Mental Health And Substance Use Disorder

Medicaid excludes inpatient hospital services other than services in an institution for mental disease. Congress specifically exempted most psychiatric care in state hospitals (Davoli, 2003)

Yet many people still aren't aware that the law exists or how it affects them. In fact, a 2014 APA survey found that more than 90 percent of Americans were unfamiliar with the mental health parity law (American Psychological Association). Many people might end up not receiving the appropriate therapeutic services that they need because their medical insurance does not cover it. However, medical insurance does cover some of it. For example, for physical therapy, some insurers require a referral from a doctor. People consider physical therapy to be a necessity as long as it's prescribed by a physician and significantly improves physical functions that were limited because of a disease, illness or surgical procedure. On the other hand, others do not consider physical therapy to be necessary for someone whose condition is getting worse or if the patient is not showing improvement. (Holmes). Many people question and ask themselves why doesn’t my insurance cover these needed services, and what can I do in order for my insurance to fully cover it? Unfortunately, many mental health provders do not accept insurance, more than likely because of the cost. Many insurance

The Mental Health Services Act is designed to accumulate and distribute funds to county mental health programs (upon program plan approval). There are five different areas that the act helps with funding in mental health. The first is Community Services & Support (CSS) which helps fund the pairing of mental health care with primary health care settings. CSS also provides mental health support services to people that aren’t able to receive the services elsewhere (Dchs.ca.gov 2015). CSS has some main objectives including reduction of homelessness, justice and child welfare system

An interesting finding by Huskamp and Iglehart (2016) is that between the Mental Health Parity Act (MHPA) and the Affordable Care Act (ACA), there should be a rise in people with mental illness seeking services, however, services are underutilized more than ever (Huskamp & Iglehart, 2016). According to Bendant (2014), in 2013 a total of 47 million people uninsured and 25% of those suffer mental illness (Bendant, 2014). These numbers are staggering for a service that is more inclusive now more than ever. The Center for Medicare & Medicaid Services (CMS) site indicates that the MHPA is regulated differently depending on the state (CMS, n. d.). The Department of Labor (DOL) has identified a few problems with the MHPA and addressed these issues to Congress via a 2017 report (DOL, n.

Medicaid coverage and financing augmented access to a variety of behavioral health services, including psychiatric care, counseling, prescription medications, inpatient treatment, case management and supportive housing. Medicaid expansion states have seen higher rates of healthcare utilization in terms of medication and services for the treatment of behavioral and mental health conditions, highlighted by studies that have shown that Medicaid expansion is associated with increases in Medicaid-covered prescriptions for and Medicaid spending on medications to treat opioid use disorder and opioid overdose (1). States that have expanded Medicaid through Section 1115 Waivers experienced coverage gains similar to the states that implemented traditional Medicaid expansions (1). In fact, Indiana made large gains in Medicaid enrollment and the uninsured rate reductions between 2013 and 2015 were higher than the average decrease among the expansion states (1).

Escalating during the great recession and the drug epidemic, the rate of the uninsured and citizens with incomplete MH/SUD coverage escalated to cataclysmic proportions. Relatively, the economics of our nation were impacted by millions of American families affected by MH/SUD disorders that reduced their productivity and earnings potential. However, the fear that MH/SUD parity would further impact struggling businesses and increase the total costs of health care played a crucial role in delaying the passage of individual attempts at parity legislation. Naturally, amendments to a true mental health parity act were inspired by Republican opposition who were against government involvement in regulating health insurance.

The piece of this health reform act related to mental health stipulates that there be state laws mandating or regulating mental health benefits ("NCSL," 2012). This author has found no literature that indicates the effectiveness of the PPACA. Perhaps it is too early to determine the success or failure of the PPACA.

Based off of this proposal it is determined that there would be an increase of about 31% compared to the previous year’s annual health budget of $2.6 billion. The money earned would be used for early intervention, “wraparound” services for families, “innovation” programs, Mental health workforce: Education and Training, and for capital facilities and training. To ensure the funding is being used efficiently and properly “Under the terms of the proposition, each county would draft and submit for state review and approval a three-year plan for the delivery of mental health services within its jurisdiction. Counties would also be required to prepare annual updates and expenditure plans for the provision of mental health services” (lao.ca.gov). This review is to make sure that the tax money is only being used towards mental illness issues and nothing else.

