All signs point to Congress passing a comprehensive health care reform bill in 2009, potentially expanding health insurance coverage to 46 million uninsured Americans. This objective will be achieved through a combination of Medicaid eligibility expansions as well as the creation of a new health insurance exchange – basically a new health insurance market place – for persons earning above 100% of the Federal Poverty Level. Premiums for participants in the exchange will be heavily subsidized by the federal government. In return for this expansion of coverage, Congress will be seeking opportunities to introduce greater provider accountability and consumer responsibility into the health care system, while promoting initiatives which increase efficiency and reduce medical errors.
Since many who receive care in CBHOs are low income uninsured (or underinsured) individuals, CBHOs and other community providers stand to greatly benefit from coverage expansions. However, confronted with a once-in-a-generation opportunity to secure significant additional resources for the public behavioral health system, many mental health organizations are pursuing a federal health care reform agenda which not only takes into consideration the overarching principles of the current health care reform debate, but strongly advocates for greater resources to community behavioral health providers to better equip them to address the health concerns of individuals with mental illness and substance use disorders.
What Factors are Driving Us?
The Substance Abuse and Mental Health Services Administration’s state survey shows that persons with serious mental illnesses served by public mental health agencies have the HIGHEST mortality rate of ANY population ANYWHERE in America’s public health system. Specifically, the average life expectancy for this population now rivals people living with HIV/AIDS. In addition, among psychiatric patients, the probability of dying is 55% higher for patients diagnosed as having substance use disorders than among those without a substance use diagnosis.
Provider Accountability
In order to stop the predicted cost growth in coming years, both the Obama Administration and Congress are committed to promoting evidenced-based practices and increasing provider accountability. This trend is reflected in new federal commitments of $1 billion for comparative effectiveness research and $20 billion to encourage the adoption and utilization of electronic health records. Both of these initiatives are based on several themes of the current health care debate: a.) provider accountability for clinical outcomes; b.) systemic application of evidenced-based interventions, c.) reduced reimbursement for sub-optimal outcomes, and d.) specific reporting of detailed encounter data.
To help community behavioral health providers prepare for a new era of accountability in health care while attempting to stem the mortality rates cited above, we are pursuing four priority initiatives:
Mental Health/Substance Use Disorders Included in Benefit Packages In the Exchange
Like the Massachusetts health care reform program, the Obama Administration endorses an approach that finances private health insurance for low income uninsured individuals via a health insurance exchange. Many private insurance companies, such as Blue Cross/Blue Shield and Aetna, would participate in this new program/health insurance market place. Many mental health organizations seek to ensure: mental health and substance abuse benefits are part of any nationwide minimum benefit package; comprehensive parity is applied to all benefit packages offered in the exchange or connector; enhanced case management must be provided to new enrollees with cognitive impairments to help them navigate the exchange/connector.
Federal Status for Behavioral Health Organizations
A new federal definition for Federally Qualified Behavioral Health Centers (FQBHC) that would a) establish federal status for CBHOs who volunteer to meet the standards of an FQBHC, b) provide a definition for such an entity that clearly identifies treatment objectives and updates the minimum core services required, and c) establish clearly-defined national standards for this entity. In return for this new federal status, providers working within FQBHCs will be asked to meet new provider accountability standards (as mentioned previously).
SMI Healthcare Home Demo to Support Co-Location of Primary Care in CBHOs
The Mental Illness Chronic Care Improvement Act of 2009 was introduced in the Senate (S. 1136) on May 21, 2009 by Senator Debbie Stabenow and in the House on June 26, 2009 (H.R. 3065) by Representative Janice Schakowsky. This bill would among many other things, co-locate primary care capacity in Community Mental Health Centers and other community-based mental health and substance abuse providers. This integrated treatment approach is aimed squarely at reducing the mortality and morbidity rates among clients in the public behavioral health system. While mental health organizations have been able to engineer a new $7 million SAMHSA program in 2008 with a similar structure and treatment goals, this demo, targeted to Medicaid beneficiaries, will more directly impact the single largest purchaser of mental health and addiction disorders.
Inclusion of CBHOs in Federal HIT Funding Initiatives
The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was enacted as part of the economic recovery bill passed by Congress earlier this year. It creates a new $17 billion Medicare and Medicaid reimbursement system to help physicians, hospitals and Community Mental Health Centers purchase and maintain health information technology for the purpose of widespread adoption and utilization of electronic health records. Although psychiatrists may access these incentive payments, CBHOs, as facilities, are not eligible for this funding. Many mental health organizations are seeking inclusion of CBHOs in any federal HIT initiatives to ensure that individuals with mental illnesses and addictions have access to the benefits of HIT via the providers that serve them.
