NAMI Texas and other organizations offer Enrollment Assistance in the Health Insurance Marketplace

*NAMI Texas Policy Intern, Maeve Hallman, wrote this post:

“As we progress through the final month of open enrollment in the Health Insurance Marketplace, over 4 million people have signed up to receive coverage through These high numbers are due, in large part, to dedicated efforts by community volunteers who assist people with their enrollment. Under the Affordable Care Act (ACA), organizations can become designated to certify their employees and volunteers as Application Counselors. To become a Certified Application Counselor (CAC), an individual must complete training sessions and pass 2 exams on the Centers for Medicare and Medicaid Services (CMS) website. Then, CACs provide in-person assistance to individuals and families by helping them understand and complete the Marketplace application and by explaining the different health plan options so that they can make an informed choice about enrollment.

Through the application, an individual learns whether or not he/she and family qualify for a premium tax credit or other cost-sharing reductions that can make the cost of insurance more affordable. Eligibility for and size of this type of financial assistance is based on personal information like household size and income, which CAC organizations like NAMI Texas are required to protect and keep confidential for the people we help to enroll. It’s important to keep in mind that, under the Affordable Care Act, many people are required to have health insurance or pay a financial penalty. Consulting a CAC like NAMI Texas can help you and your family understand what is required of you by law and what types of assistance you may be eligible for.

NAMI Texas became a designated CAC organization because of the improvements that the ACA has made to health care for individuals with mental illness. Before the law went into effect, individuals with mental illness faced a wide gap in insurance coverage. According to 2013 data from the U.S. Department of Health and Human Services, about 20% of individuals with insurance through the individual market had no coverage for mental health services. Additionally, of the 47.5 million uninsured Americans, 25% had a mental health condition or substance abuse disorder or both. Under the ACA, “mental health and substance use disorder services” are included in the 10 Essential Health benefits that all new small group and individual market plans are required to cover beginning in 2014. The ACA also extends the Mental Health Parity and Addiction Equity Act of 2008, which requires mental health and substance use disorder coverage to be comparable to general medical and surgical coverage.

NAMI Texas has 2 CACs on staff, and together we have helped approximately 30 people apply for and enroll in health insurance so far. It is very rewarding to know that we are helping individuals and families, many of whom were previously uninsured, get access to affordable health insurance coverage. Our office is one of 484 application assistance centers throughout Texas. Open Enrollment ends on March 31, 2014. So, these organizations and community volunteers will be working in full-force over the next few weeks to help as many people enroll in health insurance as we can. Our office in South Austin is open from 9 am to 6 pm Monday thru Friday and appointments with our CACs can be booked by dialing 512-693-2000. You can also find local help in your community by visiting the following website:”


Please Contact Congress Today to Keep Students Safe in Schools

Please Contact Congress Today to Keep Students Safe in Schools

NAMI applauds Senator Tom Harkin (D-IA), Chair of the Senate Health, Education, Labor and Pensions Committee for introducing The Keeping All Students Safe Act (S. 2036). This bill greatly restricts the use of restraint and seclusion in our nation’s schools to protect children from harm. Restraint means not allowing an individual to freely move their arms, legs or head. Seclusion means a person is placed in a space that they cannot leave. Children have been seriously harmed, traumatized and some have died from the use of restraint and seclusion in our nation’s schools.

Take action with this link:
A report issued by the U.S. Department of Education shows that restraint is being used in alarmingly high numbers on students with disabilities, including those living with mental illness. Effective alternatives exist to reduce and eliminate the unnecessary use of restraints and seclusion and protect students and staff. This bill supports alternatives that provide students with a safe and positive learning environment. There are currently NO federal laws regulating the use of restraint and seclusion in schools.


We urge swift action to move the Keeping All Students Safe Act (S. 2036) forward. There is also a companion bill in the House of Representatives (H.R. 1893).

Please use the following link to contact your Senators and House Representatives today and urge them to co-sponsor the bills and to move this legislation forward.

HB 1023 Workforce Shortage Draft Report: Policy Recommendations Outline

HB 1023 Draft Report: Policy Recommendations Outline
NAMI Texas
Greg Hansch (email me for copy of full report) –

Comments on these policy recommendations are due back to DSHS by April 1st. Please advise on the comments NAMI Texas should make.

