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

KNOXNEWS.COM

Decision on Medicaid Expansion holds coverage for many Tennesseans in balance

By Kristi Nelson

Posted June 2, 2013, updated June 4 2013

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

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

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

What the ACA intended

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

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

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

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

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

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

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

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

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

The ‘Tennessee Plan’

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What’s next?

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

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

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

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

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

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

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

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

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

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

Business writer Carly Harrington contributed to this report.

 © 2013, Knoxville News Sentinel Co.

The 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

Larry Drain, Legislative Liaison for DBSA Tennessee, offers this blog with its many references that provides points for and against the Murphy bill. Please take time to self educate. Larry gives us a good start.

[Children's Mental Health Network

The Morning Zen]

Congressman Tim Murphy introduces controversial Helping Families in Mental Health Crisis Act of 2013

2 Comments | Posted December 15, 2013

On Friday, one day before the anniversary of the Newtown school shooting tragedy and on the same day of yet another tragic shooting at a school in Colorado, Congressman Tim Murphy introduced the Helping Families in Mental Health Crisis Act of 2013, a bill that would effectively rewrite how the Substance Abuse and Mental Health Services Administration (SAMHSA) operates and significantly narrow the focus of the types of mental health services and supports it helps promote through its grant programs. While the bill is at this point just a proposal, it is an important read for Network faithful as it sheds a light on the thinking of many individuals across the country about how to improve mental health services in America. Unfortunately, with the continued tragedies occurring at schools across the nation the tendency to equate guns and violence with mental illness leads to recommended solutions in this bill that are narrow in focus and could potentially set back the advances in the field of mental health 20 to 30 years.

What makes writing this Morning Zen piece difficult for me is that I have the utmost respect for Congressman Murphy. A child psychologist by training, co-author of two books ("The Angry Child: Regaining Control When Your Child Is Out of Control" and "Overcoming Passive-Aggression), it is obvious that Congressman Murphy cares deeply about improving mental health services. For that he is to be applauded. But what is in this proposed bill for the most part is either mystifying or antithetical to what the research tells us works best for young people with emotional challenges and their families. In fairness, at the end of this post I have included links to position statements on the proposed bill from national organizations and thought leaders both for and against the bill. As always, we pride ourselves on providing as many perspectives as possible so that our educated readers can make up their own minds and respond to their elected officials accordingly.

The response from mental health advocates and provider groups both for and against the bill was swift. As is the general approach of the Children's Mental Health Network we took the weekend to read and digest the 135-page bill before making our comments. The list is long so grab a cup of coffee for this one.

The proposed bill is complex in that mixed in with proposals that are administratively bureaucratic, relying on reference resources that in some cases are twenty years old and frankly dismissive of anything outside of the realm of narrowly defined evidence based practice, are some excellent proposals such as continuing funding for the Garrett Lee Smith and National Child Traumatic Stress initiatives.

However, overwhelmingly the recommended changes in the bill set the advances made in knowledge about what works for youth with mental health challenges and their families back a good twenty to thirty years.

Clouding the picture of how to interpret this proposed bill was the timing of its release – on the eve of the anniversary of the Newtown tragedy and on the day of yet another shooting at a school in Colorado, where emotions were already running high and the popular press was flooded with news stories about guns, violence and mental illness. Even though research shows that those with a mental illness are significantly more likely to be a victim of violence than a perpetrator of violence, discussions in Congress about what to do tend to fall too easily into the guns + violence = mental illness equation.

Note: Be sure to read Lisa Lambert's Morning Zen post for a parent’s reflection on the anniversary of the Newtown tragedy.

Okay, with all of this in mind as a backdrop for what is in the proposed bill, let’s take a walk through some of the highlights. The 135 page document is one I encourage you to read to get your own sense of its merits and drawbacks. In this post I will focus on some of the key areas that are important to highlight. Page numbers of the bill are cited so that you can read the full text in the copy of the proposed bill that you can download here.

Additional layers of bureaucracy added while diminishing the decision-making role of key SAMHSA personnel (Page 4)
The position of Assistant Secretary for Mental Health and Substance Use Disorders would be created. This individual would directly supervise the Administrator of the Substance Abuse and Mental Health Services Administration. Reading through the responsibilities that this individual would have left me perplexed, as the duties described appear to already be in place under the responsibility of the Administrator.

