Choose life… Insure Tennessee

by hopeworkscommunity

Choose life. When in doubt, when you are not sure... When there is a question choose life.

The question of Insure Tennessee is a question of whether or not we will choose life. It is not a question of a better way to choose life. It is not a question of not this but that. As more and more stories pour in it is obvious. For thousands of Tennessean it is increasingly each day a question of life or death... a question of life or needless and preventable suffering... a future of hope or one bound by despair. It is not about finding an answer. It is about the common sense and political will to grab the one (the only one) in front of us and stop the unnecessary misery that defines the lives of so many vulnerable Tennesseans.

Chattanooga voted last night to choose life. Their city council voted overwhelmingly in favor of a resolution supporting Insure Tennessee. They joined a growing movement of cities and towns saying they support their neighbors, their friends, their families. No one should have to unnecessarily suffer or suffer as a direct result of governmental policy. Insure Tennessee.

The movement is growing. Thanks to the leadership of people like Pam Weston in East Tennessee and Meryl and Randall Rice in West Tennessee and the stories and words of more and more Tennesseans the movement is growing. It is the growing crescendo of more and more ordinary Tennesseans saying "CHOOSE LIFE!!!!!"

Imagine a flood, a hurricane in Tennessee. The waters are rising.. People are dying.... Many are on top of their houses waiting for a miracle.. a boat... a something... someone who cares.... hope. The government has boats. But they decide to wait. "Let's make sure this is a good idea..."

The waters still rise. For some it is too late. For others it will soon be too late. Action matters. The hurricane is here for thousands of Tennesseans. And they are on top of their houses waiting.

Join the movement to choose life. Talk to your local government. Ask them to join Chattanooga and the other towns and counties that have acted.

Today. Today please choose life.

Insure Tennessee

Larry Drain ~

Tragic California Case Exposes Failings in Our Mental Health Care System

CareforYouMind Feb 10,'15

Rusty Selix
Executive Director, Legislative Advocate
California Council of Community Mental Health

In April 2012, Fred Paroutaud, a California man with no history of mental illness, experienced a psychotic episode. Mr. Paroutaud was hospitalized and diagnosed with bipolar disorder. Just 72 hours after he was admitted, and despite the fact that he was still experiencing hallucinations, he was discharged and referred to outpatient group therapy. Because his condition remained unstable he requested alternate therapy and one-on-one sessions with a psychiatrist. He was denied both by his health plan and his condition deteriorated.

Concerned by his worsening depression, his wife appealed to the health plan again and again. She pleaded that her husband required more supervised and personalized treatment. While waiting for an appointment with his psychiatrist, and just two months after his first psychosis, he died by suicide.

Mr. Paroutaud’s widow is convinced that if more intensive and timely care had been available, her husband would still be alive. In October 2013, she and two other plaintiffs filed a class-action lawsuit against the health plan claiming they were harmed by its systemic denial of timely access to mental health services.

Why this story sounds familiar
While Mr. Paroutaud’s story is unique, his circumstances were not. Upon his release from the hospital, he needed intensive, monitored care. That’s not what he got. Generally speaking, commercial health plans limit coverage to two levels of care: level one is a once a week therapy visit for mild to moderate problems and medication management; and level two is hospitalization.

Those two narrow levels of care are appropriate for many people, but not all, and certainly not for all stages of mental illness. The absence of those critical, in-between levels of care is one of the ways that our mental health system falls short and where it fails people like Fred Paroutaud and his family.

When someone is in the midst of a manic episode or considering suicide, hospitalization can provide the opportunity to stabilize the condition. Upon discharge, many patients require medically monitored care in a residential facility or highly personalized care in a medically-monitored outpatient setting. Unfortunately, that level and type of care is almost impossible to find in commercial health plans.

There is another way
My hope for a health system that offers comprehensive mental health services to better address the needs of individuals with a mental health condition is not pie-in-the-sky wishful thinking. In fact, this model of care, with multiple levels and degrees of intensity, already exists within the California Medicaid system. In our public programs, care ranges from community-based health management through low-intensity community-based services, high-intensity community-based services, medically-monitored non-residential services, medically-monitored residential services, and medically-managed residential services (i.e., inpatient treatment).

This structure, with six levels of care, is the backbone of the mental health system under California’s Medicaid system, and it provides a complete, stepped approach to rehabilitation.

This type of care should not be exclusive to the Medicaid population. One of the 10 essential health benefits under the Affordable Care Act is rehabilitation; another is mental health care. This means that rehabilitation for mental health care isan essential benefit, and all Americans in commercial health plans are entitled to more rehabilitation-focused mental health services.

What you can do now
Fred Paroutaud was denied access to stepped treatment and his story is tragic. It is thanks to his widow and her persistence that we know about it at all. Unfortunately, many people suffer similar situations and denials of care, but we do not hear about them.

With increased national attention on access to mental health care, now is the time to tell us about the problems you are having in accessing the care you need. We want to know what services you were denied and the barriers you faced, such as unaffordable out-of-pocket costs, transportation issues, or lack of trained providers in your plan’s network, etc.  We also need to know what you did or didn’t do in response and how this impacted your or your family member’s recovery. As advocates and advocacy organizations, we are positioned and prepared to knock on the door of government regulators and health plans and point out the disparity in care and demand access to appropriate rehabilitative services.

Many commercial insurers don’t cover rehabilitation services because they don’t believe they have to. And if no one demands otherwise, they are unlikely to ever change. Share your story. Don’t take ‘no’ as the only answer. Let’s realize the parity we deserve.

Questions

• How have you been denied equal insurance coverage for a mental health condition? Tell us your story.
• What levels of treatment are available to you under your health plan? Are they sufficient?

Bio

Rusty has been Executive Director and Legislative Advocate for CCCMHA since 1987. He is co-author of California’s Mental Health Services Act, a tax on personal incomes over $1 million to expand community mental health care. At CCMHA, he has been instrumental in moving forward a variety of critical mental health-related initiatives, including ensuring the implementation of the federal Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program to serve children with severe emotional disturbances. He also serves as Executive Director of the Mental Health Association in California.

Advocacy Alert

TennCare and the state budget process have been in the news. Cuts to funding for mental health in Tennessee have been proposed.

Gov. Bill Haslam said recently that he's talked with nine Republican governors who have expanded Medicaid for low-income people in their states. Haslam has been criticized for refusing last year to agree to $1.4 billion in federal funds to cover about 180,000 uninsured Tennesseans. After the TennCare state budget hearing, Haslam told reporters that he talked with Health and Human Services Secretary Sylvia M. Burwell this week and that he plans to make a decision about expanding Medicaid by Christmas.

 

Can we afford more cuts? 

This week, the NAMI Tennessee Policy Committee reviewed the proposed state budget cuts. These proposed reductions call for the elimination of funding for our Peer Centers for a savings of $4.5 million as well as eliminating funding for adolescent outpatient substance abuse services and adolescent day and evening treatment services - cuts totaling $1.4 million. Additional proposed cuts will eroded our mental health system even further. 

 

The next 12 days are critical

 

Please join NAMI Tennessee and other mental health advocates by saying yes to Medicaid Expansion and no to additional cuts for mental illness. Visit your local legislator and share this message now. We have a brief window before Christmas for our message to be heard. Your voice matters!  

