CHESS Health’s Post

What if I told you that the mission of the Medicaid program and the Corrections system wasn't all that different? Both programs aim to help people live better lives. Both programs would like to reduce societal reliance on their services by lifting people out of their current struggles. On the Medicaid side we would say that we're part of an array of programs that help lift people out of poverty, while on the corrections side we would say we're working to reduce recidivism. These waivers are an opportunity to build bridges between these two critically important programs. They are an opportunity to build infrastructure that will augment the positive impact both can have on our communities. Medicaid programs have the right financing structure in place to make this a worthwhile investment for every state (more to come on that). I've said it before, and I'll say it again. Medicaid is an investment in the well-being of the community. There is the potential for significant returns on these investments - I'm excited to be a part of helping them unfold. #medicaid #corrections #poverty #recidivism #1115waivers #community

ICYMI: For incarcerated and reentering children and youth, access to substance use and other health services is CRITICAL to ensuring positive health outcomes. The #ConsolidatedAppropriationsAct of 2023 included key provisions for strengthening coverage of and access to these services through #Medicaid and the #Children’sHealthInsuranceProgram (#CHIP) for certain incarcerated and reentering children and youth. With the support of the Opioid Response Network, we developed the below issue brief to distill these key provisions – check it out! https://bit.ly/3vWyXyo 

CalPACE is proud to join Justice in Aging , California Elder Justice Coalition , and over 60 other organizations in signing a letter urging CMS to rectify an injustice in Medicare access for individuals transitioning from incarceration. Due to Medicare's overly broad coverage exclusion for individuals labeled as being 'in custody,' many older adults and people with disabilities, who have a history of involvement with the criminal legal system and are now living in the community, face barriers in accessing essential healthcare services. This limitation not only impacts their health but also has ripple effects on earnings and recidivism rates. The letter requests CMS to revise Medicare's custody definition, ensuring access to health insurance coverage and, consequently, healthcare services for older adults and people with disabilities who are not subject to institutional confinement. CalPACE is proud to support and raise awareness about this important issue. Together, we can advocate for positive change in Medicare access and healthcare equity for all. #MedicareAccess #HealthcareEquity #Advocacy Read the letter here: shorturl.at/aszQR

Today, I met with California State Senator Scott Wiener (Democrat) to discuss robust regulations for substance abuse rehab centers and mental health facilities in California. The #AffordableCareAct attracted many profiteers who opened or bought us existing facilities and began running them as for-profit treatment facilities, which has led to compromised patient care and severe ethical problems. The profit motive of capitalism – putting profits ahead of patient care - should never be applied to healthcare delivery. Daniel Calazans died from suicide after being a victim of sexual abuse at the rehab center #baysidemarin, one of the 246 treatment facilities that #AcadiaHealthCare operates in the United States, a network across 39 states, according to their website. We created and left with the Senator a document requesting the evaluation and implementation of the five recommendations for a bill for substance abuse rehab centers: # 1: Regulation: Substance abuse rehab centers must be under the category of medical facilities to prevent medical practice and protocols, holding these facilities accountable for situations similar to what happened to Daniel and other "clients."  # 2: Terminate Operations of Centers Under Investigation of Deaths In addition to Daniel's case, Acadia Healthcare has faced investigation of deaths at their facilities. These entities have severe violations but continue to operate, earning millions of dollars supported by American taxpayers.  # 3: Terminate Operations of Centers that Committed Fraud against Medical Insurance and Social Programs: The Affordable Care Act is a law providing substantial resources so that substance abuse and psychiatric illness centers could serve a more significant number of people, especially uninsured individuals and war veterans. Acadia Health Care committed a billing scheme that defrauded Medicaid of $8.5 million in West Virginia but continues to operate despite this fraud. # 4: Require Treatments with Medical-Scientific Basis Only Mental health and substance use rehabilitation clinics should be using evidence-based protocols and therapies that treat substance abuse, psychiatric disorders, and concurrent illnesses that may simulate psychiatric symptoms that are often not identified. Once regulated as medical entities, qualified centers would be able to offer treatments with better prognoses and lower risks of relapse, which today can mean death in the setting of the crisis of fentanyl and other lethal substances. # 5: Require Treatments Targeted to the Needs of Each Patient Substance abuse and mental health should be treated as two health conditions in separate ways while identifying how they may contribute to each other. #danielcalazansfoundation #baysidemarintreatmentcenter Acadia Healthcare #reevewaud #ethicsinbusiness #healthcarepolicy #advocacymatters #regulation #fraudprevention #accountabilitymatters #takingaction #factsmatter #problemsolving #stockmarketinsights  

What is #ALTCS? The Arizona Long Term Care System (ALTCS) is a program that helps families cope with long term illness or disability. The ALTCS Medicaid program is available for Arizonans to apply for if seeking finances for long term care. #MercyCare is here to help you receive the access to #QualityHealthCare you need. Learn more about ALTCS: https://bit.ly/3F9IbIX