National Mental Health Policy Laboratory (page 7)
The proposed bill calls for the creation of a National Mental Health Policy Laboratory (NMHPL) headed by a Director. The purpose of this Director position would be to:

• (A) Identify and implement policy changes and other trends likely to have the most significant impact on mental health services and monitor their impact in accordance with the principles outlined in National Advisory Mental Health Council’s 2006 report entitled ‘The Road Ahead: Research Partnerships To Transform Services’;
• (B) Collect information from grantees under programs established or amended by the Helping Families in Mental Health Crisis Act of 2013 and under other mental health programs under this Act, including grantees that are federally qualified community behavioral health clinics certified under section 201 of the Helping Families in Mental Health Crisis Act of 2013 and States receiving funds under a block grant under part B of title XIX of this Act; and
• (C) Evaluate and disseminate to such grantees evidence-based practices and services delivery models using the best available science shown to reduce program expenditures while enhancing the quality of care furnished to individuals by other such grantees."

The description of the NMHPL goes on to say that "In selecting evidence-based practices and services delivery models for evaluation and dissemination under paragraph (2)(C), the Director of the NMHPL 

• (A) Shall give preference to models that improve the coordination, quality, and efficiency of health care services furnished to individuals with serious mental illness; and
• (B) May include clinical protocols and practices used in the Recovery After Initial Schizophrenia Episode (RAISE) project and the North American Prodrome Longitudinal Study (NAPLS) of the National Institute of Mental Health.

On page 10 the language continues with "In carrying out the duties under this section, the Director of the NMHPL shall consult with representatives of the National Institute of Mental Health on organization, hiring decisions, and operations, initially and on an ongoing basis; (B) other appropriate Federal agencies; and (C) clinical and analytical experts with expertise in medicine, psychiatric and clinical psychological care, and health care management.

The Children’s Mental Health Network is troubled that there is no mention of youth and family involvement in such a consulting pool, especially with the impressive track record achieved by SAMHSA in cultivating a family-driven, youth guided approach through its system of care grants and cooperative agreements over the past 20+ years.

Interagency Serious Mental Illness Coordinating Committee (page 14)
Yet another bureaucratic layer is added to the decision-making process with the recommendation to establish an Interagency Serious Mental Illness Coordinating Committee to "assist the Assistant Secretary in carrying out the Assistant Secretary's duties.

The responsibilities of this Committee include:

• (1) Develop and annually update a summary of advances in serious mental illness research related to causes, prevention, treatment, early screening, diagnosis or rule out, intervention, and access to services and supports for individuals with serious mental illness;
• (2) Monitor Federal activities with respect to serious mental illness;
• (3) Make recommendations to the Assistant Secretary regarding any appropriate changes to such activities, including recommendations to the Director of NIH with respect to the strategic plan developed under paragraph (5);
• (4) Make recommendations to the Assistant Secretary regarding public participation in decisions relating to serious mental illness;
• (5) Develop and annually update a strategic plan for the conduct of, and support for, serious mental illness research, including proposed budgetary requirements; and
• (6) Submit to the Congress such strategic plan and any updates to such plan.

There is a long list of required members for this committee (page 15), including the Director of NIH, the Attorney General of the United States; the Director of the Centers for Disease Control and Prevention and more. Members of the Committee serve 4-year terms and would be required to meet a minimum of two times per year. In addition, the Committee “may establish subcommittees and convene workshops and conferences "to enable the subcommittees to carry out their duties."

And finally, with regard to administrative duties, on page 70 it is noted that the administration of block grants would be removed from the Director of the Center for Mental Health Services and shifted to the Assistant Secretary for Mental Health and Substance Use Disorders. Gonna be one busy Assistant Secretary if this proposal goes through!

I can't help but think that if this plan were to come to fruition there would be bureaucratic gridlock. Two new significant leadership positions assuming key duties of currently existing high ranking officials within SAMHSA and a large Committee with sub-committees to "assist the Assistant Secretary in carrying out the Assistant Secretary's duties" (Page 14). In my mind, this is a huge duplication of duties already ascribed to the SAMHSA Administrator, the Director of the Center for Mental Health Services and others within SAMHSA.

