DPA - Delaware Psychological Association

Federal Advocacy Update: Barbara Giardina, Ph.D.

April 19, 2018 12:01 PM | Kelly Wetzel (Administrator)

Federal Advocacy Update


This year the Federal Advocacy Agenda will focus our efforts on passing the bipartisan, bicameral Medicare Mental Health Access Act, and to ask Congress to strengthen Medicaid expansion, rather than weaken it.  Additionally, we may call on our Congressional leaders to sign a Dear Colleague letter to the House and Senate Armed Services Committee leadership, urging them to exert appropriate, immediate oversight of DHA’s TRICARE program.

The Medicare Mental Health Access Act (H.R. 1173, S. 448), would allow psychologists to practice at the top of their license in all Medicare settings. That is to practice without physician oversight in outpatient rehabilitation facilities, home health agency programs, partial hospitalization programs, and nursing homes to name a few. Health plans in the Private sector, as well as Tricare, the VA, and Medicare Advantage already allow this. We do know that delaying treatment of disorders such as depression, worsens outcomes by doubling the rate of hospitalization and ER visits in the Medicare population who also suffer from chronic conditions like diabetes or congestive heart failure. As the physician shortage worsens, there will be fewer people available to sign off to provide the required but unnecessary oversight.  Psychologist ask to be included in the Physician Definition of Medicare so that we may join the ranks of other doctoral-level, non-physician providers like podiatrists, dentists, chiropractors and optometrists. This will open the door to more complete mental health access for our Medicare patients. We are awaiting feedback as to whether any office would be willing to co-sponsor this legislation. We are more optimistic about this than in previous years!

Medicaid should be strengthened rather than weakened.  With mental illness being  so prevalent (44.7 million) and serious mental illness also being relatively high (10.4 million), many people are already in need of treatment options. Add another 20 million people who suffer from a substance use disorder, and you can begin to understand that it would be important to support rather than dismantle the single largest payer of mental health services (25%) , and addiction treatment (21%). We know that 11 million were offered comprehensive behavioral health treatment by the ACA Medicaid expansion. Thank goodness because we know Medicaid recipients are more vulnerable with illness than the privately insured, being twice as likely to receive MH treatment,and 2.5 times more likely to need an ER for a serious health issue.  Medicaid is the healthcare safety net designed to help those in need. Lifetime limits, lockouts, and work requirements will deprive and disqualify many deserving, very low income people.  We were pleased to find that all of our Congressional member are extremely supportive of Medicaid and the ACA expansion in Delaware.

Our need to ask our Congressional Members to sign the above mentioned Dear Colleague letter will continue to be assessed. Currently, Delaware is not one of the targeted states.  If there are problems with the local Tricare contracts, please let us know so that we may put you in contact with the right person.

Check out the following link for DELAWARE CENTER for HEALTH INNOVATION 

https://www.dehealthinnovation.org.  When you get there you’ll see the 5 committees. You can find out what each committee is about, and click on EVENTS to find out when the various committees meet. Interesting stuff for a state that aspires to in the top 5 best states for best healthcare outcomes!

Respectfully Submitted

Barbara Giardina 

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