State funded MH clients mandated no more than 8 psychotherapy sessions under any level of care: CALLING MR. BENTON
FROM: Marsha V. Hammond, PhD, Licensed Psychologist, NC
Billing address: .......................Asheville, NC 28806
E mail: hammondmv@netzero.com cell phone: 404 964 5338
Fax: 828 --------------
TO: (1) Dempsey Benton, Secretary of DHHS, NC
FAX: 919 715 4645
(2) Leza Wainwright, Co-Director of Mental Health, NC DHHS
FAX: 919 508 0951
(3) Mike Lancaster, Co-Director of Mental Health, NC DHHS
FAX: 919 508 0951
RE: absolute limitation of 8 pschotherapy sessions for any state funded client in NC
April 4, 2008
Dear Mr. Benton:
I am writing to you regarding the absolute limitation of 8 psychotherapy sessions for any state funded mental health client, under any level of care (A,B,C,D). I have appreciated your recent efforts to improve mental health services in NC.
I spoke with Christine Kudlate (e mail: kudl4428@westernhighlands.org) and Donald Reuss (donaldr@westernhighlands.org) via phone and e mail, respectively. An employee of Western Highlands Network LME, Ms. Kudlate was a refreshing change in terms of honesty and information. She stated she had recently moved from Arizona where she worked in mental health, remarking, “I am appalled at the mental health care here in NC.”
She stated that Western Highlands LME realizes that there are significant gaps in services but are necessarily limited in creating authorization for services as defined by NC DHHS. The specific service, psychotherapy, which, as you probably know is a critical one, and is the usual and customary treatment for those with persistent, severe mental health diagnoses such as my client has.
To be more specific, my client has a persistent mental illness, is 29 yrs old, well educated, jobless, and has been intermittently suicidal, and is improving with therapy. His diagnosis is Personality Disorder with narcissistic and borderline features; Major Depression, recurrent.
The treatment for this, a not uncommon diagnosis, is psychotherapy and anti-depressant medication, if tolerated. He does not need ACTT services, a more intensive service which costs tax-payers an enormous amount of money. He has a place to live. He does not need any of the array of Community Support Services if these do not include more than 8 psychotherapy sessions/ year. Ms. Kudlate informs me that 8 psychotherapy services/ year is the limit regardless of the level of care.
I would like to know what you can do about this. I ask this respectfully, assuming that you have a lot to do but with a persistence associated with having tried to obtain psychotherapy services for state funded clients I have had over the past several years and having become completely exasperated with the non-availability of such to the point that I have driven every single state funded client into Medicaid as quickly as possible. This is not particularly useful for them for once they have Medicaid and its associated SSI or SSDI monies, they are then unable to work more than about 20 hours/ week, at a very poor hourly rate, without endangering these benefits.
I have tried working with the CFAC of Smoky Mountain Center LME re: this very same problem and gotten nowhere. I have written letters, sent e mails, made telephone calls. And I am not going to continue to do this and I am not going to try and move thru the Western Highlands LME CFAC. I am counting on YOU, Mr. Benton, to get my clients more psychotherapy sessions.
This is not isolated to my client. This is true of every single state funded client across any LME in NC.
If the LME's cannot be trusted to be able to create services for clients, then may I suggest that we just forget this mental health reform for no professional provider will work with a suicidal client if there are only 8 sessions/ year. Its too risky; its lawsuit material.
And in that the LME's are only assigned to look after state funded clients, if they cannot authorize the services, then please save the taxpayer's some money and dismantle the LME's.
The news services would have us believe that there is a lack of providers for services.
May I submit that there are no lack of providers as is implied by the news services ; there is a lack of professional providers who are willing to do work which is potentially liable and unsatisfying.
Thanks for looking into this, Mr. Benton. I would like to have a response from you, Ms. Wainwright, or Dr. Lancaster by Friday April 11, 2008.
Thank you for your assistance. I am hopeful that my client can be advantaged to more than 8 psychotherapy sessions/ year.
