Congressional Republicans just unveiled the American Health Care Act, which ends the requirement that Medicaid cover mental health care.
It caps Medicaid funding, which will lead to deep cuts and jeopardize mental health services. It will alsofreeze Medicaid expansion, putting young people who are first experiencing serious mental illness at risk.
Tell your Senator Steve Daines this is unacceptable.
Call (202) 224-2651.
Use our talking points below-and add your own story, if you like.
"As a constituent, I urge you to reject American Health Care Act provisions that will harm people with mental illness:
Can't make the call?
Email Senator Daines now at this link.
NAMI is nonpartisan. We support policies that help people with mental health conditions and their families.
Here is a list of the bills we are tracking at this year's Legislature.
HB 17 Ron Ehli Increase HCBS waiver slots and assisted living reimbursement rates
HB 24 Ron Ehli Providing protections to vulnerable persons from financial exploitation
HB 35 Gordon Pierson Create a grant program for training volunteer respite providers
HB 36 Gordon Pierson Fund Alzheimers related services provided by area agencies on aging
HB 70 Jessica Karjala Strengthening guardianship services and creating a WINGS group
HB 71 Wendy McKamey Require certain licensed health professionals be trained in suicide prevention
HB 84 Jessica Karjala Allow for biennial county matching grants for mental health crisis intervention
HB95 Gordon Pierson Increasing access to behavioral health care
HB 117 Jonathan Windy Boy Provide an appropriation for grants to local veteran suicide prevention efforts
HB 118 Jonathan Windy Boy Revise and provide additional funding for state suicide prevention program
HB 142 Laurie Bishop Revise insurance law to give mental health coverage parity with physical health
HB 176 Mary Ann Dunwell Revise mental health screening laws
HB 257 Ellie Hill Smith Consider housing needs in Montana State Hospital discharge plans
HB 265 Mary Ann Dunwell Create a school suicide prevention competitive grant program
HB 309 Mary Ann Dunwell Generally revise housing laws for disabled and criminally convicted individuals
SB 31 Albert Olszewski Require medicaid reimbursement for drug therapy management
SB 45 Margaret (Margie) MacDonald Revise drug and mental health treatment court laws
SB 61 Cynthia Wolken Require certain facilities providing behavioral health srvcs to be lic by DPHHS
SB 62 Cynthia Wolken Certification for behavioral health peer support specialists
SB 63 Cynthia Wolken Revise laws related to supervision of offenders/defendants
SB 65 Cynthia Wolken Generally revise laws regarding housing options for offenders
SB 82 Albert Olszewski Generally revise laws on Medicaid overpayment audits
SB 160 Mary Caferro Require DPHHS to streamline procedures related to mental health services
LC0091 Mary Caferro Require DPHHS to certify mental health peer support specialists
LC0542 Edward Buttrey Create affordable workforce housing incentive fund
LC0719 Cary Smith Provide for high deductible health insurance thru reimbursements and tax credits
LC0909 Ryan Lynch Provide for youth suicide prevention funding
LC1063 Ellie Hill Smith Require state to provide housing as a requirement of corrections release
LC1272 Jessica Karjala Establish the Montana Suicide Review Team
LC1285 Dennis R Lenz Generally revise mental health laws
LC1324 Andrea Olsen Generally revise definition of mental health professional
LC1407 Laurie Bishop Require certain suicide prevention training for 9-1-1 dispatchers
LC1408 Laurie Bishop Require DPHHS to establish registry of suicide prevention trainers
LC1410 Laurie Bishop Mental health advisory councils & service areas to support suicide prevention
LC1416 Laurie Bishop Generally revise suicide prevention laws
LC2028 Dennis R Lenz Require school districts to address suicide prevention and response
LC2059 Jennifer Eck Generally revise laws on mental health
LC2182 Alan Redfield Revise licensing requirements for certain mental health facilities
LC2247 Dennis R Lenz Generally revise mental health education for teachers
Why Does the "Montana Mental Health Parity Act" Need Definitions of "Mental Illness" and "Substance Abuse"?
We've had some questions from different groups about why Representative Laurie Bishop's "Montana Mental Health Parity Act has definitions of "Mental Illness" and "Substance Abuse." That brings on the follow-on question of whether these are already defined in the federal Mental Health Parity law.
The federal Mental Health Parity and Addictions Act did not define mental illness, mental health conditions, or substance abuse disorder. Rather, it explicitly left these definitions up to the terms of insurance plans and applicable federal and state laws.
I've put this language below in blue.
Mental health benefits The term “mental health benefits” means benefits with respect to services for mental health conditions, as defined under the terms of the plan and in accordance with applicable Federal and State law.
