Virginia Regulatory Town Hall
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Board of Medical Assistance Services
 
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11/9/24  12:09 pm
Commenter: Edmund Creekmore Jr PhD LCP, National Shattering Silence VA Director

Public Comment on DMAS Project Bravo Medicaid Waiver 1115 enhancements
 

William McFarlane's work on early psychosis and long-term recovery in Schizophrenia, particularly from the negative symptoms of serious mental illness with ongoing family support, has been seminal in the field.  McFarlane and his collaborators cite study findings that suggest substantial decrease in the relapse rates of those recovering from 1st and 2nd episodes of psychosis with early pharmacological intervention with evidence of sustained recovery.  Dr. McFarlane's cites research, as well, describing the improved prognosis for recovery over time that has been shown to vary with the degree of family support and participation delivered at home and in the community in the improvement of negative symptom in adults diagnosed with Schizophrenia.  The Multiple Family Support treatment model, championed by McFarlane et al, in care coordination with other evidence-based, home-based treatment models, such as Assertive Community Treatment (ACT) and Crisis Resolution In Home Treatment (CRIHT), have been shown consistently to be effective in international studies in sustaining long-term recovery in these chronic "at risk" populations.  Home-based psychiatric care delivery enhanced with "point of care" and remote medical technologies represent potential alternatives to hospital and clinic based psychiatric care that should be taken into account for services provided along a broad continuum of care.  Such "state of the art" innovations of care should be fully taken into account in DMAS Bravo's enhanced funding initiatives under the Medicaid Waiver 1115 SMI proposals and should be comparable in scope under mental health parity law to those funded for SUDS and Co-morbid disorders under the ARTS Waiver programs and Opioid settlement.

In Service.

Edmund W. Creekmore, Jr., PH.D., LCP, National Shattering Silence Policy Action Co-Chair and Virginia Policy Director

CommentID: 228839