Let's move away from administrative duties to some of the new grant programs proposed, specifically the Assisted Outpatient Treatment Program. The proposed bill calls for up to 50 grants each year for a 4-year pilot program to focus on assisted outpatient treatment programs (Page 19). Each grant would be eligible for one million dollars per year for four years - $15,000,000 per year would be authorized totaling $60,000,000 over the four-year period.

Assisted outpatient treatment is a controversial topic, with some saying it is the best option for an adult with a mental illness who "lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision." Others, including the Children's Mental Health Network, see this as a potentially dangerous road to travel in that it could have wide-ranging impact on those who might be swept up unnecessarily. You can review both sides of the argument regarding Assisted Outpatient Treatment at the end of this post.

Number of seriously mentally ill who are imprisoned (page 63)
Section 405 focuses on reports of the number of seriously mentally ill who are imprisoned. An important topic for sure, the intent is to "calculate the number and type of crimes committed by persons with serious mental illness each year, and detail strategies or ideas for preventing crimes by those individuals with serious mental illness from occurring… For purposes of this section, the Attorney General, in consultation with the Assistant Secretary of Mental Health and Substance Use Disorders shall determine an appropriate definition of ‘‘serious mental illness’’ based on theHealth Care Reform for Americans with Severe Mental Illnesses: Report’’ of the National Advisory Mental Health Council, American Journal of Psychiatry 1993; 150:1447–1465. The link is provided though you will need to pay the journal for the download. We can only hope that this document, written 20 years ago, reflects the evolution of thinking about mental health challenges since then. Of greater concern is the proposed process for decision-making about defining "serious mental illness." Should this just be left to the Assistant Secretary and the Attorney General? This is much too vague for our liking.

Reducing the stigma of serious mental illness (page 79)
It is hard to even comment on this section when the entire document is stigma-laden, focusing primarily on a narrow subset of those individuals with a diagnosis of serious mental illness when describing what needs to happen within a federal agency charged with looking at the full spectrum of behavioral health issues. However, Network faithful should read it and decide for themselves.

Title XI-SAMHSA Reauthorization and Reforms (page 99)
Mentioned earlier is the fact that the Assistant Secretary for Mental Health and Substance Use Disorders would be in charge of SAMHSA. One of the more fascinating recommendations is that "At least 30 days before awarding a grant, cooperative agreement, or contract, the Administrator shall give written notice of the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.’’ This suggests adding yet another layer of review, more opportunity for delay and added bureaucracy. Though not specified, one could assume that a member of either Committee could block a grant award.

In addition, it would be required that "Before awarding a grant, cooperative agreement, or contract, the Secretary shall provide a list of the members of the peer review group responsible for reviewing the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate." This is yet another opportunity for delay and bureaucratic red tape.

Transfer of all functions and responsibilities of the Center for Behavioral Health Statistics and Quality to the National Mental Health Policy Laboratory (page 102)
This section discusses the transfer of "all functions and responsibilities of the Center for Behavioral Health Statistics and Quality to the National Mental Health Policy Laboratory. Why would one do this? In addition, in this section responsibilities currently assigned to the Administrator are reassigned to the Assistant Secretary. I am beginning to wonder what is left for the Administrator to do?

Establish a clearinghouse of evidence-based practices  (page 106)
In this section there is mention of the establishment of "a clearinghouse of evidence-based practices, which has first been reviewed and approved by a panel of psychiatrists and clinical psychologists, for mental health information to assure the widespread dissemination of such information to States, political subdivisions, educational agencies and institutions, treatment and prevention service providers, and the general public, including information concerning the practical application of research supported by the National Institute of Mental Health that is applicable to improving the delivery of services..."

Unfortunately there is no mention of consumers, families or youth involved in this review.

Limitations on Authority (page 133)
The section on Limitations on Authority includes some questionable items. For example, in this section it is stated that in order for SAMHSA to host or sponsor a conference they "must give at least 90 days of prior notification to the Committee on Energy and Commerce and Committee on Appropriations of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and Committee on Appropriations of the Senate." Again, this seems like yet another unnecessary layer of bureaucracy.

