Mrs. Hoy and her husband adopted two brothers out of the foster care system promising to give them a forever home. Because one boy developed severe mental health needs, and the family ran out of insurance benefits and the boy was once again became a ward of the state. The results were exactly the same issues that other parents are facing today: If you can’t afford treatment, then do you give your child away in order that he might receive treatment? If you don’t trade your child for treatment, could his illness become so violent that someone will be hurt? If you choose to trade away your child in exchange for treatment, you will be charged for neglect and your name placed as a child abuser? Or, if you choose not to trade your child away, and bring him home, you risk being charged with child endangerment for failure to protect your other kids.

Medicaid mandated care under EPSDT, this is an entitlement for children, as is public education; however, many states design their own Medicaid laws to circumvent this opportunity for early intervention and healing for children. Isn’t it time for an honest look at how the system operates?

To learn more about Mrs. Hoy’s experiences with mental health insurance benefits and her book “Second Time Foster Child” listen to the May 15 Not Alone podcast by clicking on the play button below or downloading the file and listening later. To listen to any of the past Not Alone broadcasts, visit The Kim Foundation Not Alone podcast page.

 
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May 15, 2012 – Toni Hoy, Author

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Gayle continues to talk about the need for prevention and early intervention for children and adults; there is a need for help before a crisis occurs, so communities should be investing in more drop-in centers, crisis alternative residence, programs for consumers who are homeless, and Crisis Intervention Training (CIT) for Law Enforcement.

Gayle has also been an innovative leader in the use of creative arts as part of the healing and wellness experience. Gayle celebrates the fact that mental health care is changing, and that we are helping people find their strengths instead of focusing on their weakness. Gayle has been one of the leading advocates for peer support programs for more than30 years. She knows her subject well!

To learn more about mental health advocacy, listen to Gaye Bluebird on the May 8 Not Alone podcast by clicking on the play button below or downloading the file and listening later. You can listen to any past Not Alone broadcast by visiting The Kim Foundation Not Alone podcast page.

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May 8, 2012 – Gayle Bluebird, Nationally Recognized Advocate

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Timothy was made a ward of the state in order to receive treatment, but this again was inconsistent and insufficient treatments. Timothy was bullied by other children because of his psychological illness, he suffered additional trauma by being separated from his family, and his depression spiraled downward. At age 12,   Timothy took his own life.

The family’s loss was overwhelming; however, with the support and encouragement of other families who had suffered similar losses, and the grassroots support for insurance parity across the state of New York, Timothy’s parents took leadership in resolving the unequal coverage for mental and physical illnesses in employer health plans. On December 22, 2006, Governor George Pataki of New York state, signed legislation enacting Timothy’s Law, requiring equal coverage between mental and physical illnesses. This is a mandatory parity benefit for treatment of adults and children with biologically based mental illnesses, or children with serious emotional disturbances.

In Nebraska on the other hand, insurance providers can give no coverage for the diagnosis and treatment of biologically based mental illness as long as they provide notice of such non-coverage in the plan.

To learn more about Timothy’s Law, listen to the May 1 Not Alone podcast by clicking on the play button below or downloading the file to listen later. To listen to any of the past Not Alone broadcasts, visit The Kim Foundation Not Alone podcast page.

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May 1, 2012 – Timothyís Law

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

To recognize Brain Injury Awareness Day in March, the Brain Injury Association of Nebraska asked friends to make origami cranes. The goal of BIANE was to create 36,000 cranes, one for every Nebraskan with brain injury. Thanks to a wide variety of friends, including people in assisted living and prison facilities, students, family support groups, and people with injuries themselves, the goal of 36,000 was exceeded!

We learned that there are other conditions that can accompany brain injuries. Chronic pain is a disorder often seen, suicide risk can be greater because of the pain, and isolation, depression, and anxiety are also present at times. There are frequent cognitive challenges or motor and sensory effects as well.

To learn more about support groups for TBI or to locate resources and rehabilitative services, visit the Brain Injury Association of Nebraska web site at www.biane.org. Tell them Not Alone sent you!

To listen to the March 6 Not Alone program featuring representatives from the Brain Injury Association of Nebraska, click on the play button below or download the file and listen later. To listen to any of the past Not Alone broadcasts, visit the Kim Foundation Not Alone podcast page.

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March 6, 2012 – The Brain Injury Association of Nebraska

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Unfortunately, many Nebraska children still lack access to affordable mental health treatment. Some Nebraska children become Medicaid eligible when parents are unable to pay for necessary treatment; however, too often, these children, as wards of the state, are removed from the home and placed in foster care. Many times children could be better served at home, with parents who have been trained in how to cope with the chronic brain illnesses. (Under Nebraska Medicaid rules, parents of children with Cystic Fibrosis, or Diabetes for example, both chronic illnesses, do receive training in caring for their diagnosed child; parents of children with chronic behavioral or emotional illnesses are not eligible for such training). 

