NAMI Minnesota Legislative Update – July 14, 2013
Olmsted Sub-cabinet Seeks Input on Draft Plan
The Olmsted Sub-cabinet held the first in a series of listening sessions on Tuesday to gather input on a draft plan to support freedom of choice and opportunity for people with disabilities in Minnesota, including people living with mental illnesses, to help people live in the most integrated setting possible.
The sub-cabinet released their draft planlate last month, and unfortunately, it falls far short when it comes to helping people mental illnesses live healthy and successful lives in the community. NAMI Minnesota's Grassroots Advocacy Coordinator, Matt Burdick, testified at Tuesday's meeting and urged the committee to take a careful look at the unique challenges faced by people with mental illnesses and to ensure that the final plan is attentive to those needs. He urged them to avoid a “one-size fits all approach” and outlined for the committee just a few of the many services and supports that help people with mental illnesses that are missing from the recommendations, including peer specialist services, ARMHS, IPS employment and community support programs
Dozens of people testified throughout the day, including individuals with disabilities, family members, advocates and providers, but the overwhelming majority of commenters did not address the needs of people living with mental illnesses.
The sub-cabinet will be holding three additional listening sessions in greater Minnesota over the coming months:
Moorhead
When: Friday, August 2nd from 9am – 11am
Where: Hjemkomst Center, 202 1st Avenue North
Duluth
When: Tuesday, August 13 from 1pm – 4pm
Where: Duluth City Hall Council Chambers, 411 West 1st Street
Rochester
When: Monday, August 19 from 1pm – 3pm
Where: Rochester Community & Technical College (Heintz Center Commons), 1926 College View Road
It is essential that the mental health community be represented at these events. If one of the listening sessions listed above is in your area, please consider attending and sharing a little bit about your experience and what services and supports have helped you or a loved one manage the symptoms of a mental illness and find success living in the community. The committee needs to hear how important it is that the plan includes recommendations that specially address the needs of people with mental illnesses and to build on the services and supports that we know work.
If you don't feel comfortable testifying, you can submit comments in writing to . NAMI Minnesota will also be submitting detailed written comments to the subcabinet to help as they continue their work. The plan is expected to be finalized by November.
Waiver to Continue MinnesotaCare Moving Forward
The Minnesota Department of Human Services (DHS) is moving swiftly on a federal waiver request (http://www.dhs.state.mn.us/dhs16_171635) that will allow MinnesotaCare to continue with several important improvements. The waiver is the result of legislation passed this session to help keep MinnesotaCare alive as the state works to implement the Federal Affordable Care Act (ACA). DHS submitted a draft of its proposal to the federal government late last month and held the first of two public hearings about the request on Monday.
If the waiver is approved as expected, MinnesotaCare coverage will continue through 2014 for people with incomes between 138% and 200% of federal poverty guidelines. In addition, MinnesotaCare enrollees will no longer have a $10,000 annual cap on hospital care nor will they be required to pay $1,000 in co-insurance for hospital care. People will also no longer have to go without insurance for four months in order to qualify and premiums for the program will be lower.
Beginning in January 2015, MinnesotaCare is expected transform into the state’s basic health plan, which an optional program under the ACA that allows states to provide health insurance for individuals with incomes between 138-200% of the federal poverty level. Without a basic health plan, people currently on MinnesotaCare would likely purchase health insurance on the health insurance exchange (MNSure) where plans would have higher cost-sharing and fewer benefits.
NAMI Minnesota attended Monday’s hearing along with other health care advocates and representatives of several of Minnesota health plans. Questions and comments were focused on the technical nuances of the plan but DHS did offer some insight on the timeline for the request. In addition to the two public hearings, there is also a 30-day window (running through July 24) to allow individuals and organizations to weigh in on the proposal. Once this comment period is complete, DHS will resubmit the plan to the Federal government who will then open their own public comment period. A final decision on the proposal is expected later this fall.
Changes at the State
In a memo to staff, Steven J. Allen, who is the Executive Director for Direct Care and TreatmentFor Mental Health and Substance Abuse Treatment Services at the Department of Human Services stated that many of their clients have a mental illness and have challenges with substance abuse and addiction and that of their clients struggling with substance abuse disorders also struggle with mental illness.
He pointed out the “increasingly compelling research base indicating that integrating mental health and substance abuse treatments is far more effective than providing these services separately. And it just makes common sense since, for our clients, these problems are deeply interwoven together.”
In an effort to move forward on integrating the state’s mental health and substance abuse treatment he announced a significant change in management structure that will be implemented in coming months. Instead of managing our programs along service lines, the state will now manage across regions through the addition of two regional clinical directors who will oversee the northern and southern areas of the state.
This new structure will place CBHH, C.A.R.E. and MSHS programs under common regional leadership with the expectation that these diverse programs will now work more closely together than in the past, especially where programs are in close proximity to one another. AMRTC will be its own "region," encompassing Anoka C.A.R.E. and MSHS Como (organizational chart attached to this message).
Douglas Panser to be the new Southern Region Director.Douglas is a licensed psychologist with a B.S. in alcohol and drug counseling education and a Master’s Degree in counseling psychology. Others will be announced in the future.
He ended the memo by stating “While our mental health programs will be developing more capacity to treat co-occurring substance abuse disorders with their client populations and our substance abuse programs will be developing increased expertise in treating co-occurring mental health disorders, important distinctions in clinical focus and important differences in program credentialing will remain. It is not my goal to make all of our programs ‘the same.’ We will be working to enhance our clinical competencies to meet the complex treatment needs of our clients. In fact, it is likely that programs will be developing even more specializations and specific clinical competencies over time.”
Changes to Injectable Medications
DHS is implementing procedure changes effective July 1, 2013 on how they process and pay for injectable medications—including injectable atypical antipsychotics.
The state recently started to enforce a long-standing policy that physician administered medications had to be billed as a medical benefit and not a pharmacy benefit. Immediately there were many questions and concerns raise, particularly for people with mental illnesses. The state stopped and then worked with providers to make sure that no one ended up not getting their medication. They allowed providers to submit prior authorizations prior to July 1, which we hope will help. If you are having problems, please call the NAMI office.
Help Educate Legislators
NAMI will be holding house parties this fall. These are informal meetings with legislators, NAMI members and mental health providers to talk about the needs of children and adults with mental illnesses and their families. If you have a legislator who serves on one of the health and human services committees or on jobs and economic development, please seriously consider hosting a house party. NAMI will provide you with the information and will guide you through the event. For more information contact Matt at
More on Children's Mental Health
NAMI has been frustrated by the lack of media attention to the major changes that were made to the children's mental health system this session. So, we wrote our own article. Read it here.