Medicaid Spending to School Districts

Medicaid’s little-known benefits for millions of US students, By Anna Gorman and Carmen Heredia Rodriguez, March 6, 2018, CNN: “Gerardo Alejandrez used to punch classmates, throw chairs and curse at his teachers, conduct that forced him to switch from school to school. ‘I had a lot of anger issues,’ the 16-year-old said recently. Then Gerardo entered a class at Oakland Technical High School for students who have mental health or behavior issues. In that classroom, the teacher gets support from Erich Roberts, a psychiatric social worker assigned to the group. Oakland Unified School District bills Medicaid, the nation’s insurance program for low-income residents, for Roberts’ services…”

Rural Mental Health Center – Iowa

Rural mental health center draws plenty of praise, but it’s faltering for lack of money, By Tony Leys, September 8, 2017, Des Moines Register: “An innovative program that provides mental-health help in a rural area desperate for such services is on the cusp of closure, partly because state officials haven’t arranged a way for it to bill Medicaid. Numerous southern Iowans who’ve used the Oak Place center are stepping forward to explain why they want it to stay open, pushing aside fears about being identified publicly as people who were hamstrung by depression or anxiety — and who sought help…”

Community Paramedic Program

These house calls save money for EMS, social services, By Robert Mittendorf, September 4, 2017, Bellingham Herald: “Bellingham Fire Capt. Jeff Brubaker carries a pager like any other firefighter, and he still uses his paramedic skills to help people. But these days he’s not riding a fire engine or an ambulance and most of his patients haven’t called 911. Not as much as they used to, at least. Brubaker is Bellingham Fire Department’s community paramedic, a relatively new position that puts him in touch with people who are frequent 911 callers but who don’t need emergency care…”

Medicaid Programs

  • Montana faces double quandary over Medicaid expansion, By Bobby Caina Calvan (AP), July 17, 2017, Washington Post: “For all the uncertainty over the fate of a health care overhaul in Washington, tens of thousands of Montana’s working poor are already in a double quandary: Even if Congress leaves Medicaid expansion mostly intact, the future of the state’s program remains uncertain…”
  • Holcomb asks feds to allow Medicaid work requirements, Associated Press, July 21, 2017, Indianapolis Star: “Gov. Eric Holcomb has submitted a finalized proposal allowing for changes to the state’s Healthy Indiana Plan 2.0 serving low-income Hoosiers…”
  • Study suggests why more skin in the game won’t fix Medicaid, By Don Sapatkin, July 19, 2017, Philadelphia Inquirer: “As patients and partisans of all stripes take a deep breath after the latest Republican effort to dismantle Obamacare, they might consider how trying to save health-care dollars can have unintended consequences. In the Netherlands,  the government sought to give people more ‘skin in the game’ in its national health system. The idea —  long supported by U.S. conservatives, even for poor people on Medicaid — is that when patients have to shell out some cash for their care, they won’t seek unnecessary services…”

Poverty and Child Development

The toll poverty takes on children’s mental health, By Mary Elizabeth Dallas, January 10, 2017, CBS News: “Growing up in poverty exposes children to greater levels of stress, which can lead to psychological problems later in life, a new study suggests.  Researchers at Cornell University reported that kids who grow up poor are more likely to have reduced short-term spatial memory. The study also reported that such kids seem to be more prone to antisocial and aggressive behavior, such as bullying.  Poor children are also more likely than kids from middle-income homes to feel powerless, the study authors suggested…”

Foster Children and Psychotropic Drug Prescriptions – California

California foster care: New laws signed to restrict psychiatric drugs, By Karen de Sá, October 7, 2015, San Jose Mercury News: “Creating sweeping new protections for tens of thousands of California’s most traumatized children, Gov. Jerry Brown on Tuesday signed the nation’s most comprehensive set of laws to curb the overprescribing of psychiatric drugs in foster care.  For the first time, the state will train caregivers and court officials on the hazards of psychotropic drugs, scour medicated children’s health records for alarming prescriptions and step up scrutiny of residential facilities that rely too heavily on the medications to control kids’ behavior…”

