Issue 16: Financing of Treatment and Services
Goal: Ensure that care for all persons with psychiatric disorders is affordable, nondiscriminatory, and includes coverage for effective and appropriate treatment.
Discussion
The Alaska Mental Health Board supports the establishment of provisions to ensure the financing of basic health care for every Alaskan at costs affordable to individual citizens and families. It is critical that coverage of psychiatric disorders be equal in scope and duration to coverage of other illnesses and without more restrictive limits than for other diseases. During the 1997 legislative session, the AMHB supported a resolution to establish a task force to study the differential treatment of psychiatric disorders versus physical disorders in insurance practice and make recommendations for changes to the legislature. While the AMHB supports recently passed federal parity legislation, we recognize that this legislation is restrictive and needs to be expanded through state legislation. In addition, if adequate mental health care is to be provided to Alaskans, private-sector health plans must cover all proven-effective modes of treatment; the cost of not treating psychiatric disorders greatly exceeds the cost of treating them.
Public funding for services to persons with psychiatric disorders who are unable to care for themselves is the responsibility of society. Local, state and federal governments have the responsibility to develop an integrated system of care and to fund this system adequately. The most basic needs of mentally ill persons when they are at their most vulnerable are for shelter, food, clothing, medical and social supports, and assistance toward self-sufficiency. Government has met such needs principally through programs for income maintenance, medical treatment, medical insurance, other health and social services, shelter and housing, education, transportation assistance, legal assistance, advocacy, training and employment. When funding patterns change, we risk treating only those whose needs are addressed by categorical funds. In recent years, Alaska has seen a marked increase in mental health services to Medicaid patients and a decline in services for those whose needs are met through mental health grant funds.
Federal funds have supported hospitals that provide psychiatric care to those under 18 and those over age 65. Congress has enacted legislation to substantially reduce this support over the next several years. This legislative change presents new opportunities and challenges in planning for mental health services.
Actions
268. Continue the work of the Parity Task Force to develop Alaskan legislation supporting parity between mental health and physical health care in insurance coverage.
269. Advocate with the legislature for parity legislation.
Responsible party (actions 1-2): Alaska Mental Health Board, Building Bridges Campaign, advocacy groups
270. The Alaska Mental Health Board will advocate for full funding of mental health programs to meet consumers' mental health needs.
271. The Alaska Mental Health Board will advocate for maximum funding for both biomedical and services research for psychiatric disorders and for federally-funded treatment and services for individuals with psychiatric disorders.
272. The Alaska Mental Health Board will participate in API 2000 planning to ensure that services offered in the future are appropriately funded.
273. The Alaska Mental Health Board calls upon the United States Congress to adopt uniform standards of Medicaid eligibility based upon individual resources and the need for services, rather than upon the location in which services are provided or the residence of the recipient.
274. The Alaska Mental Health Board will work with Department of Health and Social Services' senior staff to explore pooling funding sources, including grant funds and Medicaid to provide for integrated care, especially for co-occurring disorders.
Responsible party (actions 3-7): Alaska Mental Health Board