Thursday, April 7, 2016

Final rule strengthens access to mental health and substance use disorder benefits for low-income Americans

CMS finalizes mental health and substance use disorder parity rule for Medicaid and CHIP

In conjunction with the President’s visit to the National Rx Drug Abuse and Heroin Summit, the Centers for Medicare & Medicaid Services (CMS) today finalized a rule to strengthen access to mental health and substance use services for people with Medicaid or Children’s Health Insurance Program (CHIP) coverage, aligning with protections already required of private health plans. The Mental Health Parity and Addiction Equity Act of 2008 generally requires that health insurance plans treat mental health and substance use disorder benefits on equal footing as medical and surgical benefits.

“The Affordable Care Act provided one of the largest expansions of mental health and substance use disorder coverage in a generation,” HHS Secretary Sylvia M. Burwell said. “Today’s rule eliminates a barrier to coverage for the millions of Americans who for too long faced a system that treated behavioral health as an unequal priority. It represents a critical step in our effort to ensure that everyone has access to the care they need.

“This rule will also increase access to evidence-based treatment to help more people get the help they need for their recovery and is critical in our comprehensive approach to addressing the serious opioid epidemic facing our nation.”

“The need to strengthen access to mental health and substance use disorder services is clear,” said Vikki Wachino, Deputy Administrator of CMS and Director of the Center for Medicaid and CHIP Services. “This final rule will help states strengthen care delivery and support low-income individuals in accessing the services and treatment they need to be healthy.”

The protections set forth in this final rule will benefit the over 23 million people enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP. Currently, states have flexibility to provide services through a managed care delivery mechanism using entities other than Medicaid managed care organizations, such as prepaid inpatient health plans or prepaid ambulatory health plans. The final rule maintains state flexibility in this area while guaranteeing that Medicaid enrollees are able to access these important mental health and substance use services in the same manner as medical benefits.

Under the final rule, plans must disclose information on mental health and substance use disorder benefits upon request, including the criteria for determinations of medical necessity. The final rule also requires the state to disclose the reason for any denial of reimbursement or payment for services with respect to mental health and substance use disorder benefits.

This is one of our latest efforts to increase access to and improve mental health services and care for low income individuals, especially in light of the opioid abuse epidemic, which constitute significant health risks and cost drivers in the Medicaid program. We introduced several initiatives to assist states with behavioral health system transformation to better meet the needs of beneficiaries with substance use disorders:
  • In 2014, CMS launched the Innovation Accelerator Program, a new strategic and technical support platform designed to improve delivery systems for beneficiaries that are high need and high cost. Our first effort in this area was to provide states with expert resources, coaching opportunities and individualized technical assistance to accelerate policy, program and payment reforms appropriate for a robust substance use disorder delivery system.
  • In July 2015, CMS issued guidance to states on a new section 1115 demonstration opportunity to develop a full continuum of care for beneficiaries with a substance use disorder, including coverage for short-term residential treatment services not otherwise covered by Medicaid.
  • In response to the growing prescription opioid abuse epidemic, CMS recently released information on effective safeguards and options to help address over-prescribing of opioid pain medications.
  • CMS disseminated important information regarding screening and early intervention services for children and youth who have or may have a mental illness or substance use disorder, including best practice information for the delivery of medication-assisted treatment as well as services and supports that can address first psychiatric episodes to reduce the likelihood of ongoing hospitalizations, involvement with police and courts, and increase the chances of keeping families intact. 

The final rule is currently on display at and will be published in the Federal Register on March 30, 2016.

For more information, go to

Wednesday, February 17, 2016

HB 18 Narrowly passes the Committee, heads to the House floor

A message from our Executive Director 

HB 18 Medicaid Preferred Drug List Amendments (PDL) Update: 

On 02/17/2016, Rep. Ward offered a substitute bill which would remove long acting injectables from consideration on the PDL, meaning, there will be open access to those meds while the rest of the mental health meds will be subject to the PDL and Prior-Authorization process.

The bill passed out of Health and Human Services Committee by a hair. Votes were 5 and 5 until Rep. Chavez-Houck ran into committee to tip the scales. Votes ended in favor 6 to 5 with 1 absent.

I assure you, this is not over. There is a long way for this bill to travel. It now goes to the House Floor. I encourage you all to email and call your representative, encouraging them to VOTE NO on HB18. Should the bill make it's way out of the house, it will go to the Senate Health and Human Services Committee before it can move to the Senate Floor.

Thank you all for following this bill and for talking to your representatives! It is so important that you stay involved and continue to education our legislators. Find out your legislator here 

You who are living with a mental illness, you are my heroes! You who are fighting for your loved one's wellness, you too are my heroes! We are not weak, we are not victims, we are strong, we are fighters, we fight everyday for our well being and will fight anyone or anything standing in our way.

