health care reform strategies moving forward: transforming behavioral health recovery in an era of...
TRANSCRIPT
Health Care Reform Strategies
Moving Forward: Transforming Behavioral Health Recovery in an
Era of Health Care Reform
Pat TaylorExecutive Director
Faces & Voices of RecoveryFebruary 24, 2011
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Recovery and Wellness focus Ensuring that people in or seeking recovery
from addiction and mental illness get the care and support that they need to lead healthy and fulfilling lives.
Embracing all pathways to recovery Networks of formal and informal services and
support Policies that support, don’t hinder, the ability of
people to get into recovery and to sustain their recovery
Health reform: Why it’s important for recovery Recovery Principle – Change in focus from
treating sickness to promoting health and well being
Equity – no pre-existing condition exclusions; annual limits; parity of coverage for mental illness and addiction with other health conditions
32 million uninsured Americans will gain access to care by 2014
Why it’s important for recovery May include 87,000 people who sought care for
addiction but did not get it because they didn’t have health insurance or the ability to pay.
May include as many as 2 million people with mental illness
Because millions of people with addiction and mental illness will have primary care, screening and brief interventions, the number of people receiving care for addiction and mental illness could increase.
Addiction: as many as 20 million Mental Illness: as many as 5.1 million
Why it’s important for recovery People in the criminal justice system with mental
illness and addiction will have access to care. Will extend Medicaid coverage to a large number
of uninsured adults who will be guaranteed coverage for addiction and mental illness
The federal government will pay the lion’s share of the costs of the expansion – relatively small state investment
Making services and resources available that people can use to meet their needs.
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Setting the stage in Washington, DC and states
Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act All Members of Congress were visited; key
Congressional committees involvedVictory carried over into Affordable Care Act
State “parity” laws Informed legislators and policy makers
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Setting the stage in Washington, DC and states
Learning from history – peer recovery support Mutual aid, mental health consumer/survivor
movement; recovery advocacy movement Peer recovery coach service role Recovery community centers, Drop-in centers
More than recovery-oriented treatment – helping individuals/families/communities initiate, sustain, and honor long-term recovery
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Federal level Federal policies are being developed to
implement the Affordable Care Act. They will lay the ground work for the state effort. The Affordable Care Act gives states significant policy
discretion in implementing the law within a framework established at the federal level.
While the “essential health benefits package” will include care for addiction and mental illness, what the specific services will look like will be determined by regulation.
Essential health benefits package
Will peer and other recovery support services be in the essential benefits package?
What could it mean?
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Beyond the Affordable Care Act Other recovery supports that we can educate
policymakers and opinion leaders about and possible sources of funding Block grantsDepartment of Housing and Urban
DevelopmentDepartment of Labor Department of Justice
Advocating on two levels
1. Best possible regulations and policy choices at the federal and state levels
2. Delivery of peer and other recovery support services
Accreditation of organizations Credentialing individuals
State-level advocacy: Bestpossible regulations/policies Organized recovery communities are visible
change agents and at the table Recovery advocates and consumer/survivor advocates meet
locally to determine common agenda items under health reform
Develop relationships with elected, appointed and career state officials Meet with state officials; influence the development of rules and
regulations for state exchanges to promote the use and benefit of peer recovery support services
State-level advocacy: Best possible regulations/policies Developing and participating in
effective coalitions and strategiesForming relationships with other
stakeholders Making sure that robust assistance
and support systems are set up for people who are newly insured
State-level advocacy: Best possible regulations/policies Engaging people to seek help or
people who are seekingDevelop models for signing up people
for the health exchanges and Medicaid expansion benefit Veterans, people leaving incarceration – as
part of peer recovery support
State- and federal-level advocacy: Service delivery
1. Accreditation of organizations
2. Credentialing individuals