No financial assistance to any program without evidence-based practices (page 133)
Continuing on page 133 is the directive that the Administrator of SAMHSA "shall not provide any financial assistance for any program relating to mental health or substance use diagnosis or treatment, unless such diagnosis and treatment relies on evidence-based practices."

If you have made it this far in this lengthy post you know that this leads back to the question "What is an evidence-based practice and who is involved in deciding that?" From reading the full text of the proposed bill the decision makers are definitely skewed toward the medical community with a strong focus on a narrow slice of the overall population of individuals needing mental health services.

Elimination of unauthorized SAMHSA programs without explicit statutory authorization (page 134)
Saving one of the more controversial items for last (at least as based on the tenor of emails sent to the Network over the weekend) is the section on the elimination of unauthorized SAMHSA programs without explicit statutory authorization. The language is clear that no new programs are to be created that are not explicitly authorized or required by statute and that "by the end of fiscal year 2014, any program or project of the Substance Abuse and Mental Health Services Administration that is not explicitly authorized or required by statute shall be terminated."

The proposed bill goes on to say "The Assistant Secretary for Mental Health and Substance Use Disorders shall seek to enter into an arrangement with the Institute of Medicine under which the Institute (or, if the Institute declines to enter into such arrangement, another appropriate entity) agrees to submit a report to the Congress not later than July 31, 2014, identifying each program, project, or activity to be terminated under subsection (a).

So, there you have it. Quite a bit to chew on and I cut this post down significantly. Please take the time to read the proposed bill. Whether it gains traction in the House or not it is important to remember that this proposed bill reflects the thinking of many. If you are concerned about this, as we are, then you might want to consider an education campaign.

Next week we will share our collaborative efforts with Maryland-based mental health providers, adult and youth representatives with experience receiving mental health services, and family advocates and other agency representatives to put together a site visit for Senate and House Appropriations Committee staff to not only show them what a coordinated system of care approach looks like in the effective provision of services and supports for young adults with mental health challenges, but also to provide them the opportunity for one on one dialogue with youth and adults who utilize mental health  services, families and the amazingly dedicated professionals who work side by side with them. We began organizing this effort for Senate Appropriations staff as a result of our inquiry into the Healthy Transitions Initiative in August of this year. Senate Appropriations Committee staff have agreed to come and we will be extending an invitation to House Appropriations Committee staff this week. I will give you full details in the Morning Zen post this coming Friday.

What is so important about our education campaign is that it is not focused on one grant or particular service. We are not bringing staffers to a visit to ask for money. We are bringing staffers to a visit to let them experience firsthand the importance of a comprehensive approach to meeting (in this case) the needs of young adults with mental health challenges. Sounds like a systems of care approach to me!

And finally, here is a sampling of different individual and organizational analyses and reactions to the proposed bill, both pro and con. Remember, an educated voice is a powerful voice.

For the proposed bill

• How Should We Help the Seriously Mentally Ill?
• NAMI NY State Position Statement  
• NAPHS Applauds Rep. Tim Murphy for Introduction of Comprehensive Mental Health Reform Legislation

Against the proposed bill

• National Coalition for Mental Health Recovery press release jointly issued with the National Disability Rights Network and the Bazelon Center for Mental Health Law
• Involuntary Outpatient Commitment (IOC)1 Myths and Facts
• Mental Health America statement

Time to do your homework folks!

Scott Bryant-Comstock
President & CEO
Children’s Mental Health Network

Submitted by Jennifer Dochod, Legislative Liasion for DBSA Tennessee. The brief summary by Mr. Murphy's office highlights the points in the proposed Bill he drafted.

                     Tim Murphy

                U.S. Congressman

    for the 18th District of Pennsylvania

Short Summary of The Helping Families In Mental Health Crisis Act (H.R. 3717)

Ensuring Psychiatric Care for Those in Need of Help the Most Rep. Tim Murphy, PhD

Mental illness does not discriminate based on age, class or ethnicity. It affects all segments of society. More than 11 million Americans have severe schizophrenia, bipolar disorder, and major depression yet millions are going without treatment as families struggle to find care for loved ones.