Lead Poisoning Settlements

How companies make millions off lead-poisoned, poor blacks, By Terrence McCoy, August 25, 2015, Washington Post: “The letter arrived in April, a mishmash of strange numbers and words. This at first did not alarm Rose. Most letters are that way for her — frustrating puzzles she can’t solve. Rose, who can scarcely read or write, calls herself a ‘lead kid.’ Her childhood home, where lead paint chips blanketed her bedsheets like snowflakes, ‘affected me really bad,’ she says. ‘In everything I do.’  She says she can’t work a professional job. She can’t live alone. And, she says, she surely couldn’t understand this letter. So on that April day, the 20-year-old says, she asked her mom to give it a look. Her mother glanced at the words, then back at her daughter. ‘What does this mean all of your payments were sold to a third party?’ her mother recalls saying…”

Ex-Offenders and Health Care

Linking released inmates to health care, By Michael Ollove, June 11, 2015, Stateline: “Joe Calderon faced uncomfortably high odds of dying after his release from a California prison in 2010. According to one study, his chances of dying within two weeks — especially from a drug overdose, heart disease, homicide or suicide — were nearly 13 times greater than for a person who had never been incarcerated.  Despite suffering from hypertension during his 17 years and three days of incarceration, Calderon was lucky. He stumbled onto a city of San Francisco program that paid for health services for ex-offenders, and he was directed to Transitions Clinic, which provides comprehensive primary care for former prisoners with chronic illnesses. The clinic saw to all his health needs in the months after his release.  An increasing number of states are striving to connect released prisoners like Calderon to health care programs on the outside…”

Foster Children and Antipsychotic Drug Prescriptions – California

Use of meds by L.A. County foster, delinquent kids prompts reform, By Garrett Therolf, April 7, 2015, Los Angeles Times: “Los Angeles County officials are preparing to crack down on doctors who inappropriately prescribe powerful psychiatric drugs to foster youth and children in the juvenile delinquency system, according to a copy of the plans obtained by The Times.  Social workers and child welfare advocates have long alleged that the widespread use of the drugs is fueled in part by some caretakers’ desire to make the children in their care more docile. On May 1, the county Department of Mental Health is scheduled to launch a program to use computer programs to identify doctors who have a pattern of overprescribing the medications or prescribing unsafe combinations of the drugs…”

Medicaid Expansion and Mental Health Treatment

Medicaid expansion would have helped 18,400 mentally ill Louisianians in 2014, study says, By Rebecca Catalanello, New Orleans Times-Picayune: “More than 18,400 uninsured Louisianians diagnosed with mental health conditions were denied access to affordable mental health treatment last year — care that would have been available to them if the state’s leaders expanded Medicaid as allowed by federal law, a new study shows. The American Mental Health Counselors Association examined the impact of Medicaid expansion on the mentally ill in the United States and found that more than a half-million uninsured adults were diagnosed with a serious mental health at the beginning of 2014, but did not get treated because they lived in the 24 states that did not expand Medicaid as the Patient Protection and Affordable Care Act allows…”

Unemployment and Mental Health

For younger adults, unemployment may triple the risk of depression, By Karen Kaplan, March 19, 2015, Los Angeles Times: “Unemployment isn’t just bad for your bank account. It can also do serious damage to mental health – especially for younger adults who are just starting out in life, new research shows.  Nearly 12% of Americans between ages 18 and 25 were deemed to be depressed based on their answers to eight questions that were part of a survey conducted by the Centers for Disease Control and Prevention and state health departments. But within this age group, those who were unemployed were 3.17 times more likely to be depressed than their counterparts with jobs…”

Foster Children and Antipsychotic Drug Prescriptions – California

California toughens stance on use of mind-altering antipsychotic drugs for poor children, foster youth, By Karen de Sá, March 12, 2015, Los Angeles Daily News: “State regulators are rejecting thousands of requests from California physicians to prescribe antipsychotic drugs to poor children and foster youth, a dramatic first step in the state’s new effort to curb the excessive prescribing of powerful mind-altering medications.  Nearly 1 in every 5 requests for the medications were denied in January because they were medically unnecessary or unsubstantiated. That is triple the rate of denials that occurred in October, when the state first began requiring an extra level of oversight, suggesting the scrutiny is growing tougher over time…”

Foster Children and Psychotropic Drug Prescriptions – California

Drugging our kids: Children in California’s foster care system are prescribed risky medications, By Karen de Sá, August 23, 2014, San Jose Mercury News: “They are wrenched from abusive homes, uprooted again and again, often with their life’s belongings stuffed into a trash bag. Abandoned and alone, they are among California’s most powerless children. But instead of providing a stable home and caring family, the state’s foster care system gives them a pill. With alarming frequency, foster and health care providers are turning to a risky but convenient remedy to control the behavior of thousands of troubled kids: numbing them with psychiatric drugs that are untested on and often not approved for children. An investigation by this newspaper found that nearly 1 out of every 4 adolescents in California’s foster care system is receiving these drugs — 3 times the rate for all adolescents nationwide. Over the last decade, almost 15 percent of the state’s foster children of all ages were prescribed the medications, known as psychotropics, part of a national treatment trend that is only beginning to receive broad scrutiny…”

