Thousands of American families, including my own, have invested thousands of dollars in a promising intervention for AD/HD—neurofeedback. No health insurance plan in America pays for neurofeedback for the treatment of AD/HD as the evidence-based science is not yet there. CHADD’s Professional Advisory Board has published What We Know statements on the evidence-based science on complementary and alternative interventions, including neurofeedback, available on the website of CHADD’s National Resource Center on AD/HD.
CHADD advocates a significant additional financial investment by the National Institute of Mental Health in neurofeedback for AD/HD. During the past year, the CHADD Professional Advisory Board (PAB) has discussed with the International Society for Neurofeedback and Research (ISNR) the published science behind this intervention for AD/HD. At this point in time, we have asked ISNR eight key questions about the research. They are:
1. CHADD has stated that for a neurofeedback intervention to be described as "evidence-based,” we would expect to see randomized studies involving double-blind, sham control of equal intensity and duration. Does ISNR agree with this standard for evaluating the published science? If not, what are ISNR's standards for evaluating the published science?
2. Brainwave patterns profiles: There is ambiguity in the literature about: (a) whether or not there are different “profiles” for brainwave patterns; (b) whether or not these profiles can be categorized; and (c) whether or not these profiles can be reliably identified prior to intervention. What is ISNR’s position on the overall issue of profiles and their standardization?
3. Profile-based intervention: Are there standardized practice guidelines for neurofeedback clinicians to use in order to match profile with intervention? If so, is this done uniformly within the profession? Is there a manual that clinicians use for this purpose? Given that the need to match profile with intervention was emphasized in the letter from ISNR, why is this not made clear in the literature?
4. Generalization: Given that discussion of this is largely absent from the literature, to what extent do members of the organization feel that the effects that are seen generalize to other behaviors and real-life settings? What do clinicians say to patients in this regard?
5. Given the comorbidities present in most research samples of individuals with AD/HD, (a) what is the strength of the evidence that the intervention is specifically addressing AD/HD, and (b) to what extent are the dependent measures AD/HD-specific?
6. Persistence: What evidence is there that any effect seen persists, and does this vary by subtype of brain wave pattern? Should neurofeedback studies routinely include a 12-month follow-up assessment of outcomes? If so, should the dependent variables include real-life measures?
7. To what extent may the experience/expectation of the clinician/coach/trainer affect the outcome (i.e., is there a degree of “facilitation” in this type of intervention)? Given that you emphasize the importance of the trainer having clinical background and tailoring the training to the patient, how can it be clarified which factor—the neurofeedback itself or the intense repeated therapeutic interaction with the clinically trained trainer—is having the effect?
8. Who has access to purchase neurofeedback equipment? For clinicians using this equipment, does ISNR have any published or readily available guidelines concerning the qualifications a clinician must have or the minimal standards a clinician must meet?
As this CHADD PAB-ISNR dialogue continues, CHADD will keep the public informed, when there are advances in the evidence-based science.
Clarke
Tuesday, November 10, 2009
Friday, October 30, 2009
Work and Social Security Programs—Impact on AD/HD
My 19-year-old son is in a post-high school program that offers trial work assignments, independent living skills, and social skills, combined with some community college. We are hopeful that he will develop work skills. Social challenges are his most immediate challenge. The prospect of no health insurance because of a lack of full-time employment with a large employer is a longer-term concern (and thus our support for national health care reform). With time and support, work should be a realistic goal.
At CHADD’s 21st annual international conference two weeks ago in Cleveland, we had two sessions on work, economic crisis, and Social Security programs. Rick Tully with the Ohio Department of Mental Health presented an overview of government programs to assist in times of economic hardship. These included the Social Security Administration (SSA) income assistance programs—Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). To qualify for SSI and SSDI, one must not be able to “engage” in “substantial gainful activity” and one must have a documentable medically determinable disability.
Tom Gloss of the Social Security Administration conducted a session on the Ticket-to-Work—Work Incentives Program. Ticket to Work is a program for persons already on SSI or SSDI who want to work.
AD/HD is a qualifying medical disability for SSI for children. One has to have substantial limitations, but it is a qualifying disability. There are 194,026 children (under age 18) on SSI with a primary or secondary diagnosis of AD/HD.