The approval of Proposition 63 (also known as the Mental Health Services Act or MHSA) in November 2004 provides the California Department of Mental Health (DMH) to provide increased funding, employees and other resources to support county mental health programs. The Department will also monitor progress toward statewide goals for children, teens/young adults, adults, and families. Prop 63 includes a wide field of prevention, early involvement, service needs, the necessary transportation, technology and training fundamentals that will successfully support the system (Scheffler and Adams).

“The Mental Health Parity and Addiction Equity Act of 2008, also known as MHPAEA is defined as a federal law that prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 1). Originally, MHPAEA applied only to group health plans and group health insurance coverage, but was “amended by the Patient Protection and Affordable Care Act” to also apply to individual health insurance coverage (Centers for Medicare and Medicaid Services, para 2). “The Mental Health Parity Act of 1996 (MHPA) defined that large group health plans could not impose annual dollar limits on mental health benefits that are less favorable than any limits imposed on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 6).

Lower income populations have been categorized with high rates of being uninsured and as mentioned in this brief earlier, mental health and substance use disorders are more prevalent among lower income populations. The changes to the Affordable Care Act (ACA) regarding mental and behavioral services increased the ability for people with these health concerns to gain insurance coverage and acquire the appropriate services needed (Beronio, K., Frank, R., Glied, S., 2014). Along with these changes to coverage, the ACA emphasizes the integration of services among healthcare agencies. With the passing of the Mental Health Services Act (MHSA) in 2004, funding was provided to counties in California. San Francisco’s Department of Public Health (SFDPH)

Mental health policymakers overlooked the difficulty of finding resources to meet the needs of a marginalized group of people living in scattered sites in the community. Implications of changes in financing will need to be measured and unsuspected responses should be assessed promptly when they occur. A shortage of community resources will eventually mean that it may be necessary to preserve institutional beds primarily until community care is expanded. Structure in an important consumer role in policymaking, monitoring and evaluation has proven to be a valuable source of input in mental health policy advocacy. Particularly in politics who review the demographic pressure on long-term care services establishments. Deinstitutionalization accelerated nationwide due to the federal government in the late 1960s and 1970s. During this time Medicaid and Medicare were created with coverage for a range of services including components of the mental health field. Supplemental Security Income also made an appearance for the mentally ill. (Koyanagi, 2007)

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is an act that requires parity or equality between mental health treatment and medical/surgical treatment covered by private and public insurers with over 50 employees. That means that if an insurance covers mental health issues they can’t impose more stringent limits and financial requirements than medical/surgical coverage. The act was signed into law in 2008 by President George W. Bush. Before the act was signed into law, mental health care was not as affordable or accessible for individuals. (United States Department of Labor, 2016)

I read a news article on Medscape which talks about increasing access to mental health care. The rule require provisions of the Mental Health Parity and Addiction Equity Act of 2008 to apply to the majority of Medicaid plans and the Children’s Health Insurance Program (CHIP) (Brooks, 2015). The act ensures that mental health and substance use disorder benefits are no more restrictive than medical and surgical services (Brooks, 2015). I strongly believe that individuals deserve access to quality mental health services and substance use disorder services. In addition, improving quality and access to care will impacts the health of our nation. The proposed rule ensures that all beneficiaries who receive services through a managed care plan or

According to Treatment Improvement Protocol No. 43 (2005), a mental disorder is defined as a disease of the mind or a brain disorder. According to SAMHSA (2016), more than eighteen percent of US citizens age 18 and older live with a brain disorder combined with another problem. To put it another way, almost 1/5th of the US population lives with mental illness and either a substance use disorder or some other issue (SAMHSA, 2016). A co-occurring problem is defined as the coexistence of both a substance use disorder and mental health problem (SAMSHA, 2016). Other examples of co-occurring problems include pathological gambling, eating disorders and those previously stated are all treatable with proper evaluation, assessment and interventions