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 ~

Thanks to BP magazine for shining a bright light on a dark topic. I am glad to be a part of a support group that helps prevent suicide. For over 13 years our group has served the Jackson, Tn. community faithfully. "Thank you" to , A Better Tomorrow inspirational support group.

TAKING SUICIDE PREVENTION UPSTREAM

Across the country, school districts are providing mental health awareness and suicide prevention training for teachers and school personnel. Some are mandated or encouraged to do so by state law, others are motivated by recent incidents, and some introduce this kind of education because suicide is now the second-leading cause of death among youth aged 15-24.

Teacher and parent training are key components in any plan to address teen suicide. Increasingly, however, communities are recognizing that kids need to learn about mental health, too. Social and emotional learning across the lifespan reduces risk factors and promotes protection factors for violence, substance abuse, negative health outcomes, and suicide. One way to provide universal student training is by including a mental health component in the standard wellness or health curriculum. School districts and individual schools can implement individual, more targeted programs as well.

Knowing how to cope and developing resilience are at the core of mental health awareness and suicide prevention efforts being implemented in Massachusetts with children as young as elementary school. The Commonwealth of Massachusetts places a high value on suicide prevention, with dedicated line-item funding in the state budget for the Department of Public Health Suicide Prevention Program. With support from state officials, the DPH has launched suicide prevention programs across the state and for people across the lifespan.

Some of the skill-building and suicide prevention programs in Massachusetts schools are

• The PAX Good Behavior Game, which has been introduced by schools in collaboration with the DPH, teaches students self-regulation, self-control, and self-management in order to create an environment that is conducive to learning. (Ages 6-12)
• The Open Circle program, which strengthens students’ social and emotional learning skills to increase pro-social behaviors and reduce problem behaviors, is utilized by many school districts. (Grades K-5)
• Whyville utilizes problem-solving and other skills to help kids learn about their emotions in an online computer game. (Teens and pre-teens)
• SOS Signs of Suicide® focuses on prevention through education by teaching students to identify symptoms of depression, suicidality, and self-injury in themselves and their peers. (Grades 8-12)
• Break Free from Depression, developed by the Boston Children’s Hospital, focuses on increasing awareness about adolescent depression, how to recognize it, and how to get help. (High school)

There are dozens of programs that schools can use to promote skills development while fostering students’ mental health and their willingness to seek and accept help for mental health concerns. SAMHSA’s National Registry of Evidence-based Programs and Practices and the Suicide Prevention Resource Center Best Practices Registry include searchable descriptions for a wide variety of educational programs. For high school students, the SAMHSA Preventing Suicide: A Toolkit for High Schools has a comprehensive list of programs, but a search of the NREPP and BPR may yield programs added since the Toolkit was published.

What can you do? Find out how your school district handles mental health training and emotional skill building for students. If there is not currently a program and there is no interest from school officials, you might work with the parent-teacher organization, local mental health groups, and the local board of public health to raise awareness of the issue, then advocate for implementation of one or more programs. There may be grants available to cover the cost of training or there may be organizations in your community that would help subsidize the program.

The bottom line is that suicide prevention requires a comprehensive approach. It’s never too early to start and everyone – families, schools, communities, and peers that create supportive environments; individuals who learn and leverage positive coping skills; and mental and public health systems that treat and prevent risk factors – plays a part.

Your Turn

• What do you think about the mental health awareness and/or suicide prevention programs that are provided to kids in your community?
• What role should a school have in developing kids’ emotional and social skills?
• What steps will you take to improve mental health awareness and suicide prevention in your local schools?

Editor’s Note: The Families for Depression Awareness Teen Depression Webinaris an accessible, free resource for training parents, teachers, and others who work with youth to recognize depression, talk about depression with parents and youth, and know what to do to help a young person struggling with depression. Register for the Teen Depression Webinar live with Dr. Michael Tsappis on September 30. 

