Week of December 18–22, 2023

Medicare Part B Coverage of Counselors

• The largest expansion of Medicare's mental health services in a generation can provide a critical lifeline to America's seniors — if enough providers sign up. Why it matters: Starting Jan. 1, some 400,000 marriage and family therapists and mental health counselors for the first time can accept Medicare payment, following years of advocacy and amid a mental health crisis that has weighed heavily on seniors. These providers, representing about 40% of the country's mental health workforce, have been largely shut off to Medicare enrollees who couldn't afford to pay out of pocket. Read more here.

General Mental Health Articles

• New York City (NYC), like much of the US, faces a mental health crisis exacerbated by the COVID-19 pandemic. In response, NYC launched a mental health plan that takes a public health approach, targeting strategies based on need, balancing prevention and care, engaging the whole government, and building on existing infrastructure and recent policy reforms. This Viewpoint shares NYC’s rationale, process, and challenges, focusing on overdose—1 of 3 pillars of the plan—as a case study for other governments across the nation. Read more here.
• The ketamine infusion actor Matthew Perry received days before his Oct. 28 death has become a popular mental health treatment across the U.S. A lower dose of the traditional anesthetic has been used to treat symptoms of depression, typically via IV in clinics. Research has shown its promise, though experts have noted the clinics haven't been as regulated. Read more here.

Youth Mental Health 

• By now, you’re probably well aware that teenagers in the U.S. are facing a full-fledged mental health crisis. The American Academy of Pediatrics and Children’s Hospital Association have declared a “national state of emergency” for children’s mental health. Two Minnesota teens had an idea to get ahead of mental health crises by helping other young people become more aware of their feelings. Taara Verma and Siena Pradhan joined MPR News Host Cathy Wurzer to talk about Feel Now, the app they launched earlier this year. Read more here.
• Baltimore County Public Schools announced a new partnership with the behavioral health care company Talkspace, in order to provide free unlimited telehealth therapy to high school students ages 13 and above. "BCPS is committed to the academic success and to the physical, social, and emotional well-being of all our students," BCPS Superintendent Dr. Myriam Yarbrough said. Eligible students interested in therapy can sign up, take a brief assessment, and get matched with a dedicated licensed therapist. Read more here.
• Sometimes, it seems that we’re doing all we can to sabotage our own efforts to reverse the nation’s mental health and addiction crises, which disproportionately affect children, teens and young adults. Particularly here in Illinois, where we’re on pace to surpass our current record highs in overdose deaths, and youth suicide lifeline programs are struggling to keep up with overwhelming demand. Yet we continue to overlook one of the most effective and expedient ways to address these problems: regulatory action to curb youth exposure and access to addictive, unhealthy influences purportedly meant for adults only. Read more here.

Older Adult Issues

• The AARP estimates that 11.5 percent of the U.S. population are caring for family members in 2023. We are many, and somehow, we are still grossly overlooked and under supported in nearly every way. Over the years, I have discovered that what makes life manageable is to spend time with others and take breaks from the demands of someone else's needs. Yet, this is difficult to access because of the shortage of personal care attendants (PCA) and home health care workers. Read more here.

The Opioid Crisis and Addiction Issues

• Fentanyl and methamphetamine drove a record number of homeless deaths last year in Oregon’s Multnomah County, home to Portland, according to an annual report released by regional officials Wednesday. At least 315 homeless people died in 2022 in the Portland area, the report found. More than half of the fatalities — 123 — were from drug overdoses. Methamphetamine contributed to 85% of overdose deaths, and fentanyl contributed to 74%. Read more here.

Health Insurance and Health Care Quality

• Americans' satisfaction with almost every major part of the health care system has dropped since 2010, according to a new Gallup analysis. Driving the news: Drugmakers took the biggest reputational hit, and ratings for physicians fell sharply, too. The big picture: COVID-19, ballooning costs, an opioid crisis and other factors could contribute to Americans' souring sentiment, Gallup says. The findings also suggest that the goodwill Americans felt toward doctors at the start of the pandemic has all but disappeared. Read more here.

 Gender-Affirming Care

• An effort to get the Food and Drug Administration's approval of hormone therapies for gender-affirming treatment could help preserve patients' access to the therapies as states restrict them. The big picture: For years, transgender patients have received hormone therapies "off label" — a common medical practice in which doctors prescribe treatments for a use the agency hasn't approved. A small nonprofit formed this year with the goal of obtaining FDA approval of the drugs for gender-affirming care believes the agency's formal OK could strengthen legal protections for the treatments and boost insurance coverage. Read more here.

Medicaid Redetermination

• Sixty percent of kids who have lost Medicaid coverage this year came from just nine states, all of which are Republican-led, according to new data from the Biden administration. Driving the news: And the 10 states refusing the Affordable Care Act's expansion of Medicaid to low-income adults have disenrolled more kids than all of the expansion states combined, the administration also reported. Read more here.
• HHS wants states with the highest rates of children dropped from Medicaid to use certain federal rules that make it easier to get families back on coverage. In letters sent Monday to the governors of Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas, HHS Secretary Xavier Becerra urged the states to take up more of options CMS has offered to ensure coverage. The options include allowing states to use enrollee information they have to auto-renew coverage. Read more here.

State Policy

• Medicaid expansion in North Carolina is now in full effect, and initial enrollment data indicates a strong start, according to the state’s health secretary. “Out of the gate, (we’re) feeling really good about the number of folks enrolled,” said Kody Kinsley, Secretary of the N.C. Department of Health and Human Services, in an interview. Progress in the first few days of expansion, which started on Dec. 1, is “pretty phenomenal,” he said. As of Dec. 12, 280,000 people have enrolled to receive Medicaid insurance, according to data shared by DHHS. Read more here.
• Two state-funded businesses that manage behavioral health services for low-income residents say they will consolidate to create a single organization to serve 46 counties across eastern North Carolina.  Trillium Health Resources will take control of Eastpointe Human Services under the agreement, which was signed Saturday by the companies’ CEOs. The arrangement will reshape the state’s managed care system for providing care to Medicaid participants with mental health needs, substance use disorders and intellectual or developmental disabilities. Read more here.