Find your local state legislators  

 

Day on the Hill will be March 18, 2015 

 

Visits to legislators in their home districts make a huge impact. Visits now impact the budget process before the Governor presents his budget to the legislator and the public debates in the Statehouse begin. We also have a chance to impact the budget process and provide education to legislators by participating in Day on the Hill. We hope that you mark March 18, 2015 on your calenders and join us for this day of advocacy

Tennessee Gov. Haslam orders state agencies to cut spending

By Andy Sher

Sunday, September 28, 2014

·         NASHVILLE -- Gov. Bill Haslam has ordered state agencies to slash discretionary spending by up to 7 percent as his administration builds the new budget it will present to legislators early next year.

The move comes with the state’s general fund, which pays for most functions of government including education, showing a $302.4 million revenue shortfall for the fiscal year 2013-2014 budget that ended June 30.

Administration officials on Friday confirmed the directive given to departments. Agencies’ plans are due Monday. How much actually winds up getting cut and where in Haslam’s fiscal year 2015-2016 budget will depend on a variety of factors.

But after years of reductions, Tennessee may be on the verge of having to make tough choices next year, possibly abolishing entire programs, said one top lawmaker.

“I think that could be the case,” said Senate Finance Chairman Randy McNally, R-Oak Ridge. “In the past they’ve done some of that trimming through things like over appropriations [automatic holdbacks of funds] and positions unfilled for years.”

McNally added, “I think all of that’s gone now.”

He said the major problem with the state revenue picture is business franchise and excise tax collections.

In his Aug. 15 directive to departments, Finance Commissioner Larry Martin explained that “funding the services of state government within available revenues continues to be [a] challenge. As a result, it is expected that reductions will again be required in order to balance.”

Departments and other agencies are submitting plans in two parts. The first is to show how they would cut 7 percent. This is beyond the money the state customarily expects won’t be spent over the course of a year, known as the “over appropriation.”

The second part of the directive asks departments to provide a list of base reductions they would use to offset any proposed increase requests in areas officials consider vital.

Business taxes causing the problem

Flagging collections in Tennessee’s two main business taxes have been the main culprit behind recent problems.

The franchise tax on business property and the excise tax on corporate income forced Haslam, a Republican, and lawmakers last April to cut $276 million from the fiscal year 2014-2015 budget the governor presented to lawmakers last January.

As a result, Haslam, whom many think has national ambitions, was forced into the embarrassing position of breaking a promise he made in his State of the State speech: Providing teachers, state workers and higher education employees with 2.5 percent raises.

The total FY 14-15 budget, which took effect July 1, is $32.4 billion and 2.4 percent less than the last fiscal year’s $33.2 billion spending plan. Some $12.9 billion in this year’s budget comes from the federal government, according to a legislative analysis.

Last week, Haslam and other top officials were in New York where Wall Street’s three major bond rating agencies voiced concerns about problems with Tennessee’s business taxes.

“Because that was the cause of our shortfall, there were quite a bit of questions about that in terms of cause and whether we see a long-term trend there,” Haslam told reporters in a conference call Thursday after meeting with Fitch Ratings Inc., Moody’s Investors Service and Standard & Poor’s Financial Services.

The governor said part of the franchise and excise tax declines were due to overpayments made last year by businesses, which make payments in advance based on estimates.

“And second,” Haslam added, “the fact the businesses are getting a lot more strategic about how and what they pay. We’re trying to do work on our side to make sure we collect what we should. We had that conversation with all three agencies.”

He said one of the “key points” made to the bond rating agencies “is that last year when Tennessee had a surplus, we reacted in the right way and didn’t spend all that. This year we had a shortfall [and] we reacted in a way we have to by making cuts.”

Rating agencies “realize that revenues will rise and fall,” Haslam said. “They want to see if you are willing to adapt regardless of the circumstance.”

Haslam mentioned nothing to reporters about the latest efforts to “adapt” with the spending cut directive, which the Times Free Press obtained a day later.

A simple explanation?

The administration was put on the defensive last spring by legislative Democrats who said figuring out the problem with franchise and excise taxes should be a fairly simple thing. Rep. Mike Stewart, D-Nashville, said all they had to do was take a look at the top 50 corporate payers of the tax.

State Revenue Department officials are now studying the problems, with recommendations expected in January.

But a Nashville-based tax attorney, Brett Carter, agreed with Stewart last spring in an article he wrote for State Tax Notes, a national publication. And Carter thinks he’s figured it out a “likely” answer to the cause that indeed does appear fairly simple.

Using publicly available court documents, Carter points to the 2012 relocation of McKesson Corp.’s Southeastern pharmaceutical distribution center from Memphis across the state line to Olive Branch, Miss. Tennessee tax policies had previously resulted in litigation and Carter delved into the material.

While McKesson is just one company, Carter wrote, the court documents reveal the move was highly important because “McKesson’s facility served as the primary distribution channel for pharmaceutical companies throughout the United States and [the move] resulted in millions of dollars in franchise and excise tax revenue in Tennessee.”

Carter said the companies may have been paying more than $150 million in Tennessee franchise and excise taxes and saw a major opportunity to slash their costs by moving to Mississippi, which has lower taxes.

McNally said state lawmakers are looking at that and ways to restructure the taxes.

Contact staff writer Andy Sher at or .

 

KNOXNEWS.COM

Decision on Medicaid Expansion holds coverage for many Tennesseans in balance

By Kristi Nelson

Posted June 2, 2013, updated June 4 2013

It was supposed to be one of the strongest tenets of the 2010 Patient Protection and Affordable Care Act. Instead, it became a political football, a metaphor for states’ rights. After the Supreme Court ruled that the ACA could not force states to expand Medicaid, Gov. Bill Haslam was among those who rejected the Medicaid expansion, instead offering his alternative “Tennessee Plan” for federal government approval.

But whether the federal government and the General Assembly will accept Haslam’s plan remains to be seen, along with how well it will work to cover those who currently don’t have health insurance.

“He’s either politically brilliant, or he’s making one of the worst mistakes he could make,” Rep. Joe Armstrong, D-Knoxville, told the News Sentinel in March.

What the ACA intended

Originally, the Medicaid expansion provision was to give state health insurance coverage to a group of people who made too much to qualify for Medicaid but too little to afford insurance on the health insurance exchanges, even with the planned government subsidies.

It expanded Medicaid to qualify people younger than 65 whose income is below 138 percent of the federal poverty guideline (a little more than $15,860 annually for an individual, a little less than $32,500 annually for a family of four).

It meant that, for the first time, low-income adults who don’t have children could get state Medicaid coverage, and it standardized other qualifications.

Many states, including Tennessee, limit Medicaid enrollment to certain categories of people. To qualify for TennCare, for example, you have to be low-income and pregnant, a child, blind, disabled, aged, or fall under multiple, specific categories.

Tennessee has nearly 1 million uninsured residents, of whom at least 140,000 and maybe more than twice that number, by some estimates, likely would enroll in Medicaid if it were expanded under the ACA guidelines. About three-quarters would have been previously uninsured. Under the ACA expansion, the federal government would pick up the entire cost of new, previously ineligible enrollees for the first three years, phasing to 90 percent by 2020. In Tennessee, federal funds would have amounted to about $1.4 billion in the first year alone.