Thanks to the MA Department of Public Health Suicide Prevention Program and the Suicide Prevention Resource Center for their support in developing this post.

Thank you, Larry Drain, for making us think and feel about the serious matter of mental illness in the light of reality . . . Reality check, anyone?

hopeworkscommunity, Larry Drain

What is Murphy selling?

Donald Trump gave me the clue.

Even more than AOT or any other policy idea Tim Murphy is selling something far more visceral, far more compelling and far more appealing. Like Trump he is selling anger to those who feel like they or their loved ones have been hurt by a system that often doesn’t help very much. Like Trump he is selling justification and direction by telling them who is to blame. Like Trump he is selling redemption and hope by telling them if they just follow and support him he can change it. His message is one of quest and crusade and rescue of those hurt and victimized.

Like Trump he has never let the facts get in the way but that is not the subject of this post.

Murphy has tapped into something very real. It is far more than a few overcontrolling parents frustrated with their kids. I sat one night with one 72 year old man talking about his 38 year old schizophrenic son. The pain and outrage was real. His son had been attacked by police in a parking lot who thought he was drunk a couple of weeks before he sat down with me. He had been tased more than once and they thought some damage to his legs might be permanent. He was furious at the police but equally furious at a system that had never been there for his son and furious….well just furious that the son he loved was seemingly stuck in the life he had. I remember listening to a mother describe the day she screamed and begged the police not to shoot her son. He had a towel wrapped around his hand and they thought he might have a gun. I have heard a hundred more stories.

It is not so very different than the rage I hear when I hear people talk about the damage they feel the system has done to them. It is the rage of the 22 year old girl with no history of diabetes in her family who now, courtesy of the medication a psychiatrist had prescribed her, had just found out she now had diabetes. She screamed at me….”What the fuck am I supposed to do now?”

It is my rage. My nephew one night laid down in front of a train and died. He believed that treatment was for crazy people and he could think of few things worse than being crazy. He believed what the wider society told him about “mental illness.” He didn’t want to be embarrassed. He didn’t want to stick out. He tried to hide his desperation. He tried to macho his desperation. Finally he decided to kill it.

The rage is real. It may express itself different for different people but it is real.

I think people can find better lives. My nephew, my friend’s son and literally hundreds of thousands of other people deserve something better. And it literally makes me want to scream and scream and scream that so many never find it. It makes me want to scream when people are treated as less than people. It makes me want to scream when the only options people have are things that have already not worked. And it makes me scream when people in their zeal to control symptoms destroy the quality of the life they are trying to save.

Murphy is not going away. The rage is real.

I think back often to something I heard Robert Whitaker say once. He wondered if we would ever have an honest mental health system. What if it was just about what worked?

What if it was?

Maybe in the end that is the only real answer to the Murphys…

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

http://wp.me/p4E9xY-aD

Governor Haslam says he is not as "optimistic" about a Tennessee Plan as he was 6 weeks ago.  I take this to mean the federal government is unlikely to accept any proposed elements of the Tennessee Plan that violate or contradict federal law or regulation.  He is not going to be able to write the rules.  He is going to have to follow them.  If the condition of him fighting for Tenn Care expansion is for it to be an easy fight he is not going to make the fight.

The election has been in the strangest of circumstances the "dead period" (What kind of political system makes it off limits to talk about the most important issue to face for fear someone would have to take a stand on it?)  It is now time to define the conversation that will govern the decision on Tenn Care expansion.

The people who would have us vote no on Tenn Care expansion will try to make us believe that a no vote is the only way to save us from a federal menace that will lead us to chaos.  In face of all the facts to the contrary that is momentous argument to make but that has never stopped a politician yet.

The voice missing is ours.  It is time for Tennessee to be for Tennesseans regardless of their socioeconomic status and for politicians to talk to the people they work for.  Share your story and your concerns today.  Call your legislator and speak to him today.  You will only be heard if you speak.