Foster Children and Psychotropic Drug Prescriptions – Wyoming

Too much, too young? One in three Wyoming foster care children prescribed psychotropic drugs, By Leah Todd, August 10, 2014, Casper Star-Tribune: “For Cameron O’Malley, weekends at his sister’s house meant tucking a pair of jeans, a few shirts and his toothbrush into his backpack. The 15-year-old’s foster mom would zip a weekend’s worth of pills the size of jelly beans into plastic baggies. Cameron and his sister Carissa, 22, knew the routine: Take daily with food. Carissa didn’t like the medications, prescribed for a list of conditions she was not convinced Cameron even had: Prozac for his hyperactive attention disorder. Fluoxetine for depression. Straterra for attention deficit hyperactivity disorder. Wellbutrin for depression. They made Cameron’s brain feel weird, like he was thinking in fog. But if the adoption was to go through, he and his sister had to follow the rules. Nearly one in three foster children in Wyoming is prescribed psychotropic medications like the ones Cameron took. That’s more than four times the rate found in other low-income children not living in foster care, where the frequency is one in 12…”

Foster Children and Psychotropic Drug Prescriptions – Colorado

Colorado responds slowly to psychotropic drug use among foster kids, By Jennifer Brown and Christopher N. Osher, April 13, 2014, Denver Post: “Diego Conde was 12 when his mother died, devastated and bursting with rage at the rotten way life was treating him. The only living thing left that mattered to him was his tiny dog, Littlefoot. Then, three months later, Littlefoot died. Diego was sent to live with strangers — a string of foster families in Denver and Aurora. He got in fights at school, started drinking alcohol and smoking marijuana, and exploded in anger at his teachers and temporary parents. At 13, he overdosed on borrowed prescriptions because he ‘couldn’t take it anymore.’ And so the state medicated him heavily, with twice-daily doses of potent mood-altering psychotropic drugs he says he did not want to take. Diego spent most of his teenage years numbed by a combination of Risperdal and Prozac to tame his rage and drown his grief. Now 18, he has aged out of the foster-care system and is speaking up for the thousands of foster children in Colorado who are medicated with psychotropics because of mental and behavioral problems…”

ACA and Health Insurance Coverage

  • Number of Americans without health insurance reaches new low, By Noam N. Levey, April 7, 2014, Los Angeles Times: “The share of Americans without health insurance has dropped to the lowest level since before President Obama took office, according to a new national survey that provides more evidence the healthcare law is extending coverage to millions of the previously uninsured. Just 14.7% of adults lacked coverage in the second half of March, down from 18% in the last quarter of 2013, the survey from Gallup found. The survey results, which track with other recent polling data and enrollment reports, indicate that about 8 million people have gained health insurance since September. That figure takes into account any losses in coverage the law may have brought about by the cancellation of health plans that did not meet the new standards…”
  • Nearly 4 million seriously mentally ill still without insurance, By Michael Ollove, April 8, 2014, Stateline: “Some might consider Kelly Troyer of South Carolina lucky. She isn’t one of them. Thanks to the generosity of her church and family members, she receives some treatment for the depression and post-traumatic stress disorder she suffers as a result of the sexual assault she endured in 2012. But Troyer, 45, said her lack of health insurance and other uncovered medical costs, including a hospitalization and all her medications, has forced her into personal bankruptcy. She lives in one of the 24 states that chose not to expand their Medicaid programs, offered under the Affordable Care Act. Those decisions have left about 3.7 million Americans with serious mental illness, psychological distress or a substance abuse disorder without health insurance, according to a recent report from the American Mental Health Counselors Association (AMHCA), a group that represents mental health professionals…”
  • More in Denver signed up for Medicaid than for private insurance, By Arthur Kane, April 10, 2014, Denver Post: “In Denver, 2½ times as many people enrolled in the taxpayer-funded Medicaid program from October through the first quarter of 2014 as those who signed up for private insurance through the state exchange, state figures show. And in Colorado and nationwide, Medicaid enrollments outpace private insurance registrants. Colorado ranked 11th in the nation of states with the highest percentage of Medicaid enrollments compared with private insurance subscribers through marketplaces as of the end of February, a Denver Post analysis of federal numbers shows…”
  • Medicaid enrollment rises 8 percent in Florida, By Kelli Kennedy (AP), April 11, 2014, Florida Today: “Florida’s Republican lawmakers remain staunchly opposed to expanding Medicaid — a system they’ve repeatedly said is too expensive and doesn’t improve health outcomes. Yet Florida’s Medicaid rolls are expanding under the Affordable Care Act. That’s because people trying to sign up for health insurance under President Barack Obama’s new health law are finding out — to their surprise — that they qualify for Medicaid, the federal health insurance program for the poor…”

