Friday, April 03, 2009

Will NAMI take those w/ mental health challenges to the cleaners in asking for a repeal of the IMD exclusion rule?

I might be reading between the lines but it seems to me as per Dihoff (Executive Director of NAMI NC) that NAMI National is going for the repeal of the IMD exclusion rule which means the below. She stated in an e mail letter to mental health advocates the following (see below for entire statement of hers: "The fear is to make sure that it doesn't take the place of badly needed community housing and community evidence based treatments. "

This is what I hear: NAMI is going to allow it to happen. That means that NAMI will be advocating for non single stream payer plans.

Man alive. I hope I'm wrong.

I intend to figure out how to follow the bill until it dies a timely death. Mike: do you have a 'name' for this 'bill'?


Mike Mayer writes:

"From: Mike Mayer [] Sent: Wednesday, April 01, 2009 10:45 AMTo:; hammondmv@netzero.netCc:;;; Debra Dihoff;;; andy@triadmentalhealth.orgSubject: RE: IMD exclusion: ? to Andy/ MHA Forsyth: Re: Fwd: H.R. 1415 -- MEDICAID E...

"First, John Tote and Debra Dihoff probably know twice what I do.

All I know is that the bill for the modification of the IMD exclusion is out there. Without a fairly strong consensus across the MH community I doubt it will get far. The 'big boys' of MH (private hospital groups) may be able to get some traction but the Feds are very concerned about opening the IMD can of worms from what I have heard. We don't want to replace the public institutions of 1960 with private institutions in 2010. I think the bill tries to address this but I just haven't heard the groundswell of support for it that it would take to get it passed as a stand-alone bill and you can expect that at least some survivor/Recovery focused groups and other advocates, like ADAPT, will not support it. However, it could get tucked into an appropriations or other must pass piece of legislation.

Mike Mayer
Senior Partner, CRA

Deb Dihoff, Executive Director, NAMI NC:

"It's definitely on NAMI (national's) radar screen and making its way onto their public policy agenda. Holly Hill has done some talking with legislators about this, and when I was recently in DC Jim Pitts and I brought it up with our delegation. The fear is to make sure that it doesn't take the place of badly needed community housing and community evidence based treatments. Once somebody else pays for something, everybody goes there. What's easy to bill is easy to use."

Deby Dihoff, MA
Executive Director, NAMI/NC
309 W. Millbrook
Raleigh NC 27609
919 788 0801
FAX 919 788 0906

My response to the above:

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville/ Waynesville NAMI Member

April 3, 2009

Thanks for your comments on the IMD matter, Mike Mayer and Deb Dihoff.

If the IMD rule is repealed, there will be two sets of hospitals....just like it was in the 1980's and before.

One set of hospitals will take the indigent clients. That's the state hospitals. They will be the hospitals everyone will want to avoid. Any work that has been done in order to improve hospitals like Cherry, etc., will be for naught. All the energy will be completely sucked out of this effort.

The other set of hospitals will take the non charity/ non disabled/ non Medicaid patients. And those sets of hospitals had their own set of weird problems. All those Charter hospitals?---remember them? where they put all the Dissociative Identity Disorder clients who got sicker by hanging out w/ just each other? I could tell you some tales from both Atlanta and Asheville re: those Charter hospitals. They sucked their insurance policies clean and left many of them high and dry.

I don't see any difference between this and 'separate but equal' arguments that preceded desegretation of US Schools.

This, in particular, is why the Centerpoint LME/ NC DHHS/ Old Vineyard secret little hospital plan is so concerning. I have not heard a word from Cansler re: my request for the minutes and information that were part of what NC DHHS participated in (public information: right; transparency: right). And did Cansler have a role as a lobbyist re: this effort? I'm dying to know.

Why must we keep returning to solutions that don't work and that are retro----to say the least?

We need one payer stream of funding.

I will be extremely disappointed in NAMI if they go down the road of having the IMD exclusion rule repealed. It will reveal that they are indeed in the pockets of private industry and Big Pharma---and this is an argument that is certainly there and entertainable even now.

I'm a NAMI member. I'm a mental health provider. Better step carefully here, NAMI.

I want a one payer system. The entire country is screaming for a one payer system. All except 'the big boys' as Mike Mayer so tellingly described the private psychiatric hospital people.

There is no good reason for NAMI to support the repeal of the IMD exclusion rule---unless they are in the pocket of the 'big boys' of private psychiatric hospitals.


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