Saturday, July 14, 2012

Dear Gov. Mead: Make Wyoming a healthier place by embracing Medicaid expansion

When Rodger McDaniel writes about mental health and substance abuse treatment in Wyoming, he knows his subjects. Under Gov. Dave Freudenthal, the Rev. McDaniel was Director of the Mental Health Health and Substance Abuse Division of the Wyoming Health Department. Today in his blog (and on the op-ed pages of the Wyoming Tribune-Eagle), he makes the modest proposal that the Great Conservative State of Wyoming should embrace Medicaid expansion. It's a hard sell because Wyoming and its Governor were parties to the Affordable Care Act lawsuit that recently was spured by the conservative-dominated Supreme Court. Read on:
The enormous investment Wyoming made in mental health and substance abuse treatment in the last decade puts the state in a position to cash in big on the implementation of the Affordable Care Act (Obamacare). Governor Mead and state legislators should weigh the opportunity before rushing to join other Republican governors rejecting federal funding of Medicaid expansion. 
Today Wyoming taxpayers spend more than 95 million dollars each budget period on mental health and substance abuse services. If Wyoming implements the Medicaid expansion under Obamacare, most of that money can be returned to the general fund.
Read the rest here.
Wyoming is not always a trailblazer when it comes to mental health and substance abuse programs. But its Children's Medicaid Waiver has been a godsend to many Wyoming families in crisis. The Medicaid Waiver has helped both uninsured and underinsured families who've sent their children to a treatment program that is usually hours away from home, often out-of-state. When our daughter was diagnosed as bipolar, we had to send her to treatment for four months in Colorado and seven months in Casper. We signed her up for the Medicaid Waiver which kicked in when our insurance company limited her treatment. Before Obamacare, insurance companies either placed caps on mental health treatment or disallowed it as a pre-exisiting condition. The same held true for substance abuse treatment. When our son needed help for substance abuse almost ten years ago, our insurance lapsed after 50 treatment sessions. Since he was in a residential center and had daily sessions, the insurance was up way before the therapy could bear fruit -- nine months before he successfully returned home, clean and sober. We spent my father's inheritance to pay for some of the treatment and our son worked on the center's landscaping crew to pay for the rest. Expensive but worth it.


Many other families share our experience. Others will face problems in the future. The Medicaid Waiver helped pay for our daughter's treatment and for the "wraparound care" that followed her return to the home. A treatment team of parents, siblings, relatives, friends -- led by a certified mental health professional -- guided her back into her community. This beats the old approach of letting our teens sink or swim on their own, which didn't work our too well. Teens with mental illnesses or substance abuse problems have enough problems without having to readjust to school and home and work all by themselves.


Many families never use the Medicaid Waiver or similar programs because they don't know about it. There's a great statewide organization, UPLIFT, that is a resource for these services. I'm on the UPLIFT board and that's how I found out about the waiver. Get more info by calling UPLIFT at 307-778-8686. And be not afraid to go directly to the source at the Wyoming state offices. Yes, I know, it's a big state agency located in a monolithic grey building. But you can talk to real people there -- I did.


This web site is a good place to start: http://www.health.wyo.gov/mhsa/treatment/SystemofCare.html. As you'll see, the waiver program is now focused on keeping the child in the community by providing that wraparound care I talked about earlier.


I do not know how Obamacare, with or without Medicaid expansion, will affect these programs. But in a time of budget cuts in state funds, more Medicaid money from the Feds is a good thing, is it not?


No surprise that health care will be a major topic at this week's National Governors Association conference in Virginia. Also on the agenda is a discussion about the needs of military members returning home from the wars. Gov. Mead co-chairs the NGA committee addressing this issue. Some of the most pressing needs involved mental health care, not only for veterans but their families. The Veteran's Administration Hospital in Cheyenne recently expanded its services by hiring four new psychologists. 

1 comment:

Rodney Knight said...

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