1. General Shortage of Mental Health Providers (the state shortage of mental health providers should be addressed through improved employee recruitment and retention and the reorganization of service delivery).
a. incentives for workers:
-early exposure to career opportunities in the field and the special populations served
-mentoring by behavioral health specialists
-training stipends
-minority fellowships
-loan repayment programs
-adequate wages
-intern sites across professions

b. expansion of medical education
-robust expansion of graduate medical education
-increase availability of funded residency slots (psychiatry in particular)
-targeting graduate medical and undergraduate pre-medical students with specialty clerkships
and curriculum tracks.

c. reconsideration of scope of practice and integrated care
-existing practitioners should be deployed to use the best of their abilities and each profession
should be granted a maximum amount of reasonable responsibility.
-team-based care, collaborative care organizations, and medical/health homes
-physicians cede some simpler tasks and practice ‘at the top’ of their training, allowing other
professions to fill in the gaps through role extension.
-expanding the capacity and roles of other health care providers.
2. Maldistribution of the Mental Health Workforce
a. targeted recruitment
-recruit and retain needed health care professionals to underserved areas quires rewarding
personal and professional environments. “home-grown products” more sustainable.
-clinical rotations in underserved areas and appropriate education preparation for rural practice.
location of university departments and/or teaching clinics in rural areas, the provision of rural
-clinical experiences for medical students, and rural and scarce skills allowances for
-for geriatric specialties, multiple providers in an underserved area should consider forming
networks that would allow them to act as a single underserved site.

-b. telemedicine
-increase use of telepsychiatry and tele – mental health services
-look at Medicare and Medicaid reimbursement for tele-health services of psychiatrists, nurse
practitioners, clinical nurse specialists, physician assistants, clinical psychologists, and clinical
social workers.
-Texas Medical Board has rules for out-of-state practitioners to practice telemedicine in Texas,
but other relevant licensing boards do not.

3. Lack of Diversity – health care consumers have better therapeutic relationships and stronger retention rates when using a practitioner of their own race/ethnicity

a. Target Recruitment
-efforts to recruit minorities into health professions should be expanded.
-should be accompanied by efforts to improve the education attainment of minorities at large.
-Psychiatric care in the U.S. and Texas is and will continue to be dependent upon the services of
international medical graduates.

4. Outdated Educational Content and Teaching Methods – need for innovative practices, inter-professional collaboration, and improved quality of care. Roles and activities of health care workers must likely be reorganized to maximize the productivity of the workforce.

a. Curriculum Changes
-higher education programs and accrediting bodies must update curriculums.
-academic medical centers must embrace the innovation imperative and address the projected
workforce shortages. These efforts should identify and employ ‘disruptive innovations’ that will
spark true workforce innovative growth and increased efficiency
-Programs will require additional faculty and greater leadership development among existing
faculty, but must also seek to align changing elements of the education system and health
system with each other and with patient care needs.

b. Expanded Training in Clinical Settings
-Psychiatry clerkships and electives should be expanded and made available to students
entering medical school who have not yet chosen a specialty.
-Psychiatry residents and fellows should receive specific training in telepsychiatry delivery,including such diverse topics as program sustainability, model of health service delivery, program
infrastructure development, legal and regulatory issues, administrative strategies,
technical applications, quality of service, and clinical outcomes assessment.
-inclusion of child psychiatry and developmental-behavioral pediatric training in primary
care residency (though it has been shown that few primary care practitioners feel capable of
diagnosing or treating psychopathology in children or adolescents)
-For psychologists, a greater concentration of academic training and workplace experience
should occur in the clinical psychological setting, including the expansion of rotations for
psychologists in the primary care setting.
-Doctoral psychology training programs should: find ways to maximize the expertise of their
faculty; provide greater teaching and supervisory renumeration; maximize the knowledge and
skills of their students; and create and expand clinic relationships and affiliations.
-Community health centers have been presented as offering an ideal place for psychological
training in primary care behavioral health as these efforts would be available to patients with
fewest resources and greatest needs.
-Nursing faculty should share and build new curricula for RNS entering psychiatric nursing.

