ACT -- Why It needs to be an option under a re-vamped CMHS WAIVER
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Val's Take
The discrimination that people with mental illness have endured when it comes to adequate health care is pretty unbelieveable, and to top it off it is often unwitting. The services that people with mental illness need are sometimes the same as those of people with physical disabilities, but often they are not. Where this can gets really dangerous for the person and even for the community is in the need for intensive services-- because they often look very different. So in the past, CO Medicaid along with most states just hasn't adequately funded intensive Mental Health Community Services and it has been nothing short of a Human Rights Catastrophe with large numbers of poor white, black, and brown people with serious mental illness homeless or incarcerated or cycling between the two. The State has been trying to increase its ACT capacity, but it hasn't been willing to respond to our request for a waitlist or bringing ACT to scale to meet the need for almost a year and a half. AND Now the Deadline for Parity is Coming Up: We Need to Re-Vamp the CMHS Waiver and Include ACT as the long term care service it really is. Journal of Social Work & Disability Rehabilitation (2014) "Thus, many treatments for severe mental and substance use disorders that require long term services and supports (LTSS) that have been shown to be effective, like Assertive Community Treatment, would not be required under MHPAEA" [perhaps for private health insurance but it would be required for Medicaid]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334111/ |
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CMS & Parity & Long Term Care:
Although the proposed rule did not apply to long term care services, the final rule applies parity protections to long term care services for mental health and substance use disorders in the same manner that these protections apply to other services for these conditions.
This approach will improve the quality of care for beneficiaries with mental health and substance abuse disorders by requiring that states and plans apply MHPAEA-compliant treatment limitations consistently across all mental health and substance use disorder services rather than only a subset of services.
This approach will also improve simplicity and transparency for beneficiaries and ease of administration of the regulation. Because few states that offer long term care services for mental health and substance use disorders apply quantitative treatment limits to these services, we believe that the financial impact of this policy will be minimal in most states.
Although the proposed rule did not apply to long term care services, the final rule applies parity protections to long term care services for mental health and substance use disorders in the same manner that these protections apply to other services for these conditions.
This approach will improve the quality of care for beneficiaries with mental health and substance abuse disorders by requiring that states and plans apply MHPAEA-compliant treatment limitations consistently across all mental health and substance use disorder services rather than only a subset of services.
This approach will also improve simplicity and transparency for beneficiaries and ease of administration of the regulation. Because few states that offer long term care services for mental health and substance use disorders apply quantitative treatment limits to these services, we believe that the financial impact of this policy will be minimal in most states.