States could receive federal matching funds for covering additional low-income residents under Medicaid as early as April 2010, with wide-scale enrollment beginning this October and coverage starting Jan. 1, 2014. However, in June 2012, the U.S. Supreme Court ruled that the federal government could not make states expand Medicaid — making a linchpin of the ACA optional.

So far, 20 states have moved forward with Medicaid expansion. Ten have rejected it outright, while 10 others are not doing it now but are looking at alternatives and have not ruled it out for the future (the government gives no deadline, though states waiting much longer to decide stand to lose federal funds for the first year). Three states are still undecided, while seven — including Tennessee — are crafting their own, alternate plans.

On March 27, Gov. Bill Haslam announced that Tennessee would not expand TennCare rolls under the ACA, instead offering up an alternative he called the Tennessee Plan.

“I don’t think just pure expanding of a system that we all agree is too costly for us, is too costly for the federal government to afford long-term, is the right way,” he said then.

The ‘Tennessee Plan’

Haslam’s proposal is that the state use federal funds not to expand TennCare but to purchase private insurance through the insurance exchange for people who would have qualified for coverage under Medicaid expansion.

He outlined the proposal in the broadest terms, including five “key points”:

Individuals identified as being eligible for the Medicaid expansion group would instead be directed to the exchange, where they would be allowed to choose any qualified health plan that offers a certain level of benefits (the Silver Plan).

The state would pay the monthly premiums, matchable with 100 percent federal dollars, for those people to enroll in the Silver Plan.

People in the Medicaid expansion group would be treated like all other people enrolled in the Silver Plan, with access to the same benefits and appeals process as other people in the plans.

People in the Medicaid expansion group would have the same cost-sharing as other Silver Plan enrollees with incomes below 250 percent of the federal poverty guidelines. (On average, Silver Plan policies would pay for 70 percent of health care costs, with the remaining 30 percent paid by the planholder.)

The arrangement would have a “circuit-breaker,” or “sunset,” ending after the three-year period of 100 percent federal matching dollars, and could be renewed only with approval of the General Assembly. (This is true for states accepting the Medicaid expansion as well; they can stop using federal funds and drop the expanded coverage at any time.)

In addition, Haslam would seek to reform the way providers are paid for services, with payment based on outcomes rather than a set fee for services. The money saved, he said, would be enough to cover the state’s 10 percent share of costs after the government’s share goes to 90 percent.

“One option for covering the Medicaid expansion group is simply to add them to the Medicaid rolls, or the TennCare rolls, in our case,” Haslam said of the plan. “We don’t want to do that. There are a lot of federal requirements that come with Medicaid that make it difficult to provide quality care in the most cost-effective way possible.”

But the federal government may not allow Haslam to forgo some of those requirements. While national Centers for Medicare and Medicaid Services guidelines indicate that the main tenets of the plan — using federal dollars to pay premiums for low-income people to have commercial insurance, and reforming payment — meet federal requirements, some of the details don’t align with federal requirements intended to protect Medicaid enrollees.

For example, Tennessee would need to give those with serious health conditions a choice of enrolling in TennCare or private insurance, unless CMS were to grant Tennessee a waiver to that requirement.

The federal government would require supplementation of benefits (sometimes called “wraparound”) to make sure the commercial insurance plans include all services that would be available through Medicaid. Hypothetically, this could be done through a supplemental premium to the Silver Plan insurance provider.

The government also limits co-payments for Medicaid-eligible enrollees.

There is also an appeals process in place, required by past Supreme Court rulings, so that Medicaid patients and their doctors can challenge insurance companies’ refusals to cover “necessary treatments.” Under federal law, Tennessee would have to allow Medicaid-eligible patients this due process.

A federal entitlement program, Medicaid was designed for a population upon whom “poverty imposes special needs and the need for special protections,” said Carole Myers, a nurse practitioner and associate professor in the University of Tennessee’s College of Nursing. “They don’t have the same voice in government as those with different economic statuses and organizational affiliations.”

Haslam acknowledged in April that Tennessee probably would have to limit co-payments and provide the wraparound services for Medicaid-eligible enrollees for the federal government to approve his alternative, but he said he still thinks his overall plan is “workable.”

What’s next?

Haslam’s plan is modeled on a plan by Arkansas, which also wants to use federal matching dollars to pay commercial insurance premiums for those eligible for the Medicaid expansion. But while Arkansas got legislators’ approval before approaching the federal government, Haslam has taken the opposite approach, presenting his plan to CMS first.

Haslam did not ask state legislators to vote on whether to take the federal Medicaid expansion funds this session, though he said he has not ruled out calling a special legislative session later this year to meet federal deadlines for the health exchange enrollment starting in October.

The Medicaid expansion is the only provision in the ACA that provides insurance coverage specifically to those between 101 percent and 138 percent of the federal poverty guideline. If Haslam fails to reach an agreement with the federal government, or does not opt to accept the federal Medicaid expansion plan (which he could still do), that population likely would remain uninsured.

However, the latest word among hospital executives and advocates is that an agreement could be near.

“I think (Health and Human Services) Secretary (Kathleen) Sebelius is really eager to find some alternative plans that meet the goals of the ACA but do so in creative ways and allow states to create plans beneficial to those individual states,” said Jerry Askew, senior vice president for governmental relations for Tennova Healthcare.

Through Tennova’s parent company, Health Management Associates, Askew works with hospitals in seven states. All of them, except those in Kentucky and West Virginia, have said no to the expansion.

“They’re all trying to figure out what to do. It’s really interesting to watch how the state is to meet their individual objectives,” Askew said. As for Tennessee, he added, “It is fair to say that the governor’s plan is being built on principles that the majority in the Legislature would agree with. But it’s not a given. It’s a lot of hard work.”

Consumer-advocate groups and hospitals were in favor of the expansion, especially since hospitals stand to lose money on uncompensated “charity” care that would have been partially covered, at least, if more people were insured through Medicaid. The Tennessee Hospital Association has said the state stands to lose 90,000 jobs and nearly $13 billion.

Having that population continue to go uninsured also means higher costs in the long run, Myers said, as studies have shown that those without insurance are less likely to get preventive or early care.

“When you are resorting to getting care only when it becomes so bad you can’t stand it, and you’re in the emergency room, it’s causing a major human toll,” she said. “We know that intervention on the earliest point of the illness trajectory is the most cost-efficient. The true measure of whether we’re successful in what we’re doing in health care is in whether people have long, happy, productive lives.”

Business writer Carly Harrington contributed to this report.

 © 2013, Knoxville News Sentinel Co.

 
The National Council has just received word that the Centers for Medicare and Medicaid Services (CMS) is abandoning its recentproposal to strip mental health drugs and immunosuppresants of their protected status in Medicare.
 
CMS said its decision came in response to massive vocal pushback from healthcare consumers, advocates, and congressional leaders.
 
Congratulations - your efforts paid off!
 
Members of the National Council and the Partnership for Part D Access submitted well over 1,000 comments to CMS opposing the drug restrictions. Grassroots advocacy is one of the most powerful ways to influence public policy - and your efforts have once again demonstrated our collective strength.
 