5. Insufficient Data to Inform Workforce Planning – Effective planning must involve the sustained investment on iterative collection of data on population need, models of health care delivery, and workforce productivity.

a. Assessment of Mental Health Service Nees
-Need sufficient demand models for Texas’ mental health workforce – should consider the local
morbidity of mental illness, mental health service utilization rates for both patient with serious
mental illness and the population at-large, and the proportion of mental health needs currently
being met by primary care providers.
-Greater need to distinguish between spatial (geographic barriers to care and aspatial (social
organizational) variables in the description of patient need. Measurements of shortage should
conceptualize access using more nuanced means, including the prevalence of mental health
disorders, the extent of need among those in need, the extent primary care providers can meet
mental health needs, and the mismatch between the level of need and the services provided.

b. Workforce Development Data
-Greater consideration of factors affecting workforce development and distribution are
-More and better data should be collected on the level of service provided for different levels
of health and illness and the productivity of providers should be measured.
-Greater investments on the activity and productivity of health workers are needed to ascertain
the effectiveness of staffing levels.
-More extensive and complete minimum data requirements, including race, ethnicity, and
languages spoken would allow a better understanding of provider ability to meet population

Hill Day 2014 Webinar Series

Topic: Introduction to Hill Day
Date: February 13, 2014
Time: 3 – 4:30 p.m. Eastern Time
2 – 3:30 p.m. Central Time
1 – 2:30 p.m. Mountain Time
12 – 1:30 p.m. Pacific Time
10 – 11:30 a.m. Hawaii Time
NAMI will be hosting a webinar series in preparation for Hill Day on September 4th, 2014. This webinar will provide an introduction to Hill Day and to the webinar series. The webinar will cover what to expect in your Hill visits, the importance of building a relationship with your legislator and how to establish that relationship.

Speakers: Darcy Gruttadaro, Director, Child and Adolescent Action Center
Jean Moore, Manager, Military Veterans Policy and Support
Registration Instructions:
To register for the webinar you need to click on the link below or copy and paste the link in to your Internet Explorer browser:
Immediately after you complete the registration you will receive a confirmation from If you do not immediately receive a confirmation email please 1) double check to make sure you input your email address correctly when registering and/or 2) check you SPAM mail to see if it went there. If you still are unable to find it, please email me directly and I will send you the log-in information for the webinar.
You will also receive an automatic reminder from Live Meeting one day in advance of the webinar, just in case you misplace the original confirmation notice.
Follow the step-by step instructions sent to you from LiveMeeting to successfully join the webinar.
Step 1. Join the Live Meeting
Join the Live Meeting by placing your mouse cursor and clicking on Join the meeting in the body of the email reminder.
Step 2. Join the Audio Portion
You can hear the presentation by phone or computer:
Computer Audio
To use computer audio, you need speakers and/or a headset.
Phone Audio
Dial the (888) 858-6021 and enter your participant code from your reminder email followed by #
First Time Users: You must install Microsoft Office LiveMeeting on your Computer at least one day in advance of the meeting. Click here for more information.
MAC Users: Download internet browser called Safari at least one day in advance of the meeting and Microsoft Office LiveMeeting on your computer. Click here for more information.
Registration: You must register for the webinar in order to participate. Click here for more information on how to register.
Need Help with downloading LiveMeeting? Contact LiveMeeting Support at 877-283-7062 or
Emily Cepla, MPH
Program Manager, Child and Adolescent Action Center
National Alliance on Mental Illness (NAMI)
3803 N. Fairfax Drive, Suite 100
Arlington, VA 22203
Direct Line: (703) 600-1107

new solitary confinement resources – please share

“The National Alliance on Mental Illness says the TDCJ’s current system of long-term solitary confinement has been shown to cause mental health disturbances, suicide, depression, paranoia, psychosis and other antisocial behaviors. Greg Hansch, the policy coordinator for NAMI Texas, said it fosters an unsafe environment for both inmates and staff. “Sticking with the status quo is alarming,” Hansch said.”