You are invited to legislative plaza in Nashville on November 10.  Linda and I will be having a "Speak to the people" rally.  46000 people have spoke.  They have signed a petition urging Governor Haslam to expand Tenn Care and we will deliver that petition.  Other people in the coverage gap will be speaking.  We hope to see you there about 11am. Please share this post and spread the word.

Thanks a lot.

Larry and Linda

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 .

I found this article very meaningful for me. I believe it takes a lot of effort today, for most of us, to stay positive in a negative world. These are some lighthearted points on how to do just that.

12 Steps To Stay Positive In A Negative World

BY DR. JOEL KAHN

OCTOBER 8, 2014

This weekend we celebrated the Jewish holy day of Yom Kippur. One of the clergy scheduled an hour-long healing session sandwiched between the full day of prayers on this fast day. Fifty people showed up, some willing to share the pain they were feeling from recent diagnoses of cancer, loss of loved ones, or family traumas, and others remained silent.

When it was my turn, I brought up the challenge I felt trying to stay positive in a negative world. Cruelty, brutality and insecurity seem to me more palpable than in the past, perhaps due to 24/7 connectivity with reports of wars, tragedies and beheadings. I described steps I use to emphasize the positive during the day while still being grounded in the events occurring in the world.

Here are 12 of the techniques I use to maintain a positive outlook when the world seems so incredibly negative:

1. Control the amount of negative news in my life.

While I want to stay up on the events occurring in the world, sometimes a headline is sufficient to grasp new developments. I limit the time I spend with TV, radio and Internet, selecting only a few stories to read in full.

2. Control the number of negative people in your life.

I spend most of my days talking to patients about their problems, and some days are filled with more uplifting reports than others. However, I can select how much time I spend with relatives and friends that dwell on the negative. As painful as it may be at times, my calendar may not open to those who consistently drag me down.

3. Listen to music.

I find positive music playing in the car, my home and at work to be a great source of uplifting spirit. One of the most positive collections of music is what I have found in Kundalini yoga. I can feel bountiful, beautiful and blissful with just a few clicks of my phone.

4. Meditate.

I choose to practice a Kirtan Kriya as taught by Dr. Dharma Singh Khalsa, since it takes 12 minutes with a mantra and mudras that are simple. I often do this in the sauna, something I call saunitation, as it seems to clean out the junk in my brain.

5. Live consciously.

Awareness of my breath, the origin and nutrition of my food while eating, a blue sky, a purple flower, a bird’s song all can draw me into a feeling of gratitude for the moment that overcomes forces that can drag me down.

6. Practice gratitude.

Appreciating people for anything they may do to help during my day is always my goal, some days more successfully practiced than others. Helping others, holding a door, buying a surprise coffee for someone behind me in line (I call it random acts of caffeine), or letting someone merge into an intersection can be uplifting.

7. Pray.

In my faith there are a couple prayers that are recited on awakening. A simple two-phrase prayer expresses thanks for the return of the spirit to the body after a night’s rest. Another prayer is odd, but one of my favorites: a prayer written over 1000 years ago to be recited after urinating or defecating to acknowledge that the body is still performing its daily miracle. Although an odd blessing, when I care for patients with bowel and bladder illness, I appreciate both how grounded this moment of reflection is.

8. Read positive books and interviews.

I've read my share of Dale Carnegie, Tony Robbins, Og Mangino, and Louise Hay but going back to them every now and then is a positive moment. Also, I select TED talks that describe new innovations, survivors of challenges, and insights into nature and feel better after viewing them.

9. Give hugs.

I love hugging others and, if my patients permit, I hug and scratch backs on most visits, which brings out huge smiles. I can just watch the stress of others diminish and my own stress decrease.

10. Disconnect.

My phone is my pager, my social media, my calendar, and my tether 24/7. The smartphone is a wonder of technology that is on my waist, in my hand, or with me in the car. Some sacred time requires that it be shut off, whether it's one day a week as many religions mandate, an hour in the yoga room, or while meditating. I work to keep my phone and my brain far apart using speakerphone, Bluetooth or headsets.