Thank you for your hard work! I hope you will take a moment today to celebrate this success. You deserve it.
 
Sincerely,
 
Chuck Ingoglia
Senior Vice President, Public Policy & Practice Improvement
National Council for Behavioral Health

Medicare Rule Changes May Restrict Drug Choices for Seniors
http://guardianlv.com/2014/02/medicare-rule-changes-may-restrict-drug-choices-for-seniors/
(from Easy Browser)

The CMS decisions about which drugs to protect were supposed to be based on whether the drugs were needed to prevent increased doctor visits, hospitalizations, persistent disability, incapacitation or death that would otherwise occur within seven days if the drugs were not given. The choices about which drugs to remove from protection fail that test because, with acute mental illness, seven days without medication could easily lead to hospitalization, incapacitation or death. The same constraint exists for some 500,000 transplant patients. Seven days without the right medication could result in transplant rejection.

The quote above is from the article linked.  My jaw dropped when I read it.  CMS is proposing to drop certain drug classes from the status of protected medication.  The idea is to save money.  The article says it may save around 10% I believe.

My jaw dropped when I read the criteria.  It basically says that if doing without a drug for 7 days wont kill you, incapacitate, or put you in the hospital you really didnt need it to the point where your access to the medication is guaranteed to begin with.

WHAT ABOUT THE EIGHTH DAY??

Is it just me or does this not sound simply stupid, simply arbitrary and simply mean?  How in the world do you decide as a matter of cost containment that if someone doesnt die fast enough that dont really need a medication?  Who should have that kind of power??  Should anyone??

I read all the stuff about percents...percents of cost...percents of savings.  There is another "p" word-- PEOPLE.  Somehow it seems like it got lost.

Larry Drain at HOPEWORKSCOMMUNITY

ACA Enrollment Ending Soon -

 

Hi folks, we just want to remind everyone that the enrollment period for Patient Protection and Affordable Care Act is drawing to a close for this season. The last day to enroll will be March 31st. To be covered by April 1st, the last day to enroll is even earlier - March 15. Enrollment will start up again November 15th and go through January 15th.

  

Below are links to Tennessee events and resources you might contact for enrollment assistance. Please forward this email to anyone and everyone you know who needs assistance or needs to hurry up and get covered already! 

 

• Get Covered Tennessee Event Calendar: Click Here
• Find Help on Healthcare.gov: Click Here

 

If you've already enrolled we'd love to hear from you. Click here to share your story and tell us about your enrollment experience.

 

 

Thanks everyone and best of health to you from all of us at THCC

By: Tennessee Health Care Campaign

 

 

Join Us in the Fight to Save Access to Mental Health Treatment: Act Now by Telling Congress You Care!

Posted on January 28, 2014

The Centers for Medicare and Medicaid Services (CMS) wants to significantly limit access to antidepressant and immunosupressant medication for people subscribing to Medicare Part D. Read today’s post to learn why you should be concerned, and what you can do to support the mental health community by raising our voices in Washington.

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would remove antidepressants and immunosupressants from the protected class status under Medicare Part D and is considering removing antipsychotics from the same status the following year. If CMS adopts its proposal, it would reduce patient access to and the availability of mental health treatment.

Since it went into effect in 2006, Medicare Part D’s protected class structure ensures patients with mental health conditions have access to all or substantially all of the most appropriate medications, protecting them from “fail-first”1 experiences or other appeals processes. In many cases, delays caused by these processes can result in inadequate treatment and potentially tragic outcomes.

We need to ensure that all mental health patients have access to all the medications that they need. It is clear that CMS’ rule will signal a step in the wrong direction and the consequences will be detrimental. According to the World Health Organization, depression is currently the leading cause of disability worldwide. By 2030, it will be the leading global burden of disease.2 In the United States alone, the total direct and indirect cost associated with depression exceeds $83 billion annually.3

Ultimately if CMS’ rule is approved, there will be severe human, economic and societal consequences for not only mental health patients, but for all Americans. We must take action now.

Here’s How You Can Take Action Today

Now, more than ever, the mental health community of patients, families, friends and others need to join together to tell CMS and the Administration how big of a mistake implementing this rule will be for all Americans. Below you’ll find several ways in which you can make your voice heard during CMS’ open comment period, ending March 7,to protect antidepressants, immunosupressants and antipsychotics within Medicare Part D. The clock is ticking!

1. Make Your Voice Heard by writing to your Member of Congress. Use the sample email letter to inform your member of Congress that the implementation of this proposed rule is a big mistake. Be sure to share any personal experiences and how this rule will impact you or a loved one.
2. Share your personal stories: The Care For Your Mind blog is interested in your personal stories to help share the extent of the issue and how it will impact you or a loved one. While this rule is expected to decrease patient costs for medications, members of the mental health community understand the treatment for our conditions is far from one size fits all. Below are a few questions that may help you shape and share your story:
   a. What will happen if you lose access to your medications?
   b. Have you had a negative experience with “fail-first” experiences?
   c. How will the new rule impact you, your parents, other family members or friends?
3. We encourage you to submit your personal story here for publication on our website. And in the meantime, join our conversation online by contributing to this blog below. Your voice counts and the time to speak up is now!
4. Share this information with others:  Knowledge is power. The more people know about the proposed rule’s real life consequences, the more we can make our voices heard. Share this post and relevant information with your friends and family, on your social media accounts, through email and word of mouth offline.Together, we can send a powerful message and help ensure that patients have access to the medications they need and deserve.

At Care For Your Mind, we understand that your personal experience and ideas can help build a mental health care system that works.

1 Fail first refers to the practice of forcing doctors to prescribe the least costly drug in any class to patients first, even if the physician wants to begin treatment with a different medication.

2 World Health Organization. http://www.who.int/mediacentre/factsheets/fs369/en/

3 Greenberg, et al.(2003).The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry, 64, pp. 1465-1475

The attached document contains  a ‘pairing’ of PSC’s with their area’s Senator & Representative. For those of you planning on attending Mental Health Day on the Hill, this year, I’m hoping you can take some consumers with you. It would be great if you can use this document,  early on,& go ahead & call your area legislators for appointment times. M H ‘Day on the Hill is March 18ththis year.

I would like to know when you set appointments, so I can try to be with you. Obviously, the huge issue for Mental Health Consumers is the matter of Governor Haslam’s desire to eliminate funding for the Peer Centers. Let’s all in regions VI, & VII  “put it together”, & influence our Legislators as to how important pro-mental health legislation is. And particularly how very important it is to keep our Peer Support Centers running. You can let me hear from you by, or by my cell #:

PEER SUPPORT CENTERS IN TENNESSEE

 

REGION I

 

FRONTIER HEALTH SERVICES
Host Agency Contact: Mary Fultineer
26 Midway Street
Bristol TN 37620

 

CONTACT:​SENATOR RON RAMSEY--

​​

 

​​REPRESENTATIVE JON LUNDBERG--

​​

 

Open Arms
Coordinator: Angela Prater

1400 Windsor Avenue
Bristol, TN 37620
Open: Monday-Thursday 8:30 am - 6:30 pm
Counties Covered: Sullivan

 

CONTACT:​SENATOR RON RAMSEY--

​​

 

​​REPRESENTATIVE JON LUNDBERG--

​​

 

 

