Thursday, September 18, 2008

Persistent mental health problems defined by Congress to be DISABILITY: What does this say about NC DHHS Rehabilitation Model and Medical Necessity?

"Lawmakers said that people with epilepsy, diabetes, cancer, multiple sclerosis and other ailments had been improperly denied protection because their conditions could be controlled by medications or other measures.....In deciding whether a person is disabled, the bill says, courts should not consider the effects of “mitigating measures” like prescription drugs, hearing aids and artificial limbs. "


So, NC Mental Health Reform and NC DHHS's direction re: NC mental health reform is associated with a stated 'rehabilitation model.' How does this over-riding federal law affect that matter? If someone is persistently mentally ill----as are many of the people who could/ would/ did/ do receive Community Support Services or other mental health associated services----as disabled people are they not entitled to rights associated w/ their disability that could, assumably, be DEPENDABLE services? Not services that are willy-nilly cut due to a dysfunctional Value Options or an LME w/ a Utilization Review Department that decided that there is no outpatient therapy?

Moreover, what does the passage of this expanded disability law say about the matter of 'Medical Necessity' ? 'Medical Necessity' continues to be one of the least understood & most universally utilized terms associated with health insurance benefits. And, from my perspective, it seems to be a term that is thrown around to the advantage, mostly, of the insurance companies who pretty much can say that something is medically necessary or not.

I think this new law could potentially have a HUGE effect on these matters.

At APA Boston, at a lecture, Tony Puente, PhD, a neuropsychologist based in Wilmington NC, who has does an enormous amount of free work for psychologists across the US in terms of driving up the rates that psychologists can command for services, stated the following: "Medical Necessity is whatever your contract (with the insurance provider) says it is."

Is it?

NYT: 9.18.2008

Congress Passes Bill With Protections for Disabled

Published: September 17, 2008
WASHINGTON — Congress gave final approval on Wednesday to a major civil rights bill, expanding protections for people with disabilities and overturning several recent Supreme Court decisions.

The voice vote in the House, following Senate passage by unanimous consent last week, clears the bill for President Bush.

The White House said Mr. Bush would sign the bill, just as his father signed the original Americans With Disabilities Act in 1990......

The bill declares that the court went wrong by “eliminating protection for many individuals whom Congress intended to protect” under the 1990 law.....

In an effort to clarify the intent of Congress, the bill says, “The definition of disability in this act shall be construed in favor of broad coverage.”.....

“This is one of the most important pieces of civil rights legislation of our time,” said Representative Jim Langevin, Democrat of Rhode Island, who uses a wheelchair......"



Blogger R Jackson said...

Ms. Hammond,

Your comments are typically on point, but your approach is almost comical at times.

If you want to get your point across better, I suggest that you stick to the facts. You ramble and ramble and it appears you are a far left loon as opposed to an educated psychologist who is on point with your mission

11:49 PM  

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