11. Laugh.

Years ago, author Norman Cousins demonstrated the healing power of comedy on the course of ill patients and humor can play a healing role today as well. I often end my day with a few minutes of comedy that I have recorded on the DVR. I put the days’ worries behind, enjoy a few belly laughs, and think positively about the coming day.

12. Connect with animals.

My medical work day ends when I walk in my home and see two tails wagging with joy for the fact that I've returned. I have to lie down right then, whether in a suit or scrubs, to let Jake and Eva lick my face over and over. I doubt there's a better therapy after a long day, and I'm sure many of you feel that the love from a pet can counter so much negativity.

My wife and I have joked for years about moving to an isolated island where life is simple. Decades later, careers, children, and goals have kept us from fantasy. The Dalai Lama was quoted as saying, “When we meet real tragedy in life we can react in two ways, either by losing hope and falling into self-destructive habits or by using the challenge to find our inner strength.”

DBSATennessee.org

Ordinary heroes: Drains honored for speaking out for health care equality

B

y Linda    Braden

Larry and Linda Drain are quiet, unassuming people. But when circumstances arose that threatened Linda’s life, they both began speaking out, their voices ringing loudly to bring awareness to — and a solution for — themselves and others who have fallen through the cracks of the health care system in Tennessee. Their income is too high to qualify for TennCare, Tennessee’s public insurance program, and too low to qualify for federal subsidies under the Affordable Care Act, also called Obamacare.

In acknowledgement of their efforts, the Tennessee Health Care Campaign presented the Drains with the 2014 Heroes for Health Award in August at the John Seigenthaler First Amendment Center, Nashville. The award was given “for your dedicated support to affordable access to high-quality health care for all Tennesseans.”

The event honoring the Heroes was part of the Tennessee Health Care Campaign’s 25th Anniversary celebration. In addition to the Drains, Laura Sell was honored for the major work she did as a volunteer to promote and support enrollment in the Patient Protection and Affordable Care Act, collaborating with the Blount County Public Library.

Larry said, “It was a very eventful night. We got to speak to a lot of people, meet a lot of people that were heavy-hitters that we knew about or read about. That was neat. And to get people to treat us like we were important. As we were walking out the door, I said, ‘Linda, do you ever get over being surprised when people treat us nice?’ I’m surprised every single, solitary time. It’s just been a strange happening. When it first started out, we didn’t have a clue ... The way we look at it is that we are extraordinarily ordinary people, and the idea that people would know who we are or that people would listen to what we have to say — I wouldn’t have predicted that in a thousand, million years. Then when it took off, it went insane.”

Story begins

The story began with Linda, who has been drawing Supplemental Security Income (SSI) for some time because of epilepsy, brain surgery and additional health conditions. Larry said, “She has TennCare. She has to have the TennCare in order to live. If she does not have the medication, if she doesn’t have the medical care, she will die.

“Ten years ago, a good day for her was having 10 to 15 grand mal seizures. She went through brain surgery, and the last 10 to 14 years have been extraordinarily eventful, but the medication is her pathway to life.”

After Larry turned 62 last September, he decided to take early retirement and begin drawing Social Security.

“If I had to take all the dumb, stupid, worst things in my entire life that I have ever done, that one is so far to the top that there is not a second place,” he said. “The way we had it figured out, we could live if we took what she made in SSI and what I made in retirement. We weren’t going to be rich — in fact, we were going to be poor — but we would be able to pay our bills, do what we needed to do. We were going to be OK.

“After a couple of months, Social Security called us in and said, ‘You guys make way too much money.’ They were very nice, not cruel or mean or anything like that. ... But they said, ‘We have a limit on unearned income, and you guys are way over it.’”