Currently, there are no SSA medical disability criteria for AD/HD in adults. The law requires that there be a medically determinable impairment and that there be substantial functional limitations. Adults who meet the Diagnostic and Statistical Manual (DSM) criteria for AD/HD would meet the medically determinable impairment criteria. Then, SSA would determine the severity of disability and its relation to work. Failure to precisely list AD/HD in adults will be a major roadblock to some individuals becoming eligible for SSDI or SSI. There are no SSA regulations preventing an adult with AD/HD from becoming eligible.
For any of the mental disorders, one must have substantial limitations in specific areas such as activities of daily living, concentration, social interaction, and ability to adapt to changes in the environment.
The challenge: Many people with AD/HD and related disorders don’t have the severity of limitations to meet the SSI and SSDI test. But they also may not have the ability to sustain permanent and consistent full-time work. Finding a social policy that encourages work, reduces disability, and provides health insurance—while keeping the social safety net of SSI and SSDI—is a very difficult challenge. CHADD continues to work with national public policy makers to address these difficult issues.
Clarke
You can read this blog and others like it at the HealthCentral website.
At CHADD’s 21st annual international conference two weeks ago in Cleveland, we had two sessions on work, economic crisis, and Social Security programs. Rick Tully with the Ohio Department of Mental Health presented an overview of government programs to assist in times of economic hardship. These included the Social Security Administration (SSA) income assistance programs—Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). To qualify for SSI and SSDI, one must not be able to “engage” in “substantial gainful activity” and one must have a documentable medically determinable disability.
Tom Gloss of the Social Security Administration conducted a session on the Ticket-to-Work—Work Incentives Program. Ticket to Work is a program for persons already on SSI or SSDI who want to work.
AD/HD is a qualifying medical disability for SSI for children. One has to have substantial limitations, but it is a qualifying disability. There are 194,026 children (under age 18) on SSI with a primary or secondary diagnosis of AD/HD.
Currently, there are no SSA medical disability criteria for AD/HD in adults. The law requires that there be a medically determinable impairment and that there be substantial functional limitations. Adults who meet the Diagnostic and Statistical Manual (DSM) criteria for AD/HD would meet the medically determinable impairment criteria. Then, SSA would determine the severity of disability and its relation to work. Failure to precisely list AD/HD in adults will be a major roadblock to some individuals becoming eligible for SSDI or SSI. There are no SSA regulations preventing an adult with AD/HD from becoming eligible.
For any of the mental disorders, one must have substantial limitations in specific areas such as activities of daily living, concentration, social interaction, and ability to adapt to changes in the environment.
The challenge: Many people with AD/HD and related disorders don’t have the severity of limitations to meet the SSI and SSDI test. But they also may not have the ability to sustain permanent and consistent full-time work. Finding a social policy that encourages work, reduces disability, and provides health insurance—while keeping the social safety net of SSI and SSDI—is a very difficult challenge. CHADD continues to work with national public policy makers to address these difficult issues.
Clarke
You can read this blog and others like it at the HealthCentral website.
Wednesday, September 23, 2009
"Medical Homes" Included in Healthcare Reform Proposals
This morning I attended a Campaign for Mental Health Reform congressional briefing, “The Integration of Mental Health and Health: Evidence from the Medical Home.” CHADD is a Campaign member. All five congressional committee draft healthcare reform legislative proposals contain financial incentives for creating and expanding “medical” or “healthcare” homes.
CHADD endorses the concept and experience of a “medical home” (clinical home/healthcare home) for children with special healthcare needs as defined, implemented, and advocated over the past decade by the American Academy of Pediatrics. Medical homes as defined by AAP are about a single medical practice taking ownership/responsibility to coordinate interventions for children with special needs, whether those children have either complex needs or a variety of needs.
The essential elements of a medical home for children with special healthcare needs are:
• Personal physician in a culturally and linguistically competent physician-directed medical
practice who provides continuous and comprehensive care;
• A focus on the “whole” child, youth, and family with coordinated care/services/supports;
• A family-driven partnership that ensures a coordinated network of community-based services where both physicians and families share accountability for quality improvement through a performance measurement system;
• A focus on transitions to ensure no disruptions of services as children and youth
progress through normal stages of growth and development;
• Privacy-protected, family-driven electronic medical records for communication with youth and families, and consultation between treating professionals.