Sincerely,
Marsha V. Hammond, PhD
CC: Wainwright; Lancaster; Kudlate; Reuss; Madame Defarge NC Mental Health Reform blogspot
Billing address: .......................Asheville, NC 28806
E mail: hammondmv@netzero.com cell phone: 404 964 5338
Fax: 828 --------------
TO: (1) Dempsey Benton, Secretary of DHHS, NC
FAX: 919 715 4645
(2) Leza Wainwright, Co-Director of Mental Health, NC DHHS
FAX: 919 508 0951
(3) Mike Lancaster, Co-Director of Mental Health, NC DHHS
FAX: 919 508 0951
RE: absolute limitation of 8 pschotherapy sessions for any state funded client in NC
April 4, 2008
Dear Mr. Benton:
I am writing to you regarding the absolute limitation of 8 psychotherapy sessions for any state funded mental health client, under any level of care (A,B,C,D). I have appreciated your recent efforts to improve mental health services in NC.
I spoke with Christine Kudlate (e mail: kudl4428@westernhighlands.org) and Donald Reuss (donaldr@westernhighlands.org) via phone and e mail, respectively. An employee of Western Highlands Network LME, Ms. Kudlate was a refreshing change in terms of honesty and information. She stated she had recently moved from Arizona where she worked in mental health, remarking, “I am appalled at the mental health care here in NC.”
She stated that Western Highlands LME realizes that there are significant gaps in services but are necessarily limited in creating authorization for services as defined by NC DHHS. The specific service, psychotherapy, which, as you probably know is a critical one, and is the usual and customary treatment for those with persistent, severe mental health diagnoses such as my client has.
To be more specific, my client has a persistent mental illness, is 29 yrs old, well educated, jobless, and has been intermittently suicidal, and is improving with therapy. His diagnosis is Personality Disorder with narcissistic and borderline features; Major Depression, recurrent.
The treatment for this, a not uncommon diagnosis, is psychotherapy and anti-depressant medication, if tolerated. He does not need ACTT services, a more intensive service which costs tax-payers an enormous amount of money. He has a place to live. He does not need any of the array of Community Support Services if these do not include more than 8 psychotherapy sessions/ year. Ms. Kudlate informs me that 8 psychotherapy services/ year is the limit regardless of the level of care.
I would like to know what you can do about this. I ask this respectfully, assuming that you have a lot to do but with a persistence associated with having tried to obtain psychotherapy services for state funded clients I have had over the past several years and having become completely exasperated with the non-availability of such to the point that I have driven every single state funded client into Medicaid as quickly as possible. This is not particularly useful for them for once they have Medicaid and its associated SSI or SSDI monies, they are then unable to work more than about 20 hours/ week, at a very poor hourly rate, without endangering these benefits.
I have tried working with the CFAC of Smoky Mountain Center LME re: this very same problem and gotten nowhere. I have written letters, sent e mails, made telephone calls. And I am not going to continue to do this and I am not going to try and move thru the Western Highlands LME CFAC. I am counting on YOU, Mr. Benton, to get my clients more psychotherapy sessions.
This is not isolated to my client. This is true of every single state funded client across any LME in NC.
If the LME's cannot be trusted to be able to create services for clients, then may I suggest that we just forget this mental health reform for no professional provider will work with a suicidal client if there are only 8 sessions/ year. Its too risky; its lawsuit material.
And in that the LME's are only assigned to look after state funded clients, if they cannot authorize the services, then please save the taxpayer's some money and dismantle the LME's.
The news services would have us believe that there is a lack of providers for services.
May I submit that there are no lack of providers as is implied by the news services ; there is a lack of professional providers who are willing to do work which is potentially liable and unsatisfying.
Thanks for looking into this, Mr. Benton. I would like to have a response from you, Ms. Wainwright, or Dr. Lancaster by Friday April 11, 2008.
Thank you for your assistance. I am hopeful that my client can be advantaged to more than 8 psychotherapy sessions/ year.
Sincerely,
Marsha V. Hammond, PhD
CC: Wainwright; Lancaster; Kudlate; Reuss; Madame Defarge NC Mental Health Reform blogspot
posted by Marsha V. Hammond, PhD at 2:04 PM
1 Comments:
Ms. Hammond: Thank you very much! You are "right on." You may recall that the State/LME, prior to approving the eight sessions,was telling licensed providers to "bill community support." for THERAPY services. This practice was unethical,and probably illegal. The current eight sessions, as you pointed out, is still woefully inadequate. Again.Thanks!
James(Jimmy)Hare, MSW/LCSW
5HareRaisers@g-mail.com
5Hareraisers
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