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Service Accessibility Through North Carolina’s Medicaid Expansion

 

On December 1st, 2023, Medicaid Expansion took place in North Carolina, giving hundreds of thousands of previously ineligible people access to Medicaid Services. Medicaid Expansion has allowed many new families to access Medicaid health services, including adult mental health and substance use services. 

Benchmarks is piloting the Standardized Assessment Protocol (SAP) project in North Carolina. This project has expanded to In-Home Family Services (IHFS), which is a part of the child welfare system that strives to promote family preservation through mandated support and services to the families who are involved. Many reports that bring a family in contact with the child welfare system involve neglect.

Neglect is defined as the failure to provide a child with needed food, clothing, shelter, medical care, or supervision, and affects millions of children. For some families, this neglect can occur due to lack of resources, living in poverty, or stem from a parent or guardian’s untreated mental health or substance use problems. For the families who are struggling to make ends meet and living in poverty, finding the time and funds to tend to their health and wellness needs is likely limited. Social workers working with families in IHFS work to address some of these barriers to a parent or guardian’s services during case planning.

For the children who are involved with IHFS, we hope to see more parents begin receiving Medicaid services. By adding more parents and guardians (as well as children!) to the Medicaid rolls, the system is removing a barrier that was preventing families from accessing needed health services. As previously mentioned, some parents of the children who become involved with child welfare suffer from their own mental health and/or substance use issues and need additional services and support in these areas. Not having access to these services could be contributing to parents not being able to take care of their own needs, causing them to create an environment that is not ideal for them or their children. Now, many of those parents will have access to appropriate health care, including mental health and substance use services. A parent who can take care of themselves, both physically and mentally, will be more able to tend to the needs of their children as well. With additional support from mental health and substance use providers systems, parents will be able to maintain a safer environment for their children, eliminating the need for contact with the child welfare system.

With Medicaid Expansion taking place, we anticipate that more parents will have the necessary insurance to get linked to their own services. Children who are in IHFS in participating SAP counties are eligible to enter the pathway to wellbeing and receive a Trauma-intensive Comprehensive Clinical Assessment (TiCCA). The TiCCA will provide treatment recommendations for the child and family address their trauma-related needs. Due to Medicaid Expansion we hope to see more parents having access to the resources for their own mental health and substance use assessments, and any treatment that results from those assessments.

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Where I reside, therapy is unaffordably $200-plus an hour. Such non-Big-Pharma-profiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered at all by the public healthcare plan.

The pharmaceutical industry, meanwhile, notably profits from the continual and even addictive sedation and concealment, via tranquilizers and/or antidepressants, of symptoms of cerebral disorders, including the anxiety and/or depression that often accompany higher-functioning autistic spectrum disorder — especially if there’s related adverse childhood experience trauma.

From my understanding, only a small percentage of Canadian physicians currently are integrating ACE-trauma science into the diagnoses and (usually chemical) treatments of patients.

And I don't believe it’s just coincidental that the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions. ...

Also, I’ve read claims within conservative news-media that Canada can’t afford a fully publicly funded ‘pharmacare’ plan through which generic-brand prescription medication is universally accessible.

We continue to be the world’s sole nation that has universal healthcare but no similar coverage of prescribed medication, however necessary.

A late-2019 Angus Reid study found that, over the previous year, due to medication unaffordability, almost a quarter of Canadians decided against filling a prescription or having one renewed. Resultantly, many low-income outpatients who cannot afford to fill their prescriptions end up back in the hospital system as a result, therefore costing far more for provincial and federal government health ministries than if the medication had been covered.

Ergo, in order for the industry to continue raking in huge profits, Canadians and their health, as both individual consumers and a taxpaying collective, must lose out big time.

Canadians were promised a ‘pharmacare’ plan before by the federal government— only to have the pharmaceutical industry successfully threaten to abandon their Canada-based R&D, etcetera, if the government went ahead with the plan.

Why? Because such universal medication coverage would negatively affect the industry’s superfluously plentiful profits. The profits would still be great, just not as great.

The Angus Reid study also found that about 90 percent of Canadians — including three quarters of Conservative Party supporters specifically [who definitely are not known for supporting publicly-funded social programs] — support a national 'pharmacare' plan. Another 77 percent believed this should be a high-priority matter for the federal government.

So, while we are envied abroad for our “universal” healthcare system, full care seemingly still comes second to the industry’s big-profit interests.

Last edited by Frank Sterle Jr.
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