TRICARE: Will Soldiers and Veterans be Supported?
You've seen this issue come up several times here at CPB, and now the rubber is hitting the road as the House and Senate Armed Services Committees sit down with TRICARE legislation to consider "a provision to allow licensed professional counselors to practice independently under TRICARE, the military healthcare system, and in Defense facilities. Unfortunately, TRICARE currently does not allow soldiers to see licensed professional counselors without physician referral and supervision. Counselors are also prevented from practicing independently in military treatment facilities and other Department of Defense (DOD) programs. As a result, soldiers have to jump through numerous hoops before they can access mental health services from a counselor.
Representatives Robin Hayes (R-NC) and Walter Jones (R-NC) have sponsored the "TRICARE Mental Health Services Enhancement Act (H.R. 1358)," which would grant independent practice authority to counselors in TRICARE and other DOD programs. Equivalent legislation has not yet been introduced in the Senate, but may be introduced as an amendment to the Defense bill. Because the House and Senate Armed Services Committees are going to be considering the Defense Authorization bill this week, it is essential to contact your members of Congress NOW to ask for their support for recognition of counselors in DOD programs." - ACA Action Alert
Read more background on this legislation here and here. Use your seven minutes today to contact your legislator. Ask them to advocate for soldiers, veterans, and their families through TRICARE.
This Is the Future Unless We Change It
The Missouri legislature, looking at budget deficits and rising health care costs, voted to cut 90,000 people from their Medicaid rolls. 90,000 individuals have had the social safety net pulled from under them. When the changes take effect in August, elderly and disabled people with incomes that exceed the new cutoff - $579 a month - could lose their Medicaid coverage and be forced to move to nursing homes.
STL Today: "Gov. Matt Blunt signed legislation Tuesday that will scale back Medicaid, the government's $5 billion health care program for the poor.
The changes are expected to eliminate taxpayer-financed insurance coverage for about 100,000 parents, people with disabilities and elderly people. Thousands more will have to pay some of their medical bills.
[...]
Blunt said Medicaid was growing faster than Missouri taxpayers' ability to finance it."
KFVS: "Medicaid patients say they will no longer be able to afford things they need like medications, at home caregivers, and repairs to their wheelchairs. It’s not just Medicaid recipients who are feeling the brunt of these cuts though. These cuts have a trickle down effect, hitting doctors’ offices that rely heavily on Medicaid recipients. One Heartland medical center will probably have to cut certain services for its Medicaid patients soon."
NPR: "For disabled Missourians like 44-year old Irene Schivers, the situation is no less serious. Schivers spends her days in a mobile home she shares with two dogs, a computer and a collection of dolls. Cerebral palsy and lupus have made her unable to work. She says that the new guidelines, with would require her to take in less than $500 a month before Medicaid kicks in, will make her ration food and give her dogs away.
"They want us to die," says Schivers. "We are a burden on society, so they don't care. We don't work, so why should we get anything? Just go ahead and die."
Governor Blunt explained to Missouri citizens that it is morally wrong to raise taxes to pay for the Medicaid program, and he would therefore be forced to sign the budget into law. This question will face every state in the nation because health care costs are rising everywhere. Every state will have to choose between raising taxes, enacting meaningful health care reform, or sentencing America's most vulnerable people to abject poverty without government aid.
Counseling Policy Blog advocates that we stand up for the voiceless, and insist that lawmakers either shore up Medicaid, Medicare, Social Security Disability, Veterans' Benefits and the other vital health care programs protecting the poorest and sickest among us or create and follow through with meaningful health care reform that ensures quality health care for Americans who can't afford it.
The choice is stark: Either care for the poor and sick, or cut them off from government aid and leave them to fend for themselves. For those of you who don't work with Medicaid populations, know that these are families just like yours but with the twin yokes of poverty and health problems. Counselors will advocate for caring, for acting compassionately, for prioritizing the dignity of the sick and disabled.
When these people are forced into nursing home care or into the Emergency Rooms of Missouri hospitals, it is the citizens of Missouri who will pay higher hospital bills and higher nursing home prices. When jails become homeless shelters for the disabled poor, it is Missouri citizens who will subsidize building new jails or new residential care facilities. When families grow desperate, it is Missouri citizens who will bear the brunt. For Governor Blunt to claim that raising taxes is immoral while ensuring that every Missourian will pay more for their own health care is disingenuous at best. Governor Blunt is putting wealthy special interests above the needs of the disabled and above the reality of those citizens who will end up footing the bill.