In my work, I see the challenges faced by individuals reentering society from prison or jail, particularly in accessing essential healthcare due to gaps in Medicaid coverage. The passage of the Consolidated Appropriations Act of 2024 (CAA) offers a beacon of hope, signaling a significant advance in supporting these justice-involved populations. The CAA mandates a game-changing policy: starting in 2026, states must suspend rather than terminate Medicaid for incarcerated individuals. This ensures immediate access to healthcare upon reentry, facilitating a smoother transition back into the community. It’s a monumental shift towards recognizing the dignity and health needs of every individual. Furthermore, the CAA allocates $113.5 million in grants to help states improve systems ensuring healthcare access for those reentering. This investment in operational capacity is crucial for turning policy into practice, ensuring these individuals receive the support they need. Guidance from the Centers for Medicare and Medicaid Services, promised under the CAA, will also play a critical role. It aims to help states navigate the complexities of linking healthcare with the corrections system, ensuring continuity of care for those at the juncture of reentry. Community health centers (CHCs), with extended funding under the CAA, are key in providing accessible care to underserved populations, including returning citizens. Their role is indispensable in ensuring successful transitions, embodying a model of care that supports and heals. The CAA's changes reflect a bipartisan understanding that healthcare access is fundamental to successful reentry and public safety. These policies acknowledge the link between individual well-being and community health, offering hope for a future where support defines the path forward for those reentering society. It’s a step towards a more supportive, rather than stigmatizing, approach to reentry. Read more here:

📢 Important Awareness Alert! Native American Communities in Arizona: Stay Informed It's disheartening to shed light on a sobering issue that has been plaguing our Native American communities in Arizona. There is an ongoing scam targeting our fellow Native Americans, where fraudulent rehab centers and sober houses have been exploiting vulnerable individuals. Numerous Native Americans seeking help were lured into these facilities, only to find out that the promised services were never provided. To make matters worse, they were often left homeless in the scorching Phoenix summer heat. It is truly distressing to witness such exploitation of our community members who sought assistance during their time of need. The consequences of this fraudulent scheme go beyond mere neglect. These deceitful providers have shamelessly profited by billing Medicaid for services that were never rendered. This has resulted in millions of dollars being unjustly earned, while those in need continue to suffer. Thankfully, authorities have taken notice and initiated investigations into this appalling situation. Over 400 licenses have been suspended as part of the ongoing efforts to address this scam and bring justice to those affected. However, we must remain vigilant and spread awareness to prevent further harm. Let us come together as a community to support and protect one another. Share this post and spread the word about this sober living scam targeting Native Americans in Arizona. By staying informed and actively participating in discussions surrounding this issue, we can help prevent future exploitation and empower those affected to seek genuine support. Remember, our collective strength lies in our unity and determination to create a safe and supportive environment for all. Together, we can ensure that the most vulnerable in our community receive the care they deserve. #NativeAmericanCommunity #Arizona #FraudAwareness #SupportAndProtect

Medicaid is the largest payer of mental health services in the U.S. But Medicaid, by statute, has been prohibited from paying for certain essential services. For instance, even though jails and prisons have become the default mental health institutions in this country and reentry from incarceration is a particularly high-risk transition for people with serious mental illness or substance use disorder, Medicaid has historically not been allowed to pay for behavioral health services in either jails or prisons. That is changing. An important new report from NAMI and #HARP (The Health and Reentry Project) describes recent opportunities for Medicaid reimbursement for incarcerated adults and children. Only two states, Washington and California, have taken advantage of these new Medicaid options. Advocates in other states should look to their state Medicaid benefits office to seek a waiver for these long overdue new policies. https://lnkd.in/dtt3vUM3 Margot Cronin-Furman Vikki Wachino Kari Pedersen, PMHNP Silicia Lomax, MPH John Sawyer, PhD, ABPP-CN

Excellent article on the poisonous legacy of the sobriety house fraud that targeted Native Americans. Described by Attorney General Kris Mayes as "one of the biggest scandals in the history of the state of Arizona,” scammers gave alcohol and drugs to vulnerable people struggling with addiction while billing Medicaid for outpatient treatment that never occurred. The fraud is estimated to have cost taxpayers $1.5 - $2.5 billion in just two years. On some reservations, Tribal members were last seen stepping into a white van that whisked them away from friends and family. Today, many recovery professionals and Native patients aren't sure who to trust. Legitimate sobriety centers have a harder time getting funded; some counselors are reluctant to refer clients to residential treatment. But as always there's good news: a grassroots response of volunteers and leaders who are starting new, culturally-centered programs and reaching out to people on the street to get them the help they need. https://lnkd.in/g_CtD3JT #behavioralhealth #addiction #indigenoushealth #sobriety #recovery