Health Affairs Behavioral & Addiction Recommendations
& Some Candid Commentary
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Selected Recommendations: Medicaid Reentry Act (H.R. 1329)
[At least in some ways, Colorado is beyond the "IDEA" Phase of some of these innovative policies and so are many Jails. The SCALE problem --- is not to be TRIFLED with. Jeffco Jail had a 1/2 time psychiatrist and around 1,000 inmates. Colorado Medicaid has dipped its TOE into discharge planning from jail --- but they have the same problem that JEFFCO JAIL has --- what's being done is nominal compared to the need. ASPR’s Hospital Preparedness Program
[In a lot of ways, this implicates Stephen Covey's Quadrant I -- what's urgent and important and Quadrant II -- what's not urgent but important. Nobody is saying ignore Crisis Services -- BUT the POLICY FAILURE of an INADEQUATE CONTINUUM OF CARE --- especially at the HIGH (INTENSIVE) END--- means states like Colorado have a lot of CRISES] Incentivize coverage for Individual Placement and Support programs
[This is SO IMPORTANT! A lot of "mental illness" and "developmental disability" and brain injury and substance issues do involve SOCIAL BEHAVIOR -- and they can involve a lot of other things such as executive functioning issues.. Our MERITOCRACY and UNCONSCIOUS BIAS are in many ways a RATIONING OF STATUS & GOODS. Super Sensitive People are gonna pick up on that --- and they may be viewed as ANTI-SOCIAL for not going along with the STATUS QUO. The Status Quo is suspect. [This isn't an apology for anti-social behavior, but we are SOCIAL ANIMALS -- and if we're having a lot of social conflict -- we need to look at some of our underlying assumptions] Health Information Technology for Economic and Clinical Health Act (2009)
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Health Equity and Accountability Act of 2020 (H.R. 6637)
What is the BIG SOCIAL DETERMINANT OF HEALTH?
HOUSING We've got to figure out how to fund DISABILITY HOUSING & AFFORDABLE HOUSING.
An Aside on Health Equity, Social Justice Attention & What Are We Really Fighting About We are Big Supporters of Black Lives Matter and we understand why it had to be BLACK LIVES MATTER. BUT a lot of the conflict between some Whites and everybody else is a lot less about SUBSTANCE and a lot more about ATTENTION. ATTENTION especially in 2021 is every bit as much a CURRENCY as the dollar, the pound or the franc. In a lot of ways, the TECHNOLOGY is just a super add-on to the hardwired biology. The reality is --- We're not really that different. Decisions in this society are often NOT MADE RANDOMLY (people can pick up on a pattern) -- but they are made on ARBITRARY & CAPRICIOUS bases that may or may not be overlaid with some type of "RATIONAL BASIS." Further, people want to be on the RIGHT SIDE or the LEFT SIDE of those arbitrary and capricious decisions --- because the mechanisms that are supposed to protect them --- don't really work very well. Medicaid Disaster Relief for the COVID-19 National Emergency State Plan Amendment
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Affordable Care Act
- State-level Medicaid accountable care organizations
- Require health-related social needs screening as part of quality performance measure for social determinants of health interventions, such as housing programs
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National Health Service Corps loan repayment program
[We're NOT a big fan of this but we think we understand where it is coming from. Doctors make a lot of money compared to most people and mental health professionals want to make that doctor money and largely don't -- although they still make more than most people. Further, there is a SHORTAGE of BEHAVIORAL HEALTH PROFESSIONALS -- because many of them could make more money doing something else and generally under better working conditions. World Health Organization --Quality of Life instrument
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WE NEED TO INTEGRATE BEHAVIORAL HEALTH WITH THE REST OF MEDICINE.
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