HEALTH

Haslam may submit Medicaid expansion plan in fall

Tom Wilemon, twilemon@tennessean.com and The Associated Press

1 day ago

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Larry McCormack / File / The Tennessean

Gov. Bill Haslam said Thursday that the state may soon submit a proposal to Washington to expand Tennessee’s Medicaid program but did not release any new details on how it might work.

It is unacceptable that people who are suffering from and struggling with mental health issues in their life be at risk of injury, trauma, assault or even death in their interactions with police officers whose only training as "being a good police officer"  leads them to a course of action that produces tragedy.  There is ample evidence that CIT training (Crisis Intervention Training) makes a difference. The "Memphis Model" has made an impact in many communities both large and small. Tragedies may continue to happen, but to expect and accept them as the cost of doing business as normal is simply and deeply wrong.

A few days ago I talked with a man whose 39-year-old "mentally ill" son had been attacked, beaten up and tasered by police in this community who "were doing their job."  Over the last few days I have spent a lot of time thinking about other incidents I either have direct knowledge of  or I have heard about.  And it has left me deeply troubled.

There are lots of people to blame and many people seem intent on solving the problem by trying to figure out who to blame.  I hear people talk about needing more psychiatric hospitals, more coercive treatment options etc.  I dont think there are really going to be an appreciable increase in psychiatric beds regardless of where you stand on the argument, rather you think it is a good idea or not.  Financially it simply not an option.  Arguments that vastly increasing AOT (assisted outpatient treatment) can solve the problem are not honest or realistic.

Someone will be the next Kelly Thomas.  Someone will be the next person a police officer faces on the street corner or in their home or in the jail.  It is happening right now.  It will be happening in a few minutes.  It will be happening tomorrow.  And what stops it from being someone you know, someone you care about, or even you.

It is pointless to bemoan the fact that police are being asked to do things they are not trained to do and then do absolutely nothing about providing them that training.  It is as unfair to the officer who is trying to do the best he can as it is to the person he is trying to deal with.

As far as I know the decision to implement CIT training is a local decision and depends very much on the financial resources of that community as well as the commitment to training that local officials may have.  Many communities, like the one I live in, have gotten officers involved in a piecemeal fashion but they are largely at the mercy of who offers the training and when.

Again, no one should be the victim of where they live.  I have been following in recent days the effort of New York state to deal with the same issue.  The proposal that is currently being fought over is whether or not to include in the state budget funds for what they are calling a "center of excellence for CIT training."  The idea, as I understand it, is for the state to establish a resource that could help communities access CIT training in a way they can afford and in a way that is most effective to them.  It shifts the burden of the argument from "is it practical?  Can we afford to do it?" to "Can we afford to not do it?"

It is too late for anything like that to happen in Tennessee this year, but is not to late to start the conversation.  Several other states already have chosen to establish something like "a center of excellence for CIT."  Some have found access to federal funding.  Others have found grants from other sources.

In the end, it not only saves lives but also saves money because of the injuries and traumas it prevents.

A couple of days I had a post which included a video of the beating of Kelly Thomas.  I made myself watch the video several days before the post and was horrified.  If you havent watched the video and still doubt the importance of what I am talking about watch the video yourself.  I have also seen videos of other beatings from virtually all over the country.  It is more than a Tennessee problem but it is a Tennessee problem.

In the days and weeks that follow I will be revisiting this conversation over and over.  I am by no means anywhere close to an expert.  If you think you know more than me on the subject there is a good chance you are correct.  My goal is to start a conversation, a widespread conversation, in Tennessee that prepares the ground to talk about this issue not as one that affects isolated localities but every person in this state.

It is a conversation I hope you will join.

Larry Drain, hope works community blog

A very personal plea for medicaid expansion: a letter to the governor

By Hopeworkscommunity

Dear Governor Haslam:
I want to start by first thanking you for your decision to restore funding to peer support centers in Tennessee.  As a mental health advocate I can tell you it is one of the best decisions you have ever made and I am so thankful you made it.

But my decision to write this letter is about much more than the peer support centers.  In your state of the state message you talked a couple of times about the importance of government giving good customer service.  You seemed to put a lot of stock in that idea.  It was not the first time I have heard you speak about it.  The decision to fund peer centers was a great example of good customer service.

My hope is that you will consider my request in the light of that concept.  I am in a desperate situation and without your help I dont know where to turn.

I want to ask you to reconsider your stance on medicaid expansion.  I know you are in a tough spot.  Anything that makes the Tea Party mad faces great obstacles in Tennessee and few things make them angrier than health care reform.  Perhaps what I am asking you is impossible for you to politically do.  Several people have told me it is.

As I said my situation is desparate.  Let me take a minute to describe it.

I have been “free” of health care insurance for many years.  It is a freedom I would gladly lose.  I have been told that I need surgery.  The surgery is a minor one that thousands of people undergo every year.  No insurance means no surgery.  The doctor tells me the lack of surgery though may not be a minor thing though, that in fact if my condition should become an emergency my life may be in danger.  I pray every day not to die a preventable death.  Many people have far more dangerous situations than me and face far more immediate risk.  Being poor should never, at least not in Tennessee be the cause of anyone’s death.  And without action on your part it will be though.

My desperation though is not based purely on issues of my health.  It goes far deeper than that.

My wife is disabled and has been on TennCare for a while.  She is a TennCare miracle.  Without it she would have died long ago.  Even with all her progress without it she would no live a month.  In order to save her insurance and in a very real sense her life after 32 years of marriage we have had to separate.  I dont know, without TennCare expansion we can ever live together again.

The situation is very complex, but let me share it with you as briefly as I can.  My wife receives SSI for disabilities.  Recently I took retirement from Social Security.  It was the worst decision I have ever made.

We found out that in Social Security’s eyes, even though our combined checks left us below poverty, we made far too much money.  Linda lost over $700 and her check was reduced to $20 a month.  I told Social Security that I would have to get a job in order for us to survive.  We figured without her check we had about $40 to live on for the month of January and we just cant live like that.  Who could??

Social Security told us that since her TennCare was disability based and not income based (like it would be if TennCare was expanded) that if I made over $85 a month her TennCare would be lost.

I love my wife and wont let her die.  The day after Christmas we separated.  The hope is that with a separate address she can regain her SSI check.  My hope is to move as close to her as possible.  Right now I do not see how we can ever live together again.

You do not make the rules for Social Security and none of that is your fault.  The law is what it is and despite its cruelty and hurtfulness we have no choice but to do our best to live with it.  A law that supports the break up of thousands of marriages seems so evil, but I dont right now see how I can affect it.

I am asking for your help though.  Maybe I dont have the right but I have no where else to turn.  I know you deeply love and care for your wife.  What would you say to me if our situations were reversed??

Please act.  Whatever the resolution please act.  My wife will keep her TennCare.  I will never do anything to put that in jeopardy.  Without your help though my marriage will not survive and for Linda and I that is a death of a different sort.