VITAL POLICY – Special Legislative Session May Result in More Federal Control Over Healthcare, Loss of Medical Privacy, More Liberal Ideology in Public Education

Item 2 on Governor’s Special Session Call

There is a solid set of reasons that most states are avoiding waivers from the federal government to allow federal matching funds for Medicaid to cover the cost of services for mental illness and substance abuse disorders at institutions of mental diseases. Those reasons include potential loss of privacy, data mining of personal information, expansion of federal control over healthcare, increased federal influence of school-based and other mental health services, and a diversion of existing federal Medicaid funds from medical treatment to mental health and substance abuse treatment.

Item two on the governor’s agenda-call for the special session seeks exactly such a waiver. Gov. Lee Issues Official Call, Presents Legislative Priorities Ahead of Public Safety Special Session (

A letter from the United States DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Services to state Medicaid directors, dated November 13, 2018, describes regulatory language that spells out mental health intervention in public schools, data sharing, and regulatory guidelines, considered by some to be federal overreach and evidence of excessive government control.

Here are a few highlights from the letter.

Another approach to support earlier identification and engagement in treatment is support for increased screening for mental health conditions and improved access to mental health services through schools.”

Improving data-sharing capabilities between schools, hospitals, primary care, criminal justice, and specialized mental health providers is an effective way to improve communications between these types of entities and the healthcare system.”

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has published comprehensive guidance for professionals and health care consumers explaining the circumstances in which health care providers covered by the Health Insurance Portability and Accountability Act (HIPAA) can share information related to mental health. The HHS OCR guidance, required by section 11003 of the 21st Century Cures Act, clarifies how the HIPAA Privacy Rule permits covered health care providers and other mental health treatment professionals to disclose information to a patient’s family members, caregivers, and others to facilitate treatment and protect the health and safety of patients with SMI and SED and others.”

The full text of the HHS letter is linked here. Opportunities to Design Innovative Service Delivery Systems for Adults with a Serious Mental Illness or Children with a Serious Emotional Disturbance (

Analysis by Tennessee Stands paints a grim picture for individual liberty if the governor’s proposal to seek a waiver for mental health services under Medicaid is successful. “This [mental health intervention] is a trojan horse. More federal money equals more federal regulation and more federal control over the liberties of the people of Tennessee.” – Gary Humble, Executive Director, Tennessee Stands

To see the full analysis of the “Medicaid Waiver” by Tennessee Stands, a link is provided here. We are playing with fire putting more federal money into mental health in the name of public safety. – Tennessee Stands

David Seal is a retired Jefferson County educator, recognized artist, local businessman, 917 Society Volunteer, and current Chairman of the Jefferson County Republican Party. He has also served Jefferson County as a County Commissioner and is a citizen lobbyist for the people on issues such as eminent domain, property rights, education, and broadband accessibility on the state level.