Friendship House
Coordinator: Glenda Edwards

805 West Walnut Street
Johnson City, TN 37604
Open: Tuesday-Thursday 8 am – 5 pm
Counties Covered: Unicoi, Washington, Carter

 

CONTACT:​SENATOR RUSTY CROWE--

​​

 

​​REPRESENTATIVE MATTHEW HILL--

​​

 

Friendship Connection
Coordinator: Melissa Frazier

117 Wexler Street
Kingsport, TN 37660
Open: Monday-Thursday 9 am-6 pm
Counties Covered: Sullivan

 

CONTACT:​SENATOR RON RAMSEY--

​​

 

​​REPRESENTATIVE TONY SHIPLEY--

​​

 

Freedom Peer Support Center – Greeneville
Coordinator: Charles McLain

616 East Church Street
Greenville, TN 37743
Open: Mon, Tues, Thurs, Fri 11 am-5 pm
Counties Covered: Greene, Hawkins

 

CONTACT:​SENATOR STEVE SOUTHERLAND--

​​

​​

​​REPRESENTATIVE DAVID HAWK--

​​

 

Higher Ground
Coordinator: Charles Justice

1404 Crossroads Drive
Mountain City, TN 37683
Open: Tues, Wed, Thurs, Fri 9 am-5 pm
Counties Covered: Johnson

 

CONTACT:​SENATOR RON RAMSEY--

​​

 

​​REPRESENTATIVE TIMOTHY HILL--

​​

 

 

New Start - Sneedville
Coordinator: Charles McLain

119 Nora Alder Drive
Sneedville, TN 37689
Open: Tues, Wed, Thurs, Fri 12-5 pm
Counties Covered: Hancock

 

CONTACT:​SENATOR FRANK NICELEY--(615)

​​

 

​​REPRESENTATIVE MIKE HARRISON--(423)

​​

 

 

REGION II

 

CHEROKEE HEALTH SYSTEMS
Host Agency Contact: Stella Melton
or
215 Hedrick Drive
Newport, TN 37821

 

CONTACT:​SENATOR STEVE SOUTHERLAND--(423)

​​

 

​​REPRESENTATIVE JEREMY FAISON--(615)

​​

 

 

Health Recovery Group-Morristown
Peer Counselor: Mike Clayton

815 W 5th North Street
Morristown, TN 37814
Hours: Mon, Wed, Fri 1-4 pm
Counties covered: Hamblen, Cocke

 

CONTACT:​SENATOR STEVE SOUTHERLAND---(423)

​​

 

​​REPRESENTATIVE TILMAN GOINS--(423)

​​

 

 

 

Health Recovery Group-Newport
Peer Counselor: Mike Clayton
or
215 Hedrick Drive
Newport, TN 37821
Hours: Tues &Thurs 1-4 pm
Counties covered: Hamblen, Cocke

 

CONTACT:​SENATOR STEVE SOUTHERLAND--(423)

​​

 

​​REPRESENTATIVE JEREMY FAISON--(615)

​​

 

 

 

RIDGEVIEW PSYCHIATRIC HOSPITAL & CENTER
Host Agency Contact: Sharon Stratton

240 West Tyrone Road
Oak Ridge, TN 37830

 

CONTACT:​SENATOR RANDY MCNALLY--(865)

​​

 

​​REPRESENTATIVE JOHN RAGAN--(865)

​​

 

 

Friendship Place
Coordinator: Linda King

201 Sewanee Street #100
Harriman, TN 37748
Open: Tues – Fri 12 PM to 5:30 PM
Counties Covered: Morgan

 

CONTACT:​SENATOR KEN YAGER--(865)

​​

 

 

​​REPRESENTATIVE KENT CALFEE--(615)

​​

 

 

Horizons
Coordinator: Linda White

11 Joel Lane
Oak Ridge, TN 37830
Open: Wed – Sat 12 PM to 5:30 PM
Counties Covered: Anderson

 

CONTACT:​SENATOR RANDY MCNALLY--(865)

​​

 

​​REPRESENTATIVE JOHN RAGAN--(865)

​​

 

 

Wings
Coordinator: Barbara Smith

1327 East Central Avenue, Suite 5
Lafollette, TN 37766
Open: Wed – Thurs, 11 AM - 6; Fri, 11 AM – 7 PM Sat, 10 AM – 6 PM
Counties Covered: Campbell

 

CONTACT:​SENATOR KEN YAGER--(865)

​​

 

​​REPRESENTATIVE DENNIS POWERS--(615)

​​

 

 

HELEN ROSS MCNABB CENTER
Host Agency Contact: Jana Morgan

526 Lamar Street
Knoxville, TN 37917

 

CONTACT:​SENATOR STACY CAMPFIELD--(865)

​​

 

​​REPRESENTATIVE GLORIA JOHNSON--(865)

​​

 

 

Friendship House

Coordinator: Michelle Palmer

526 Lamar Street
Knoxville, TN 37917
Open: Tues., Thurs. & Sat. 10 AM to 2 PM
Wed. & Fri. 10 AM to 6 PM
Counties Covered: Knox

 

CONTACT:​SENATOR STACY CAMPFIELD--(865)

​​

 

​​REPRESENTATIVE GLORIA JOHNSON--(865)

​​

 

 

PENINSULA BEHAVIORAL HEALTH
Host Agency Contact: Mary Nelle Osborne

1451 Dowell Springs Blvd Suite 101
Knoxville, TN 37909-2451

 

CONTACT:​SENATOR STACY CAMPFIELD--(865)

​​

 

​​REPRESENTATIVE STEVE HALL--

​​

 

 

Maryville Wellness Recovery Center
Coordinator: Joey Amason

532 E. Broadway Avenue
Box 9
Maryville, TN 37804
Open: Mon – Thus, 10:00 AM – 4:00 PM
Counties Covered: Blount

 

CONTACT:​SENATOR DOUG OVERBEY--

​​

 

​​REPRESENTATIVE ART SWANN--

​​

 

 

 

Sevierville Wellness Recovery Center
Coordinator: Marjorie Diefenbach

509 High Street
Sevierville, TN 37862
Open: Mon – Thur, 11 am – 6 pm
Counties Covered: Sevier

 

CONTACT:​SENATOR DOUG OVERBEY--

​​

 

​​REPRESENTATIVE DALE CARR--

​​

 

 

Knox Wellness Recovery Center
Interim Coordinator: Leslie Judson

1451 Dowell Spring Road
Knoxville, TN 37919
Open: Tuesday- Thursday 3-7
Counties Covered: Knox

 

CONTACT:​SENATOR STACY CAMPFIELD--

​​

 

​​REPRESENTATIVE STEVE HALL--

​​

 

 

REGION III

 

FORTWOOD CENTER
Host Agency Contact: Dot Stephens

1028 East 3rd Street
Chattanooga, TN 37403

 

CONTACT:​SENATOR TODD GARDENHIRE--

​​

 

​​REPRESENTATIVE JOANNE FAVORS--

​​

 

Lighthouse Peer Support Center
Coordinator: Marty Davis

509 South Highland Park
Chattanooga, TN 37403-4116
Open: Monday – Thursday 10:00 AM – 6:00 PM
Saturday – 10:00 AM – 3:30 PM
Counties Covered: Hamilton