To understand why so many go without treatment, the Energy and Commerce Subcommittee on Oversight and Investigations launched a top-to-bottom review of the country’s mental health system beginning in January 2013. The investigation revealed that the approach by the federal government to mental health is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies.

Not only is this frustrating for families in need of medical care, but when left untreated, those with mental illness often end up in the criminal justice system or on the streets. The mentally ill are no more violent than anyone else, and in fact are more likely to be the victims of violence than the perpetrators, but individuals with untreated serious mental illness are at an increased risk of violent behavior. Tragically, undertreated mental illness has been linked to homicides, assaults, and suicides.

The Helping Families In Mental Health Crisis Act (H.R. 3717) fixes the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients and families most in need of services. The legislation:

EMPOWERS PARENTS AND CAREGIVERS

What the investigation found:

Physicians are often unwilling to share or receive information with loved ones about an individual who has a serious mental illness and is experiencing a psychotic break because of complicated federal rules on communicating with immediate family members and caregivers. This scenario is especially problematic for parents of young adults with mental illness because psychosis begins to manifest between ages 14 and 25.

Clarifies Health Information Portability and Accountability Act (HIPAA) privacy rule and the Family Educational Rights and Privacy Act so physicians and mental health professionals can provide crucial information to parents and caregivers about a loved one who is in an acute mental health crisis to protect their health, safety, and well-being.

2332 Rayburn House Office Building | Washington, DC 20515
Murphy.House.Gov | (202) 225-2301 | (202) 225-1844 | @RepTimMurphy | Facebook.com/RepTimMurphy

The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 2

FIXES THE SHORTAGE OF INPATIENT PSYCHIATRIC BEDS

What the investigation found:

There is a severe lack of inpatient and outpatient treatment options. Seventy years ago, the country had 600,000 inpatient psychiatric beds for a country half the size. Today, there are only 40,000 beds.

What the legislation does:

Increases access to acute care psychiatric beds for the most critical patients by making two narrowly tailored exceptions to the Institutions for Mental Disease (IMD) exclusion under Medicaid. The IMD exclusion is what originally caused the shortage of psychiatric beds.

ALTERNATIVES TO INSTITUTIONALIZATION

What the investigation found:

Approximately forty percent of individuals with schizophrenia do not recognize they have a mental illness, making it exceedingly difficult for them to follow through on a treatment regimen.
What the legislation does:
Promotes alternatives to long-term inpatient care such as court-ordered ‘Assisted Outpatient Treatment,’ which has been proven to save money for state and local governments by reducing the rates of imprisonment, homelessness, substance abuse, and costly emergency room visits by the chronically mentally ill.

REACHING UNDESERVED AND RURAL POPULATIONS

What the investigation found:

The delay between a first episode of psychosis and the onset of treatment averages 110 weeks. Early diagnosis and medical intervention improves outcomes dramatically, but there is only one child psychiatrist for every 7,000 children with a mental illness or behavioral disorder.

What the legislation does:

Modeled on a successful state project in Massachusetts, the bill advances tele-psychiatry to link pediatricians and primary care physicians with psychiatrists and psychologists in areas where patients do not have access to mental health professionals.

DRIVING EVIDENCE-BASED CARE

What the investigation found:

The federal government spends $125 billion annually on mental health, but there is little interagency coordination on programs, nor does the federal government collect data on how mental health dollars are spent or whether those dollars are resulting in positive health outcomes.

What the legislation does:

Creates Assistant Secretary for Mental Health and Substance Use Disorders within the Department of Health and Human Services to coordinate federal government programs and ensure that recipients of the community mental health services block grant apply evidence-based models of care developed by the National Institute of Mental Health. The Assistant Secretary will ensure federal programs are optimized for patient care rather than bureaucracy.

The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 3

What the investigation found:

STABILIZING PATIENTS BEYOND THE ER

Access to physician-prescribed medication is vital for vulnerable individuals in avoid acute mental health crisis. Current policies that permit only “one drug” per therapeutic class policy ignore the clinical needs of individuals with mental illness who rely on vital, non-interchangeable prescription drug therapies.

