The White House Responds To The Letter!

Okay, so the White House hasn't contacted any of us directly, but someone read that email and took action. First, I received a phone call from a White House Hotline. The lady I spoke with asked how I was doing with all of this and gave me a phone number for here in California. She wasn't able to help us directly, she was calling from an agency in Missouri of all places, but she seemed to really care, which was nice.

And then I received this email from the DEPUTY REGIONAL ADMINISTRATOR, Office of the Regional Administrator | Centers for Medicare and Medicaid Services 

Hi, Ms. McRee. The White House forwarded your email of 12/11 to our office for response. I’ve attached the formal letter that will be mailed to you on Monday. However, because of the urgency of your granddaughter’s situation, I thought it prudent to get you the information as quickly as possible.

Enclosed was this letter attachment,

Dear Ms. McRee:

I'm writing to you about your December 11, 2015 email to President Obama regarding your daughter's and granddaughter's issues with a mental health diagnosis and attempts to get appropriate care under their insurance. The White House has taken note of your particular issue and has forwarded your letter to our agency and to this office for a response because you live in Califomia. Our office provides support and counsel to Medicare and Medicaid beneficiaries in your state.

First, I would like to say that I'm terribly sorry to read about your family's struggles; it's difficult to watch someone you love deal with illness and worry.

I showed this letter to the mental health experts in our Medicaid division and asked what they could tell me immediately. Here's what I learned.

While this complaint was about your granddaughter's insurance, CenCal, her Medi-cal Managed Care plan, individuals with moderate to severe mental health needs are served by mental health plans run by their county of residence. These plans are regulated as health plans and held to the same standards. CenCal does not cover psychiatric residential placements, that should be covered by her County Mental Health Plan (CMHP).

Your granddaughter should be a patient of her county's CMHP, based on her multiple hospitalizations. The CMHP should assess her for any medically necessary service. Including residential placement, and then provide her with a range of services based on medical necessity. While you asked about long-term residential placement, youth are generally assessed for short-term placements with a variety of intensive supports for community placement, including therapeutic behavioral services, intensive care coordination, intensive home-based services. targeted case management, as well as other mental health services available to patients of all ages. If, in fact, longer term residential services are necessary, the health plan CMHP should secure the placement, however the number of these facilities for youth has decreased with the increased availability of community supports.

Once we know your granddaughter's county of residence, my office can assist her mother in identifying mental health services, such as the CMHP, other community mental health centers, or advocates. At this juncture, and without having specific information about your granddaughter's case, our experts strongly recommend against relinquishing parental rights. This would leave your granddaughter a legal orphan and would eliminate your family's capacity to advocate for her. She should not have to be put into foster care in order to receive the services she requires.

Our office has already spoken to the State of Califonia to ask some preliminary questions; the state indicates that they would be very willing to help your family. I suggest that you have your daughter call our office as soon as possible, at 4l5-744-3568. This is the main line to our Division of Medicaid and children's Health. Please have her reference the letter you wrote to the President and my response, directing her to call. our regular business hours are 9-5, Monday through Friday.

Because of the urgency of this situation, I'm emailing you a copy of this letter today, and we will follow up with a hard copy on Monday.

I'd like to thank you very much for taking the time to reach out to President Obama about this issue and I hope that our office can help your family. I am happy that much-needed mental health services are available to patients like your granddaughter, who are on Medicaid. In addition, the Affordable Care Act extended federal parity protections to millions of Americans with small group and individual health plans. This means that all health plans and insurers are legally required to offer coverage for mental health and substance abuse issues that is compatible to coverage for general medical and surgical care.

Again, thank you for writing to us. 


***This is only a beginning. One case is a start in the right direction, but does not change things for other families facing similar struggles. Coming up - Do you know of your resources?, Joining together to help all parents help their children, and many more steps until we have bridged this information gap***