Any topic (writer’s choice)
Colleague 1
Description of the federal Mental Health Parity and Addiction Equity Act and the Affordable Care Act
The federal Mental Health Parity and Addiction Equity Act (MHPAEA) that was created in 2008 specifically mandated that parity was required for employers to provide their employees with a broad set of benefit features that not only included coverage for behavioral health services and substance use disorders (SUD), but also equaled medical and surgical benefits as well (Friedman, Xu, Harwood, Azocar, Hurley, & Ettner, 2017). This act required employers to offer packages that included financial requirements such as copayments, quantitative treatment limits that included annual outpatient visits, and non-quantitative limits that were in connection to provider networks and prior authorization (Friedman et al., 2017).
The Affordable Care Act (ACA) sometimes known as the Patient Protection Affordable Care Act (PPACA) or Obamacare is aimed to make healthcare affordable to more individuals and families. This act was signed into law by President Barack Obama in 2010, specifically to do three main things: reform the private insurance market, expand Medicaid to the working poor, and to create changes in how decisions are made medically (Silvers, 2013;Tai & Volkow, 2013). In relation to addiction, the ACA is known as one of the largest expansions that provides coverage for mental health and substance use disorders (Digital Communications Division, 2019).
Explain how you might respond to the scenario provided utilizing the two acts.
As her co-worker I would respond by letting her know that she is not alone in this. Due to her current demeanor, she may not remember the incident. Therefore, when she is sober, I would let her know that under the MHPAEA, within our benefit package provided to us by the company, is an insurance plan that delivers us with coverage for medical, behavioral health and substance use disorder expenses (Friedman et al., 2017). I would make sure that she understands that she has the right to use this benefit package to receive the help she needs.
When referring to the ACA, I would reiterate to my co-worker that this act alone is known for having one of the largest expansion packs that provides coverage for mental health and substance use disorders. The ACA works to create changes within the medical field because prior to this act, obtaining medical care was completely separated when it came to receiving help for behavioral health and substance use. Tai and Volkow (2013) describe how treatment for substance use disorders under the ACA should primarily focus on long-term strategies that are aimed at reducing relapse in individuals who struggle with addiction (p. 166). I would let my co-worker know that under this act she is protected to receive the help she needs, and it will be affordable.
Identify the rights the employee has in this situation.
Under the MHPAEA, the employee in the scenario has the right to a benefit package that has been provided to her through the company that will and should cover the cost of the addiction treatment that she has drunkenly requested. According to Friedman et al. (2017) employers are required by law to provide their employees with benefit packages that include coverage for behavioral health services and substance use disorders that are equal to medical coverages or expenses. The employee has the right to use her benefit package to seek treatment for her alcohol addiction.
As a social worker when working with the client in this scenario, it may be best to use a task-center approach that focuses on solving the problem. In this case, the client would like to seek treatment for her addiction the alcohol. As her social worker, it is evident that the client is aware of her problem and would like help taking the necessary steps to change. The social worker should refer her to a rehabilitation facility where she could get treatment for her alcohol addiction. It would be important for the client and social worker to interact regularly to ensure that the client is making the necessary changes to be successful in overcoming her addiction.
Explain how the laws you discuss protect the employee who violated the companys policy on drunkenness.
Though the employees behavior was inappropriate for the work setting, under these laws she cannot be terminated from her job. The reasoning behind her intoxication within the work setting could be due to something she is facing that is affecting her mentally, emotionally, and physically. She outwardly stated that she is addicted to alcohol and needs treatment. I am pretty sure that it is found to be unethical to terminate an employee who confessed having a substance abuse disorder, especially if the company benefits include coverage for behavioral health and substance abuse.
Explain why such laws might be important.
These laws are important because many people suffer with behavioral health issues and addictions because they are unable to afford the treatment. Laws such as the MHPAEA allow there to be coverage within the companys benefit package that includes coverage for behavioral health and substance abuse disorders. Whereas, the ACA ensures that individuals and families can afford the coverage. The main reason why people deny help or are unable to receive the necessary help is due to the cost of it, but these laws make them easily accessible and affordable.
References
Digital Communications Division (2019). Does the Affordable Care Act cover individuals with mental health problems? Retrieved from https://www.hhs.gov/answers/affordable-care-act/does-the-aca-cover-individuals-with-mental-health-problems/index.html
Friedman, S., Xu, H., Harwood, J. M., Azocar, F., Hurley, B., & Ettner, S. L. (2017). The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders. Journal of Substance Abuse Treatment, 80, 6778. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jsat.2017.06.006
Silvers J. B. (2013). The Affordable Care Act: objectives and likely results in an imperfect world. Annals of family medicine, 11(5), 402405. https://doi.org/10.1370/afm.1567
Tai, B., & Volkow, N. (2013). Treatment for Substance Use Disorder: Opportunities and Challenges under the Affordable Care Act. Social Work in Public Health, 28(3/4), 165174. https://doi-org.ezp.waldenulibrary.org/10.1080/19371918.2013.758975
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Colleague 2
RE: Week 2 Discussion 1
COLLAPSE
Post a brief description of the federal Mental Health Parity and Addiction Equity Act and one other act you chose for this discussion as it relates to addictions.
The Federal Mental Health Parity and Addiction Equity Act of 1966 provided that large group health plans cannot impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on medical/surgical benefits (CMS, 2020). The Affordable Care Act (ACA) became law in March 2010. The ACA provides greater access to substance use disorder treatment though major coverage expansions, regulatory changes requiring coverage of substance use disorder treatment in existing insurance plans, and requirements for substance use disorder treatments to be offered on par with medical and surgical procedures (Abraham, Andrews, Grogan, DAunna, Humphreys, Pollarck & Friedmann, 2017).
Explain how you might respond to the scenario provided utilizing the two acts.
I would respond inquiring through the benefits department about the two acts. Most agencies have numbers that someone can call when individuals need help or counseling. I would call this number and give this information to the counselor on the phone. I know that is it difficult to speak to an intoxicated individual. When the coworker sobers up, I would tell them both of these acts that could help him better himself.
Identify the rights the employee has in this situation.
As an employee, the individual is entitled to the same rights as anyone with a medial or psychological condition, meaning that individual is entitled to support from the employer, time off for counseling and rehab, and complete confidentiality (Cassiobury Court, 2020). The employee may obtain a disciplinary depending on the contract that they signed when they were hired. This may be forgiven if they get the help that is needed.
Explain how the laws you discuss protect the employee who violated the companys policy on drunkenness.
These laws I discussed dont protect the employee who violated the companys policy on drunkenness. When the employee got the job, the rules and regulations were known and probably signed by the employee. The two acts that I chose wont protect the employee from a discharge. These acts only state that the insurance agencies or employer cant discriminate against these individuals.
Explain why such laws might be important.
The laws that I chose are important. These acts ensure that the employee is offered the same care as a person with medical issues. There are some employers that may not want to help people that have addictions but under these acts, they can get the help that is needed.
The Mental Health Parity and Addiction Equity Act (MHPAEA) (2020). Retrieved from: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet
Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American journal of public health, 107(1), 3132. https://doi.org/10.2105/AJPH.2016.303558
Employment Rights for Someone With An Addiction (2020). Retrieved from: https://cassioburycourt.com/2019/05/employment-rights-for-someone-with-an-addiction/
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