What the legislation does:

Protects certain classes of drugs commonly used to treat mental illness so physicians have prescribe the right medication for those on Medicare and Medicaid similar to the protected classes for persons with epilepsy and cancer.

ADVANCES CRITICAL MEDICAL RESEARCH

What the investigation found:

The National Institute of Mental Health measures public health outcomes to develop medical models of care. For example, the Recovery After Initial Schizophrenia Episode (RAISE) project shows earlier intervention with treatment for a person at risk of developing full-blown schizophrenia allows patients to lead functional lives. The NIMH also excels at basic medical research, but lacks the financial resources.

What the legislation does:

Authorizes the BRAIN research initiative at the National Institute of Mental Health and encourages the agency to undertake additional research projects on serious mental illness and self- or other-directed violence.

HIGH QUALITY COMMUNITY BEHAVIORAL HEALTH SERVICES

What the investigation found:

Community Mental Health Centers receiving funds from the federal government receive lower reimbursements federal insurance programs than comparable care facilities.

What the legislation does:

Applies rigorous quality standards for a new class of Federally Qualified Community Behavioral Health Clinics (FQCBHC), requiring them to provide a range of mental health and primary care services.

DEPARTMENT OF JUSTICE REFORMS

What the investigation found:

Between twenty and fifty percent of the incarnated system inmates have a mental illness. Mental health courts have provided a cost-effective and responsible alternative to incarcerating the mentally ill.

What the legislation does:

So patients are treated in healthcare system and not warehoused in the criminal justice system, the bill reauthorizes mental health courts and requires the Department of Justice to collect more data on interactions between the police and the mentally ill. The bill also authorizes Byrne Justice Assistance Grants (JAG) to be used for mental health training of law enforcement and corrections officers.

The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 4

BEHAVIORAL HEALTH AWARENESS FOR CHILDREN AND TEENS

What the investigation found:

Despite increased medical and scientific research into the nature and source of serious mental illness, a mental illness stigma persists.

What the legislation does:

The Department of Education, working with mental health stakeholders, will undertake a national campaign aimed at reducing the stigma of severe mental illness in schools. The bill also reauthorizes the Garrett Lee Smith suicide prevention program.

INTEGRATES PRIMARY AND BEHAVIORAL CARE

What the investigation found:

Low-income individuals with serious mental illness and addiction disorders have high incidences of cancer, heart disease, diabetes and asthma. Untreated depression increases the risk of chronic diseases, and can double the cost of healthcare for health disease and diabetes. Integrating mental healthcare providers into electronic medical records systems will result in better coordinated care for patients as well as cost savings.

What the legislation does:

Extends the health information technology incentive program to mental health providers so they can communicate and work with primary care clinicians.

INCREASES PHYSICIAN VOLUNTEERISM

What the investigation found:

Health centers and mental health clinics are experiencing a staff shortage. Clinicians and healthcare professionals can volunteer at federal free clinics, but federal legal barriers and the high cost of medical malpractice insurance prevent them from doing so at community health centers and mental health clinics.

What the legislation does:

Eliminates federal legal barriers under the Federal Tort Claims Act preventing physician volunteerism at community mental health clinics and federally-qualified health centers.

REFORMS THE SUBSTANCE ABUSE & MENTAL HEALTH SERVICES ADMINISTRATION

What the investigation found:

Unauthorized in the last decade, the Substance Abuse and Mental Health Services Administration has lacked mission focus. Grant programs are not evidence-based or guided by the best available medical science.

What the legislation does:

Emphasizes evidence-based treatments, sunsets unauthorized programs, and strengthens congressional oversight of all federal behavioral health grants.

Murphy stuck????

by Larry Drain

GOP Newtown bill hits impasse | TheHill
http://thehill.com/blogs/healthwatch/mental-health/204125-gops-newtown-bill-hits-impasse-in-house#.U1g8L-DtN98.facebook
【from Next Browser】

It sounds based on reports like these that the Murphy Bill is not going to pass as written.  Things change I know, but it looks that way.  There is I understand a democratic bill being written by Rep.  Barber.  Things dont seem to look really great.  The really interesting thing is that it might not matter rather or not the Torrey crowd thinks they have made a great case.  It may only matter whether or not they find common ground with people up to now they have shown no interest in finding common ground with.  Rhettoric that they are so good with may not be their friend.  Winning the battle may cause them to lose the war.