Jamie Justice 

Tuesday, February 9, 2016

HB 18 was held in Committee

House Bill 18 was held in Committee

The House Health and Human Services Committee  listened to people who came to speak in favor of the bill. We are grateful to our Executive Director, Jamie Justice, who is advocating diligently on behalf of NAMI’s community and making sure our voices are being heard. After much deliberation, the Committee decided to hold the bill in the committee until the Commission on Criminal and Juvenile Justice Committee (CCJJ) takes a position on the bill. CCJJ has major concerns about the bill given that there is evidence in other states where this kind of legislation negatively impacts those with serious mental illness and drives up incarceration rates. Results that work directly against CCJJ’s efforts to redirect those who are nonviolent offenders with mental illness away from jails and prison and into treatment.

We also want to thank those who took time off work and away from their families to testify against the bill! There is so much power in telling your stories and educating our law makers about what it’s really like for individuals and families, not what those in power believe are happening.‪#‎mentalhealthUT‬

Defeating this bill will not happen without all of your continued support, efforts, emails, phone calls, and presence! The Health and Human Services Committee will likely hear this bill again this week.
It is not over yet, but yesterday’s outcome was a success! 

We will keep you post it.
You can access the committees’ audio link for today at this link

Monday, February 8, 2016

NAMI Utah Call to Social Media Action - 02.08.2016

NAMI Utah Call to Social Media Action - 02.08.2016

Fiscal Note       2016-2017 FY Utah Budget   NAMI Utah Position on PDL   Open Access

House Bill 18, sponsored by Representative Raymond Ward, would remove the Medicaid Preferred Drug List (PDL) exemption for psychotropic drug classes, placing the most vulnerable among us at risk for possible negative repercussions, including the state’s homeless population.

H.B. 18 Medicaid Preferred Drug List will be heard in the House Health and Human Services Committee today, Monday, Feb. 8, between 3:40 and 6:00 p.m.

To help shine a light on this bill, we encourage you to share the following suggested posts and hashtags in advance of today’s meeting.


#BlockUTHB18 #utleg #mentalhealthmatters #utpol #mentalhealthUT

Suggested Tweets/Instagram Copy

I trust my #UTdoctor, not #UTLeg, to make the best medical decisions for #mentalhealthUT. #BlockUTHB18 #mentalhealthmatters #UTpol 

Don’t limit my ability as a #UTdoctor to prescribe the most effective drugs to my patients. ‪#‎mentalhealthmatters ‪#‎utpol ‪#‎mentalhealthUT ‪#‎BlockUTHB18 #UTLeg

Facebook Posts

H.B. 18 Medicaid Preferred Drug List will be heard in the House Health and Human Services Committee today, Monday, Feb. 8, between 3:40 and 6:00 p.m. Let’s fill the room. ‪#‎mentalhealthmatters ‪#‎utpol ‪#‎mentalhealthUT ‪#‎BlockUTHB18 #UTLeg #mentalhealthmatters

HB18 seeks to restrict access to what a team of fewer than 25 committee members determines to be "too expensive." ‪#‎utleg please listen to the experts on this one.

‪#‎utpol ‪#‎mentalhealthUT ‪#‎BlockUTHB18 #UTLeg #mentalhealthmatters

So many bills fly unnoticed through the Utah Legislature during its warp-speed 45-day session. H.B. 18 has been defeated multiple times, yet still comes up each session. Reach out to your legislator and let them know you do not support trying to save a few dollars on the backs of Utah's most fragile population. They'll only listen if we speak up! ‪#‎utpol ‪#‎mentalhealthUT ‪#‎BlockUTHB18 #UTLeg #mentalhealthmatters

Tuesday, October 27, 2015

Bipolar & Severe Irritability Research Studies

NIH Bipolar & Severe Irritability Research Studies: Enrolling Participants Nationwide

Do You Have A Child with Bipolar Disorder or Severe Irritability?

At the NIH Clinical Center in Bethesda, Maryland, several research studies are being conducted into the causes of bipolar disorder and severe mood dysregulation (SMD). These studies seek children and adolescent participants who have bipolar disorder or severe irritability.

All evaluations, research procedures, inpatient (day or full hospitalization) and outpatient visits are free of cost. Both parent and child must agree to the child’s participation. Schooling is provided during inpatient care. Children and parents are compensated for participation. Travel and lodging expenses are paid by NIMH.

Bipolar Disorder

Those eligible to participate must be ages 6-17, have bipolar disorder and be able to perform research tasks including neuroimaging, computer tasks, and neuropsychological tasks.