If you live in Missouri, know that the fight isn't over. Next year's budget will be a new battle, and you can start now to ensure that these bad decisions are publicized and then reversed. For the rest of us, know that our statehouses are also looking at reduced federal money, shrinking industrial tax bases, and skyrocketing health care costs. It's only a matter of time before your state legislature is deciding whether to care for the sick, give tax breaks to the very rich, or create a health care system that is viable for every American.
Let your representatives know where you want them to stand when decision time comes.
CPB will post regularly about the proposed federal budget cuts, and we will do our best to monitor statehouses' moves regarding health care. It's up to you, however, to get involved and initiate change for the better. Make a call...Write a letter...run for office, it's your country and your responsibility. Go get 'em!
Why Are We Advocates?
Reports by the U.S. Surgeon General and President Bush’s New Freedom Commission on Mental Health have stated some need to know facts regarding mental health in children and adolescents. Remember as you read these facts that, while the government asked for this study in order to know how best to support Americans with mental health, the FY 2006 budget is slashing the programs necessary to provide the services.
Prevalence of Child and Adolescent Mental Disorders
- Four million children and adolescents in this country suffer from a serious mental disorder that causes significant functional impairments at home, at school, and with peers. Twenty-one percent of our nation’s children ages 9 to 17 have a diagnosable mental or addictive disorder that causes at least minimal impairment.[3]
- In any given year, only 20% of children with mental disorders are identified and receive mental health services.[4]
Consequences of Untreated Mental Disorders in Children and Adolescents
Suicide
- Suicide is the third leading cause of death in youth aged 15 to 24. More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined.[5]
- Over 90% of children and adolescents who commit suicide have a mental disorder.[6]
- In 2002, almost 4,300 young people ages 10 to 24 died in this country by suicide.[7]
- States spend nearly $1 billion annually on medical costs associated with completed suicides and suicide attempts by youth up to 20 years of age.[8]
School Failure- Approximately 50% of students with a mental disorder age 14 and older drop out of high school; this is the highest dropout rate of any disability group.[9]
Juvenile and Criminal Justice Involvement
- Youth with unidentified and untreated mental disorders also tragically end up in jails and prisons. According to an NIMH funded study – the largest ever undertaken –an alarming 65% of boys and 75% of girls in juvenile detention have at least one mental disorder.[10] We are incarcerating youth with mental disorders, some as young as 8 years old, rather than identifying their disorders early and intervening with appropriate treatment.
Higher Health Care Utilization
- When children with untreated mental disorders become adults, they use more health care services and incur higher health care costs than other adults. Left untreated, childhood disorders are likely to persist and lead to a downward spiral of school failure, limited or non-existent employment opportunities, and poverty in adulthood. No other illnesses harm so many children so seriously.[11]
Early Identification, Evaluation, and Treatment are Essential to Recovery and Resiliency
- Research shows that early identification and intervention can minimize the long-term disability of mental disorders.[12]
- Mental disorders in children and adolescents are real and can be effectively treated, especially when identified and treated early.
- Research has yielded important advances in the development of effective treatment for children and adolescents living with mental disorders. Early identification and treatment prevents the loss of critical developmental years that cannot be recovered and helps youth avoid years of unnecessary suffering.[13]
- Early and effective mental health treatment can prevent a significant proportion of delinquent and violent youth from future violence and crime.[14] It also enables children and adolescents to succeed in school, to develop socially, and to fully experience the developmental opportunities of childhood.
When advocating for the programs and policies necessary to aid our nation's most vulnerable citizens, it's helpful to structure your advocacy around the facts. These facts, having been produced by and for a Republican administration, allow us to contact our Republican lawmakers with confidence. Spend your seven minutes today
educating a lawmaker on the needs of our young people, and the short-sightedness of slashing Medicaid.