 

CONTACT:​SENATOR TODD GARDENHIRE--

​​

 

​​REPRESENTATIVE JOANNE FAVORS--

​​

 

 

VOLUNTEER BEHAVIORAL HEALTH CARE SYSTEM
Host Agency Contact: Vicki Harden

 

 

The Cottage
Coordinator: Paul Turney

112 College Street
Jasper, TN 37347
Open: Mon, Wed, Fri 9:30 AM – 6:00 PM
Tues &Thurs 10:30 AM – 7:00 pm
Counties Covered: Marion, Grundy

 

CONTACT:​SENATOR JANICE BOWLING--

​​

 

​​REPRESENTATIVE BILLY SPIVEY--

​​

 

 

Dakoda Place - Athens
Coordinator: Tina Gesolgon

PO Box 685
424 Old Riceville Road
Athens, TN 37303
Open: Monday – Friday 9:00 AM – 3:00 PM
Counties Covered: McMinn

 

CONTACT:​SENATOR MIKE BELL--

​​

 

​​REPRESENTATIVE JOHN FORGETY--

​​

 

 

Dakoda Place - Cleveland
Coordinator: Tina Gesolgon

940 South Ocoee Street
Cleveland, TN 37311
Open: Tues & Thurs 9:00 AM – 3:00 PM
Counties Covered: Bradley

 

CONTACT:​SENATOR MIKE BELL--

​​

 

​​REPRESENTATIVE KEVIN BROOKS--

​​

 

 

Friends & Company
Coordinator: Angela Smithers
or
1200 S. Willow Avenue
Cookeville, TN 38503
Open: Tues 12-5; Wed - Fri 9-5
Counties Covered: Putnam, White

 

CONTACT:​SENATOR CHARLOTTE BURKS--

​​

 

​​REPRESENTATIVE RYAN WILLIAMS--

​​

 

 

Friendship Circle
Coordinator: Becky Porter

412 Delaware Avenue
Dayton, TN 37321
Open: Monday – Friday 9:00 AM – 5:00 PM
Counties Covered: Rhea

 

CONTACT:​SENATOR KEN YAGER--(865)

​​

 

​​REPRESENTATIVE RON TRAVIS--

​​

 

 

My Friends House
Coordinator: Linda Joan Smith

209 B South Church Street
Livingston, TN 38570
Open: Monday – Friday 9:00 AM – 5:00 PM
Counties Covered: Overton, Clay, Pickett

 

CONTACT:​SENATOR CHARLOTTE BURKS--

​​

 

​​REPRESENTATIVE JOHN MARK WINDLE--

​​

 

 

 

PREPS Center
Coordinator: Sandra Crabtree

47 Willow Street
Crossville, TN 38555
Open: Mon - Fri 8:00 AM – 4:00 PM
2nd Friday 8:00 AM – 12:00 PM
2nd Saturday 9:00 AM – 1:30 PM
Counties Covered: Cumberland

 

CONTACT:​SENATOR CHARLOTTE BURKS--

​​

 

​​REPRESENTATIVE CAMERON SEXTON--

​​

 

 

Harmony House
Coordinator: Mary Webb

107 Lyon Street Suite 3
McMinnville, TN 37110
Open: Monday - Thursday, 8 am to 2 pm
Counties covered: Warren

 

CONTACT:​SENATOR JANICE BOWLING--

​​

 

​​REPRESENTATIVE CHARLES CURTISS--

​​

 

 

 

REGION IV

 

CENTERSTONE

Host Agency Contact: Mary Moran

1101 Sixth Avenue North
Nashville, TN 37208

 

CONTACT:​SENATOR THELMA HARPER--

​​

 

​​REPRESENTATIVE MIKE TURNER--

​​

 

 

ReConnect Nashville
Coordinator: Greg Bennett
or
1101 Sixth Avenue North
Nashville, TN 37208
Open: Monday – Friday 10 – 4 open one Saturday per month
Counties Covered: Davidson

 

CONTACT:​SENATOR THELMA HARPER--

​​

 

​​REPRESENTATIVE MIKE TURNER--

​​

 

REGION V

 

CENTERSTONE
Host Agency Contact: Mary Moran

1101 Sixth Avenue North
Nashville, TN 37208

 

CONTACT:​SENATOR THELMA HARPER--

​​

 

​​REPRESENTATIVE MIKE TURNER--

​​

 

 

ReConnect Clarksville
Regional Coordinator: Carla Sanders
or
611 8th St.
Clarksville, TN 37040
Open: Mon – Fri 10 – 4; open one Saturday per month
Counties Covered: Montgomery, Robertson

 

CONTACT:​SENATOR MARK GREEN--

​​

 

​​REPRESENTATIVE JOE PITTS--

​​

 

 

ReConnect Dickson
Regional Coordinator: Carla Sanders
or
224 N Main ST
Dickson, TN 37055-1802
Open: Mon – Fri 10 – 4; open one Saturday per month
Counties Covered: Dickson

 

CONTACT:​SENATOR JIM SUMMERVILLE--

​​

 

​​REPRESENTATIVE DAVID SHEPARD--

​​

 

 

ReConnect Tullahoma
Regional Coordinator: Brenda Hargrove

709 North Davidson St
Tullahoma, TN 37388
Open: Mon – Fri 10 – 4; open one Saturday per month
Counties Covered: Coffee, Lincoln

 

CONTACT:​SENATOR JANICE BOWLING--

​​

 

​​REPRESENTATIVE JUDD MATHENY--

​​

 

 

ReConnect Columbia
Regional Coordinator: Wanda Yeager
or
6011 Trotwood Avenue
Columbia, TN 38401
Open: Mon – Fri 10 – 4; open one Saturday per month
Counties Covered: Maury, Lawrence

 

CONTACT:​SENATOR JOEY HENSLEY--

​​

 

​​REPRESENTATIVVE SHEILA BUTT--

​​

 

 

ReConnect Shelbyville
Contact Person: Brenda Hargrove
or
1110 Woodbury Street
Shelbyville, TN 37160
Open: Mon – Fri 10 – 4; open one Saturday per month
Counties Covered: Bedford

 

CONTACT:​SENATOR JIM TRACY--

​​

 

​​REPRESENTATIVE PAT MARSH--

​​

 

 

VOLUNTEER BEHAVIORAL HEALTH CARE SYSTEM
Host Agency Contact: Vicki Harden

 

 

Enrichment House
Coordinator: Effie Cates

538 East Main Street
Gallatin, TN 37066
Open: Tues – Fri 8:00 AM – 5:00 PM
Counties Covered: Sumner, Wilson

 

CONTACT:​SENATOR FERRELL HAILE—(

​​

 

​​REPRESENTATIVE WILLIAM LAMBERTH--

​​

 

 

Our Place
Coordinator: Lyndi Shupp

120 S. Hancock Street
Murfreesboro, TN 37130
Open: Mon – Thurs & Sat 9:00 AM – 3:00 PM
Counties Covered: Rutherford

 

CONTACT:​SENATOR BILL KETRON--

​​

 

​​REPRESENTATIVE RICK WOMICK--

​​

 

 

REGION VI

 

CAREY COUNSELING CENTER
Host Agency Contact:
Sherri Sedgebear

PO Box 793
Huntingdon, TN 38344

 

