The Healthcare Guild
I want to share some exciting news — Kansas City helped launch a national LGBT healthcare guild this past month (, thanks to the generous support of the LGBT-Affirmative Therapists Guild (

Why is the Healthcare Guild important? Here are the highlights of what it will do:

The Guild:
• Serves as a referral and resource center for LGBTQIA consumers;
• Educates consumers about how to find culturally competent and affirming healthcare providers;
• Unites LGBT-affirming providers for networking and professional development;
• Provides education and consultation for developing practitioner cultural competency; and
• Advocates for sexual and gender minorities by promoting inclusive and competent healthcare policies.

For more information, check out the video on the new website.

The Healthcare Guild is a national organization that will allow any size community the opportunity to network in the same way we have been able to here in Kansas City. The organization will serve as a home base for existing affirming healthcare groups like the LGBT-Affirmative Therapists Guild of KC, providing networking, resources, and referrals. The great thing about the national structure is that now any community can start its own chapter with its own webpage through this site!

If you are a healthcare provider who lives in a community that could use a referral page of resources, go to and click “JOIN” for more information.
Missouri legislators’ Medicaid vote shows a failure to plan ahead
The Missouri Senate voted last month to defeat proposals to expand federal Medicaid funding for the state, despite the fact that the Affordable Care Act will begin in 2015, which will affect the state’s ability to provide psychiatric care for indigent and uninsured citizens. The Missouri Department of Mental Health recently released an update to their original statement of concern regarding the Affordable Care Act and the importance of the state strengthening Medicaid funding (

Although President Obama recently delayed the reduction of disproportionate share hospital payments to begin in 2015 (rather than 2014), the new federal legislation will reduce disproportionate share hospital payments by about 50 percent, whether or not the state decides to extend Medicaid coverage. These payments are the primary funding that hospitals use to treat those who fall through the cracks and are generally unable to afford care. The fact that the state did not allocate funding means that state programs will be ill-equipped to expand eligibility for Medicaid to at or below 138% of the poverty level (which is also part of the 2015 federal changes). By not complying with these changes, the state will lose a significant amount of federal funding, which will greatly impact the state’s ability to care for uninsured and indigent patients.

Missouri hospitals are already deficient in the number of psychiatric community hospital beds available for adults ages 18-65. As this deadline approaches, Missouri legislators have failed to take the appropriate action to account for the changes taking place in 2015. This will most likely have a cascading effect, as hospitals will be forced to decrease the number of beds available to those who require inpatient psychiatric care because of the loss in funding, the state of Missouri will be inadequately funded to make the necessary changes to effectively provide services according to the new federal plan, and state and local law enforcement will be burdened with managing psychiatric patients through the legal system rather than helping them through the healthcare system.

Not only will the failure to plan ahead impact the state’s ability to provide services, but it will also decrease efficiencies already in place. Once the state recognizes the impact that the new legislation has on healthcare services for those in need, reparations will be costly and will most likely fail to provide care to thousands of psychiatric patients who will fall through the cracks.

I encourage you to learn more about the potential effects of these changes and learn why Missouri needs to make appropriate changes to work in harmony with the Affordable Care Act rather than working against it. Here are two resources to start with:
• The “Medicaid Expansion FAQs” prepared by the St. Louis University School of Law’s Center for Health Law Studies:
• The Statement of Concerns presented by the Missouri State Department of Mental Health:
• “Avert the mental health crisis: Expand Medicaid in Missouri,” an op-ed piece from the St. Louis Post Dispatch:

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