“A dozen advocacy groups — among them, the Texas Defender Service that represents death row convicts, the guards’ union, the Texas Criminal Justice Coalition, the National Alliance on Mental Illness-Texas, the Texas Civil Rights Project, American Civil Liberties Union of Texas, Texas Inmate Family Association and various Catholic and interfaith religious groups — are asking for Texas prison officials to allow contact visits with family members, communal recreation activities between death row prisoners, work assignments, participation in group religious services, TV viewing, arts and crafts, and phone calls to family and attorneys.”


“Mental health advocacy organizations such as Mental Health America of Texas and the National Alliance on Mental Illness of Texas likewise have described a pressing need for administrative segregation reform. Administrative segregation has been shown to exacerbate mental health disturbances, assaultive and other antisocial behaviors, and chronic and acute health disorders.[3] Psychological effects can include anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, psychosis[4], and increased risk of suicide[5]. The social difficulties and mental health conditions that are related to administrative segregation can also cause severe problems with reentry and reintegration, contributing to the costly problem of recidivism in Texas. In light of recent the Texas Department of Criminal Justice data indicating a significant increase in the number of individuals with mental illness living in administrative segregation, mental health advocates have pinpointed this as a major concern for Texas communities and Texans living with mental illness.”


Behavioral Health Integration Advisory Committee

Please let us know if you have any recommendations related to SB 58 and the Behavioral Health Integration Advisory Committee, which is “charged with addressing planning and development needs to integrate Medicaid behavioral health services, including targeted case management, mental health rehabilitative services and physical health services, by September 1, 2014.”

Recommendations are due by February 5th.

Below is the form being used to collect input by the advisory committee. They are seeking recommendations in the categories of managed care contracts, stakeholders communications, HHSC coordination and oversight, quality measures, integration of behavioral health and physical health services, home health pilots, and miscellaneous recommendations. You are more than welcome to submit comments on your own, or send them to me ( and I can potentially submit them on behalf of NAMI Texas.

I greatly appreciate your review of these materials and your input.

Greg Hansch
Policy Coordinator, NAMI Texas

Behavioral Health Integration Advisory Committee

Public Recommendations Requested


The Behavioral Health Integration Advisory Committee, created by Senate Bill 58 of the 83rd Texas Legislature, is charged with addressing planning and development needs to integrate Medicaid behavioral health services, including targeted case management, mental health rehabilitative services and physical health services, by September 1, 2014.

Provide a list of 5 to 10 recommendations on the 6 recommended categories. Provide this list is to HHSC by February 5, 2014. Submit the list to

List of Categories with Example Recommendation

• MCO Contracts
 Example: Require all MCO’s to authorize services within 30 days.

• Stakeholder communications
 Example: Medicaid recipients should receive information regarding the changes in coverage.

• HHSC Coordination and Oversight
 Example: HHSC to develop a way to better coordinate mental health services across all State Health and Human services agencies.

• Quality Measures
 Example: Measure outcomes of number of hospitalizations for individuals who are receiving mental health rehabilitation services.

• Integration of behavioral health and physical health services
 Example: Make sure billing guidelines are adjusted to allow for integration of behavioral health and physical health services.

• Health Home Pilots
 Example: Choose two areas of the State to implement health home pilots.

• Other
 Example: Please list anything here that doesn’t fit the other categories that you would like to see.

DSHS Request for Information (RFI): Jail-Based Competency Restoration Services

Request for Information (RFI): Jail-Based Competency Restoration Services

ESBD #: 537-14-0006, Issued: December 31, 2013

Response Due: 3:00 PM Central Standard Time on January 17, 2014

The Department of State Health Services (DSHS) Mental Health and Substance Abuse Division announce the availability of General Revenue funds to provide jail-based competency restoration services. These include mental health, or co-occurring psychiatric and substance use (COPSD) treatment services, as well as education for individuals found Incompetent to Stand Trial (IST), and are intended to be consistent with competency restoration services provided in State Mental Health Hospital (SMHH) facilities.

This RFI will be used as a research and information gathering tool for preparation of the competitive solicitation. No contracts will be issued as a result of this RFI; however, awards will be made as a result of the future RFP. Do NOT submit a proposal based on this RFI.

Please submit written comments and questions via email using the format outlined in the RFI document.

For complete information and to download the RFI document and any appendices, please visit