NAMI
National Alliance on Mental Illness
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Public Policy Update

April 10, 2015
Chris Bouneff, Executive Director

Greetings, NAMI Oregon public policy followers. It's time for one of our periodic updates during the legislative session. (Apologies in advance for the long email this week.)

This week, however, we'll take a look outside of the Legislature. As much focus as we put on the legislative session, there is just as much happening in the other branches of government that we follow because their actions influence what happens in the world of mental health and addiction treatment and supports.

Two cases in point:

* The Oregon Supreme Court last week voided reforms to the Public Employees Retirement System approved in 2013. Those reforms were part of a "grand bargain" that also helped the state make new investments in education and health care that otherwise wouldn't have been possible without PERS reforms.

The Supreme Court ruling erases most PERS savings, meaning the state will eventually have to come up with a ton more money for PERS. You can read more about the ruling and its potential impact here: http://goo.gl/vwD6Xi 

The ruling isn't expected to impact the 2013-15 budget cycle, which ends this June 30. And there is talk that it also won't impact the 2015-17 budget, which is currently being negotiated. Its impact may not truly hit the state until 2017-19, according to some news reports.

But at the very least, it will cast a shadow over the budget for the next two years, including the scope and size of continued investments in Oregon's community mental health system. And that could change the scope and size of our advocacy for such initiatives as our housing development incentive fund legislation, which is awaiting action in the Joint Ways & Means Committee.

We may know more after the final revenue forecast is issued on May 14. A proposed budget from the Ways & Means co-chairs should follow closely on the heels of the forecast's release.

* The Oregon Insurance Division is updating the administrative rule that implements the state's mental health and addiction insurance parity law - and this is a good thing.

Some on this email list may remember NAMI's arduous journey to enact insurance parity in Oregon, an effort that culminated successfully in 2005. Just as important as passing the law was the drafting of the Oregon Administrative Rules (OARs) that put the law into action.

The rule was due for an update. For one, the old rule references the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4). The fifth edition of the DSM has been out for some time now and is in wide use, so the DSM-5 needed to be added. But the Division took the opportunity to also modernize the rule based on the past 10 years of experience.

(You can read the proposed rule here: http://goo.gl/h17w4m. And NAMI Oregon's comments on the rule can be found here: https://goo.gl/DXn9RC)

Under the new rule, consumers will have a much easier pathway to appeal insurance denials for coverage, more akin to the pathway they'd have for most medical conditions. This is because the rule does away with certain blanket exclusions that were possible under the old rule.

The rule also requires insurers to be more explicit in the disclosures and documentation they provide consumers so consumers better understand benefit decisions and have reasonable access to the information necessary to appeal any denials of coverage.

It's a positive step forward. And just like legislative efforts, it required NAMI to be extensively involved. Meeting with fellow advocates, attending Insurance Division meetings, reading pages and pages of documents, serving on a Rules Advisory Committee, submitting public comments, and keeping tabs on the entire process.

 

These are just two examples of the work that NAMI staff and members pursue on behalf of all individuals and families affected by mental illness. The work doesn't fall under the legislative spotlight, but it's work that's just as important.

As always, if you have any questions or comments, please feel free to send them my way.

Thanks,

Chris

------------------
National Alliance on Mental Illness

Chris Bouneff
Executive Director
NAMI Oregon
4701 SE 24th Suite E
Portland, OR  97202
503-230-8009 ext. 202
fax 503-230-2751
chris@namior.org 
www.namior.org 

Join Us on Facebook:
www.facebook.com/NAMIOregon 

 

2014 Public Policy Survey Results

NAMI member and allies overwhelmingly picked housing as their top priority in our recent public policy priorities survey. Click here to read the results and summary of the survey, which will be discussed at June's public policy meeting.

NAMI Oregon Releases Health Transformation Guide

Many Oregonians may still be puzzled by the term "health transformation," but the changes forthcoming in Oregon's Medicaid system could vastly improve health care in our state or just be another shot in the dark that fails to hit its intended target. NAMI Oregon has long advocated for an integrated health care system that focuses on individual and family health. To that end, NAMI Oregon is pleased to issue its "Policy Guide to Health Transformation and Integration in Oregon" that collects all of NAMI's various positions on health care transformation into one document. This will serve as our guiding vision for our advocacy on health care reform.

Please see previous Public Policy Updates below.

Previous Public Policy Updates

Stay involved with us - sign up for our e-news and legislative alerts, and click the links below to view minutes from Public Policy Committee meetings.