 

Liberty Place
Coordinator: Priscilla Johnson

111 East Eaton St
Trenton, TN 38382
Open: Tues – Fri 10-8; Sat 8-4
Counties Covered: Gibson

 

CONTACT:​SENATOR JOHN STEVENS--

​​

 

​​REPRESENTATIVE CURTIS HALFORD--

​​

 

 

Outreach Center
Coordinator: Kathy Graham

1539 Hwy 69 North
Paris, TN 38242
Open: Tues- Fri 10-6; Sat 8-4
Counties Covered: Henry

 

CONTACT:​SENATOR JOHN STEVENS--

​​

 

​​REPRESENTATIVE TIM WIRGAU--

​​

 

 

C.A.R.E.S. Center
Coordinator: Teresa Madison

946 Flatwoods Road
Camden, TN 38320
Open: Thurs – Fri 9-4; Sat 9-3
Counties Covered: Benton

 

CONTACT:​SENATOR JOHN STEVENS--

​​

 

​​REPRESENTATIVE TIM WIRGAU--

​​

 

 

Sunrise Outreach Center
Coordinator: Shawna Williams

110 East Church Street
Union City, TN 38261
Open: Tues – Fri 10-6; Sat 8-4
Counties Covered: Obion

 

CONTACT:​SENATOR JOHN STEVENS--

​​

 

​​REPRESENTATIVE ANDY HOLT--

​​

 

 

PATHWAYS
Host Agency Contact: Pat Taylor

238 Summar Dr
Jackson, TN 38301

 

CONTACT:​SENATOR LOWE FINNEY--

​​

 

​​REPRESENTIVE JOHNNY SHAW--

​​

 

The Hope Center
Coordinator: Debbi Young

222 E. Court St. Suite A
Dyersburg, TN 38024
Open: Tues – Thurs 8:00 AM – 3:30 PM
Counties Covered: Crockett, Dyer, Lake

 

CONTACT:​SENATOR LOWE FINNEY--

​​

 

​​REPRESENTATIVE BILL SANDERSON--

​​

 

 

Rainbow Center
Coordinator: Thomas Byars

67 American Drive
Jackson, TN 38301
Open: Tue, Wed & Thurs 8:00 AM – 4:00 PM
Counties Covered: Madison, Haywood

 

CONTACT:​SENATOR LOWE FINNEY--

​​

 

​​REPRESENTATIVE JIMMY ELDRIDGE--

​​

 

Comfort Center
Coordinator: Kim Buckley

300 Holly Street
Lexington, TN 38351
Open: Mon - Fri 8:00 AM-4:00 PM
Counties Covered: Henderson

 

CONTACT:​SENATOR DELORES GRESHAM--

​​

 

​​REPRESENTATIVE STEVE MCDANIEL--

​​

 

 

PROFESSIONAL CARE SERVICES
Host Agency Contact: Jimmie Jackson

1997 Hwy 51 S
Covington, TN 38019

 

CONTACT:​SENATOR MARK NORRIS--

​​

 

​​REPRESENTATIVE DEBRA MOODY--

​​

 

 

Hearts in Hands
Coordinator: Brenda Robbins

12615 S. Main
Somerville, TN 38068
Open: Mon, Tues, Thurs, 8:00 AM – 5:00 PM
Wed 8:00 AM – 2:00 PM
Counties Covered: Fayette

 

CONTACT:​SENATOR DELORES GRESHAM--

​​

 

​​REPRESENTATIVE BARRETT RICH--

​​

 

 

Togetherness House
Coordinator: Melissa Belair

477-B South Washington
Ripley, TN 38063
Open: Mon, Wed, Fri, 8:30 – 5; Tues, 9 – 5; Thurs, 1-5
Counties Covered: Lauderdale, Tipton

 

CONTACT:​SENATOR LOWE FINNEY--

​​

 

​​REPRESENTATIVE CRAIG FITZHUGH--

​​

 

QUINCO MENTAL HEALTH CENTER
Host Agency Contact: Heather King

10710 Old Hwy 64
Bolivar, TN 38008

 

CONTACT:​SENATOR DELORES GRESHAM--

​​

 

​​REPRESENTIVE JOHNNY SHAW--

​​

 

 

Horizon of Bolivar
Coordinator: Shirley Kelley

428 W. Market St.
Bolivar, TN 38008-2606
Open Tues-Fri, 8 am – 4 pm
Counties Covered: Hardeman, Chester

 

 

CONTACT:​SENATOR DELORES GRESHAM--

​​

 

​​REPRESENTIVE JOHNNY SHAW--

​​

 

 

Horizon of Savannah
Coordinator: Jana James

430 Pinhook Drive
Savannah, TN 38372
Open: Wednesday – Friday 8:00 AM – 4:00 PM
Counties Covered: Hardin, McNairy

 

CONTACT:​SENATOR DELORES GRESHAM--

​​

 

​​REPRESENTATIVE VANCE DENNIS--

​​

 

 

REGION VII

 

SOUTHEAST MENTAL HEALTH CENTER
Host Agency Contact:
Debra Dillon

135 N. Pauline
Memphis, TN 38104

 

CONTACT:​SENATOR JIM KYLE--

​​

 

​​REPRESENTATIVE JOHN DEBERRY--

​​

 

 

Turning Point
Coordinator: Zoe Simpson

4088 Summer Ave
Memphis, TN 38122
Open: Mon., Thurs. & Fri. 8:30 AM to 4:30 PM
Counties Covered: Shelby

 

CONTACT:​SENATOR BRIAN KELSEY--

​​

 

​​REPRESENTATIVE G. A. HARDAWAY--

​​

 

 

Tennessee Mental Health Consumers’ Association
Host Agency Contact: Lori Rash

 

The Beers-Van Gogh Peer Center
Coordinator: Megan Hoffmann

669 Madison Ave
Memphis, TN 38103
Open: Mon – Fri 12 PM to 5 PM
Counties Covered: Shelby

 

 

CONTACT:​SENATOR JIM KYLE--

​​

 

REPRESENTATIVE JOHN DEBERRY--

​​

 

1

 

DBSA Opposes CMS Proposal to Eliminate Access to Mental Health Treatments as Part of the "Six Protected Classes"In a misguided effort to save money, CMS proposal would deny vital treatments for people with mental health conditions who are covered under Medicare Part DChicago, IL (January 17, 2014)  
On January 6, the Centers for Medicare and Medicaid Services (CMS) circulated a proposed rule that would remove antidepressants and immunosupressants from the protected class status they received under Medicare Part D in 2015, and to remove antipsychotics from that status in 2016. Despite a growing public recognition of America’s mental health treatment crisis, the Administration inexplicably proposed undoing one of Medicare’s signature protections for people with mental health conditions by suggesting that when it comes to drug treatment one size fits all.

“DBSA advocates for the right of people with mental health conditions like depression or bipolar disorder to choose their own paths to mental, emotional, and physical wellness,” stated Allen Doederlein, President of DBSA. “Implementation of this proposed ruling has the potential not only to undermine hard-won treatment advances a person with a mental health condition may have made, but also to undermine a person’s ability to choose the right treatment that a clinician identifies as the best fit for a serious, life-threatening condition.”

