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“Landmark” Decision: Federal Government Will Okay Medicaid To Pay For Residential Treatment Beds

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(11-14-18) U.S. Health and Human Services Secretary Alex M. Azar II announced yesterday that the Trump Administration will allow states to apply for Medicaid waivers so the federal government can begin paying for mental health treatment delivered in inpatient settings known as IMDs, or institutions of mental disease.

This is a major change that most recently was requested in a  September 12 letter written by National Alliance on Mental Illness CEO Mary Giliberti and signed by eleven of the fourteen non-federal members of the Interdepartmental Serious Mental Illness Coordinating Committee. As a member of ISMICC, I signed that letter. The move was backed by Assistant Secretary for Mental Health Dr. Elinore F. McCance-Katz.

Azar’s announcement should lead to more Americans with serious mental illnesses being able to get short-term, in-patient residential care because the federal government will pay for it.

Approximately 10.4 million adults in the United States had an SMI  (serious mental illness) in 2016, but only 65 percent received mental health services in that year.

Attempts in Congress to overturn the so-called IMD Medicaid Exclusion, which prohibits the use of federal Medicaid financing for care provided to most patients in mental health and substance use disorder residential treatment facilities larger than 16 beds, failed because of lobbying by groups that argued eliminating it would lead to a greater use of inpatient hospital beds and the construction of more hospital-like residential facilities rather than spending federal funds for community services. In the House during hearings about a major overhaul of mental health services, Democrats successfully kept Republicans from removing the IMD exclusion. Granting waivers gives states a pathway around the IMD Exclusion and its supporters.

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Her Son Was Fatally Shot After She Couldn’t Get Him Help: A Preventible Tragedy Claims Another Life

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(11-12-18) Guest blog.

LOSS OF A MENTALLY ILL CHILD BY LETHAL FORCE
Written by Margie Annis

My child was a 30-year-old man, who still called me Mama and who said to me several hours before his death: “I can do this on my own, I’m a grown man, love you Mama.”

How to begin this story has been a struggle. My son died at the hands of our broken criminal justice and mental health system.

Victims so many victims.

The rollercoaster of grief from losing a child – the nightmares that will not stop – the ‘what if’s ‘and ‘should of’s’  that will not stop – from the moment I gave birth to my son, all I wanted for him was to be good and happy in life and he was – until he was afflicted with a severe mental illness and had a fatal encounter with an off-duty correctional officer in Pasco County, Florida.

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“I lost everything.” Former Reporter Becomes Homeless. Powerful Account Of How We Treat Those Abandoned On Our Streets

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(11-9-18) I serve on the board of directors of the Corporation For Supportive Housing, a national non-profit that implements innovative programs  to reduce homelessness. Several of our efforts are aimed at helping young people who are aging out of foster care, the seriously mentally ill – including individuals with co-occurring addiction problems – and persons being released from jails and prisons. Not everyone  on the streets, however, fits into those categories, as this eye-opening story documents.

Thank you Lori Yearwood for having the courage to tell your story in the Washington Post. (After reading, visit Lori Yearwood’s website to learn more about her.)

Lori Yearwood, 53, in Salt Lake City. Yearwood wrote a first person piece about her two years in homelessness, her experience climbing out and her current period of transition. (Preston Gannaway for The Washington Post)

Homeless women are the sexual assault survivors no one talks about. Here’s my story.

Story by Lori Yearwood, published in The Washington Post 

After nearly two years of homelessness, I could no longer bear sleeping, let alone bathing, in the shelter where I had spent too many nights. Its shower stalls were often littered with used toilet tissue and tampons. Drug paraphernalia — needles and syringes — were sometimes strewn across the bathroom floors. On the night that I found human feces smeared across the stall where I was attempting to clean myself, I walked out of the shelter and started sleeping on a bench in a park near downtown Salt Lake City.

My bathing spot: a rushing river that ran through Memory Grove Park. On a September morning in 2016, I took off my clothes and entered the freezing water.

As I dried off with a T-shirt and got dressed, I remembered how, not so long ago, I had bathed in privacy and peace, in a porcelain claw-foot tub in my own farmhouse.

Exhausted and hungry, I began walking toward a nearby church that offered free coffee and sack lunches when a police officer commanded me to stop.

“Someone saw you bathing naked and called the police,” he said.

I stood in front of him, my hair sopping wet.

“You have done this more than once,” he said.

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Top Federal Mental Health Official Supports AOT and Peer Services In Article Listing SAMHSA’s Goals

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(11-6-18) In a recently published article, Dr. Elinore F. McCance-Katz,  Assistant Secretary for Mental Health and Substance Use, explained how she and the Trump Administration intend to implement federal mental health and substance abuse programs. Her article in Psychiatric Services magazine’s October issue should appeal to both peer groups and supporters of Assisted Outpatient Treatment.

This is not an easy feat because several peer organizations oppose AOT, which they view as coercive treatment, and several AOT supporters question the value of peers, because several oppose AOT.

Before Dr. McCance-Katz took charge, the Substance Abuse and Mental Health Services Administration  was perceived during testimony at congressional hearings as being strongly anti-AOT and strongly pro-peers.

Dr. McCance-Katz’s recent decision to reassign Paolo del Vecchio, director of SAMHSA’s Center for Mental Health Services (CMHS), was viewed by some of his supporters as a signal that the agency was shifting its focus from peer services and the recovery model of treatment in favor of a more traditional medical model. When Dr. McCance-Katz announced SAMHSA would re-examine the criteria it uses to declare a treatment program as “evidence based,” some peer leaders became nervous. Few scientific studies have been done about the value of peer services versus traditional services.

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Judge Steve Leifman Continues To Institute Reforms in Miami: Creating National Model

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(11-2-18) Judge Steven Leifman, my good friend and one of the main characters in my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, has won an award from the Brain & Behavior Research Foundation because of reforms he has instituted in Miami-Dade Florida and his tireless national advocacy.

Take a moment to watch the short video about his award and you will be inspired.

He also was featured on a podcast about the steps he has taken to turn his community into a national model for jail diversion and community treatment. Here is the podcast.

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Common Sense Steps To Implementing Jail Diversion In Your Community

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(10-31-18) How do you start an effort in your community to reduce the inappropriate incarceration of persons with mental illnesses?

Cynthia Kemp, a deputy director at the Substance Abuse and Mental Health Services Administration, gave attendees at a Louisiana Mental Health Summit yesterday in Baton Rogue, a step-by-step explanation based on how Arlington County, Va., launched its national recognized jail diversion system.

“Begin with a champion,” Kemp told the 300 community leaders, who were invited by Louisiana Senator Bill Cassidy (R.) to the summit.

It could be a judge, sheriff, police chief, state legislator, mayor – anyone who understands that locking up people who are sick is a waste of tax dollars and human potential.

Step Two: Hit the streets. Talk to the police to learn what problems they face because of persons with mental illnesses becoming entrapped in the criminal justice system. The National Alliance on Mental Illness  reports that 40% of persons with a serious mental illness will have an encounter with the police. 49% of all fatal police shootings involve someone with a mental illness. In addition to the police, advocates need to speak with public defenders, judges, prosecutors, local mental health providers, parents and persons with lived experience – and identify what barriers they see keeping individuals from getting decent care.

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