Substance use disorder benefits The term “substance use disorder benefits” means benefits with respect to services for substance use disorders, as defined under the terms of the plan and in accordance with applicable Federal and State law.
That language can be found at 29 U.S. Code Section 1185(e)(4)-(5) which is available here.
That gap in definition either requires clarity in the Montana law or it will be generally left to the determination of insurance companies or the potential applications of tangential federal laws that were not focused on mental health and addiction parity.
With that in mind, Representative Bishop's House Bill 142 includes explicit definitions of "mental illness" and "substance abuse" to make it clear what these conditions are and why they need to be fully covered in Montana insurance plans.
Those two definitions are in blue below.
(4)(3) (a) "Mental illness" means a clinically significant behavioral or psychological syndrome or pattern that occurs in a person and that is associated with:
(i) present distress or a painful symptom;
(ii) a disability or impairment in one or more areas of functioning; or
(iii) a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.
(b) Mental illness must be considered as a manifestation of a behavioral, disturbance in an individual's cognition, emotional regulation, or behavior that reflects a psychological, or biological dysfunction in the underlying mental functioning of a person, causing distress or disability in social, occupational, or other important activities.
(b) Mental illness includes:
(i) any mental health condition or disorder that falls under any of the diagnostic categories listed in the mental disorders section of the current edition of the International Classification of Diseases or that is listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders;
(iii) a diagnosis of any of the following for a child with autism who is 18 years of age or younger, for whom coverage also must comply with 33-22-515(3) through (5):
(A) autistic disorder;
(B) Asperger's disorder; or
(C) pervasive developmental disorder not otherwise specified.
(c) Mental illness does not include:
(i) a developmental disorder, except autism; or
(ii) a speech disorder;
(6) (a) "Substance use disorder" means a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using alcohol, drugs, or both despite significant substance abuse-related problems.
(b) Substance use disorder includes any condition or disorder that falls under any of the diagnostic categories listed in the mental disorders section of the current edition of the International Classification of Diseases or that is listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. Substance use disorder includes but is not limited to impaired control over substance use, social impairment, risky use of substances, tolerance of substances, and withdrawal symptoms when blood or tissue concentrations of a substance decline.
(c) Substance use disorder does not include caffeine or nicotine abuse.
You can read the full text of House Bill 142 at this link.
Please support the Montana Mental Health Parity Act. You can find out how in this video.
Matt Kuntz, J.D.
The closing of a year offers a time for reflection. I've been the Executive Director for NAMI Montana since June of 2008. In those years, I've learned a lot about my own mental health challenges and the challenges that affect my loved ones. I've also made a lot of incredible friends that battle with serious mental illness, post traumatic stress, and/or addiction issues fighting everyday for recovery and hope.
This Christmas I caught up with people who are doing better than they or anyone ever thought they would be. People who are celebrating the holidays with a greater sense of peace and more relationship connections than ever before.
I also grieved friends and family who lost their battle with mental illness. Saw facebook posts from friends who were trying to get through the holidays after losing a child to suicide. Hurting for them and all of our NAMI families across the country who are in the same position.
These illnesses are unfair and complicated. Some people respond immediately to treatment while others struggle for years to maintain hope that recovery is possible. It's similar in both hopeful and tragic ways to how cancer patients respond to treatment.
We should not expect that the road to improving the mental illness treatment system will get any easier. There will be steps forward and there will be steps back. We will hit obstacles that will require tenacity, creativity and teamwork to overcome.
I know that together we are up to the task.
MHA Ventures and InSight Telepsychiatry are partnering to help bring on-demand, scheduled and direct to consumer care to hospitals in the state of Montana. These efforts will improve access to mental health care and providers.
HELENA, MT (PRWEB) DECEMBER 23, 2016
A new partnership between MHA Ventures and InSight Telepsychiatry will improve care options throughout communities in Montana. MHA Ventures (MHAV), the for-profit subsidiary of the Montana Hospital Association, works with successful healthcare organizations to help Montana become a “Top 10 Healthy State.” InSight has been endorsed by MHAV to help members of the association improve the mental health in the communities they serve through telepsychiatry.
Telepsychiatry is psychiatric care delivered through secure videoconferencing.
Members of the Montana Hospital Association provide the full spectrum of health care services, including hospital inpatient and outpatient, skilled nursing facility, home health, hospice, physician, assisted living, senior housing and insurance services.
Mental health is an important topic to address across the state as Montana has the highest suicide rate among any state in the United States at nearly twice the national average. Approximately 54 of 56 counties in Montana are designated as mental health professional shortage areas meaning those counties do not meet the criteria of having at least one mental health professional per 10,000 people. Psychiatrist providers are particularly hard to come by in Montana outside of the few cities.