This is an outpatient descriptive study using brain imaging and clinical assessment. Study participation begins with an initial outpatient evaluation that lasts one day. Subsequently, testing and brain imaging occur at visits which last two-three days, occur every year, and continue until age 25. Phone contact occurs every six months in between visits.

Severe Irritability

Those eligible to participate must be: ages 7-17; displaying symptoms of chronic anger, sadness, or irritability, as well as hyperarousal (such as insomnia, distractibility, hyperactivity) and extreme responses to frustration (such as frequent, severe temper tantrums); able to perform research tasks that include neuroimaging, computer tasks and neuropsychological testing. Participants must currently be in treatment with a physician, medically healthy, and not currently hospitalized, psychotic, or suicidal.

Non-Treatment Study

This is an outpatient descriptive study using brain imaging and clinical assessment. Study participation begins with an initial outpatient evaluation that lasts one day. Subsequently, testing and brain imaging occur at visits which last two-three days, occur every two years, and continue until age 25. Phone contact occurs every six months in between visits.

Treatment Study

If unstable on current medications participant receives day or full hospitalization to discontinue medication and participate in a 12- to 15-week study of the efficacy of methylphenidate plus citalopram, vs methylphenidate plus placebo, for decreasing irritability in children with severe mood and behavioral problems. (If clinically appropriate, participants who received methylphenidate plus placebo will be offered the opportunity to receive methylphenidate plus citalopram at the end of the study.)

To find out about study criteria and qualifications, or for more information, please call (301 496-8381) or email us at

Friday, August 7, 2015

Why Should I participate in a Clinical Trial?

NIMH, part of the National Institutes of Health (NIH), supports research studies on mental health and disorders. Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease.

Choosing to take part in clinical research is an important personal decision. Your decision to participate will depend on your interests, needs, and expectations about research. For basic information about clinical research and to help you make a decision about whether to participate, please visit “NIH Clinical Research Trials and You” at . This website will help you learn more about clinical trials, why they matter, and how to participate.

Finding a Clinical Trial

Around the Nation and Worldwide

NIH conducts clinical research trials for many diseases and conditions, including cancerAlzheimer’s diseaseallergy and infectious diseases, and neurological disorders. To search for other diseases and conditions, you can visit [ Tips for finding trials on ]
This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world. gives you information about a trial's purpose, who may participate, locations, and phone numbers for more details. This information should be used in conjunction with advice from health care professionals.

At the NIH Clinical Center in Bethesda, Maryland

Search NIH Clinical Research Studies
The NIH maintains an online database of clinical research studies taking place at its Clinical Center, which is located on the NIH campus in Bethesda, Maryland. Studies are conducted by most of the institutes and centers across the NIH. The Clinical Center hosts a wide range of studies from rare diseases to chronic health conditions, as well as studies for healthy volunteers. Visitors can search by diagnosis, sign, symptom or other key words.

Join a National Registry of Research Volunteers

ResearchMatch External Web Site Policy
This is an NIH-funded initiative to connect 1) people who are trying to find research studies, and 2) researchers seeking people to participate in their studies. It is a free, secure registry to make it easier for the public to volunteer and to become involved in clinical research studies that contribute to improved health in the future.

Thursday, May 21, 2015

People Not Prisons: Utahns Need to Speak UpFor Our Neighbors Behind Bars

NAMI Utah hosted a press conference today to address the rhetoric surrounding prison relocation. NAMI Utah is part of People Not Prisons, a loose coalition of advocacy groups working on behalf of people with a mental health condition, people recovering from substance use disorders, and individuals trapped in Utah’s criminal justice system.

People Not Prisons (PNP) is concerned with ongoing rhetoric about correctional facilities and the people within them. We believe that the public and its elected officials should be focused on improving conditions, programs and policies that impact the human beings in our criminal justice system – rather than arguing about the location of the new prison.
 “About 95% of the people who are currently in Utah state prison beds will be released back into their communities.” Says ACLU of Utah Public Policy Advocate Anna Brower. “For our own safety, we need correctional facilities that work”.

The People Not Prisons Coalition includes:
Utah Support Advocates for Recovery Awareness (USARA)
Utah Association of Addiction Treatment Providers (UAATP)
Odyssey House
First Step House
Disability Law Center
Utah Prison Support
New Roads Behavioral Health
Utah Prisoner Advocate Network (UPAN)
The Catholic Diocese of Salt Lake City
Utah Association of Addiction Treatment Providers (UAATP)

Friday, April 10, 2015

No Care for Us


Non-Medicaid Expansion States Block Uninsured People with Serious Mental Illness from Receiving Affordable, Needed Treatments
Prepared by Joel E. Miller, James K. Finley, Rebecca Gibson and Whitney Meyerhoeffer

A new groundbreaking study from the American Mental Health Counselors Association (AMHCA) shows that nearly 570,000 people diagnosed with a serious mental health condition, would have received affordable, needed treatments, but were denied access to services because several states refused to participate in the new Medicaid Expansion Program. The federal government would have paid 100 percent of the treatment costs; the monies were already included in the federal budget. The comprehensive study also highlights that 458,000 fewer people would have avoided a depressive disorder mainly by securing health insurance through the Medicaid Expansion Program.