Seven Minutes a Day
I've been living through mental health reform for 4 years now in the state of North Carolina. The old public mental health system's been converted into a public/private hybrid that walks like a state bureaucracy and quacks like a state bureaucracy. The reform's stated intentions were to lower costs, increase competition and client choice, and improve quality through a business mentality. Instead we've seen big public agencies go private and subsume other public agencies. We've seen red tape grow thicker and longer. We've seen the entity that administers state dollars struggle through poor management, broken systems, and outright denial. It's been a mess.
I got tired of wringing my hands over the whole situation and got on board with the one private agency that's successfully negotiated the mental health reform tsunami. Through sheer boldness and tenacity, the leaders in this agency have worked tirelessly to get paid for the work we've performed. The state continues down a path that leads right back where they started...but with less money than when they started there.
Rather than sit back and simply watch and groan as bureaucracy after bureaucracy ate away at the funds necessary to meet the needs of western North Carolina's citizens, I decided to channel that energy into something productive. I started writing about political topics on another blog, attending informational meetings and learning what I could about the mechanics of the systems that continue to repeat the same mistakes. I began advocating for legislation that might move our profession and our mental health systems in the right direction. Here's what I've learned so far:
1. It feels great to call a Congressperson's office to advocate for or against a piece of legislation. They work for me. I am the public they serve, and they're obligated to hear me out.
2. One phone call, no matter how impassioned, will not turn the tide of events. A lone opinion won't sway a legislator one way or the other. This rule changes if the one call is from a big donor to the legislator's campaign or is a valued friend.
3. Several phone calls from different people can change the vote of a legislator.
4. Letters and emails are effective if (a) they're not form letters; (b) they're all addressed from within the legislators constituency; and (c)they're in sufficient numbers.
5. Staffers at your legislators office will get to know you if you give them the chance. Even if they don't agree with you, they will still like you if you are polite, consistent, and genuine.
6. It only takes about seven minutes a day to advocate for yourself, your profession, and your clients.
Seven minutes a day. Whether it's making a phone call, writing a letter, sending an email, educating an influential person in your local coffee shop, your seven minutes can add another voice to the growing chorus of those who believe that it is our job as a nation to care for the most vulnerable among us.
If you're a manager, urge your employees to use seven minutes a day to advocate for continued Medicaid benefits for the needy. If you're a therapist, take seven minutes to advocate for mental health parity in insurance claims. If you're a person who uses mental health services, use your seven minutes to call your representative to tell him what you used the mental health system for today. There's no one who can't be a part of this growing movement to advocacy for the mental health professions.
Use Counseling Policy Blog's sidebar to find an organization you'd like to receive legislative alerts from. Use the Congress.org link to find contact info for your representatives. Let me know, by comment or email, how it's going and how I might help.
Seven Minutes A Day.
May is National Mental Health Month
Most Americans aren't going to know that this is National Mental Health Month just like they didn't know that last month was National Poetry Month. The reason? Too few voices reaching too few ears. As part of our advocacy work, educating the public about mental health issues can have far-reaching effects.
Counseling Policy Blog suggests a twin track approach:
1. Use your professional connections to set up educational forums for local leaders - Sherriff's Department, Police Department, School Principals, Churches, Social Services, and the local press. There's oodles of information all over the web for you to distribute or present. Here's a site you might try for starters:
* The National Mental Health Association is going big guns into this month, and they are dripping with information.
2. Maintain and increase connection to your state and federal representatives who are making top-down policy decisions that will affect us all.
Media and Publicity Guide
One of every two Americans who need mental health treatment do not receive it, and the rate is even lower —and the quality of care poorer— for ethnic and racial minorities.
It's time to grow advocacy, friends. Your efforts and your willingness to incite advocacy in others can bring about a shift in the thinking of policymakers at local, state, and federal levels. But they're not going to come around without our help. Seven minutes of advocacy every day, to your representatives or to other professionals who aren't yet advocating for themselves and their clients, can raise awareness of mental health issues and move mental health towards parity with physical health issues.
Go get 'em, advocates!
If You Live in the D.C. Area
Consider attending the May 11 Congressional Briefings on Children's Mental Health by the Campaign for Mental Health Reform:
Promoting Resilience and Mental Health:
The Need for Early Intervention for Children and Adolescents
A Congressional Briefing sponsored by the Campaign for Mental Health Reform
In coordination with:
Representatives Tim Murphy and Grace Napolitano, Co-Chairs
Congressional Mental Health Caucus
Wednesday, May 11, 2005
11:30 a.m. – 1:00 p.m.