“We are excited by this partnership’s ability to help bring care to Montana communities that have been struggling with acute needs for psychiatric care,” says Dr. Jim Varrell, Medical Director of InSight. “With on-demand telepsychiatry, hospitals can have access to psychiatrists who can make admission or treatment decisions within an hour on average. Other locations like clinics, primary care offices or correctional facilities, can also benefit from our scheduled telepsychiatry services. With telepsychiatry, psychiatry providers can offer care to anyone, anywhere as long as there is adequate internet connectivity.”
In addition to facility-based models of telepsychiatry, InSight is also working with the Montana chapter of Mental Health America to offer telemental health care to individuals in their home or other private spaces online.
InSight is already working with the Billings Clinic in Montana to provide on-demand, after-hours telepsychiatry services in the emergency department.
Telepsychiatry is an effective, cost-conscious and proven way to bring psychiatry providers, especially those with hard-to-find specialties, into areas where there may be a shortage like Montana rural and frontier land.
For nearly 30 years, MHAV has improved consumer care and reduce operating costs by tailoring flexible programs to fit the needs of each individual hospital.
InSight, the leading national telepsychiatry service provider organization, has over 17 years of industry experience, serves over 225 organizations across 26 states and has implemented telepsychiatry programs across the spectrum of care. Together, MHAV and InSight will work to improve the mental health of communities throughout Montana.
One of the most difficult things to understand about suicide prevention is how big of a difference it can make to reduce the means of committing suicide in your home. The difference between the availability of lethal means during a suicidal crisis can be the difference between life and death.
The "Means Matter Campaign" from the Harvard Injury Control Research Center describes the importance of reducing a suicidal person’s access to highly lethal means as a critical part of a comprehensive approach to suicide prevention. It is based on the following understandings (click on each to learn more from the Means Matter website):
Thankfully, you do not need to understand all of the complexities of how Means Reduction can help prevent suicides in order to suicide proof your home. All you need is around $21.
You can get the Master Lock Gun Lock recommended by Montana's Suicide Prevention Coordinator Karl Rosston and a Vaultz Medicine Case for $20.94 plus shipping and handling.
While locking up guns and medications will not entirely reduce the danger of suicide, it's an incredibly powerful step to help avoid tragedy.
FOR IMMEDIATE RELEASE - FROM SENATOR JON TESTER's OFFIC
November 17, 2016
Tester to Help Lead Veterans Affairs Committee
Senator pledges to hold the VA accountable, make sure vets get the care they’ve earned
(U.S. Senate)—After spending the last 10 years fighting for Montana’s veterans as the state’s only member of the Veterans Affairs Committee, Senator Jon Tester has doubled-down on his commitment to our service men and women by becoming Ranking Member of the Senate’s Veterans Affairs Committee.
“Giving a voice to Montana’s veterans is one of the most important jobs I have as a Senator,” Tester said. “This next Congress I will work with Republicans, Democrats and veterans advocates to hold the VA accountable and deliver for the brave men and women who risked life and limb to protect our most fundamental liberties.”
By accepting one of the Committee’s two top leadership positions, Tester has committed to working with both Republican and Democrats, as well as the Veterans Service Organizations, to hold the VA accountable, get meaningful reforms passed, and make sure our country fulfills its promise to the men and women who have served.
“The VFW wants to congratulate Senator Jon Tester on his selection as the Ranking Member of the Senate Committee on Veterans Affairs” said Bob Wallace, the Adjutant General of the VFW. “Senator Tester has been a strong advocate for America’s veterans and we look forward to working with him in the 115th Congress.”
“I couldn’t be prouder of Jon’s accomplishments while representing the veterans of Montana on Capitol Hill. His accomplishments on veterans’ issues are second to none. On behalf of all the veterans I work with and serve, we thank him and wish him the very best in all of his endeavors,”said Joe Parsetich, former Head of Montana DAV and current Mentor Coordinator for the Veterans Treatment Court in Great Falls.
Tester is widely known as one of the Senate’s most vocal advocates for veterans. As Ranking Member of the Senate Military Construction and Veterans' Affairs Appropriations Subcommittee, Tester just spearheaded the passage of major legislation that increases funding for veterans health care by $3.3 billion.
"Senator Tester has long been an advocate for troops, veterans and their families and his appointment as the Ranking Minority Member of the Senate Committee on Veterans Affairs is great news. MOAA looks forward working with Senator Tester in his new role and with the Committee to do all we can to help improve the health and well-being of our Nation's veterans and their families," said Lt. Gen. Dana Atkins, USAF (Ret), President/CEO of the Military Officers Association of America.
