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.

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 .

 

HEALTH

Haslam may submit Medicaid expansion plan in fall

Tom Wilemon, [email protected] and The Associated Press

1 day ago

• Facebook
• Twitter
• Google Plus
• more

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.

The death of the Murphy Bill: On being the national spokesman
Larry Drain


The Murphy Bill as we know is dead.  The Republican leadership in the House announced a change in strategy.  They basically decided to toss in the towel on the more controversial parts of the plan and try to see if they can move forward on elements that seem to have a greater consensus behind them. There may be CPR efforts yet but it appears done.

It was a bill in trouble from the start despite the massive pr campaign that tried so hard to say it wasnt so.  It managed to unify groups that might not agree on what kind of reforms they wanted, but were absolutely sure what they didnt want and that was the Murphy Bill.

Part of the problem was Murphy himself.  He assumed that as "the only psychologist in Congress" he was the obvious and deserved national spokesman for mental health reform.  He wasnt.  Being a psychologist certainly didnt qualify for the role.  Neither did being a member of the House of Representatives.  It seemed that Dr. Torrey annointed him and for some reason they both thought that mattered.  In the end it was hard to know where he started and Dr. Torrey ended and that was perhaps a fatal flaw.

He didnt understand that leadership was built or that it was a two way street.  He alienated people who had lived mental health reform their entire adult lives.  He thought it was about them joining him and never seemed to know it was the other way around.  And he never realized that trust was everything and that when he snuck AOT into the medicare bill he destroyed his chances of trust with people whose support he needed.

He was naive.  The only people who believe federal laws change everything are federal lawmakers and most of them know better.  To say that his law was going to prevent the next shooting was simply ego.  He believed his own press clippings and his posturing before the dead were even buried just seemed like rank opportunism.

Mental health reform is an ongoing effort by many, many people with different values and priorities.  Sometimes it is its own worst enemy.  People who cant stand each other have a hard time standing together for anything.  Murphy I hope has to some degree taught people they can find unity despite their differences.  And maybe the fragile unity borne of him will be the biggest take-away from the entire thing.

He may indeed try again.  He probably will.  Dr.  Torrey most surely will.  He has won many, many short term victories and will doubtless win more, but the big prize has eluded him again. He is not the national spokesman he has annointed himself to be either.

If the mental health system was sane…

By Hopeworkscommunity

There would be a range of services availible reflecting the human needs of those it serves.

Those services would be availible to those that need them.

Those services would be based on what works, not what makes money, reflects any particular philosphy or interest, and not because it is what we are used to doing.

Asking for help would not label someone, brand them, be a cause of shame, a source of discrimination.  Asking for help should not be a problem.

It would realize that lack of a place to live, lack of food, lack of adequate clothing, lack of a job are frequently barriers and problems for the people they serve and address them in a direct and effective manner.

It would know that inadequate health and inadequate health care are common problems for the people they serve and be part of an effort to serve the entire person in an integrated fashion.

The goal would be to empower, educate, and support people towards gaining control over their lives so as to maximize their chances of leading happy, meaningful and successful lives.

This would not be empty words, but a passionate conviction that fuels and structures everything done in the system.

It would not mistake the people it serves for the labels it places upon them.

It would know that the most important thing about help is that it is what you do with people and not what you do to them. It would see itself as partnering with the people it serves.

It would know that people can say no and that not be a symptom of illness or distress.

It would view peoples values, hopes, thoughts, and aspirations as a source of strength and not a symptom of illness.

It would take substance abuse ultimately seriously. Drinking and drugging are the two primary ways people with mental health issues try to treat themselves.

It would make sure that one of the core experiences that someone seeking help has is contact and interactions with others who have dealt with similiar issues. It would treat seriously the idea that you can learn from the experience of others and them from you.

It would not tell people who have hard times or more problems they have failed or are failures.

It would take the issue of trauma seriously. Knowing how people have been hurt and not being part of hurting them further should be cornerstones of the system.

It would treat the issue of what happens in jails and prisons to people with mental health issues as a moral outrage and the impulse to do something about it as a moral necessity.

It would be honest about the risks and benefits of psychotropic medication. Help people to make real and informed choices.

It would treat families as important and not as irrelevant or a threat to what it is doing.

It would treat justice as a driving force and value in everything it does.