One of the briefing speakers was Ted Epperly, MD, the president of the American Academy of Family Physicians. I asked the other speakers (a psychiatrist with the Carter Center Mental Health Program, a psychiatrist with the Missouri Department of Mental Health, and a PhD health and disease management director of prevention programs) if they agreed with Dr. Epperly’s policy and practice objective that every American have a “trusted relationship with a personal physician”? They did. All emphasized the need for a full interdisciplinary team. All agreed that the practice should be fully integrated and “patient-centered.” All agreed that the physician should be the “quarterback” of the team and have the ultimate accountability. All agreed that physician assistants, nurse practitioners, and various mental health professionals were essential to the team. All agreed that this was the goal. All agreed that this is not practice today, but we are moving toward it. All agreed that the electronic medical record was a methodology to help achieve this objective.
There are many different models of “medical homes,” involving different types of professionals based on the age and health situation of the consumer. CHADD supports adapting the AAP model for children with special needs to other populations, including adults.
Clarke
You can read this blog and others like it at the HealthCentral website.
CHADD endorses the concept and experience of a “medical home” (clinical home/healthcare home) for children with special healthcare needs as defined, implemented, and advocated over the past decade by the American Academy of Pediatrics. Medical homes as defined by AAP are about a single medical practice taking ownership/responsibility to coordinate interventions for children with special needs, whether those children have either complex needs or a variety of needs.
The essential elements of a medical home for children with special healthcare needs are:
• Personal physician in a culturally and linguistically competent physician-directed medical
practice who provides continuous and comprehensive care;
• A focus on the “whole” child, youth, and family with coordinated care/services/supports;
• A family-driven partnership that ensures a coordinated network of community-based services where both physicians and families share accountability for quality improvement through a performance measurement system;
• A focus on transitions to ensure no disruptions of services as children and youth
progress through normal stages of growth and development;
• Privacy-protected, family-driven electronic medical records for communication with youth and families, and consultation between treating professionals.
One of the briefing speakers was Ted Epperly, MD, the president of the American Academy of Family Physicians. I asked the other speakers (a psychiatrist with the Carter Center Mental Health Program, a psychiatrist with the Missouri Department of Mental Health, and a PhD health and disease management director of prevention programs) if they agreed with Dr. Epperly’s policy and practice objective that every American have a “trusted relationship with a personal physician”? They did. All emphasized the need for a full interdisciplinary team. All agreed that the practice should be fully integrated and “patient-centered.” All agreed that the physician should be the “quarterback” of the team and have the ultimate accountability. All agreed that physician assistants, nurse practitioners, and various mental health professionals were essential to the team. All agreed that this was the goal. All agreed that this is not practice today, but we are moving toward it. All agreed that the electronic medical record was a methodology to help achieve this objective.
There are many different models of “medical homes,” involving different types of professionals based on the age and health situation of the consumer. CHADD supports adapting the AAP model for children with special needs to other populations, including adults.
Clarke
You can read this blog and others like it at the HealthCentral website.
Wednesday, September 2, 2009
AD/HD and the Role of Government
Following receipt of our August 13, 2009 e-mail blast to our 68,000 constituents titled Get Involved—Health Care Reform and Congress—13 Principles to Consider, a gentleman asked to be removed from our mailing list. He was in his fifties and has lived with AD/HD his entire adult life. He commented that to deal with AD/HD, CHADD did not need to promote “government dependence.” So, I wanted to share with you some CHADD philosophy, as articulated through our public policy platform on adults with AD/HD and children with AD/HD, as developed and approved by our volunteer leadership.
Many people with AD/HD face policy obstacles to fulfilling their life expectations. These can be government policies and these can be business policies. For example, health insurance is regulated by government but mostly implemented by insurance businesses. In health care reform, we are just trying to eliminate discrimination and policy obstacles.
For example, CHADD’s 13 principles include the following three:
1) Health care plans should require “parity” for mental health assessment and treatment. This includes non-discrimination between health conditions.
2) Health care plans must not discriminate on the basis of pre-existing conditions or health status.
3) Health care plans must not terminate coverage when people become seriously ill or are being treated for long-term chronic conditions and must not have lifetime caps.
People with AD/HD frequently have less generous coverage and pay more out-of-pocket costs because of discrimination. People with “pre-existing” AD/HD are frequently denied health insurance. And people with AD/HD frequently face limits on the treatment of AD/HD over time. CHADD’s objective is not to make people with AD/HD become “dependent” on the government. Our objective is to eliminate discriminatory coverage policies so citizens with AD/HD can receive the same health benefits as other citizens.