“I am pleased to hear Senator Tester will help lead the Senate Veterans Affairs committee as the ranking Democrat. Regardless of which side of the aisle a person sits, veterans need the voice of experience, moderation, and reason on Capitol Hill. Jon Tester is that man,” said Ed Saunders LTC (ret) US Army and member of Billings DAV.
Tester also worked with colleagues on both sides of the aisle to craft and introduce the Veterans First Act, which will fix the VA's Choice Program, bring more accountability and transparency to the VA, and enhance benefits and care to more veterans and their families. Despite the fact that this bill was introduced and unanimously passed out of Committee back in April, leadership still hasn’t brought it to the floor for a vote.
“NAMI Montana is excited to have Senator Tester as the ranking member of the Senate Veterans Committee,” said Matt Kuntz, Executive Director of NAMI Montana. “We've worked with Senator Tester for years on both issues of national significance to veterans and those of individual Montana veterans in need of help. He's proven his willingness to go to bat over and over again for our nation's veterans.”
In addition to being a strong voice for veterans in Washington, Tester is also a constant presence in the state, working directly with veterans on the ground to help them get the care and benefits they’ve earned. Earlier this year Tester launched his Veterans’ Choice Outreach Tour to hear directly from veterans across 28 rural Montana communities. Tester also recently held a Small Business Opportunity Workshop in Great Falls, specifically aimed and helping veterans and entrepreneurs connect. And after more than five years of effort, Tester recently announced that the VA will establish a brand new Vets Center in Helena.
You can read more about Tester’s work on behalf of veterans HERE, HERE and HERE.
"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of earlier wars were treated and appreciated by our nation." -- George Washington
Please take two minutes this Veterans Day to advocate for effective healthcare for our nation's veterans. The Republican party just took over the Presidency, U.S. Senate, and U.S. House of Representatives. They are going to get their chance to make a mark on the Veterans Administration's (VA) care for our nation's veterans. It is a good bet that a large part of their platform for improvement will rely on private care outside of the VA.
NAMI Montana has advocated for effective care for Montana's veterans both inside and outside of the VA for years and we believe that both types of care are critical. However, there is one dangerous pitfall to care outside of the VA that we need you to ask Congress to avoid.
The danger is that veterans' care will be contracted out to an Accountable Care Organizations that will then offer private healthcare providers reimbursement rates and covered services that are worse than those of State Medicaid. The private healthcare providers will then refuse to accept those reimbursement rates and the veterans will either be left without care or scrambling to find another way to pay for their healthcare coverage.
This is the exact scenario that nearly played out in Montana during the Veterans Choice Act roll-out, before Senator Jon Tester intervened. This scenario is 100% preventable as long as Congress knows that it needs to be addressed when they are writing any VA reform bills.
Please contact Senator Steve Daines, Senator Jon Tester and Congressman Ryan Zinke and ask them "to make sure that private reimbursement rates for VA medical care are at least at the same cost and scope of services as State Medicaid reimbursement for the state that the veteran received care."
Senator Steve Daines - (202) 224- 2651- email contact (202) 224-2651
Senator Jon Tester - (202) 224-2644 - email contact
Congressman Ryan Zinke - (202) 225-3211 - email contact
Not from Montana, but still want to advocate on this critical issue in the care for our nation's veterans? You can find the contract information for your Congressional Representative here and your your Senators here.
During the banquet on Thursday night of the 2016 Montana Conference on Mental Illness, we will present the 2016 NAMI Montana Hero Awards to five people who have had an extraordinary impact on the fight against mental illness in Montana.Dr. Erin Amato, MD of Montana Psychiatry has worked incredibly hard to bring innovative treatments, such as Deep Transcranial Magnetic Stimulation and Ketamine, for treatment resistant depression to Montana.
Dr. Eric Arzubi, MD of the Billings Clinic has developed a strong track record of innovation and advocacy in efforts such as Project Echo, Triple Chronotherapy Research for suicide prevention, and the creation of a Psychiatric Residency program in Montana.
Tiffany Hanson, CPA is a shareholder with Anderson ZurMuehlen, NAMI Montana's Treasurer, and a long-time advocate for improved mental health awareness and treatment programs for Montana's children.
Marga Lincoln is a reporter for the Helena Independent Record. Marga is being recognized for her in-depth and compassionate coverage of the Helena School District's response to a suicide epidemic and the District's eventual adoption of the Youth Aware of Mental Health program.
Gary Popiel is the President of NAMI Montana and a driving force behind the establishment of the Center for Mental Health Research and Recovery at Montana State University.
Each of these incredible men and women have utilized their passion to improve the lives of people with mental illness and their unique skill sets to make incredible strides in improving Montana's mental illness awareness and treatment systems.
NAMI Montana is deeply grateful to them for all of their hard work and dedication to this critical cause.
One in five Montana families are affected by mental illness.