It would be honest with the people it serves about what it doesnt know if it wants them to have trust in what it does know.

It would attack the issue of suicide with passion. No one should ever feel like death is the best solution to life.

It would tell people that no problems make you less human,

It would view hope as realistic and know that when they dont they do more harm than good.

Larry Drain

It is unacceptable that people who are suffering from and struggling with mental health issues in their life be at risk of injury, trauma, assault or even death in their interactions with police officers whose only training as "being a good police officer"  leads them to a course of action that produces tragedy.  There is ample evidence that CIT training (Crisis Intervention Training) makes a difference. The "Memphis Model" has made an impact in many communities both large and small. Tragedies may continue to happen, but to expect and accept them as the cost of doing business as normal is simply and deeply wrong.

A few days ago I talked with a man whose 39-year-old "mentally ill" son had been attacked, beaten up and tasered by police in this community who "were doing their job."  Over the last few days I have spent a lot of time thinking about other incidents I either have direct knowledge of  or I have heard about.  And it has left me deeply troubled.

There are lots of people to blame and many people seem intent on solving the problem by trying to figure out who to blame.  I hear people talk about needing more psychiatric hospitals, more coercive treatment options etc.  I dont think there are really going to be an appreciable increase in psychiatric beds regardless of where you stand on the argument, rather you think it is a good idea or not.  Financially it simply not an option.  Arguments that vastly increasing AOT (assisted outpatient treatment) can solve the problem are not honest or realistic.

Someone will be the next Kelly Thomas.  Someone will be the next person a police officer faces on the street corner or in their home or in the jail.  It is happening right now.  It will be happening in a few minutes.  It will be happening tomorrow.  And what stops it from being someone you know, someone you care about, or even you.

It is pointless to bemoan the fact that police are being asked to do things they are not trained to do and then do absolutely nothing about providing them that training.  It is as unfair to the officer who is trying to do the best he can as it is to the person he is trying to deal with.

As far as I know the decision to implement CIT training is a local decision and depends very much on the financial resources of that community as well as the commitment to training that local officials may have.  Many communities, like the one I live in, have gotten officers involved in a piecemeal fashion but they are largely at the mercy of who offers the training and when.

Again, no one should be the victim of where they live.  I have been following in recent days the effort of New York state to deal with the same issue.  The proposal that is currently being fought over is whether or not to include in the state budget funds for what they are calling a "center of excellence for CIT training."  The idea, as I understand it, is for the state to establish a resource that could help communities access CIT training in a way they can afford and in a way that is most effective to them.  It shifts the burden of the argument from "is it practical?  Can we afford to do it?" to "Can we afford to not do it?"

It is too late for anything like that to happen in Tennessee this year, but is not to late to start the conversation.  Several other states already have chosen to establish something like "a center of excellence for CIT."  Some have found access to federal funding.  Others have found grants from other sources.

In the end, it not only saves lives but also saves money because of the injuries and traumas it prevents.

A couple of days I had a post which included a video of the beating of Kelly Thomas.  I made myself watch the video several days before the post and was horrified.  If you havent watched the video and still doubt the importance of what I am talking about watch the video yourself.  I have also seen videos of other beatings from virtually all over the country.  It is more than a Tennessee problem but it is a Tennessee problem.

In the days and weeks that follow I will be revisiting this conversation over and over.  I am by no means anywhere close to an expert.  If you think you know more than me on the subject there is a good chance you are correct.  My goal is to start a conversation, a widespread conversation, in Tennessee that prepares the ground to talk about this issue not as one that affects isolated localities but every person in this state.

It is a conversation I hope you will join.

Larry Drain, hope works community blog

Mental health issues topic of presentations

By Linda Braden Albert | [email protected] | Posted 14 hours ago

A series of presentations on mental health issues will begin Thursday at the Blount County Public Library. The first presentation is by Sita Diehl, past executive director of the National Alliance on Mental Illness (NAMI) Tennessee and currently national director of state advocacy for NAMI National.

Larry Drain, recently named president of NAMI Maryville, said, “When they asked me to take the job, I really wanted to figure out a way not only to help NAMI but to help the community. Every day, nowadays, when you read the paper or watch TV or whatever, in one way or another, mental health issues are there. There’s a lot of bad information, misinformation, so the idea I had was that if we could bring a series of people to Maryville to talk about mental health issues, that would be a real, real positive thing for this community.”