Likewise, our objective that a health care initiative must provide health care coverage for all Americans is not intended to make Americans “dependent” on government, but to ensure that all Americans have the health insurance coverage that they need.
The last two principles I will address here are: a health care initiative that allows young adults to stay covered on their parents’ plan until the age of 26, and a health care initiative that specifically covers young adults, with a particular focus on young adults with special health care needs. As the father of a soon-to-be 19-year-old son with substantial co-occurring disorders, I am supportive of CHADD’s advocacy of these principles in order to avoid “government dependence.” The education system and the vocational rehabilitation system have encouraged our son to apply for Supplemental Security Income (SSI), as his vocational future is uncertain. The major reason for this encouragement is lack of health insurance—depending on student status, at ages 18 and 22 he is on his own to locate his own health insurance. Our son and his parents reject the notion of needing SSI at age 18. He has lots of years left to develop his vocational skills and enhance his education. But we are worried about health insurance. The Ross family opposes the economic incentive to apply for government financial assistance because of the fear and possibility of no health insurance. Parents throughout the nation and in our family and social circles have this same philosophy.
So, asking the government to provide adequate non-discriminatory health insurance for all citizens, particularly those with a history of special needs is not promoting “government dependence,” but encouraging independence to pursue life choices. As CHADD CEO, I regret that we lost a constituent. But as the father of a young adult with special needs, I am glad that I work for an organization whose volunteer leadership sees the validity of these objectives.
Clarke
You can read this blog and others like it at the HealthCentral website.
Many people with AD/HD face policy obstacles to fulfilling their life expectations. These can be government policies and these can be business policies. For example, health insurance is regulated by government but mostly implemented by insurance businesses. In health care reform, we are just trying to eliminate discrimination and policy obstacles.
For example, CHADD’s 13 principles include the following three:
1) Health care plans should require “parity” for mental health assessment and treatment. This includes non-discrimination between health conditions.
2) Health care plans must not discriminate on the basis of pre-existing conditions or health status.
3) Health care plans must not terminate coverage when people become seriously ill or are being treated for long-term chronic conditions and must not have lifetime caps.
People with AD/HD frequently have less generous coverage and pay more out-of-pocket costs because of discrimination. People with “pre-existing” AD/HD are frequently denied health insurance. And people with AD/HD frequently face limits on the treatment of AD/HD over time. CHADD’s objective is not to make people with AD/HD become “dependent” on the government. Our objective is to eliminate discriminatory coverage policies so citizens with AD/HD can receive the same health benefits as other citizens.
Likewise, our objective that a health care initiative must provide health care coverage for all Americans is not intended to make Americans “dependent” on government, but to ensure that all Americans have the health insurance coverage that they need.
The last two principles I will address here are: a health care initiative that allows young adults to stay covered on their parents’ plan until the age of 26, and a health care initiative that specifically covers young adults, with a particular focus on young adults with special health care needs. As the father of a soon-to-be 19-year-old son with substantial co-occurring disorders, I am supportive of CHADD’s advocacy of these principles in order to avoid “government dependence.” The education system and the vocational rehabilitation system have encouraged our son to apply for Supplemental Security Income (SSI), as his vocational future is uncertain. The major reason for this encouragement is lack of health insurance—depending on student status, at ages 18 and 22 he is on his own to locate his own health insurance. Our son and his parents reject the notion of needing SSI at age 18. He has lots of years left to develop his vocational skills and enhance his education. But we are worried about health insurance. The Ross family opposes the economic incentive to apply for government financial assistance because of the fear and possibility of no health insurance. Parents throughout the nation and in our family and social circles have this same philosophy.
So, asking the government to provide adequate non-discriminatory health insurance for all citizens, particularly those with a history of special needs is not promoting “government dependence,” but encouraging independence to pursue life choices. As CHADD CEO, I regret that we lost a constituent. But as the father of a young adult with special needs, I am glad that I work for an organization whose volunteer leadership sees the validity of these objectives.
Clarke
You can read this blog and others like it at the HealthCentral website.
Wednesday, August 12, 2009
Research Interests and Priorities
In the past two weeks, a federal government agency and a sister medical association have asked CHADD about our research interests and priorities related to AD/HD. Below is the list of 20 AD/HD research interests that we have tentatively identified.
