives: Medicare/Medicaid

Please Complete 5-Question Survey on Mental Health Guide

Prior to the 83rd Texas legislative session, the Hogg Foundation for Mental Health published “A Guide to Understanding Mental Health Systems and Services in Texas 2012.” As they prepare to update the guide for the next legislative session, the Hogg Foundation would appreciate your feedback in order to improve the usefulness of the publication. Please take a moment to complete a brief five question survey provided in the link below by December 20th. Your participation is invaluable to ensuring the guide serves as a beneficial reference tool. To access the electronic version of the guide, please visit http://hoggblogdotcom.files.wordpress.com/2013/01/hoggmentalhealthguide.pdf

Take survey here: https://www.surveymonkey.com/s/mhguidesurvey

Uninsured Children in Texas

While a majority of Americans think that the number of uninsured children is rising, it actually continues to decline. Medicaid and CHIP are working, and the uninsured rate will fall even faster with full implementation of the ACA. But there are still far too many uninsured children, especially in the South, and our leadership needs to keep working hard on fixing this. Texas saw the largest drop of uninsured kids from 2010 to 2012, but still has more than any other state. Medicaid expansion would have a direct, positive impact on kids in Texas.

Source: http://www.publicnewsservice.org/2013-11-20/health-issues/report-more-tx-children-have-health-insurance/a35722-1

NAMI Medicaid expansion report: http://www.nami.org/Template.cfm?Section=Health_Care_Reform&Template=/ContentManagement/ContentDisplay.cfm&ContentID=155752

SB 58 testimony 5/1/13

House Public Health Committee
Testimony on SB 58
5.1.13
NAMI Texas

My name is Greg Hansch. I work as Policy Coordinator for the Texas chapter of the National Alliance on Mental Illness, also known as NAMI Texas. My testimony is on SB 58.

NAMI Texas has 27 local affiliates throughout Texas and nearly 5,000 members made up of mental health consumers, family members, friends, and professionals. Our purpose is to help improve the lives of people affected by mental illness through education, support, and advocacy.

On behalf of NAMI Texas, I strongly encourage the Committee to strengthen the extent to which SB 58 allows for local choice and choice among providers. As a general principle, local communities should be given the opportunity to determine what model of mental health services delivery system best fits their individual needs. In this case, they should be able to choose whether they want a carve-in, carve-out, or traditional fee-for-service model. Local decision-makers, mental health stakeholders, and individual Texans know better than anyone else does which system will work best in their respective area and should not be forced by the state to accept any one model.

It is also important that, if this carve-in is approved, HMOs should be free to credential any provider that meets national credentialing criteria. Requiring providers to meet any other standards beside the national standards that already exist would create unnecessary, unjustified barriers to qualified providers being able to help meet the state’s need for Medicaid case management and psychosocial rehabilitation services. In order to make our provider network robust and inclusive, we should open eligibility to the network for any provider meeting the nationally-recognized credentialing standards that HMOs have.

Thank you very much for the opportunity to speak with you today. I’m happy to answer any questions that you may have.

Greg Hansch
Policy Coordinator, National Alliance on Mental Illness (NAMI) Texas
ghansch@namitexas.org
(512) 693-2000 (office) (908) 229-7082 (cell)

President Obama on mental health care

*Please note: This blog post was authored by Stephanie Yin, a Human Development and Family Sciences major at the University of Texas and the new Public Policy Intern for NAMI Texas.

This morning, President Obama and VP Biden held a press conference covering the issue of gun violence. Twenty-three proposals for minimizing the rate of gun violence and for increasing the safety of Americans were introduced. One of the proposals touched on the topic of improving mental health services. The Obama administration is currently suggesting $25 million as an incentive for states to work towards innovative approaches to reach out to young adults in need of treatment for mental illnesses. The age group of 16-25 years is targeted since it has the highest rates of mental illness and is found to be the least likely to seek help. Project Advancing Wellness and Resilience in Education (Project AWARE) is another part of the plan in improving mental health services. Project AWARE includes Mental Health First Aid training to educate teachers and school staff in recognizing signs of mental illnesses in young adults and how to refer them to treatment. $40 million is suggested to go into this project so that schools may work with law enforcement and local facilities to provide mental health services to students. 5,000 more mental health professionals will also be trained to focus on helping students and young adults. Lastly, the President intends to release finalized rules on the federal mental health parity law, which requires insurance companies to cover mental disabilities the same way that they would with physical disabilities.