Diehl’s current position entails her traveling from state to state, organizing efforts to make outcomes for mental health possible in each state, Drain said. “I’ve known her for years, and she was the very first person I asked. Her topic will be about finding support, whether you’re a family member, whether you’re somebody with a mental illness. She will talk a lot about NAMI, some about the mental health system in Tennessee. There will be a question and answer period after she gets through talking. Anybody who comes will be enriched by her.”

On April 24, Doug Varney, commissioner of mental health and substance abuse services for the state of Tennessee, will speak on mental health and drug addiction. Drain said, “I think he will talk some about prescription drugs and meth, what the state is trying to do to deal with some of these things. Especially in Blount County, it is such a live issue. ... He knows the topic inside out.”

Additional speakers in upcoming months include Ben Harrington, executive director, East Tennessee Mental Health Association; Scott Ridgeway, director, Tennessee Suicide Prevention Network; Allen Doderlain, national president, Depression and Bipolar Support Alliance; Pam Binkley, recovery coordinator, Optum Health, who will talk about emotional first aid; Lisa Ragan, director, Office of Consumer Affairs, Tennessee Department of Mental Health, who will speak on peer support, recovery, etc.; and Elizabeth Power, a nationally known expert on post-traumatic stress disorder. Mental health professionals from Blount Memorial Hospital have also been invited to speak.

Drain said, “I think this will be a quality addition to the Maryville community and I hope lots of folks will come. ... For a lot of folks here, the whole area of mental health, mental health treatment, the resources involved and things like that are so confusing. My hope is that all these speakers can shed some light, bring some facts and really help people in the Blount County area.”

Larry Drain, hopeworkscommunity

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

http://www.urban.org/health_policy/health_care_reform/localmedicaidexpansion.cfmS.L. Brannon on DBSA Life Unlimited web site
http://bot.ly/1kEBzlZ

The issue of Medicaid expansion is a mental health issue. The fact is, we must prepare for the deaths of thousands of our fellow consumers because mental illness is not an attractive topic of concern, not a winning political issue. Let's face it, mental illness, left untreated, is not a pretty picture. So, mental health care must be made affordable. That's the reason we need mental health care provided for those who are the most vulnerable and the most desperate for proper mental health care.

And, so, here we are . . . are we ready to witness a huge, preventable loss of life? Or, are we ready to call on those we elected to serve us and let them know we expect them to step up and do the right thing?

Click on the link. Watch the video. Then you are welcome to click our Forums tab to create the topic you want to discuss.

http://bit.ly/1c24AkT

Larry Drain, Legislative Liaison for DBSA Tennessee, published the flowing blog on his Hope Works Community blog site this evening. He is responsible for DBSA Tennessee's advocacy effort beginning with his Nov. 25, 2013 blog to bring attention to the crisis. Larry wrote:
 "Now word has come that funding for peer support centers is to be totally stopped. The fate of 45 centers and all the people they serve is uncertain at best. The department has managed to find the smallest possible cut that affects the most possible people."

At Larry's recommendations, DBSA Tennessee became the first statewide consumer organization to take action; first, with a Christmas card to the Governor Campaign and, later, an online petition to urge Governor Haslam to cancel plans to close the centers. Recruiting organizational leadership, Larry was the first to post an "Open Letter to the Governor" from the State Director, DBSA Tennessee. 

Additionally, Larry's strong desire to save the peer support centers led him to write numerous blogs, place numerous phone calls, and speak directly to leaders and advocates representing peer service organizations. He can take pleasure in the fact that his efforts were fruitful. And he can be comforted that thousands of the most vulnerable of our brother and sister consumers can enjoy the safe haven of 45 peer support centers in the days to come. 

We applaud Larry for his work and perseverance. Thanks, Larry.
Steve

Peer Support lives
February 3, 2014 
hopeworkscommunity blog


It was announced tonight in Governor Haslam’s 2014 budget for the state of Tennessee that proposed budget cuts that would have closed all 45 peer support centers in Tennessee has been rescinded and all peer support centers will be fully funded. 

Thanks to a governor who listened and to so many who spoke out.

It has been a good night for all of us. 

Much to be thankful for.  Glad to have some good news to share.