Another concern expressed was that even though early interventions have been proven effective, and have reduced the severity of the chronic mental illness when children reach adolescence or adulthood, Nebraska’s system does not usually believe children under age 5 will benefit from treatment.

We appreciate the leadership and advocacy brought by Voices for Children over the years; their questions concerning an honest evaluation of the issues, and identifying perspectives of what is best for Nebraska children and families in need of mental health services continue to impact the direction of our system of care.  They also focus our attention on how key players, including the legislature, the department of health and human services, the social service agencies, and Nebraska families might work together to create a successful plan for leading children with behavioral health needs toward recovery and resiliency.

To learn more about Voices for Children, listen to the February 28 Not Alone podcast by clicking on the play button below, or download the file and listen later. To listen to any of the past Not Alone broadcasts, visit The Kim Foundation podcast page.

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February 28, 2012 – Carolyn Rooker, Director of Voices for Children

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Eventually, he did find help, hope, and healing, and has made it his life’s mission to motivate others toward recovery and resiliency. Moe’s words during the Not Alone broadcast reflected his belief that we can create an environment of sanity, stability, safety, and sobriety for others, and that the peer movements, peer efforts, and peer support groups are making this change possible.

Moe Armstrong was especially adamant about Veterans helping others; he has played an influential role in initiating the Vet2VetUSA.org program and believes that peer support is the missing link to healing programs. He also feels strongly that people need to understand their own illness. Peer programs can help each one teach one, according to Moe Armstrong. This will change mental health care for the better.

Moe has such a positive attitude and a spirit that rises to the challenge; he invited each of us become an “action junkie” beside him, helping others find their path to recovery. To hear more from Moe, listen to the February 14 Not Alone broadcast by clicking on the play button below, or by downloading the file and listening later. To listen to past broadcasts of Not Alone, visit The Kim Foundation Not Alone podcast page.

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February 14, 2012 – Moe Armstrong, Former Navy Seal

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

“The idea of At Ease is to remove as many of the obstacles as possible that prevent active military, veterans, and their families from getting care for post-traumatic stress disorder and other behavioral health issues,” At Ease Founder Scott Anderson said. “It is estimated that only 30% to 35% of military entitled to VA benefits for PTSD ever pursue getting help. What we want to do is to make sure that the people who need care, get it, and particularly that they get care that it is well-documented and proven to be effective.”

The stigma of receiving care for mental health issues is often a barrier that prevents many military personnel from getting the care they need. In an effort to reduce this barrier, At Ease is 100 percent confidential. Because the program is comprised of therapists who volunteer their time, low costs allow At Ease to offer its services at cost effective rates or for free. No one is turned away due to their ability to pay. Another key feature of the program is that unlike other civilian organizations, everyone who works with At Ease has a military connection which allows them to better understand the needs of the client. 

“The military has a very distinct culture, its own language really, so to have a civilian try to understand that and still be able to move the therapeutic process forward can be very challenging,” At Ease Program Supervisor Paul Greenwell said. “Having a past military affiliation is just one more way we’re able to reach these folks and really make a connection quickly.”

As more and more troops return from deployments in Iraq and Afghanistan, the need for mental health services will continue to increase. Anderson cites that somewhere around 400,000 troops will return home with some form of post-traumatic stress disorder, traumatic brain injury, or both. Combined with the number of loved ones who suffer from “virtual or non-combative PTSD” the number of people seeking mental health care could easily reach a million people, according to Anderson.

“There are just too many people for any one resource to serve them all. We have great respect for the services that the VA offers. We apply a lot of the same research and use a lot of the same treatment modalities. We all have to work together because there’s going to be a tsunami of people needing care and we’ve got to serve them and we’ve got to serve them as quickly as possible,” Anderson said.  

In order to serve the flood of people needing services, At Ease is hopeful that funding will allow them to expand services across the state into more rural communities. In addition, the Grand Island office will be launching a teletherapy program where clients can go to any hospital and receive therapy by video conference. At Ease will also be implementing a Web-based, Skype-type of teletherapy where clients will be able to receive therapy from their own homes.   

“We’re hoping that by allowing people to receive therapy from the confidentially and anonymity of their own homes that we’re going to be able to reach a lot more people than through conventional therapy.  It will also help us reach into more remote, rural communities,” Anderson said.

Between the breadth of programs, the reach of services, and the commitment of the staff, At Ease is dedicated to making a difference for military families and removing the obstacles of receiving help for post-traumatic stress disorder.

“The people who are working in this program, chose to work for At Ease because they really care about the veterans. They have the expertise in mental health, they understand the issues, and they also have a passion for working with veterans and military families – that’s number one,” Greenwell said.  “We recognize where they’ve been and the struggles that were a part of that. We really do have a heart for serving them.”

