KEEP TALKING ABOUT MENTAL HEALTH
EVEN AFTER MAY
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Just because May is over does not mean that the conversation around mental health should be over too. 1 in 5 people will experience a mental health condition in their lifetime, but everyone has mental health. Continuing the conversation will help to normalize mental healthcare and end the stigma.
If you missed our kickoff event or any of our workshops offered throughout May, you can still view them on our YouTube Channel. Learn more about the Intersection of Race, Culture and Mental Health or listen to Patrick Tigue, RI's Health Insurance Commissioner, discuss taking action to end mental health discrimination in health insurance.
Thank you again to all our May is Mental Health Month Sponsors!
Rhode Island College, Butler Hospital, Behavioral Information Systems, Navigant Credit Union, BankRI, Pawtucket Credit Union, Honorable J. Clement Cicilline, Century 21 Topsail, Community Care Alliance, SUMHLC, Newport Mental Health, Thrive Behavioral Health, Lifespan, CODAC Behavioral Healthcare, The Wilson Organization, Horizon Healthcare Partners, HousingWorks RI at RWU, Robert Siminski, Ed.D.
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ACTION ALERT #1
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REIMBURSEMENT RATES
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BE PART OF THE EFFORT TO IMPROVE ACCESS
TO MENTAL HEALTHCARE IN RI
Have you ever had trouble finding a mental health provider in your insurance network?
Do you pay out-of-pocket costs for mental healthcare?
Do you have trouble affording mental healthcare at all?
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ACTION ALERT #2
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STAND UP FOR PEOPLE
WITH DISABILITIES
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We need your help! Please submit a letter to the Governor's Office or call him at (401) 222-2080 to ask for an Olmstead Plan for Rhode Islanders with disabilities. Ask Governor McKee to use some of the federal American Rescue Plan Act funding to establish an Olmstead Plan and Olmstead Implementation Office. Constituents’ voices are powerful. Share your story. Even if you are not living with a disability, stand up for those who are. And you don’t have to be an expert on Olmstead Plans to ask for one.
Olmstead refers to the U.S. Supreme Court's 1999 landmark ruling in Olmstead v. L.C., which found that segregation of people with disabilities is discrimination under the Americans with Disabilities Act (ADA). Plaintiffs Lois Curtis and Elaine Wilson, both living with developmental disabilities, were forcibly institutionalized after their treatment for mental illness because their state lacked a community-based program as an alternative to institutionalization. The court ruled that states have a legal obligation to ensure that individuals with disabilities have the opportunity to live, work, and receive services in the community in the least restrictive setting permitted by their disabilities.
Rhode Islanders with serious persistent mental illness; intellectual, developmental and physical disabilities; and older adults and youth at risk of institutionalization need your help. They are counting on us to speak up for them. Rhode Island is one of seven states in the country that does not have any such plan. Now is the time to finally right this wrong.
An Olmstead Plan would include a statewide assessment of the supply and demand of supportive housing options, community services, and treatment for people with disabilities. It would establish a comprehensive, renewable plan to coordinate all these resources. And it would place permanent, reliable funding streams in place to support them.
An Olmstead Plan would cover:
- Supervised/supportive housing options
- Affordable housing for people who live independently with SSI/SSDI benefits & housing vouchers
- Home modification
- Educational and employment supports
- Transportation
- Assistive technology & durable medical equipment
- Full continuum of behavioral health treatment options
- Community and home-based services
- Workforce development
- Criminal justice reforms to divert people with disabilities from arrest/incarceration
- Policy, legislative and regulatory solutions
Without the appropriate resources, people with disabilities are left to fend for themselves. Many unnecessarily languish in nursing homes, hospitals, prison and homeless shelters. We are better than this, aren’t we?
Please, take two minutes to call Governor McKee’s Office to politely ask for an Olmstead Plan. Rhode Islanders with disabilities deserve our care, concern and protection.
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LEGISLATIVE UPDATES
We are counting on voters’ voices to move important legislation across the finish line. We can't do this without YOU! Please, contact your legislators on the following bills.
Telemedicine (Senate Bill 004 Sub A and House Bill 6032) - Makes expanded access to telemedicine permanent in Rhode Island, ensuring that reimbursements to behavioral health providers are paid equitably across in-person, video conferencing, and telephone appointments. The bill passed the Senate Floor and was heard in the House Finance Committee. MHARI submitted testimony supporting the bill. Senate Bill 004 Sub A passed the Senate. Now, both bills are stuck in the House Finance Committee.
Mental Health Treatment Court Senate Bill 678 and House Bill 6025 create within the district court a dedicated calendar offering treatment and sentencing alternatives to eligible defendants deemed to suffer from serious and persistent mental illness. This will help hundreds of Rhode Islanders with serious and persistent mental illness avoid incarceration. Senate Bill 678 is stuck in the Senate Judiciary Committee and House Bill 6025 is stuck in House Finance Committee.