More resources: 

 The video of the press conference can be found at: http://www.youtube.com/watch?feature=player_embedded&v=s7ri0U7jSs8

-“Now is the Time: The President’s Plan to Protect our Children and our Communities by Reducing Gun Violence”: http://www.whitehouse.gov/sites/default/files/docs/wh_now_is_the_time_full.pdf

-Center for Medicare & Medicaid Services’ State Health Official Letter on the application of the Mental Health Parity and Addiction Equity Act to Medicaid managed care organizations, the Children’s Health Insurance Program, and alternative benefit (benchmark) plans: http://www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO-13-001.pdf

-USA Today article on the President’s mental health announcements: http://www.usatoday.com/story/news/health/2013/01/16/obama-calls-for-changes-to-mental-health-care/1839733/

-TheHill.com article on the President’s mental health announcements: http://thehill.com/blogs/healthwatch/mental-health/277529-obama-gun-plan-calls-for-long-awaited-rules-on-mental-health#ixzz2IA634NzX

federal health policy plan – National Coalition on Health Care

The National Coalition on Health Care recently released a proposal to help the federal government address the issues of the budget deficit and rising health care costs. They offer a 7-point strategy, along with 50 specific recommendations, for closing the deficit and reducing health care costs.

The 7 points of this strategy are:

1. Change the provider incentives to reward value, not volume;

2. Encourage patient and consumer engagement;

3. Use market competition to increase value;

4. Ensure that the highest-cost patients receive high-value, coordinated care;

5. Bolster the primary care workforce;

6. Reduce errors, fraud, and administrative overhead; and

7. Invest in prevention and population health.

NAMI Texas strongly encourages you to read the full report. Please send our Policy Coordinator any feedback on the report that you may have, we would greatly appreciate your input on this. You may reach our Policy Coordinator at ghansch@namitexas.org

You can learn more about the National Coalition on Health Care Coverage here: http://nchc.org/

Their plan – “Curbing Costs, Improving Care: The Path to an Affordable Health Care Future” – is available here: http://nchc.org/node/1273

Report by Texas Council of Community Centers – “Redesigning the Publicly-Funded Mental Health System in Texas”

On September 25th, 2012, the Texas Council of Community Centers released a draft of a report called, “Redesigning the Publicly-Funded Mental Health System in Texas”. The report is the result of the Healthcare Opportunities Workgroup (HOW), an effort led by the Texas Council. You can read the report here: http://www.txcouncil.com/userfiles/file/HOW/System%20Redesign%20DRAFT%209%2025%2012%20UPDATED%20FINAL.pdf

The draft report contains the following 3 recommendations:

1. Carve-in Medicaid covered mental health services into the STAR and STAR+PLUS Health Maintenance Organization (HMO) plans.

  • Ensure access to vital Medicaid services that enhance and support recovery including psychiatric, rehabilitative skills training and counseling services for adults with serious mental illness and children with serious emotional disturbance through a designated benefit package and capitation rate in managed care.
  • Require STAR and STAR+PLUS plans to support and fund designated Health Homes for adults with Serious Mental Illness and children with Serious Emotional Disturbance.
  • Require STAR and STAR+PLUS plans to establish a network of comprehensive mental health providers by contracting with DSHS certified private and public Medicaid Mental Health Rehabilitation providers.

2. Retain local control over important community decisions related to public mental health services through the network of Local Mental Health Authorities.

3. Strengthen community mental health and substance use disorder services by leveraging the 1115 Transformation Waiver to maximize federal revenue as a match to state and local funding expended for indigent care.

The Texas Council is seeking input on this draft report. If you have comments to provide, please submit them at the following link by close-of-business on Friday, October 19, 2012: https://www.surveymonkey.com/s/6PJ9SWQ

Article about Texas Medicaid Transformation Waiver

See the link below to an excellent article about the incredible opportunities and significant funding challenges associated with Texas’ Medicaid Transformation Waiver. Over $800 million in federal money is available to the Rio Grande Valley over a 5-year period, but first they need to come up with a $300 million+ match, which is difficult because they lack both a hospital district and adequate local tax revenue. But if they find a way to access some or all of that federal money, they’ll have to develop new, innovative programs that are positive for individuals with serious, persistent mental illnesses – “the so-called menu could range from programs to reduce hospital readmission rates to developing health information exchanges to keeping clinics open at night and on the weekends.”