Psychiatr News October 6, 2006
Volume 41, Number 19, page 10
© 2006 American Psychiatric Association
Government Efforts Fall Short In Addressing Victims' MH Needs
Rich Daly
The final tally for federal spending on short-term and long-term mental
health care after last year's hurricanes remains unclear, but to critics it
appears to be far too little.
In the year since the twin disasters of hurricanes Katrina and Rita, the
federal government has provided $110.6 billion in aid for relief, recovery,
and rebuilding efforts. The vast majority of federal funds were allocated to
meet needs unrelated to health care.
The largest segment of health care support came via Congressional approval
of $2 billion in Medicaid waivers for hurricane victims, which allowed eight
states to reimburse clinicians for uncompensated care they provided to an
estimated 325,000 evacuees. In the aftermath of the storms, 32 states provided
up to five months of simplified enrollment in their Medicaid plans for
displaced low-income individuals.
Based on normal levels of Medicaid spending, significant mental health
assistance is believed to have been provided through Medicaid to enrollees
affected by the storms to whom the Department of Health and Human Services
(HHS) granted special "evacuee" status. HHS extended the public
health state of emergency through the end of this year to ease Medicaid access
for Gulf Coast residents and evacuees.
States have not yet reported their Medicaid mental health spending totals,
said federal officials.
Another large federal health-related aid effort is the congressionally
approved $16.7 billion in Department of Housing and urban Development's (HUD)
Community Development Block Grants. The grant program—passed
specifically to assist states affected by the storms—is designed to help
rebuild damaged housing and other infrastructure, but localities may opt to
spend some of it on health care needs. Final health care allocations by
localities from the largest single housing recovery program in U.S. History
will take up to a year for HUD to tally.
Congress also gave the region $550 million in social-service block grants,
which states have the flexibility to allocate to health care needs. Louisiana,
for instance, allocated $80,000 of the one-time funding for mental health
programs.
Critics complained that the largest portion of federal mental health funds
appears directed at short-term and crisis-recovery assistance. The historic
nature of the disaster should have spurred a federal response of similar scale
directed at longer-term interventions.
Among examples of some higher-profile federal health care support is the
mobilization of all of HHS's emergency response capabilities to provide the
affected states and localities with crisis health care assistance. Experts
from all areas of HHS, including the Centers for Disease Control and
Prevention and the Food and Drug Administration, augmented state and local
public health personnel. The U.S. Public Health Service Commissioned Corps
provided crisis care as well as longer-term health care assistance to
Louisiana health officials, including a recent assessment of 72 nursing homes
and 61 hospitals in the 12 southernmost parishes of
Louisiana.
| |
Almaz Oko, a Miami resident who came to Chicago after Hurricane Andrew
destroyed her home in 1992, sits in the community room of Deborah's Place, a
transitional housing facility for women, in March. Oko said she still suffers
from insomnia and flashbacks and thinks Katrina's victims face a long
recovery.
AP Photo/Photographer: M. Spencer Green
|
|
The Substance Abuse and Mental Health Services Administration (SAMHSA),
which is an HHS agency, also arranged for the provision of significant amounts
of mental health counseling and referrals to hurricane survivors (see article
above).
SAMHSA's center for Mental Health Services, in partnership with the Federal
Emergency Management Agency (FEMA), awarded about $110 million for
crisis-counseling programs, including $34 million—the second largest
grant of its kind—to a Louisiana program.
FEMA also established a program to find and coordinate the services of
licensed medical and mental health clinicians in the region as well as
nationwide—including more than 50 psychiatrists—who volunteered to
provide short-term care.
FEMA said it deployed a record 6,300 personnel, including nurses and
physicians who treated more than 165,000 people in the weeks following the
storms.
The Department of Veterans Affairs deployed health care personnel,
including nurses, radiology technicians, health care technicians, respiratory
therapists, and others, to help increase the ratio of those available to
provide medical services to those who needed it. The department's health care
professionals provided support to several New Orleans hospitals through the
end of September.
Although much of the federal health care effort in the wake of the storms
was focused on short-term assistance and recovery, an initiative with
long-term impact is the HHS-supported effort to revamp Louisiana's health care
system, a project known as the Louisiana Health Care Redesign Collaborative.
HHS supported the redesign with staff, expertise, and efforts to remove
roadblocks. HHS Secretary mike Leavitt pledged to support Medicare and
Medicaid waivers to help drive the overhaul. The state aims to present its
blueprint for redesign by October.
Another key aspect of a long-term mental health effort is assessing the
continuing impact of the storms on the mental health of the survivors. To this
end, the National Institute of Mental Health approved a $1 million grant to
extend a Harvard study that will use telephone interviews to assess the
continuing mental health of more than 1,000 hurricane survivors in the Gulf
Coast region and scattered across the country.
Information on the federal response to the 2005 hurricanes is posted
at
<www.dhs.gov/interweb/assetlibrary/GulfCoast_Katrina1yearFactSheet.pdf>.
Get information about faster international access.
Privacy Policy
Copyright © 2006
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
| 