The next few weeks, next few months may be interesting.  Common ground.... what a weird approach to American politics.

hopeworkscommunity | April 23, 2014

I'm sharing the news of my being among national Award Winners for accomplishments over the past year. It has been a pleasure to serve as State Director and local chapter President. And I consider it an honor to be recognized by DBSA national.

I appreciate all the wonderful support I was given by my fellow officers, Board members, and the chapter membership throughout the year. You may view the announcement on the national web site athttp://www.dbsalliance.org/site/PageServer?pagename=peer_chapter_spotlights

                       Congratulations to our 2013 Chapter Service Award Winners!
The DBSA Chapter Service Awards recognize exemplary service by DBSA 
chapters, state organizations, and their leaders. Winners will be honored at the 2014 Chapter Leadership Forum in addition to receiving a cash award.

Steve Brannon of DBSA Jackson (TN) and DBSA Tennessee - Outstanding
Leadership
Steve is an excellent role model for pursuing a wellness-focused life while living with a mood disorder. He fights stigma by openly sharing his journey in the local newspaper, on DBSA’s website, and on his weekly online newsletter. He has worked with the local police department to help educate and train police officers for crisis response teams. Steve was selected for DBSA Peer Advocacy Training and was a representative of DBSA for Hill Day in Washington, D.C.
At his local chapter, DBSA Jackson (TN), Steve gently encourages, trusts, and believes in support group participants. He instituted a monthly “share your inspiration” night in which group members report on what keeps them going, creating an environment of hope and personal growth. Steve is dedicated to further advancing DBSA’s mission into surrounding communities and across the state. The number of support groups has doubled in the past year under his direction, encompassing all major cities and some smaller cities across the state. He has traveled hundreds of miles at his own expense to conduct local chapter visitations as state director. Steve’s passion for the advancement of DBSA’s mission in Jackson and the state of Tennessee is so strong that he has diligently dedicated his time and resources for over a decade.

DBSA Tennessee - State Organization Service 
DBSA Tennessee's amazing accomplishments made 2013 a rewarding year! 
They supported chapters in their state by hosting educational presentations and training programs, giving them the tools necessary for successful chapters. With help from DBSA Tennessee, five local chapters were interviewed on television or radio to promote DBSA to the community. Leaders encouraged one chapter’s community outreach, resulting in a city-wide Mental Health Day declared by their mayor. DBSA Tennessee’s robust plan to help new chapters in the startup process helped find free meeting locations, assistance in affiliation fees and paperwork, and provided a sponsor from an already established chapter to assist the new chapter.
Five members of DBSA Tennessee attended DBSA’s Peer Advocate Training in Washington, D.C. and then created an advocacy plan for their state including a campaign against proposed budget cuts to close all 45 of Tennessee’s Peer Support Service Centers. DBSA Tennessee is a growing, thriving organization. With its advocacy for peer support and local chapter start-up, community outreach and commitment to peer education, DBSA Tennessee is one of the most energetic affiliates of DBSA.

DBSA Murfreesboro (TN) - Rookie Chapter Service
DBSA Murfreesboro began in July of 2013 with support from DBSA Tennessee. 
The chapter started out with one support group, which saw its attendance 
double in fewer than six months, becoming one of the fastest growing local 
chapters in the state. The growth of the chapter can be attributed to the forces behind it that work tirelessly to get the word out about the group. Flyers and pamphlets are distributed to agencies and health care providers, the Salvation Army, local hospitals and businesses, and more. DBSA Murfreesboro provides post-hospitalization support for those who would otherwise have none. Educational materials, resources, and wellness tools are provided to each chapter participant. They have also started a family and friends support group.