Watch the video related to health care reform bill
Stag News footage of the protesters from the 8/29/09 town hall meeting concerning health care reform. Look out for the “Billionaires for Wealthcare” cameo. Special thanks to: The ED Show (MSNBC) The Huffington Post, The Ron Reagan Show, RandiRhodes.com, ThinkProgress.com, BradBlog.com, HotAir.com, DailyKOS.com ThePoliticalCarnival.blogspot.com, TrueBlueLiberal.com, PoliticusUSA.com, CounterPunch.org, and all the other bloggers who featured our video! Key Words: Angry Spring Valley …
Help answer the question about health care reform bill
If the health care reform bill is so good?
If the health care reform bill is so good for America, then why is obama, his family, Congress, and their families exempt from it?
About Author
Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in lobbying for research toward the diagnosis and treatment of mental illness and also achieving health care reform. Lean more at www.thenationalcouncil.org.
Recommended Products
2010 will be a conservative blowout, so obama is gonna try to pass as much BS as he can
It’s right there in black and white.
First of all, Obama wants to make insurance more available to all and change the system so that it is cheaper. He also wants change so that the insurance companies find it harder to get out of paying for treatment. The system he is proposing looks similar to that which works in Holland and Switzerland where private companies are involved in providing insurance.
Second, of course universal health-cover sucks. That is why we in Western Europe have it. We think, hmm, our healthcare system sucks. I know, lets keep it. I guess that is the same with Japan and Canada as well.
Third, Obama campaigned on reforming the healthcare system. He said he wanted to make insurance more available and he was elected by the American people to do this.
FACT – the US has higher death rates for kids both for kids aged under one and those under five than western European countries with universal health coverage.
FACT – American insurance companies push up prices and work to stop paying out claims on those they cover.
FACT – the USA spends more on healthcare PER PERSON than any other nation on the planet.
That means that a dead American four year old would have had a better chance of life if they were born in Canada, France, Cuba, Germany, Japan etc, all of which have universal health coverage.
Last of all if you do not like the policies that Obama was elected to bring in, he can always be voted out of office in 2012.
Yes you are talking about TORT reform. the Democrats do not want to touch the Lawyers. it seems the Lawyers are in the democrats pocket.*
Under any Democrat President in history, the same M.O. emerges.
The Democrats "identify" a "crisis" and whip the people up into a frenzy about it. They proclaim themselves the carriers of the elixir that will heroically save all mankind from this "crisis.'' When Republicans seek to oppose the spending it will take for this elixir, they are automatically called hate mongers and obstructionists.
Clinton tried it with school lunch menus. He whipped that whole thing into some kind of "crisis." The Democrats wanted to raise the program by 10% and the Republicans wanted to raise it by 7%. That got reported in the media as a 3% CUT by Republicans. Only when a Democrat is President could an INCREASE be reported as a CUT. Just to make Republicans look bad, but too many people buy into the bullshit.
Al Gore, who wasn't even President, tried it with global warming and it didn't work. Today, it's health care. What'll it be tomorrow? The whole "world is ending in 2012" thing, or what?
the new york times has an interactive feature which is actually very clear to understand. check it out.
Obama does not have a bill. He has only given guidelines to what he wants. His last address made it more specific.
The bills in congress are not healthcare bills. They are health coverage bills. The government is trying to take control of a large portion of our economy. They are trying to make it so the government is a single payer source (I know i will get thumbs down for this, but follow hr3200 to its logical conclusion).
The current bills want to cover everybody in the US (Illegals too, there is nothing in these bills to prevent illegals from being covered. Amendments to ensure citizenship were tabled)
The federal government wants to punish you for not having insurance (they will get your money one way or another)
The government wants to regulate what care you will get. (When the system becomes overblaoted as any government system does, they will have 2 options increase taxes or ration care)
I know that there are a lot of people that will disagree with this. If they actually read the bills, and follow to there logical conclusions, in 10 years we will be a whole lot worse of than we are now. So doing nothing would actually be cheaper.
Reform must actually deal with the underlaying problems. HR 320o does not. Obama gave lip service to 1 of them.
Who would believe the White House?
You are commenting on Bill that was defeated by We The People – The new bill, the corrupt US gov will not disclose the actual legislature until 2014 HEALTH PLAN PREMIUM PAYMENTS, REFERRAL CERTIFICATION AND AUTHORIZATION.—The set of operating rules for
health claims or equivalent encounter information, in a health plan, health plan premium pay ments, and referral certification and authorization transactions shall be adopted not later than July 1, 2014
send this video to congress… 100 times
This just another astro-turf lobby ad. get the facts for yourself at the white house website!
This looks to me like the print version of the actual bill.
Its 615 pages though, so you may want to find a summary.
http://help.senate.gov/BAI09A84_xml.pdf
Not positive that that is the final/current draft of the bill, but its the one on the senate website, so I'm guessing its good.