Substance Abuse: 20% of mental hlth parity ; Insko on overwhelming #'s of non-Medicaid clients& what this means

If the NC Insurance Committee of the House sinks mental health reform by dragging out the substance abuse red herring, it will be because they have not done their homework. 38 states have mental health parity and those state legislatures' have created various means to cap matters such that the spending does not get out of control.

See: What have States Done to Ensure Insurance Parity?
http://www.mentalhealthamerica.net/go/parity/states

Of the 38 states that have parity laws, ONLY 2 HAVE EXCLUDED SUBSTANCE ABUSE: KENTUKY AND WASHINGTON: Report from American Psychological Association's (Practice Directorate):
Jeff Cook, J.D.Director of Field & State OperationsAmerican Psychological Association Practice Organization750 First Street, NEWashington, DC 20002(202) 336-5875 (Office)(202) 336-5797 (Fax)202) 336-5797 (Fax)jcook@apa.org

Mr. Cook states , "Our actuary, Ron Bachman, has told us that the cost of the substance use disorder portion of a parity law that includes both mental health and substance use disorder is typically about 20%." Ron Bachman: rbachman@apa.org

http://www.mentalhealthamerica.net/go/parity/states

HERE ARE THE E MAIL ADDRESSES OF THE MEMBERS OF THE INSURANCE COMMITTEE FOR THE NC HOUSE. The mental health parity bill is: H973
davida@ncleg.net, johnbl@ncleg.net, brub@ncleg.net, angelab@ncleg.net, nelsonc@ncleg.net, billcu@ncleg.net, margaretd@ncleg.net, jerryd@ncleg.net, billf@ncleg.net, bruceg@ncleg.net, hughh@ncleg.net, juliah@ncleg.net, davidl@ncleg.net, garlandp@ncleg.net, drews@ncleg.net, mitchells@ncleg.net, williamw@ncleg.net, trudiw@ncleg.net, tomw@ncleg.net

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Raleigh N&O:
How can we make sense out of recent conflicting comments on thestate's mental health system?

One writer says North Carolina is near the bottom among the states infunding for mental health -- we need more money. Another writer saysit would be wrong to put more money into the system when the localmental health agencies are unable to spend $93 million.

Another personpoints to the recent overspending for Community Support services.First, an important fact: People between the ages of 19 and 64 don'tqualify for Medicaid no matter how poor they are or how sick they areunless they are disabled or have minor children.

It follows then that few people with mental illness qualify forMedicaid. So, while it is true the Medicaid budget for mental healthis overspent, what that means is that the relatively few people withmental illness who qualify for Medicaid are receiving substantialservices.

The many people with mental illness who are not Medicaid-eligible mustwork with providers who are willing to be paid 100 percent withlimited state dollars or to provide services pro bono.

Many Medicaidproviders are unwilling or unable to see state-supported or indigentpatients.

We need more state dollars to support these consumers andkeep them out of our jails, emergency rooms and state institutions.Local agencies spending all their service dollars receive their moneyfrom the state in block grants before the services are provided ratherthan through billings after the services have been provided.

We couldaddress the problem of unspent funds by allocating most or all of thestate service dollars in block grants. Once we spend all the currentservice dollars, we would have a better idea of how much more money isneeded to serve all the mentally ill who do not qualify for Medicaid.

All the writers are correct, but they are each describing only onepart of the elephant.

Verla InskoState House of RepresentativesChapel Hill(The writer, a Democrat, represents the 56th House District. Thelength limit on letters was waived to permit a fuller discussion.)