CHARLESTON, W.Va. - Along with expanding Medicaid to the working poor, West Virginia will change billing rules to provide more behavioral health services though the program.

The Department of Health and Human Resources is preparing to accept Medicaid billing from independent, licensed, masters-level clinical social workers. The West Virginia Center on Budget and Policy studied the availability of these services, and health-policy analyst Erin Snyder said the change should help ease a problem.

"There's a limited number of psychiatrists and psychologists as it is, and most areas of the state are considered mental-health professional shortage areas," she said. "With Medicaid expansion, there's an additional 150,000 individuals who will need access to health care."

According to the DHHR, the details are still being worked out but the change should be in effect for the next fiscal year, which begins July 1, and should result in a very limited increase in costs for the program. Providers point out that behavioral health care saves money in the long run by reducing a lot of other costs.

Snyder said it should be a boost for the state's physical health and economy.

"Having effective behavioral-health treatment will increase productivity, decrease the burden on the criminal justice system and decrease health costs," she said. "It's a real benefit to the state."

Snyder said the billing rules had been a barrier to some people getting the care they need, adding that most neighboring states already have removed similar barriers. In many cases in West Virginia, Snyder said, independent providers have had to have a psychologist or psychiatrist review their treatment notes, which she calls an unnecessary step.

"In reality," she said, "when their supervisors review these notes, it's just cursory, in order to bill Medicaid."

Medicaid covers treatment for behavioral-health issues such as depression and substance abuse, both of which are serious problems in the state. By expanding Medicaid to cover families with incomes up to one-and-one-third of the federal poverty level, behavioral health professionals predict a lot more West Virginians should gain access to the help they need.


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More than 1,000 family members of firefighters who died in the line of duty, including some from Texas, will gather in Emmitsburg, Maryland, starting this Friday, to honor their loved ones.

The occasion is the National Fallen Firefighters Memorial Weekend and 13 of the firefighters being honored are from Texas.

Victor Stagnaro, CEO of the National Firefighters Foundation, said their names will be added to a memorial wall.

"Every firefighter that's died in the line of duty since 1981 has their name inscribed on a bronze plaque that's mounted on a marble wall," Stagnaro explained. "The monument itself at the center is a marble sphere, I would say, and there's a flame that never goes out."

Fire chiefs from around the country will present the families with a rose, a badge and an American flag flown at the U.S. Capitol and the memorial site. Anyone who would like to honor the firefighters can participate in "Light the Night for Fallen Firefighters," this Wednesday through Sunday night, by lighting their homes, businesses and other landmarks with red lights, or by signing a virtual remembrance banner on the foundation's website.

The Foundation was formed in 1992 to not only honor those firefighters who pass away but provide support for their relatives. Through a "Fire Hero Family Network," survivors are matched with others who have similar experiences and circumstances. Stagnaro pointed out assistance is available for however long it's needed.

"We continue to support those families -- through scholarships, through wellness conferences, we have kid's camps -- all other types of activities to help support those families throughout the year," Stagnaro outlined.

He added relatives of people honored in previous years will be in attendance this weekend to offer support to those who are just beginning their journey. This year's tribute is for 226 fallen firefighters nationwide.


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Rates of suicide among young people have increased by about 36% in roughly the last two decades and the surge has caught the attention of federal policymakers.

The Biden administration has a new National Strategy for Suicide Prevention and a Federal Action Plan, highlighting the need for a coordinated approach to prevention and equity in treatment and research. It follows the Bipartisan Policy Center's launch of a youth mental health task force in January.

Val Demings, co-chair of the Youth Mental Health and Substance Use Task Force and a former member of Congress from Florida, said in Sioux Falls last week rural communities face unique mental health challenges.

"For example, having access to care, the affordability of care, removing the stigma," Demings outlined. "You may be in a substandard educational setting. You may also have substance abuse, addiction in the household. And so we have got to, as a nation, deal with the social ills that cause decay in certain communities in the first place."

A big focus of the task force is a link between suicide and increased use of technology and social media. The U.S. Surgeon General said young teens who spend more than three hours a day on social media are at double the risk of mental health struggles, including depression and anxiety.

Technology can also be used to help deliver health care services in rural places. In 2021, the Helmsley Charitable Trust launched a virtual crisis care program in South Dakota, equipping law enforcement with iPads, so they can connect people with mental health professionals by video.

Walter Panzirer, trustee of the trust, has seen positive results.

"We had a 75% reduction of transports to the mental health facilities," Panzirer pointed out. "They were able to get care at home, locally; 25% of the calls were for youth."

People living in rural places are almost twice as likely to complete suicide than those living in large cities, according to the Centers for Disease Control and Prevention. The agency said South Dakota had the fifth-highest suicide rate in the country in 2021 at over 200 deaths.

If you or someone you know is in crisis, contact the Suicide and Crisis Lifeline at 988.

New continuing education classes can help New York psychologists better work with disabled patients.

The courses center on understanding disabilities - providing universal access for patients with disabilities, ethics, and cultural competence.

Sharon McLennon-Wier, Ph.D. - executive director of the Center for Independence of the Disabled New York - said in developing the curriculum, there were certain takeaways people should have.

"The first step really is for people to understand that a disability is a disability, and there are going to be barriers to the environment with it," said McLennon-Wier. "And we need to work together to ensure that each and every person has access to treatment."

Other takeaways are ensuring clinicians are aware of their expectations, noting they're not trained to work with every single client.

It's taken two years to get these courses up and running, and McLennon-Wier said she is eager to see how these will shape up.

The first course begins on May 29 and anyone interested can register online at www.cidny.org/ce.

There's also a hope psychologists will learn about confronting their stigmas toward disabilities.

McLennon-Wier said she feels this begins by looking through the lens of ableism. She said people should consider how they implement universal access for disabled patients.

"Does your biases prevent you from utilizing the knowledge of treatment that you have?" said McLennon-Wier. "Does it work with what's needed by that person who has a disability because first is the treatment practice, but also you have to understand the implications of disabilities."

Other considerations should be given to issues like the segregation disability creates. She said she thinks certain determinants of health like race and gender also impact a person's mental health.

Future classes could deal with different psychological treatments with an infusion of multicultural disability competence.