Health Care Reform Strategies Moving Forward: Transforming Behavioral Health Recovery in an Era of Health Care Reform Pat Taylor Executive Director Faces & Voices of Recovery February 24, 2011

2 Recovery and Wellness focus Ensuring that people in or seeking recovery from addiction and mental illness get the care and support that they need to lead healthy and fulfilling lives. Embracing all pathways to recovery Networks of formal and informal services and support Policies that support, don’t hinder, the ability of people to get into recovery and to sustain their recovery

Health reform: Why it’s important for recovery Recovery Principle – Change in focus from treating sickness to promoting health and well being Equity – no pre-existing condition exclusions; annual limits; parity of coverage for mental illness and addiction with other health conditions 32 million uninsured Americans will gain access to care by 2014

Why it’s important for recovery May include 87,000 people who sought care for addiction but did not get it because they didn’t have health insurance or the ability to pay. May include as many as 2 million people with mental illness Because millions of people with addiction and mental illness will have primary care, screening and brief interventions, the number of people receiving care for addiction and mental illness could increase. Addiction: as many as 20 million Mental Illness: as many as 5.1 million

Why it’s important for recovery People in the criminal justice system with mental illness and addiction will have access to care. Will extend Medicaid coverage to a large number of uninsured adults who will be guaranteed coverage for addiction and mental illness The federal government will pay the lion’s share of the costs of the expansion – relatively small state investment Making services and resources available that people can use to meet their needs. 5

Setting the stage in Washington, DC and states Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act  All Members of Congress were visited; key Congressional committees involved  Victory carried over into Affordable Care Act State “parity” laws  Informed legislators and policy makers 6

Setting the stage in Washington, DC and states Learning from history – peer recovery support  Mutual aid, mental health consumer/survivor movement; recovery advocacy movement  Peer recovery coach service role  Recovery community centers, Drop-in centers More than recovery-oriented treatment – helping individuals/families/communities initiate, sustain, and honor long-term recovery 7

Federal level Federal policies are being developed to implement the Affordable Care Act. They will lay the ground work for the state effort.  The Affordable Care Act gives states significant policy discretion in implementing the law within a framework established at the federal level. While the “essential health benefits package” will include care for addiction and mental illness, what the specific services will look like will be determined by regulation.

Essential health benefits package Will peer and other recovery support services be in the essential benefits package? What could it mean? 9

Beyond the Affordable Care Act Other recovery supports that we can educate policymakers and opinion leaders about and possible sources of funding  Block grants  Department of Housing and Urban Development  Department of Labor  Department of Justice

Advocating on two levels 1. Best possible regulations and policy choices at the federal and state levels 2. Delivery of peer and other recovery support services  Accreditation of organizations  Credentialing individuals

State-level advocacy: Best possible regulations/policies Organized recovery communities are visible change agents and at the table  Recovery advocates and consumer/survivor advocates meet locally to determine common agenda items under health reform Develop relationships with elected, appointed and career state officials  Meet with state officials; influence the development of rules and regulations for state exchanges to promote the use and benefit of peer recovery support services

State-level advocacy: Best possible regulations/policies Developing and participating in effective coalitions and strategies Forming relationships with other stakeholders Making sure that robust assistance and support systems are set up for people who are newly insured

State-level advocacy: Best possible regulations/policies Engaging people to seek help or people who are seeking Develop models for signing up people for the health exchanges and Medicaid expansion benefit  Veterans, people leaving incarceration – as part of peer recovery support

State- and federal-level advocacy: Service delivery 1. Accreditation of organizations 2. Credentialing individuals

Pat Taylor Executive Director Faces & Voices of Recovery