Members of DBSA Murfreesboro participated in the state chapter meetings and backing of their U.S. Representative. For a chapter that achieved all of this in six months, DBSA Murfreesboro has a fine resume of accomplishments, but they consider their greatest success to be the level of support offered to each person who walks through their doors.

http://www.dbsalliance.org/site/PageServer?pagename=peer_chapter_spotlights

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

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

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

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

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

WHAT ABOUT THE EIGHTH DAY??

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

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

Larry Drain at HOPEWORKSCOMMUNITY

Scott Walker Emails: Former Top Aide Wrote

'No One Cares About

Crazy People'

Chris GentilvisoThe Huffington Post02/22/14 11:31 AM ET

Wednesday's release of thousands of pages of emails from Scott Walker's tenure as Milwaukee County Executive show a former top aide wrote that "no one cares about crazy people."

Back in 2006, the Milwaukee Journal Sentinel reported on the death of Cindy Anczak. The 33-year-old woman died of starvation complications while being treated at the Milwaukee County Mental Health Complex for bipolar disorder.

According to the Center for Media and Democracy's PR Watch, Anczak's parents filed a legal complaint in October 2010, which was brought by Walker staffers to the attention of then-Deputy Chief of Staff Kelly Rindfleisch.

"Totally coincidental to the election," replied Walker campaign advisor RJ Johnson, about the timing of the filing.

"Corp council [the County's attorney] wants to offer 50-100k," emailed Rindfleisch.

"Ok - any time after Nov. 2nd would be the time to offer a settlement," replied Keith Gilkes, who headed Walker's campaign.

"Barrett is going to make this the center of his campaign," Rindfleisch wrote in another email.

"yep and he is still going to lose because that is his base," replied Joan Hansen, a County official.

"Yep," Rindfleisch wrote. "No one cares about crazy people."

The AP noted on Wednesday that Rindfleisch was convicted in 2012 of felony misconduct in office for doing campaign work for a GOP lieutenant governor candidate on government time. She was sentenced to six months in jail and three years of probation, and is appealing her conviction on the grounds that Fourth Amendment rights were violated.

"Most of those would be four or more years old and they've gone through a legal process ... a multi-year extensive legal process by which each and every one of those communications was reviewed by authorities," Walker told reporters in Madison on Wednesday. "I'm confident that they reviewed them and they chose to act on the ones they've already made public."

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

Mental health stigma resides everywhereStigma resides everywhere, especially mental health stigma.  The urge to quiet the voices of those who live with challenges, those who are different or those whose choices don’t mirror the “norm,” seems to be overwhelming as of late. “Don’t air your dirty laundry.”  How many of us heard that admonition as children? When we talk about mental illness, too often there are only two approaches discussed: sick or well, right or wrong. We talk about strong people and the weak people, those who feed their depression and mental illness and those who stoically rise above. When we talk about mental health in such limited parameters, we strip it of the crippling humanity that makes it possible: agony, loneliness, shame, trauma and stigma. We just tell people to think the right way, get the right amount of sleep and exercise, take the right meds, and when they don’t, we tell them to go away. In our current society, the mentally ill are considered the disease as much as the illness itself.

Here’s the rub:  Change and recovery occur when things are faced.  An acquaintance asked me recently why I speak openly about mental health recovery and surviving domestic violence and sexual assault. This well-meaning person felt that by airing my “dirty laundry,” I would cause myself more pain. Actually the opposite is true. When the mentally ill speak openly, others know they are not alone. Others learn what worked and what didn’t. By speaking – at first a whisper, then a roar – we lessen pain’s power. We learn to cope, we change the norm and we affect the changes we want to see.

Be part of the conversationThere is a well-known saying in mental health and social work circles:

“Nothing about us, without us.”

Only by being part of the conversation can we affect legislation, self-advocate for better care and show society that those with mental health conditions can live healthy, productive lives.

Why should we stand up and “air our dirty laundry?”  To help those unaffected by mental illness but whom are the gatekeepers of the systems we need access to, to understand our reality. Because it reflects one-in-four person’s realities. Because stigma born from misconceptions can only be corrected by those who are affected. Because society needs to see us living lives and being productive with the proper treatment. Because we learn the most from those whose voices society tries the most to silence.

Mental Health Stigma: Airing our “Dirty Laundry” Posted on February 8, 2014 by Paulissa Kipp

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.