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

Please sign and pass on to others

     DBSA Tennessee is determined to give voice to the great need of the most vulnerable consumers of our state. Larry Drain, Legislative Liaison for State Affairs, provides you a convient way to sign on to a petition calling on Governor to reverse direction.

Thank you,

Steve Brannon

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 succes 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

Below is the news release from Governor Haslam and our elected officials on cuts in services to Medicaid to be effective July 1, 2014. Tennesseans are loosing in every way as the expansion to Medicaid, with the huge funding it brings, is refused by Governor Haslam. I urge readers to use the contact information at the end of the release to inform our representatives and senators of the sufferings that will result by the implementation of Amendment 21.
Thank you, Larry, for bringing the announcement to our attention. [Larry Drain, Legislative Liaison for State Legislative Affairs, DBSA Tennessee]


Notice of Change in TennCare II Demonstration Amendment 21 

The Commissioner of the Tennessee Department of Finance and Administration is providing official notification, pursuant to 42 CFR § 447.205 and 59 Fed. Reg. 49249, of intent to file an amendment to the TennCare II Demonstration, as well as corresponding amendments to the Medicaid State Plan. The amendments will be filed with the Centers for Medicare and Medicaid Services (CMS), a federal agency located in Baltimore, Maryland, with a Regional Office in The State is required to meet certain advance notice obligations whenever an amendment to the TennCare Demonstration is filed. This demonstration amendment, which will be known as “Amendment 21,” is being filed with a proposed effective date of July 1, 2014. The benefits 
listed in this notice are currently supported with non-recurring funds that have been made available through a hospital assessment fee scheduled to expire on June 30, 2014. Should the fee be renewed, the changes contained in Amendment 21 will not occur.

Amendment 21 will eliminate certain currently covered services and establish benefit limits on others. Children under 21 will not be affected by these changes. Eligibility for TennCare will not be affected by these changes. Pregnant women and institutionalized persons will not be affected by proposed benefit limits; however, they will be affected by the elimination of coverage for occupational therapy, speech therapy, and physical therapy.

The specific changes to be made are as follows:
• Implementation of a combined annual limit of 8 days per person for inpatient hospital and inpatient psychiatric hospital services
• Implementation of an annual limit on non-emergency outpatient hospital occasions of 8 per person (an “occasion” is a day)
• Implementation of a combined annual limit on health care practitioners’ office visits of 8 “occasions” per person (an “occasion” is a day)
• Implementation of an annual limit on lab and X-ray services of 8 occasions per person (an “occasion” is a day)
• Elimination of coverage for occupational therapy, speech therapy, and physical therapy

It is our intention to submit this amendment to CMS with the request that it be approved in time for implementation to occur on July 1, 2014. Corresponding State Plan Amendments will be filed, where appropriate. We estimate that implementation of the amendment and corresponding State Plan changes will result in a decrease in aggregate annual expenditures of $302,722,400 in State Fiscal Year 2015. 

Copies of this notice will be available at county health departments in Tennessee, and on the TennCare website located online at http://www.tn.gov/tenncare/.

Written comments may be submitted by email to [email protected] or may be mailed to Mr. Darin Gordon, Director, Bureau of TennCare, 310 Great Circle Road, Nashville, Tennessee 37243. Persons wishing to review copies of written comments received may submit their requests to the same email and/or physical address.

The question is a simple one. Do you, as a consumer, want more of your fellow consumers to get help or do you want fewer of your fellow consumers to get help? Now, I hope I know what your answer is going to be.


Peacefulness to you . . .





Medicaid expansion and the mental health budget
by hopeworkscommunity


The article below points out some amazing facts about the relationship of medicaid expansion to the mental health budget in many states. It is well worth reading and pondering.

Overall roughly 40% of state mental health budget dollars go towards paying for services for poor people with little or no insurance. In 2009 it amounted to over 16 billion dollars. With mental health parity now the law of the land mental health expenses can only go up. When a state like Tennessee refuses to accept federal dollars for medicaid expansion the only possible result is a growing strain on state mental health budgets that in the end can only hurt an already hurting system. It will be a larger and larger hole with more and more people trapped in it.

In Tennessee we see the developing storm. Let me start by saying I have no inside facts. What follows is my attempt to make sense of things. If anyone wants to share better sense I will gladly listen.

