News Stories on Managed Care Difficulties Needed
In Washington, there has been talk outside Congressional committees
and at the Health Care Financing Administration (HCFA) about making substantial
changes to the statutes that govern how Medicaid policy is implemented
in the states. Many are proposing that Congress eliminate or drastically
reduce HCFA oversight of how states contract with private managed care
organizations to provide Medicaid services. Congress may begin formal hearings
on these issues as early as May 1997.
It is hoped that news stories about difficulties with managed care will
improve public awareness at this crucial time when Congress considers decisions
about how billions of Medicaid dollars will be spent.
If you are willing to share your story with the press...
the National Mental Health Association (NMHA) may use your story to help
make the public and Congress aware of the human side of many of the policy
decisions that are being considered. If your story matches the news angles
sought by newspaper, radio, or TV reporters - NMHA will help you get the
story out.
K.C. Day
Nat. Mental Health Consumers' Self-Help Clearinghouse
1211 Chestnut Street, 10th Floor
Philadelphia, PA 19107
800-553-4539 ext. 256
For over two years, Congress has been involved in the arduous process of
reauthorizing the Individuals with Disabilities Education Act (PL 94-142).
Last week, the House and the Senate approved legislation that would reauthorize
the law for the next five years. The president will sign it shortly. IDEA
is the federal mechanism that guarantees children with disabilities the
right to a free and appropriate public education.
Both the House and the Senate this week passed their bills reauthorizing
the Individuals with Disabilities Act (IDEA). The votes were 420 to 3 in
the House, and 98 to 1 in the Senate. Senator Gorton (R, WA) offered an
amendment to permit states to set their own discipline rules. It was defeated
by a single vote. The President is expected to sign the bill shortly.
"Seriously Emotionally Disturbed" is no longer the legislative
term in the new bill.
"Emotionally Disturbed" has replaced it. This change can make
more children eligible for IDEA services.
The bill that was passed does
include "cessation", or permanent expulsion. It also
does
include "severely disruptive behavior" as a cause for removal.
The bill contains 45 day removal, automatic without appeal, for assault.
Firearm violations and narcotic violations have been added as causes for
the automatic 45 day removal, automatic without appeal, for assault. Firearm
violations and narcotic violations have been added as causes for the automatic
45 day removal. Children may be removed from their placement but they still
must receives educational services. While these constitute a change from
the existing "stay put" provisions, the overall bill is a great
improvement from early, very punitive versions. This is mostly attributable
to the "consensus" process conducted by Senate staff who held
weekly meetings for two months between parents, teachers and advocates.
Many thanks to the dozens and dozens of MHAs that contract their Members
of
Congress. Through your efforts, due process protec tions for children
with mental and emotional disabilities remained in the law and children
will not be summarily denied educational services.
After months of behind-the-scenes negotiations, the Clinton Administration
and
Congressional leadership announced they have reached a budget agreement
that would balance the federal budget in 2002. The deal would alter domestic
spending priorities, slow the growth of health care entitlements and cut
taxes to benefit families and investors.
Three details of the balanced budget agreement are of particular interest
to NMHA. First, there is no per-person federal spending cap on Medicaid.
Second, the plan includes $15 to $16 billion to finance expanded health
care for low-income children. Third, $5 billion has been earmarked for
Section 8 subsidized housing contract renewals.
The next step is to draft the budget deal into legislative language and
put it to a vote in the House and Senate. Then the 13 appropriations committees
will divide domestic discretionaly spending between themselves.
NMHA was very encouraged to see that both congressional parties and
the White House remain supportive of expanding health care coverage to
low-income children. The United States currently has about 10 million children
who do not have private health insurance and are not enrolled in Medicaid.
The budget deal designates $15 to $16 billion over the next five years
to provide health insurance to at leat 5 million American children.
Two major bipartisan bills being discussed are the "Hatch-Kennedy"
bill and the "Chafee-Rockefeller" bill. Both measures have been
introduced in the past two weeks and Congress is beginning the lengthy
process of hearings and cost-estimates. Neither bill specifically refers
to mental health parity for children. However, Dr. Mary Jane England, president
of the Washinton Business Group on Health, recently testified before the
Senate to impress upon Congress the importance of early and effective intervention
for children and adolescents with mental health disorders. Her comments
were favorably received and NMHAA is lobbying for explicit parity language
to be included in the children's health bills.
NMHA will be keeping you updated on the balanced budget details and the
progress of the children's health bills.
FURTHER PROGRESS ON STATE MENTAL HEALTH PARITY
At this writing, mental health parity measures have been introduced in over 30 state legislatures and groundbreaking bills are passing across America.
Alaska
just introduced a Joint Resolution to develop a Task Force to study Mental Health Parity.
just passed a full parity bill in late April and the legislation is on its way to Governor Howard Dean (D) for his signature. The measure is unique because it provides parity for substance abuse as well as mental health.
state legislature approved a parity initiative limited to severe mental illnesses, and Governor Roy Romer (D) signed that bill into law some weeks ago.
Both houses of the legislature have passed some form of parity legislation. Steve McCaffrey and our affiliate network in the state are working to get a final bill to the governor's desk before the session adjourns in a few weeks.
Senate just passed a full parity bill in late April. John Tote tells
us that a fierce battle is expected in the House.
After reviewing the experience of both private companies and states
that have adopted parity for mental health benefits, the National Institute
of Mental Health (NIMH) recently issued a comprehensive report stating
that nondiscriminatory mental health care, "results in lowered
costs and lower premiums (or, at the most, very modest cost increases)
within the first year of parity implementation." (empasis added)
Moreover, NIMH specifically found that its research does NOT support assertations
-- made by some big business groups -- that "high financial costs"
will result from parity because they are using outdated assumptions. Since
the projected cost of parity is THE issue at both the state and national
level, the NIMH study is particularly significant. For the first time,
a nonpartisan and objective agency (unconnected to mental health advocates
or our opponents) has examined all available data and concluded that parity
won't break the bank -- as NMHA and its allies have contended all along.
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