345 Cannon House Office Building -- Caucus Room
(Lunch will be provided)
The key to enhancing resilience and the mental health of our nation’s children and adolescents is through the early identification and treatment of mental health problems. We invite you to hear from our panelists regarding the scientific basis for intervening early and the cost of failing to provide needed treatment. Several of the panelists will describe their personal experiences and how timely, effective mental health treatment helped them and their families.
Panelists:
Cynthia Wainscott, on behalf of the Campaign for Mental Health Reform and Chair, National Mental Health Association Board of Directors
Kenneth Duckworth, M.D., Medical Director, National Alliance for the Mentally Ill, and Assistant Professor, Harvard University Medical School
Larke Nahme Huang, Ph.D., Commissioner, President’s New Freedom Commission on Mental Health, and Managing Research Scientist, American Institutes for Research
Rosa Maria Gil, D.S.W., Founder & President, Comunilife, Inc; past-President of the Association of Hispanic Mental Health Professionals
Marley Prunty-Lara, student, Augustana College, Sioux Falls, SD and University of Minnesota-Twin Cities, Minneapolis, MN
Morton Sherman, Ed.D., Superintendent, Cherry Hill School District, New Jersey
AND/OR the Senate version:
A Congressional Briefing
Sponsored by the Campaign for Mental Health Reform
In coordination with:
Senators Gordon Smith, Christopher Dodd, Mike DeWine
Jack Reed, Arlen Specter, and Tom Harkin
Wednesday, May 11, 2005
8:30 a.m. - 10:00 a.m.
902 Hart Senate Office building
(breakfast will be provided)
Same Program as above with the same panelists.
Alert your representatives about these important briefings, and if one of your representatives is a co-sponsor, then call to let them know how much you appreciate their hard work advocating for those who depend on mental health services.
America's Most Vulnerable Need Your Help
Medicaid is slated to be cut by $10,000,000,000. Children and Family services such as Supplemental Security Income (SSI), Temporary Assistance to Needy Families (TANF), child care, foster care and adoption assistance programs, and the Social Services Block Grant are slated to be cut by nearly $7,000,000,000.
That's $17,000,000,000 worth of cuts to Medicaid and other programs for needy families. That means that up to a million families in need of mental health and related services will not receive them. Without adequate mental health care, SSI, TANF, child care, and child welfare services this nation will experience a meteoric rise in unemployment, crime, and broken homes.
The budget's spending targets passed the House and Senate last week, though the House passage could have been stopped if six democrats hadn't failed to show up for the vote:
Representative Edolphus Towns (D-NY 10) (202) 225-5936
Representative Steve Rothman (D-NJ 9) (202) 225-5061
Representative William Jefferson (D-LA 2) (202) 225-6636
Representative Harold Ford (D-TN 9) (202) 225-3265
Representative Lloyd Doggett (D-TX 25) (202) 225-4865
Representative James Clyburn (D-SC 6) (202) 225-2313
If you live in one of these districts, your voice can be very loud in this debate. Time to call and let your representative know that hollowing out the nation's Medicaid, Social Security Disability, Foster Homes, and Social Services Block Grants while doling out over a hundred billion dollars of tax cuts isn't a position you can get behind.
Here are some other cuts in the budget:
Head Start funds would be reduced $3.3 billion over five years, with 118,000 fewer youngsters enrolled in 2010.
The budget cuts food stamps by $1 billion over 10 years, which means 200,000 to 300,000 fewer low-income working families with children will receive nutrition assistance.
The budget cuts $6,600,000,000 from the Pension Benefit Guaranty Corporation.
The budget cuts $4,700,000,000 from Student Loan Programs.
The budget calls for a sell-off of public parks to private interests for total revenue of $175,000,000 over 10 years by privatizing 40,000 individual federal forest properties.
This budget cuts funds for the most vulnerable people in our society.
This budget also offers $106,000,000,000 in tax cuts.
There's a lot a politicking to be done between now and the passage of the budget. Call your Representatives and Senators. Vent some spleen. Argue impassionedly. Or just call and let them know that you support retaining funds for the neediest Americans. No matter how you choose to do it, it's fun.