At Ease will be celebrate its accomplishments and look toward the future at its Annual Luncheon on Monday, January 30 at the Centurylink Center. The luncheon, which serves the dual purpose of bringing awareness to the program and helping to break down the stigma of receiving help for post-traumatic stress, will feature former Staff Sergeant Sal Giunta, USA, as the keynote speaker. Mr. Giunta is the first living American to receive the nation’s highest decoration for valor, the Medal of Honor, for actions that occurred since the Vietnam War. Tickets, for the At Ease Annual Luncheon, which cost $50, can be purchased by visiting www.lfsneb.org.

Learn more about At Ease USA by visiting http://www.ateaseusa.org/.

Older individuals must take charge of their own healing and learn to advocate for themselves. They must help others understand that mental illnesses are like other illnesses, they are treatable! Both Theresa and Ken feel that recovery came once they understood the need to be responsible and play a defining role in their own treatment. Theresa and Ken are highly trained, certified peer support workers, and both agreed that it wasn’t until they came in contact with trained peer workers that their own lives began to turn for the better.  

Yes, there is help, there is hope, and there is healing! Thank you Ken and Theresa for having such a positive impact on Not Alone broadcasts!

To learn more about the role of peer support workers, listen to the Dec. 6 Not Alone program by clicking on the play button below, or download the file and listen later. To listen to past broadcasts, visit The Kim Foundation Web site Not Alone podcast page. 

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December 6, 2011 – Mental Health Consumers/Peer Advocate

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Nebraska moved forward several years ago with a commitment to close large ‘mental hospitals’ and to develop community based treatment centers to enable consumers to stay connected to their homes and families. Local treatment was intended to help alleviate crisis by providing early, appropriate intervention and care.  In this approach, peer role models encourage other peers to develop the tools and skills needed for help, hope and healing and the results have been impressive. 

The development of peer support services, the proliferation of WRAP classes, Crisis Intervention Training available to police officers, the inclusion of consumers and family members on boards and advisory committees, and the greater participation of consumers in national conferences and workshops has become visible evidence of change. We see the Keya House in Lincoln and the proposed Wellness Center in Omaha as direct reflections of consumer leadership.

A great example of consumer led change centers on a recent request by Nebraska Medicaid to establish a drug formulary, whereby consumers had to accept the least costly of the medications available, rather than having their own physician prescribe medication most effective for each individual. This request was defeated by the Legislature because the consumers urged their state senators not to establish the formulary. They expressed the consequences of this action so logically and eloquently that the Senators agreed and the program was rejected for implementation by the Division of Medicaid Services.

Yes, Nebraska has need and opportunity to improve response or to become more pro-active in many areas of mental health care; however, we can celebrate the fact that consumers are increasingly assuming leadership and responsibility which is leading to meaningful change. Resiliency and recovery are always two worthy goals.

The Kim Foundation also recently visited the VA Hospital for Nebraska-Western Iowa Research Week Open House and learned about research programs in other VA hospitals across the US, and how this research transitions into advancements in Veterans’ health care.   

We were pleased by the long-term research and patient care partnership of Creighton University Medical Center, the University of Nebraska Medical Center, and the Veterans Administration Hospital located in Omaha. Although most of the mental health related research of these medical centers is focused on the effects of substance abuse at this time, we did receive briefings regarding on-going research in other VA centers relating to women’s health, traumatic brain injury and PTSD that were of special interest to The Kim Foundation. We hope the Veterans Administration will continue to acknowledge and strengthen its response to veterans and their loved ones who must live with service related mental health issues.

The Centers for Medicare and Medicaid Services state that the EPSDT service is “Medicaid’s comprehensive and preventive child health program for individuals under age 21.”  The CMS continues, “In addition, Section 1905(r)(5) of the Social Security Act (the Act) requires that any medically necessary health care service listed at Section 1905(a) of The Act be provided to an EPSDT recipient even if the service is not available under the State’s Medicaid plan to the rest of the Medicaid population.”

On March 18, 2011, NAMI National hosted a teleconference with guest speaker Jane Perkins, legal director of the National Health Law Center. Jane is considered the leading expert on EPSDT. Ms. Perkins stated that “States must apply the federal definition of “medical necessity” and that this broad definition cannot be narrowed by state rules. The federal definition of medical necessity is defined in the federal statute which states “If a practitioner of the healing arts deems that a treatment is medically necessary to correct or ameliorate a condition, the state must provide it, whether or not it is covered under any other state plan.”  

Ms. Perkins listed services not covered under EPSDT, which include respite, habilitative care, and home modification. She defined habilitative treatment as ‘to teach a skill they never had.”  This is an important delineation when formally requesting services under the EPSDT provision, continued Ms. Perkins, as the law does include rehabilitative care. Ms. Perkins stressed the importance of wording when requesting services under EPSDT. Such wordings include EPSDT and correct or ameliorate.

Toni Hoy, author of  “Second Time Foster Child,” has used EPSDT as the basis for the Hoy Family federal lawsuit against the state of Illinois, filed in November, 2010.  The suit is pending in the Northern District Federal Court.

Jane Perkins is hosting a 16-month workgroup on EPSDT; The Kim Foundation urges readers to visit her website at www.healthlaw.org. Her email is perkins@healthlaw.org.