The study, entitled “Access Denied: Non-Medicaid Expansion States Blocked Uninsured People with Serious Mental Illness from Receiving Affordable, Needed Treatments” shows that on a state-by-state basis, thousands of uninsured people who had been diagnosed with a serious mental health condition on January 1, 2014, and residing in the 24 states that did not expand Medicaid under the Affordable Care Act, were denied affordable, needed care throughout the year.

Utah has 15,312 uninsured people ages 18-64 with a serious mental health disorder who were projected to access services under Medicaid expansion. 

Thursday, March 19, 2015

2015 Utah Legislative Review

2015 Utah Legislative Review

Healthy Utah/Medicaid expansion
As you are aware by now, Healthy Utah (Utah’s version of Medicaid expansion) passed the Senate but it failed in the House. On the last day of the legislative session, a special committee was created, made up of Governor Herbert, Lt. Governor Cox, Senate President Niederhauser, Speaker Hughes, Senator Shiozawa, and Representative Dunnigan. They studied the Medicaid expansion plan over the coming months and will have an agreed upon solution by July 31st with a special session to happen shortly after. So stay tuned!

Criminal Justice Reform
The Criminal Justice Reform legislation was an outcome of the policy recommendations of the Utah Commission on Criminal and Juvenile Justice (CCJJ). House Bill 348 is a massive piece of legislation with positive implications for the reform of the criminal justice system. There are a number of improvements regarding the treatment of inmates that have a mental illness and alternatives to incarceration for non-violent offenders with a mental health condition and/or substance use disorders. The bill also requires the Department of Corrections and the Division of Substance Abuse and Mental Health to track performance and outcomes, establish standards for mental health and substance abuse treatment, and analyze specified programs, among other administrative requirements. Almost $12 million was allocated to help HB348’s policy changes. But the most important change that still needs to happen is to expand Medicaid in Utah for proper mental health and substance use disorder treatment.

Suicide Prevention Legislation
House Bill 209 mandates that certain behavioral health professionals must complete a minimum of two hours of suicide prevention training in order to obtain or renew a license. This does not apply to all behavioral health professionals or physicians.
House Bill 364 provides additional funding for suicide prevention and anti-bullying programs to the Utah State Board of Education and to the Division of Substance Abuse and Mental Health.

School Safety & Crisis Line
Senate Bill 175 will improve behavioral health services in our state. This bill provides funding for a statewide crisis text line service focused at youth who face bullying, abuse, and/or suicidal thoughts. Also, it will handle tips concerning threats of violence or criminal activities related to schools.

We recommend reading the Disability Law Center legislative wrap-up and ACLU Utah’s blog entries on Criminal Justice Reform.

Friday, January 23, 2015

Crazy: A Father’s Search Through America’s Mental Health Madness

Several years ago when I was dealing with two children who had mental health issues and doing a lot of “Why me?” “Why us?” and “Why THEM?” thinking, I heard of an organization called NAMI. It sounded intriguing, so I did a little investigating and heard about a conference they were having that focused on providing families and individuals with information on how to successfully handle the myriad of challenges that arise whenever you’re dealing with mental illness.
I signed up immediately.

The conference began with various speakers, which I figured I’d try to stay awake through until we got to the really interesting stuff, which was the WORKSHOPS. Then the keynote speaker started talking, and I was spellbound. Seriously. There was definitely some magic dust floating around.

The speaker’s name was Pete Earley, and even though I was impressed by the fact that he was an important journalist and had been nominated for a Pulitzer Prize for his book, Crazy: A Father’s Search Through America’s Mental Health Madness, I was more impressed that he was a parent just like me – a parent who had experienced his own frustration, confusion, sadness, anger, and yes, hopefulness – when it came to trying to find help for his child. Pete Earley’s reputation, resources and contacts may have been different than mine, but the obstacles we faced were the same.
I had the pleasure of being able to speak briefly with Mr. Earley after his presentation. He was off to catch a plane to who knows where (someplace exotic, I’m sure), but for that short period of time we were just two parents who understood each other, and who wished the world were just a little bit different for our children.

I encourage you to come experience the magic for yourself. An Evening with Pete Earley  

Wendy Fayles
Family Mentor