A large portion of the Tennessee state funds for mental health goes to people with little or no insurance. The behavioral health safety net and state psychiatric hospitals are part of the expense but by no means all of it. The money that the state could save in mental health spending will as things stand now not happen.
Mental health parity will drive the costs up in unspecified ways. In the last 8 years we have cut over 165,000 dollars in tax income from state coffers. Not suprisingly when too much demand is tied to too little money someone is going to be left out.

Unless something changes the peer support centers in Tennessee will be eliminated. 4.5 million dollars will be saved. I dont know how you count what will be lost. Perhaps a bandaid will be found and we may escape the choices ahead. I hope so. I fervently hope so.

The savings of mental health dollars that medicaid expansion might give is all I can see that offer the opportunity to build a system that really does work and doesnt have to be refought each year. Let Governor Haslam know what you think.

The Washington Post
http://m.washingtonpost.com/blogs/wonkblog/wp/2012/07/05/how-the-medicaid-expansion-also-saves-states-money/
(from Easy Browser)

Larry Drain

by hopeworkscommunity

Tennessee according to current plans will do away with its 45 peer centers.  What exactly  will it lose.  This information comes directly from Tennessee Dept of Mental Health and Substance Abuse.

The peer centers in Tennessee serve an average of 3500 people a day.  They are served literally for dollars a day.  106 certified peer specialists are employed.  They serve every corner of the state.  Almost every community has access to at least once.  If you could put all the peer centers together in one location they would be by far the largest source of mental health services in the state of Tennessee.

They provide recovery education.  Quoting from the Department... "Trained Certified Peer Recovery Specialists lead evidence-based classes, covering such topics and curricula as the Wellness Recovery Action Plan, Illness Management and Recovery, the Chronic Disease Self-Management Program, and the BRIDGES psycho-education course. Other topics include stress management, anger management, and grief counseling.

Each center also provides support groups to its members.  They provide opportunities to volunteer in the community and give back.  And perhaps most importantly an opportunity for socialization for people  who might otherwise have none... "Peer Support Centers provide socialization opportunities that address the isolation felt by many people who live with mental illness. Members enjoy going to local community events, such as art fairs, city clean-up days, or holiday festivals; playing games together, such as charades, cards, or even kickball; and even going out for lunch from time to time.

They make a difference.  Here is what the people attending centers say about what they got from the experience:

• 96% felt better about themselves
• 95% were better able to ask for help when needed.
• 94% were more independent
• 93% felt like they were more in control of their life.
• 93% felt like they were less likely to go to a psychiatric hospital.
• 91% felt like they were less lonely

Is there anything in your life that has such important impacts in your life??  How much would you be willing to pay for something that did?

And most importantly if you knew you could help other people to feel the same way about their life how much would you pay?  In a time when the government does so many things that dont make a difference how badly would you want them to continue doing this?

You can make a difference.  Speak now.  Speak loud.  Speak often.

Save the peer centers in Tennessee

The case for shutting down the peer centers

by hopeworkscommunity

1.  Take a service that operates for about the price of a Mcdonald's quarter pounder, fries, and coke per person per day....

2. That serves a population largely not served by any other programs....

3. That historically normally has had lots of problems including using a lot of very expensive services with little success....

4.  And enable that population to experience success for the first time in their lives, often dramatic success.....

5.  And then shut down that service to save a few dollars in the short run ignoring totally the long term savings that success means for the individual, their families, their communities and the state....

6.  And basically abandon one of the most vulnerable populations in this state without any real backup or contingency plan....

Thats basically it. 

You might call it a "no-brainer."

A big step backward into the future: mental health “reform” Washington style

by hopeworkscommunity

The new mental health reform bill introduced by Rep Murphy provides for the following according to the Treatment Advocacy Center:

" Requires states to have commitment criteria broader than “dangerousness” and to authorize assisted outpatient treatment (AOT) in order to receive Community Mental Health Service Block Grant funds.

Allocates $15 million for a federal AOT block grant program to fund to 50 grants per year for new local AOT programs.

Carves out an exemption in HIPAA (Health Insurance Portability and Accountability Act) allowing a “caregiver” to receive protected health information when a mental health care provider reasonably believes disclosure to the caregiver is necessary to protect the health, safety or welfare of the patient or the safety of another. (The definition of “caregiver” includes immediate family members.)"