For nearly a decade, the “six protected class” policy has ensured that Medicare patients with mental health conditions, many of whom have severe, treatment-resistant symptoms, have access to the most appropriate drug without having to go through “fail-first” experiences or lengthy appeals and grievance processes.  Often, delays caused by these processes can result in suicide and other tragic outcomes, and inadequate treatment leaves people open to relapse, co-occurring conditions which greatly shorten lifespans, and increased suicide risk.

Commenting on the proposed ruling, Joseph R. Calabrese, MD, Director, Mood Disorders Program, Bipolar Dis. Research Chair & Professor of Psychiatry and Dir. Bipolar Disorders Research Center at Case Western Reserve University, stated “the effectiveness and tolerability of antidepressants can vary greatly among people who choose this treatment option. Our extensive clinical experience demonstrates that the best therapy for one person may be ineffective or poorly tolerated in another individual. Moreover, successful treatment frequently involves trial of several different medications in a quest to find the best treatment in terms of efficacy and tolerability. As a result, it is important that people with mental health conditions have access to a wide variety of treatments and that clear information about these options is available both to clinicians and the individuals they serve and treat.”

We understand that the Administration's proposal represents an effort to save money.  However, CMS has clearly failed to anticipate the predictable increase in costs to both Medicaid and Medicare Part A from the resulting spike in inpatient admissions.  The Depression and Bipolar Support Alliance strongly opposes this proposed rule and is joining other stakeholders in the fight against it. These activities include submitting comments to the regulatory rulemaking process which are due on March 7.

Background:  In 2005, CMS directed that Part D formularies include all or substantially all drugs in six drug classes, including: antidepressant; antipsychotic; anticonvulsant; immunosuppressant (to prevent rejection of organ transplants); antiretroviral (for the treatment of infection by retroviruses, primarily human immunodeficiency virus (HIV); and antineoplastic. The Medicare Improvements for Patients and Providers Act created the six protected classes, and the Affordable Care Act also defined them by name. Today, Medicare Part D plans must carry "all or substantially all" of the chemically distinct drugs in these categories on their formularies. For other categories, the plans can typically carry one brand-name drug and one generic drug.

The petition for peer centers

by hopeworkscommunity

Please sign and pass it on to as many people as you can.  We need signatures.

 

I’ve started the petition “Governor Bill Haslam: Restore funding to the 45 peer support centers in Tennessee” and need your help to get it off the ground.

Will you take 30 seconds to sign it right now? Here’s the link:

http://www.change.org/petitions/governor-bill-haslam-restore-funding-to-the-45-peer-support-centers-in-tennessee

Here’s why it’s important:

 

The 45 peer support centers in Tennessee serve an average of 3500 a day.  For literally a few dollars a day they provide a safe, positive, supporting and therapeutic environment to their members.  They reduce hospitalization 93% for their members.  They provide success to many people who have never known it.  For many people they are the mental health system.  The 4.5 million dollars currently budgeted is a bargain financially, socially and emotionally.  Please keep the peer centers in Tennessee

 

You can sign my petition by clicking here.

Thanks!
Larry Drain

The bill, Helping Families in Mental Health Crisis Act (H.R. 3717), introduced by Rep. Tim Murphy of Pennsylvania, would cut funding for the Protection & Advocacy for Individuals with Mental Illness (PAIMI grant) by 85% and restrict DLAC from engaging in systemic or public policy advocacy.

 

The bill, in part, is a reaction to testimony at a Congressional hearing in which scant anecdotal information presented in a totally one sided manner portrayed the PAIMI program as part of the problem instead of, as we know it to be, part of the solution.  The implication was that PAIMI programs were using their resources and authority to keep people with mental illness from getting necessary treatment.  We know the opposite to be true – PAIMI programs have been at the forefront of advocating for people with mental illness to receive appropriate treatment ever since President Ronald Reagan signed the PAIMI Act into law in 1986.  Unfortunately, Rep. Murphy, who ironically is a proponent of evidenced based policy making, is ignoring the well documented evidence of 27 years of successful advocacy by PAIMI advocates on behalf of people with mental illness.

 

Among the many changes contained in its 135 pages, the bill would defund mental health consumer networks, a model in which people with psychiatric disabilities have opportunities to develop independence and personal growth in supportive environments with their peers; deny mental health block grant funding to any state that has not adopted a forced treatment regime (“Assisted Outpatient Treatment,” a euphemism for Involuntary Outpatient Commitment); and amend HIPAA law to make it easier to access the records of people with a mental health diagnosis. This legislation would essentially move the clock back on decades of progress in mental health, promote discrimination and stigma, use coercion and drugs as the blunt instruments of care, silence the advocates and keep people away from seeking the treatment they need.

 

We are convinced that the only way Rep. Murphy’s misguided bill can succeed is if the people who know the truth about the PAIMI program remain silent.  We need people who have benefitted from the PAIMI program, our allies, and members of DLAC’s Board and advisory councils which have guided our PAIMI program to speak up – to share what they know to be true - that DLAC and the PAIMI programs throughout America have been dedicated and effective advocates for people with mental illness.

 

ACTION NEEDED:

We need you to contact the members of Tennessee’s Congressional Delegation (contact information below) and communicate to them the negative impact this legislation would have and urge them not to co-sponsor this legislation.  All you have to do is leave that message with the person that answers the phone. If you want to get into more detail feel free to use the talking points and background information in this email, but the key message is to ask your legislator not to co-sponsor H.R. 3717.

 

Talking Points

 

•             Representative Murphy’s legislation (H.R. 3717) will reduce funding for the Protection and Advocacy for Individuals with Mental Illness (PAIMI) program by about 85% leaving individuals with mental illness no independent advocates to help address the myriad of issues they face every day.

•             Representative Murphy’s legislation (H.R. 3717) will make it easier to discriminate against people with mental illness in housing, employment, and education, and lead to fewer individuals receiving the treatment they need.

•             Representative Murphy’s legislation (H.R. 3717) would remove the ability for our agency to fully serve individuals with mental illness. In its 27 year history, the PAIMI program has been highly successful assisting people with mental illness and should continue to have the broadest authority possible to ensure people with disabilities are free from abuse and neglect and receive the services and supports they need.  Contrary to the implication in Rep. Murphy’s bill our PAIMI program, Disability Law & Advocacy Center of Tennessee, has been instrumental in securing appropriate treatment for and ensuring the safety of:

o    Youth with severe mental health issues

o    People with mental illness in jails and prisons

o    People with mental illness residing in the community (board & care homes)

 

The links are to provide you background information should you want it.

 

Tennessee House Representatives

 

Rep. David Roe (TN-1)                                     

Rep. John  Duncan, Jr. (TN-2)                        

Rep. Chuck Fleischmann (TN-3) 

Rep. Scott DesJarlais (TN-4)            

Rep. Jim Cooper (TN-5)                                

Rep. Diane Black (TN-6)                              

Rep. Marsha Blackburn (TN-7)   

Rep. Stephen Fincher (TN-8)      

Rep. Steve Cohen (TN-9)           

 

Thanks for reading. If you have any questions, please let us know. Please also feel free to share this email with others in your network.
 

Francisca Guzman

Media & Development Advisor

Disability Law & Advocacy Center of Tennessee