Homelessness and Housing First

  • Housing is most cost-effective treatment for mental illness: study, By André Picard, April 8, 2014, The Globe and Mail: “For every $1 spent providing housing and support for a homeless person with severe mental illness, $2.17 in savings are reaped because they spend less time in hospital, in prison and in shelters. That is the most striking conclusion of a study, obtained by The Globe and Mail, that tested the so-called Housing First approach to providing social services. Beyond the cost savings, the new research shows that placing an emphasis on housing gets people off the streets and improves their physical and mental health…”
  • Study finds new approach to homelessness saves money, keeps people off street, Canadian Press, April 7, 2014, Times Colonist: “New conclusions by the Mental Health Commission of Canada suggest the ‘housing first’ approach to battling homelessness is showing real results. The report, details of which were obtained by The Canadian Press, shows more than 2,000 homeless Canadians diagnosed with mental illness have found stable housing in all regions of the country over a two-year period. The massive At Home-Chez Soi pilot project, created in 2008 following a $110-million investment from the federal government, has proven effective for people from diverse cultural backgrounds and circumstances. The study suggests it has also been cost-effective, with every $10 invested resulting in cost savings of almost $22…”

Poverty and Children’s Health

Evidence mounting that poverty causes lasting physical and mental health problems for children, By David Templeton, November 24, 2013, Pittsburgh Post-Gazette: “Sheila Good faced the decision most mothers dread. Should she spend more time raising her son or earning a paycheck? Should she be a better mom or a better provider? For her 6-year-old son, Benjamin, a little redhead dedicated to baseball, either choice would induce stress. It’s one of those puzzles of poverty with health impacts on children. Three recent studies add to mounting evidence that poverty can exact a lasting toll on a child’s mental and physical well-being, with stress representing a key pathway. Those studies focus on poverty’s impact on a child’s brain volume, the adverse impact of childhood poverty on adult health, and the mental and behavior problems associated with substandard housing…”

Mental Health Screening for Children

Screening children for mental health issues may not guarantee care, By Chelsea Conaboy, November 25, 2013, Boston Globe: “Six years after the state launched an unprecedented effort to address the mental and developmental needs of young children, doctors in Massachusetts are screening more children for behavioral health concerns than any other state. Nearly 7 in 10 Massachusetts children under age 6 in low-income families were screened in 2011 and 2012 — more than twice the rate in the United States as a whole, according to data released this month by the Massachusetts Budget and Policy Center as part of the national Kids Count report. Doctors in North Carolina, which had the second highest rate, screened just over half of this group of children…”

Homelessness and Housing

  • A new start for KC’s homeless as shelter eliminates daily lines for beds, By Lynn Horsley, November 13, 2013, Kansas City Star: “Every afternoon for 30 years, as many as 100 men and women have lined up behind reStart’s homeless shelter in downtown Kansas City, waiting for overnight stays in a grim dormitory. They got a free meal and bunk bed in a crowded room. They had to leave during the day, often to wander the streets and then return to line up again each afternoon. But by the end of this week reStart is declaring, ‘This is the end of the line.’ Literally. No more lining up. Instead, single adults will stay in rooms of four to six people that they can call home while reStart helps them find long-term housing. It’s part of a national trend to end chronic homelessness, and it’s showing early signs of success in Kansas City…”
  • Huge increase of mentally ill homeless in Alameda County, By Doug Oakley, November 14, 2013, Contra Costa Times: “The number of homeless people in Alameda County with severe mental illness jumped by 35 percent in just two years, according to a census taken earlier this year by a consortium of local agencies called EveryOne Home. The overall number of homeless people in the county was slightly higher since the last count two years ago, up 86 at 4,264, according to the report released Tuesday night. It did not break out individual cities within Alameda County. When the count was taken during the spring, 1,106 homeless identified themselves as having a severe mental illness, up from 818 in 2011, the report said…”