Budget Article 16 - Housing - MHARI submitted testimony to the House Finance Committee in support of funding affordable housing in Rhode Island. Housing is recovery. Housing is food security, education, and employment. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) considers the four pillars of recovery to be: health, home, purpose and community. Safe, stable housing is the foundation of all the good things in our lives. Tell your legislators that Rhode Island must invest in affordable housing for all Rhode Islanders.
Behavioral Health Provider Reimbursement Rates
Three bills require insurance companies and Medicaid to increase the reimbursement rates paid to behavioral health providers. Rhode Island has a shortage of outpatient providers, especially psychiatrists, because of low reimbursement rates. If passed, these bills would incentivize providers to participate in insurance networks, so that patients won’t have to go on long wait lists to see a provider. Senate Bill 591 Sub A passed the Senate. Now it and House Bill 5546 are stuck in the House Committee on Health and Human Services. House Bill 6268 is stuck in the House Finance Committee.
Health Insurance Reform - Several bills seek to codify into state law the consumer protections guaranteed by the Affordable Care Act (ACA). If the United States Supreme Court overturns the ACA, Rhode Islanders will lose many of the protections we have come to rely on, unless we make them part of our State’s laws. Senate Bill 003 Sub A and House Bill 5763 prohibit insurers from charging higher premiums based on sex. Both bills are expected to pass the Senate Floor. Senate Bill 005 Sub A and House Bill 5441 prevent insurers from discriminating against pre-existing conditions and require coverage for essential health benefits like behavioral health services, preventative and wellness services, and more. Bill 005 Sub A passed the Senate, but 5441 is stuck in the House Health and Human Services Committee. House Bill 5651 prohibits insurers from placing annual and lifetime limits on coverage. It too is stuck in the House Committee on Health and Human Services.
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FROM THE DESK OF OUR PARITY PROGRAM MANAGER
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KAREN MALCOM
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Many people just accept ‘NO’’ for an answer when their mental health insurance claim is denied. But, the appeals process is one way to hold insurers accountable and to exercise our rights under mental health parity laws. More than 50% of health insurance appeals are successful. Just because this process can be long and complicated does NOT mean it should not be done.
It helps if you keep all of your health plan’s coverage information and correspondence in a notebook to help ease the process and organize your appeals materials. Appeals are often not won at the first level. Success is more likely with ongoing and persistent appeals.
KEEP IN MIND…You may have to file your appeal within a specified time period; it is vital that you do so.
Depending on your specific insurance plan, there are typically three levels of insurance appeals. The process requires you to complete each level, before initiating the next and can be resolved at any one of the levels.
If your claim is denied due to a particular service being billed or coded incorrectly, your mental health professional may be able to gather and submit the necessary information on your behalf to resolve the issue without the necessity of a formal appeal.
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NEED HELP FILING AN APPEAL?
Call Rhode Island’s Health Insurance Consumer Hotline at 401-270-0101.
Below is a brief overview of the three levels of the appeals process. It’s best to call RI’s free health insurance consumer helpline at 401-270-0101, but you can also learn more by clicking here.
First Level Appeal or Request for Reconsideration
The goal of the first appeal is to prove that your claim or request for pre-authorization DOES meet the insurance guidelines and that it was incorrectly rejected. You or your mental health professional may contact your insurance company IN WRITING to request reconsideration.
Second Level Appeal
The goal of this appeal is to prove that the request should be accepted within your health plan’s coverage guidelines. Second level appeals are typically reviewed by a medical director of your insurance plan who was not involved in the claim decision.
Independent External Review
External reviews are conducted by an independent, third-party reviewer in collaboration with a professional who is board-certified in the same specialty as the patient’s provider.
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COMMUNITY NEWS & RESOURCES
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PARENT SUPPORT NETWORK OFFERS MENTAL HEALTH PEER SUPPORT GROUP
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Youth Speaking Out is a group of peers with lived Mental Health and Substance Use disorders who meet weekly to provide each other support. They provide a safe space to empower youth to interact with peers, receive support, and develop leadership.
Dinner is provided, game nights, ice cream socials, music sessions, and more. Leadership development and opportunities are available. The group meets on Thursday InPerson/Hybrid at 3:00 p.m. Ages 15-19 welcomed.
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FREE WELLNESS E-BOOK
FOR
MHARI SUPPORTERS!
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Anyone for Tennis? Join us as we once again partner with USTA RI on September 11, 2021 for our 2nd Annual Fall Tennis Tournament. Rain date will be September 18, 2021.
All are welcome to play in this doubles style round robin tournament. Details to come. Stay tuned!
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MENTAL HEALTH ADVOCACY NEEDS YOUR SUPPORT
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Even though May is over, supporting mental health shouldn't end. A gift to the Mental Health Association of Rhode Island will allow us to continue to advocate, educate and aid in policy development to increase awareness about mental health issues and remove obstacles to treatment.
Together, we will make mental healthcare a reality for all Rhode Islanders.
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