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2010 Public Policy Priorities
- Increase the funding of peer run networks
and services in every state through Mental Health Block grant and increase
federal appropriations for consumer-run statewide organizations/coalitions.
- Increase the funding for peer-run alternatives
to hospitalization such as crisis respite, warmlines, and in-home supports.
- Promote trauma-informed, holistic services and supports.
- Ensure that training and continuing education in behavioral health
is based on holistic, trauma-informed approaches.
- Advocate that the National Center for Complementary and
Alternative Medicine (NCCAM) emphasize the uses of complementary and
alternative medicine for mental health issues.
- Reform Medicaid and Medicare to support recovery and community
integration.
- Ensure full implementation of Medicare parity legislation.
- Recommendations for state Medicaid reform:
- Promote supervision of peers by other peers. [1]
- Reimburse peers working in a variety of roles. [2]
- Allow peers to use self-determination care accounts to hire
other peers.
- Expand the definition of “medical necessity” to include recovery
and community integration. [3]
- Promote the central involvement of peers in the evaluation of
services.
- Provide clear and accurate information about Medicaid to
consumers.
- Ensure significant participation by mental health peers on
Medicaid Advisory Councils. [4]
- Create model legislation to carry forward our priority policy
recommendations.
- Enable people to return to work through consumer-driven Social
Security reform, using the following strategies:
- Raise asset limits and income limits
- Increase work incentives such as Plans for Achieving
Self-Support (PASS) [5] and Impairment-Related Work Expenses (IRWEs) [6]
- Increase employment-related supports (education, training,
child care)
- Re-evaluate benefits based on geography
- Promote coordination amongst agencies that provide benefits
to ensure coordination of benefits.
- Limit pharmaceutical industry influence on policy and practice by
eliminating direct-to-consumer advertising and doctor incentives.
- Reform the Food and Drug Administration (FDA) to ensure independent
research on pharmaceuticals and to block the reclassification of ECT devices
to Class II.
- Promote universal psychosocial coverage – “parity with choice”
covering a variety of peer-run alternatives in the community and
rural/tribal areas.
- Ensure peers are adequately prepared to participate in all major
policy and planning decisions at all levels.
- Reauthorization of the Substance Abuse and Mental Health Services
Administration (SAMHSA) including continued funding of consumer-run
Technical Assistance Centers.
- Ensure the human and civil rights of people with psychiatric
disabilities, including the right to community-based alternatives to
unnecessary institutionalization as articulated in the Olmstead decision and
the Americans with Disabilities Act (ADA).
- Increase accessibility and affordability of housing for people with
psychiatric disabilities; ensure adequate funding of consumer/survivor run
housing. [top]
[1] The Coalition supports revising the language of the
August, 2007 CMS letter to state Medicaid Directors, which specified that
"mental health professionals should supervise peer specialists, " to reflect
language used by the Pennsylvania Medicaid office: “Peer specialists can be
supervised by either a mental health professional or a person with a bachelor’s
degree and 2 years of direct care as a peer and/or mental health worker or a
person with a high school diploma or general equivalency degree and four years
of mental health direct care experience, which may include experience in peer
support services." [top]
[2] Medicaid should reimburse peers to work in a variety of
roles including Personal Care Attendants (PCAs) in mental health, peer bridgers
in inpatient settings, members of crisis teams, and wellness coaches in addition
to the role of Certified Peer Specialist. [top]
[3] Each state is allowed to develop its own definition of
“medical necessity” for operation of the Medicaid program in the state. [top]
[4] Code of Federal Regulations 42, Section 431.12 requires
that states form committees to advise Medicaid agencies. Those committees must
include recipients of services and they must provide financial arrangements, if
necessary, to make recipient participation possible. Currently, these councils
rarely include mental health peers, and rarely have influence on state Medicaid
policy decisions. We recommend this regulation be expanded to state that “at
least two representatives from each major disability group” be on the Medicaid
Advisory Council. These representatives need to represent a significant
proportion of the persons with the disability, and themselves have the
disability of the group they represent. They need not however, presently be
Medicaid recipients. The representatives from the disability groups should be
informed of the appropriate federal and state Medicaid regulations by
consumer-run Technical Assistance Centers (TACs). The participants’
transportation and time should be covered by the State Medicaid Office. [top]
[5] PASS plans allow a person with a disability to set
aside otherwise countable income and/or resources for a specific period of time
in order to achieve a work goal. [top]
[6] Allowable expenses that can be deducted from a disabled
person’s gross monthly wages. [top]
View Policy Priorities for 2011
View Policy Priorities for 2008
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