Larry questioned how that could be, and was told that his Social Security retirement is considered unearned income. He said, “I asked them, how could that be unearned income? I worked 47 years for that. It’s my money. They said, legally it’s unearned income. They told Linda that her check for $720 was going to become $20. We were going to lose $700. I said, ‘I’ll just give the retirement back. I’ll just get another job and we’ll be OK.’ And they said, ‘Well, you can do that, but the only way you can do that is to give us back every single penny we have given you today.’ Well, if I could give it all back today, I would never have needed it to begin with.”

No recourse

Larry thought he could continue drawing his retirement and also have a job to make ends meet. He said, “What they said after that has basically driven the whole situation. They said, ‘You have to understand, that because your wife is on TennCare, if you make over $85 in a month, she will lose her TennCare.’ So we went home, and we did all the figuring we could.”

Their projected budget for January would leave them with $30 for essentials such as food and gasoline, and the following months would be worse. “We looked at everything we could, trying to find a way. ... But there wasn’t a way,” Larry said. “We were in a position where, if I got a job to give us enough money to live on, it would kill my wife. It would take her insurance away, and it would kill her. If I didn’t get a job, we couldn’t live. We couldn’t live on a dollar a day. It just wasn’t doable. So on Dec. 26, after 33 years of marriage, we separated.”

The original plan was for Linda to stay with a relative until they could find her a permanent place so she could retain her SSI and TennCare. Larry would then find a place as close by as he could. Larry said, “At that time, our understanding was that, according to the way the laws were in the state of Tennessee, we would never again live together as man and wife.”

There were two possible solutions: Change Social Security laws or expand TennCare, the state’s managed Medicaid program which provides health care coverage primarily for low-income children, parents, pregnant women and elderly or disabled adults. Social Security laws were not going to be changed, but Tennessee Gov. Bill Haslam could spearhead expansion of Medicaid. Larry said, “If he expanded Medicaid, then Linda didn’t have to be a member of a category, she didn’t have to be ‘disabled,’ to get it. All she had to do was be poor. If he expanded Medicaid, then she would have her insurance, which meant we could live together, I could get a job, and although we’d struggle, we would live. Without him expanding Medicaid, we had no help at all.”

Letters to governor

Larry began drawing attention to the need for TennCare expansion by writing a series of letters to the governor. Some were very personal, some general and policy oriented, but in each letter, Larry pleaded with Haslam to submit a plan for TennCare expansion. The 100th letter was emailed on Sept. 2. As of that date, the governor had not responded to the Drains, but he did announce on Aug. 28 that he plans to submit a proposal to Washington to expand Tennessee’s Medicaid program. He did not release any details, however.

Larry said more than 1,200 individuals from across Tennessee have told him they also contacted Haslam. Larry’s 100th letter to the governor begins to list the names, and he plans to continue adding names in subsequent letters until every one is included.

Each letter is available atdeargovernorhaslam.wordpress.com and is viewed by 4,000 to 6,000 persons daily. In addition, a petition entitled “Gov. Haslam: Expand TennCare and Let Me Stay With My Wife!” at www.thepetitionsite.com has almost 46,000 signatures in support of the Drains.

The Drains’ story was told in the Nashville Tennessean and other major news outlets, drawing even more attention to those who, as Larry said, “didn’t fall through the cracks — we live in the cracks.”

Twenty-five miles separate this couple now. Linda is in Knox County, while Larry is in Blount County. They are waiting for the time when they can once again live together as man and wife without Linda losing her life.

Larry said, “I should not have to drive 25 miles to see my wife. It’s wrong in every sense of the word.”

HEALTH

Haslam may submit Medicaid expansion plan in fall

Tom Wilemon, [email protected] and The Associated Press

1 day ago

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Larry McCormack / File / The Tennessean

Gov. Bill Haslam said Thursday that the state may soon submit a proposal to Washington to expand Tennessee’s Medicaid program but did not release any new details on how it might work.