1. Gene-Environment Interaction
2. Gene Risk Factors
3. Biogenetic Markers
4. Executive Functioning
5. Neurocognitive Deficits Associated with AD/HD
6. Brain Research Integrating Neurology and Psychiatry
7. Longitudinal Neuroimaging Research
8. Chart Trajectories to Determine Interventions
9. Lifespan Dynamics and Characteristics
10. Impairment Index
11. Mental Disorders as Developmental Disorders
12. Personalizing Interventions
13. Impact of Culture, Race, Etc. (including disparities and possible differential medication impact)
14. Translate Research to Practice (and Public Health)
15. Core Features of AD/HD versus Comorbidity Features
16. Autism-AD/HD Interface
17. Efficacy of Neurofeedback
18. Outreach to National Center on Complementary and Alternative Medicine
19. Patient Perspective into Evidence-Based Practice (including the lived experience)
20. Evidence Base of CHADD's Parent to Parent Program
Many of these topics are discussed in some depth in our National Resource Center on AD/HD (NRC) website and in the public policy section of CHADD's website.
Your questions, observations, and commentary will be very helpful as we refine the list.
Clarke
You can read this blog and others like it at the HealthCentral website.
1. Gene-Environment Interaction
2. Gene Risk Factors
3. Biogenetic Markers
4. Executive Functioning
5. Neurocognitive Deficits Associated with AD/HD
6. Brain Research Integrating Neurology and Psychiatry
7. Longitudinal Neuroimaging Research
8. Chart Trajectories to Determine Interventions
9. Lifespan Dynamics and Characteristics
10. Impairment Index
11. Mental Disorders as Developmental Disorders
12. Personalizing Interventions
13. Impact of Culture, Race, Etc. (including disparities and possible differential medication impact)
14. Translate Research to Practice (and Public Health)
15. Core Features of AD/HD versus Comorbidity Features
16. Autism-AD/HD Interface
17. Efficacy of Neurofeedback
18. Outreach to National Center on Complementary and Alternative Medicine
19. Patient Perspective into Evidence-Based Practice (including the lived experience)
20. Evidence Base of CHADD's Parent to Parent Program
Many of these topics are discussed in some depth in our National Resource Center on AD/HD (NRC) website and in the public policy section of CHADD's website.
Your questions, observations, and commentary will be very helpful as we refine the list.
Clarke
You can read this blog and others like it at the HealthCentral website.
Tuesday, July 7, 2009
Health and Wellness in Health Care Reform
CHADD is pursuing the promotion of health and wellness as part of our health care reform agenda.
A blogger and former CHADD chapter coordinator reacted to my June 25 blog on health care reform messages noting: “Totally left out of the debate are such factors as encouraging health and wellness. A huge chunk of our health care costs arise from avoidable conditions—obesity, lifestyle choices (smoking, for instance), inactivity, and so on.” I did leave this out of my blog entry that week; however, CHADD is actively involved with this objective. Blog comments are supposed to be very brief; thus, I limited my message and links to two coalitions.
Encouraging health and wellness is an important component of health care reform and part of both the National Health Council (NHC) and Campaign for Mental Health Reform (CMHR) advocacy. CHADD works through these coalitions. The NHC comprises roughly 44 voluntary health agencies (VHAs), including those addressing heart, cancer, diabetes, epilepsy, arthritis, asthma, and autism, as well as CHADD. We reach consensus and publicize the consensus.
Likewise, the CMHR is a coalition of 17 national mental health associations, including National Alliance on Mental Illness (NAMI) and Mental Health America (MHA). We reach consensus and publicize the consensus. My June 25 blog merely highlighted the priorities of these two important coalitions. These 61 national health organizations are serious about the principles I discussed in last week’s blog.
CHADD participates in three organizations where promoting health and wellness are important advocacy elements:
1. The Whole Health Campaign is a newer coalition that advocates integration of mental health and substance abuse into public health systems promoting healthy lifestyles, preventing disability and disease, encouraging lifelong management of chronic disease, monitoring health trends, and linking people to needed health services. The Whole Health Campaign advocates five actions to promote health and wellness that includes mental health and substance abuse. Link here for their five actions and paper on health and wellness.