TRANSLATION:

What does it mean?

1.  States will be substantially limited in their control over their own mental health policy.  This, in and of itself, represents a radical change of immense implications.  It is a wall once breached that will never be rolled back.

2.  The future direction of mental health policy will basically be in the hands of the Treatment Advocacy Center.  After years and years of failing to get states to follow their policy of coercion first to the degree they want their view would effectively become federal policy.  What they could never win by choice they will win by force.

3.  Much gains in knowledge about what really works and helps people with mental health issues would be rendered unimportant and out of fashion.  The notion of recovery would be given a death blow.

4.  States by federal statute would have to agree to commit more and more people.

5.  Failure to do so would make you ineligible for federal block grants that are the backbone of so many state mental health budgets.

6. Privacy laws would not allow so much privacy.  Confidentiality would have holes big enough to drive a hole through.

And that is only the beginning.  It is a step back into an era of mental health care that was a national disgrace and one in which a diagnosis of mental illness was a life sentence.

The case for shutting down the peer centers

by hopeworkscommunity

1.  Take a service that operates for about the price of a Mcdonald's quarter pounder, fries, and coke per person per day....

2. That serves a population largely not served by any other programs....

3. That historically normally has had lots of problems including using a lot of very expensive services with little success....

4.  And enable that population to experience success for the first time in their lives, often dramatic success.....

5.  And then shut down that service to save a few dollars in the short run ignoring totally the long term savings that success means for the individual, their families, their communities and the state....

6.  And basically abandon one of the most vulnerable populations in this state without any real backup or contingency plan....

Thats basically it. 

You might call it a "no-brainer."

Larry Drain recently joined in to pressure the elected officials to seriously consider the consequences of their actions upon the most vulnerable consumers of Tennessee. I ask that you join me in reading his blog and giving serious consideration to what we need to do and individuals to right a wrong. Thank you.

New post on Hopeworks Community


A place to go…. a plea for peer support

by Larry Drain,  hopeworkscommunity.com

All of us need a place to go. We need a place that
provides the resources, the relationships, the support and the experiences that
give us a chance to lead lives of purpose, dignity , and meaning. That place is
different for everyone. Without it life seems never what to be what we want or
hope for. Instead pain and disappointment define our days. Life is a never
ending source of deprivation and opportunity seems reserved for other
people.

For many people with serious mental health issues that place has
come to be their local peer support center. Counseling and medication may be
helpful to them, but neither is sufficient for them to have a realistic chance
at a successful, stable life in the community. They need a lived experience with
other people who have dealt with the same challenges they have, a lived
experience with others who have found that life can be better, that what you
know and practice makes a difference, a lived experience with others who show
that it is possible and needed to take control of their own life and be
responsible for their own choices. They need a lived experience in an
environment which shows them that not only do they have the opportunity to get
but the ability to give in a meaningful fashion, an experience that not only do
they count, but that they can be counted upon. Many of them have been in and out
of psychiatric institutions most of their life. Disruptions and problems have
marked their entire life and they may never have known the stability in living
essential to some measure of happiness and feeling of personal
significance.

Peer support centers have been their safe place. It has
given their lives the impetus that has allowed them to function successfully in
the community many for the first time. Many of them have no insurance or
financial resources and peer support centers are the only place they even have
access to. If you are poor and have serious mental health issues you have very
few places in this state to turn to for help. Peer support centers are one
essential life line.

The proposal to cut peer support funding puts all
this in jeopardy. Peer support centers radically improve the quality of the
lives of the people that go there. They improve the quality of the communities
they are located in. They do not meet the needs of everyone, but the people they
do meet the needs of normally have little where else to go. They give you much
more bang for your back than many much more expensive options. They keep people
out of psychiatric hospitals whose experience in hospitals is that they cant
make it anywhere else.

Peer support centers are a kindness to people who
have very little kindness in their lives. Before you take that kindness away
consider not the savings, but the costs. Think about the costs measured not in
numbers, but just in misery. We all need a place to go that matters.

In the overall scheme of things the money that will be saved by cutting peer
support centers is small potatoes. The gain of keeping them open at present
levels is immeasurable.

Please give us a place to go. Support peer support centers.

hopeworkscommunity | November 20, 2013