[NYAPRS Enews] MHW: Advocates to Intensify Health Care Reform Push in '09

[Matt Canuteson]

Advocacy Push For Health Care Reform To Grow More Intense In '09

Mental Health Weekly January 5 2009

 

Encouraged by the words of the incoming administration, mental health
advocates are optimistic that mental health will be viewed as critical
to overall health care reform. President-elect Barack Obama and his
transition team have positioned health care reform as a national policy
issue and mental health groups plan to continue their efforts to push
for the integration of mental health care on that agenda.

 

One strategic approach involves mental health groups urging consumers
and their families to share their experiences with mental illness and
the health care system and to offer suggestions on health care reform
via the president-elect's transition team website, www.change.gov
<http://www.change.gov> .

 

During the presidential campaign, representatives from the Whole Health
Campaign, a coalition of more than 70 mental health and addiction
organizations, attended the Democratic and Republican National
Conventions and urged the integration of mental health reform into
health care reform.

 

The push for health care reform is an important focus for the Campaign
for Mental Health Reform and for the field in general, said William
Emmet, director of the Campaign for Mental Health Reform. "We all see
the focus on

health care reform as a real opportunity to make sure mental health is
fully integrated into our health care system," Emmet told MHW.

 

"If done right, health care reform will help address a lot of the
problems we feel in the mental health arena," said Emmet, pointing to
the New Freedom Commission on Mental Health Report and its findings on
the fragmentation on the mental health system. "If healthcare reform can
address some of the fragmentation that would be a terrific step
forward." The fragmentation is evident whether one is talking about the
delivery of services or the financing, he added.

 

A number of organizations in the Campaign and individually have been in
discussion with President elect Obama's transition team, Emmet said. The
transition website has been a very helpful component, he said. People at
the center of the healthcare reform effort, including HHS
Secretary-Designee Sen. Tom Daschle, understand mental health's pivotal
role in health care. "I'm encouraged by that," Emmet said.

 

The Campaign and many mental health organizations realize that health
care reform is a major effort; however, the mental health field is "not
driving it," Emmet said. "Our job is to be able to educate the [incoming
Obama] administration and members of Congress about how mental health
fits into the larger healthcare reform effort."

 

Health information technology is an area in which the Campaign wants to
provide input, Emmet said. Advocates' job, he said, is to explain how
the mental health field sees health information technology or the
medical home model, for example, and the need to incorporate components
relevant to mental health in those areas.

 

Financial Commitment

Healthcare reform and economic recovery offer opportunities for a
meaningful financial commitment to mental health and addiction services,
said Linda Rosenberg, president and chief executive of the National
Council for Community Behavioral Healthcare. "2009 is a critical year

for the economy, for healthcare reform and for our behavioral health
community," Rosenberg told MHW.

 

Rosenberg added, "The economic downturn has put demand for mental health
and addictions services on a collision course with cuts to publicly
funded services." Rosenberg noted that in many states, National

Council member organizations are reporting cuts that curtail services
and access and lead to further erosion of staff coverage and quality -
in some cases, there is even the possibility of not making payroll.

 

"Years of federal and state neglect have caught up with us and our
already frayed mental health safety net is near collapsing," she said.
Rosenberg noted that to many people, healthcare reform means universal
coverage, and the National Council views universal coverage as an
American right. "However, for people with serious mental illnesses and
addictions, universal coverage isn't enough," she said.

 

"Mental illnesses and addictions are bipartisan, they are pervasive,
have profound consequences on people's lives and enormous economic costs
- yet support for care is not commensurate with impact," said Rosenberg.
"The National Council sees healthcare reform and economic recovery
packages as opportunities to right this wrong."

 

Issue Briefs

The Judge David L. Bazelon Center for Mental Health Law has released a
series of issue briefs on the integration of mental health in healthcare
reform. Current health reform proposals address the need for expanded
access to care, but as coverage is expanded, costs must

be controlled, according to the Bazelon Center.

 

Among its recommendations, the Bazelon Center notes that health reform
should include provisions designed to ensure that all Americans have
coverage for quality healthcare services they can afford, including
mental health care; this includes public programs that provide coverage
for those who are unable to obtain private health insurance.

 

"We along with the other national mental health advocacy groups
comprising the Campaign for Mental Health Reform are advancing the
integration of mental health care to ensure any overhaul of the health
care system best meets the needs of children and adults with mental
disabilities from prevention/wellness initiatives through the management
of chronic illness," Laurel Stine, director of federal relations for the
Bazelon Center, told MHW.

 

Stine added, "It is essential the system is recovery-driven, focuses on
evidence-based practices, and fosters collaborative/integrated care."

 

The mental health advocacy community is very energized about the
progress made with the recent enactment of the federal mental health
parity law, said Stine. "We hope to maintain this momentum and cohesion
as we press forward on meaningful reforms to the healthcare system
through advocacy outreach efforts to President-elect Obama with the new
administration and the 111th Congress."

 

"Siloing mental health will not build a system that achieves these goals
and is counter to the movement behind parity enactment," she said.

 

Working With The Transition Team

Like other mental health organizations, Children and Adults with
Attention Deficit/Hyperactivity Disorder (CHADD) has also been involved
with the Obama transition team. E. Clarke Ross, chief executive of
CHADD, said the organization was part of a three-organization delegation
that met with Kareem Dale, disability coordinator, public liaison and
intergovernmental affairs.

 

"We emphasized the alarming data on the number of children with special
needs who are not graduating high school and the failure of the national
government to collect any systematic data on children being accommodated
in school with Section 504 plans," Ross told MHW.

 

Ross said his organization endorses the concept of a medical home
(clinical home/healthcare home) for children with special healthcare
needs as defined, implemented and advocated over the past decade by the
American Academy of Pediatrics (AAP).

 

"Medical homes as defined by AAP are about a single medical practice
taking ownership/responsibility to coordinate interventions for children
with special needs, whether those children have either complex needs or
a variety of needs," said Ross. According to CHADD, some of the
essential elements of a medical home for children with special
healthcare needs include:

 

* A personal physician in a culturally and linguistically competent
physician-directed medical practice who provides continuous and
comprehensive care.

* A family-driven partnership that ensures a coordinated network of
community-based services where both physicians and families share
accountability for quality improvement through a performance measurement
system.

* A focus on transitions to ensure no disruptions of services as
children and youth progress through normal stages of growth and
development.

 

"We are delighted with the citizen participation process [transition
team website] as well as HHS Secretary-Designee Daschle's public forum
process," said Ross. "We believe that the Obama transition team is
serious about learning and considering citizen input into healthcare
reform." 

 

 

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