2. Between January and May, the federal agency Substance Abuse and Mental Health Services Administration (SAMHSA) has convened “listening” sessions with mental health and substance abuse organizations, including CHADD. The result of these sessions was the SAMHSA publication of nine principles. The first principle is: “Articulate a national health and wellness plan for all Americans, with a focus on prevention and early intervention.” Link here for a copy of the SAMHSA principles.
3. CHADD co-chairs, with the March of Dimes, the CDC National Center on Birth Defects and Developmental Disabilities (NCBDDD) External Partners Group (EPG) advocacy effort. The U.S. Congress, through the Economic Stimulus Act, established a new $600 million Prevention and Wellness Fund. The EPG was instrumental in convincing the Congress to insert “disabilities” in the initial legislation. At the last moment, in back-door tradeoffs, “disability” was deleted and the Fund focuses on chronic and infectious diseases. We continue to advocate that disability be included in prevention and wellness programs. Learn more about these efforts on the CDC-NCBDD website (click on “partners”) or visit the EPG website.
Several blogs ago I summarized the National Academy of Sciences’ Institute of Medicine report on prevention of mental health challenges in teens and young adults. This is a component of health and wellness.
Visit the public policy section of the CHADD website to see the comprehensive agenda we are pursuing. You can also read the health care reform objectives CHADD submitted to President Obama’s transition team. A single blog, briefly reviewing a few of the coalition efforts we advocate, is no substitute for the comprehensive agenda we work on.
There are many other aspects to health care reform, many of which CHADD is involved with. Visit our public policy website and keep the comments coming—particularly directly to your elected members of the U.S. Congress.
Clarke
You can read this blog and others like it at the HealthCentral website.
A blogger and former CHADD chapter coordinator reacted to my June 25 blog on health care reform messages noting: “Totally left out of the debate are such factors as encouraging health and wellness. A huge chunk of our health care costs arise from avoidable conditions—obesity, lifestyle choices (smoking, for instance), inactivity, and so on.” I did leave this out of my blog entry that week; however, CHADD is actively involved with this objective. Blog comments are supposed to be very brief; thus, I limited my message and links to two coalitions.
Encouraging health and wellness is an important component of health care reform and part of both the National Health Council (NHC) and Campaign for Mental Health Reform (CMHR) advocacy. CHADD works through these coalitions. The NHC comprises roughly 44 voluntary health agencies (VHAs), including those addressing heart, cancer, diabetes, epilepsy, arthritis, asthma, and autism, as well as CHADD. We reach consensus and publicize the consensus.
Likewise, the CMHR is a coalition of 17 national mental health associations, including National Alliance on Mental Illness (NAMI) and Mental Health America (MHA). We reach consensus and publicize the consensus. My June 25 blog merely highlighted the priorities of these two important coalitions. These 61 national health organizations are serious about the principles I discussed in last week’s blog.
CHADD participates in three organizations where promoting health and wellness are important advocacy elements:
1. The Whole Health Campaign is a newer coalition that advocates integration of mental health and substance abuse into public health systems promoting healthy lifestyles, preventing disability and disease, encouraging lifelong management of chronic disease, monitoring health trends, and linking people to needed health services. The Whole Health Campaign advocates five actions to promote health and wellness that includes mental health and substance abuse. Link here for their five actions and paper on health and wellness.
2. Between January and May, the federal agency Substance Abuse and Mental Health Services Administration (SAMHSA) has convened “listening” sessions with mental health and substance abuse organizations, including CHADD. The result of these sessions was the SAMHSA publication of nine principles. The first principle is: “Articulate a national health and wellness plan for all Americans, with a focus on prevention and early intervention.” Link here for a copy of the SAMHSA principles.
3. CHADD co-chairs, with the March of Dimes, the CDC National Center on Birth Defects and Developmental Disabilities (NCBDDD) External Partners Group (EPG) advocacy effort. The U.S. Congress, through the Economic Stimulus Act, established a new $600 million Prevention and Wellness Fund. The EPG was instrumental in convincing the Congress to insert “disabilities” in the initial legislation. At the last moment, in back-door tradeoffs, “disability” was deleted and the Fund focuses on chronic and infectious diseases. We continue to advocate that disability be included in prevention and wellness programs. Learn more about these efforts on the CDC-NCBDD website (click on “partners”) or visit the EPG website.
Several blogs ago I summarized the National Academy of Sciences’ Institute of Medicine report on prevention of mental health challenges in teens and young adults. This is a component of health and wellness.