Tell us your story - if you have a personal story that illustrates the need for changes in statewide mental health policy and you would like to become an advocate for policy improvement, complete our Advocate Information Form and return it to us today.

HIPAA Privacy Rule Clarification

The U.S. Department of Health and Human Services has issued a clarification on when it is appropriate for mental health care providers to share information protected under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, especially with family members and loved ones. The HIPAA Privacy Rule allows for health care providers to share information about a patient's care with family members not only when permission has been expressly granted, but also in circumstances when the patient may be unable to grant permission but the provider deems sharing information will be in the patient's best interest. For details, read the HIPPA Privacy Rule guidance.

Communication Checklists

Communication between care providers and family members of patients seeking treatment for mental illness improves the quality of care and reduces the risk of suicide for these patients. While confidentiality is a fundamental component of a therapeutic relationship, misunderstandings by clinicians about the limitations created by HIPAA, FERPA, and state laws for preserving confidentiality has caused unnecessary concern regarding disclosure of relevant clinical information. 

To address this deficit of communication, the Oregon Council on Child and Adolescent Psychiatry published a checklist for mental health providers in 2012.  The authors, Dr. Stewart Newman and Jerry Gabay (NAMI Oregon Board Member), have created a companion checklist to help families seek information from providers. Click here to view both the provider checklist and the family member checklist.


Related Files

Public Policy Committee meeting minutes - August 2010 (PDF File)
Public Policy Committee meeting minutes - September 2010 (PDF File)
Public Policy Committee meeting minutes - November 2010 (PDF File)
Public Policy Committee meeting minutes - February 2011 (PDF File)
Public Policy Committee meeting minutes - March 2011 (PDF File)
Public Policy Committee meeting minutes - April 2011 (PDF File)
Public Policy Committee meeting minutes - May 2011 (PDF File)
Public Policy Committee meeting minutes - October 2011 (PDF File)
Public Policy Committee meeting minutes - November 2011 (PDF File)
Public Policy Committee meeting minutes - January 2012 (PDF File)
Public Policy Committee meeting minutes - February 2012 (PDF File)
Public Policy Committee meeting minutes - March 2012 (PDF File)
Public Policy Committee meeting minutes - June 2012 (PDF File)
Public Policy Committee meeting minutes - August 2012 (PDF File)
Public Policy Committee meeting minutes - November 2012 (PDF File)
Public Policy Committee meeting minutes - December 2012 (PDF File)
Public Policy Committee meeting minutes - January 2013 (PDF File)
Public Policy Committee meeting minutes - March 2013 (PDF File)
Public Policy Committee meeting minutes - December 2013 (PDF File)
Advocate Information Form (Word Document)
June 2011 Public Policy Update (PDF File)
July 2011 Public Policy Update (PDF File)
October 2011 Public Policy Update (PDF File)
November 2011 Public Policy Update (PDF File)
December 2011 Public Policy Update (PDF File)
January 2012 Public Policy Update (PDF File)
February 2012 Public Policy Update (PDF File)
March 2012 Public Policy Update (PDF File)
May 2012 Public Policy Update (PDF File)
August 2012 Public Policy Update (PDF File)
October 2012 Public Policy Update (PDF File)
February 2013 Public Policy Update (PDF File)
March 2013 Public Policy Update (PDF File)
April 2013 Public Policy Update (PDF File)
July 2013 Public Policy Update (PDF File)
December 2013 Public Policy Update (PDF File)
January 2014 Public Policy Update (PDF File)
March 2014 Public Policy Update (PDF File)
October 2014 Public Policy Update (PDF File)
January 2015 Public Policy Update (PDF File)
CCO Basics Fact Sheet (PDF File)
CCOs By County (PDF File)
DOJ Civil Agreement (PDF File)
2013 Legislative Priorities (PDF File)
Housing Bill Summary (PDF File)
Budget Fact Sheet (PDF File)
Medication Access Fact Sheet (PDF File)
Human Services and Housing Committee list (PDF File)
2014 Public Policy Survey (PDF File)
State Budget (PDF File)
Medical Access House Bill 2421 (PDF File)
Housing Funding House Bill 2825 (PDF File)
February 2015 Public Policy Update (PDF File)
Housing Fund Testimony (PDF File)
February 27, 2015 Public Policy Update (PDF File)
March 2015 Public Policy Update (PDF File)
April 2015 Public Policy Update (PDF File)

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