WDEF 12 of Chattanooga

Linda and Larry Drain

Exciting news is always welcome. One of our own steps out to bring national attention to those suffering due to lack of medical healthcare coverage.  Links to articles in The Tennessean and USA Today are below.

Larry Drain, DBSA Tennessee Legislative Liaison, is well known among many for his staunch work in advocacy for health care for all. Larry and Linda Drain share their story, open up their lives, in hopes that many will find the help they need. After 33 years of marriage, Larry and Linda had no other choice but to separate in order for Linda to keep the healthcare coverage she so desperately needs. Also, Larry is without healthcare coverage because his income is "too low" to meet the requirements for coverage.

The NBC Today show asked to interview Larry and Linda. The interview is expected to happen today. Airing of their interview is expected some time this week. Let's all send our best wishes and thoughts to this couple as they do all that they can to see that no one else needlessly suffers in like fashion.

Respectfully, 
Steve Brannon
State Director
DBSA Tennessee

Links to Larry and Linda's story:

http://usat.ly/VSQXne

http://tnne.ws/VSQCAY

Murphy misunderstandings

byLarry Drain, hopeworkscommunity

Rep.  Murphy has not went gently into the good night.  Dr. Torrey will never go gently into the good night.  They are trying it sounds like to provide cpr to their bill. Rather the things that didnt work the first time will work on second effort is anyone's guess.  I think sometimes it is really hard for annointed national spokesmen to realize they are not and never were.

But this post is not about that.  It is about a fundamental misunderstanding of the American mental health system that was part of the reason that may have doomed the Murphy Bill from the start.

Murphy seemed to believe we were doing far too much for too many.  He thought people who were doing better in the system were robbing those who were doing poorly of help and resources. And he thought if resources were properly allocated things would be okay. Using terms like "worried well" he seemed to want to pit one group against another or at least give worried family members someone to blame. Somehow, I never really understood how, he seemed to think that this misallocation of resources was the fault of Samsha. It was us against them, with guys in black hats, just lacking an afternoon channel from being great soap opera. People were getting rich, famous and powerful off the worried well and just abandoned those in serious need. It had drama, moral outrage, and more than a little passion. It just lacked truth.

Anyone who had watched or been part of the last few years would tell you that state after state year after year had cut their mental health budgets to the bone. In some places there was only skin. The bone had long since disappeared. It was not that too much was done for too many. Too little was done for everyone. Many people lacked insurance and couldnt even access the services that were there. It wasnt misallocation of funds. It was abandonment. Never, not once, have I ever heard anyone touting the Murphy bill ever acknowledge this.

The baggage from Dr. Torrey obscured their vision. No state bought his love affair with psychiatric hospitals. It was too little bang for way too much bucks. No one believed. It was a cash cow around their necks that threatened to bankrupt their community systems. There was little or no proof it worked. When insurance companies basically stop paying for a service that service is on borrowed time. No one drank the kool aid any more.

There will probably always be psychiatric hospitals. But they will never be the centerpiece of the mental health system again. Putting your money into backline services, what you do when things go wrong, destroys your ability to keep things from going wrong. There was never any conspiracy. People just decided what they thought mattered and all of Dr. Torrey's pr and marketing campaigns just didnt change that. In the end I dont think federal law can bring back psychiatric hospitalization as the gold standard of mental health care. The truth is that even people with "severe mental illness" can and do make it in their communities with effective support and services.

The notion that one group of people needing help was more worthy than another and that they were in competition just seemed like such a mean and stupid notion. It completely just ignored the reality of the bloody battle for funding that is the reality for so many states. It was a pseudo explanation for the fact that state after state just said "Dr. Torrey we dont buy what you say and your way will not increase the amount of services for people with severe needs but radically decrease it."

Count me cynical. Count me way cynical. Murphy lost because it was never about a battle for the "severely mentally ill." It was a battle for Dr. Torrey and a vision found lacking a long time ago.