Visit the public policy section of the CHADD website to see the comprehensive agenda we are pursuing. You can also read the health care reform objectives CHADD submitted to President Obama’s transition team. A single blog, briefly reviewing a few of the coalition efforts we advocate, is no substitute for the comprehensive agenda we work on.
There are many other aspects to health care reform, many of which CHADD is involved with. Visit our public policy website and keep the comments coming—particularly directly to your elected members of the U.S. Congress.
Clarke
You can read this blog and others like it at the HealthCentral website.
Thursday, June 25, 2009
Health Care Reform Messages
Every day in the national media there are reports of the debates, discussions, proposals, and controversies about national health care reform. This is a very complicated arena.
Here are the highlights of CHADD’s priorities for health care reform (as of today).
CHADD, as a member of the National Health Council Voluntary Health Agencies, advocates five principles in addressing health care reform, as part of the Council’s “Campaign to Put Patients First” initiative:
1. Cover everyone.
2. Curb costs responsibly.
3. Abolish exclusions for pre-existing conditions.
4. Eliminate lifetime caps.
5. Ensure long term and end-of-life care.
At CHADD’s encouragement, each NHC principle includes an emphasis on “non-discrimination between health conditions.”
CHADD, as a member of the Campaign for Mental Health Reform, advocates the following priorities for mental health in health care reform:
6. Parity for mental health conditions in health benefit design; something stronger than “nothing in this legislation shall prevent implementation of mental health parity” and adequacy of the mental health benefit for subpopulations, such as children.
7. Chronic Care-Chronic Condition Management must include mental illness and mental disorders, such as serious and persistent mental illnesses such as schizophrenia, co-occurring physical illness and mental illness such as health attack/stroke and depression, and co-occurring mental disorders such as the AD/HD child mental disorder co-occurring prevalence data. Focus on lifelong disorders.
8. Encouragement of the “medical home” concept whereby professionals take responsibility for coordinating, integrating, and communicating services and supports. Included in this are consumer-family access to electronic medical records and implementation of personal health records.
9. Affirmative provisions dealing with racial and ethnic disparities, and affirmative provisions recognizing “disability based health disparities.”
There are many other important priorities. These are CHADD’s current priorities, through our membership in these two coalitions. CHADD belongs to many other Washington, DC-based coalitions.
Let us know if there are any very important principles missing from our current priorities. Get involved with your senators and representatives in the U.S. Congress to ensure that these priorities are included.
Clarke
You can read this blog and others like it at the HealthCentral website.
Here are the highlights of CHADD’s priorities for health care reform (as of today).
CHADD, as a member of the National Health Council Voluntary Health Agencies, advocates five principles in addressing health care reform, as part of the Council’s “Campaign to Put Patients First” initiative:
1. Cover everyone.
2. Curb costs responsibly.
3. Abolish exclusions for pre-existing conditions.
4. Eliminate lifetime caps.
5. Ensure long term and end-of-life care.
At CHADD’s encouragement, each NHC principle includes an emphasis on “non-discrimination between health conditions.”
CHADD, as a member of the Campaign for Mental Health Reform, advocates the following priorities for mental health in health care reform:
6. Parity for mental health conditions in health benefit design; something stronger than “nothing in this legislation shall prevent implementation of mental health parity” and adequacy of the mental health benefit for subpopulations, such as children.
7. Chronic Care-Chronic Condition Management must include mental illness and mental disorders, such as serious and persistent mental illnesses such as schizophrenia, co-occurring physical illness and mental illness such as health attack/stroke and depression, and co-occurring mental disorders such as the AD/HD child mental disorder co-occurring prevalence data. Focus on lifelong disorders.
8. Encouragement of the “medical home” concept whereby professionals take responsibility for coordinating, integrating, and communicating services and supports. Included in this are consumer-family access to electronic medical records and implementation of personal health records.
9. Affirmative provisions dealing with racial and ethnic disparities, and affirmative provisions recognizing “disability based health disparities.”
There are many other important priorities. These are CHADD’s current priorities, through our membership in these two coalitions. CHADD belongs to many other Washington, DC-based coalitions.
Let us know if there are any very important principles missing from our current priorities. Get involved with your senators and representatives in the U.S. Congress to ensure that these priorities are included.
Clarke
You can read this blog and others like it at the HealthCentral website.
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