Sunday, September 14, 2008

Barriers to NC mental health care participation: NC Psychiatric Association keeps Dr. Lancaster to themselves behind the $450 fee gate

Some people probably think that I like to write judgmental pieces like this. The premises associated with this kind of writing makes me sad, actually.

And I didn't go to the NCPsychiatric Association meeting in order to get a line on something so I could gig that organization, either.

However, I lived in Denmark for a while, the land of well disciplined people and children. There, you never heard a parent raise their voice to reign in the behaviors of children; their strategy is more effective than this: they shame them.

Relatedly, today, Mike Lancaster, MD, a psychiatrist and the co-chair of The Department of Mental Health within NC DHHS, gave a 1.5 hour talk on NC Mental Health Reform at the annual NC Psychiatric Association meeting in Asheville, NC. His was the last talk of their conference.

I don't know what he said; I was not willing to pay $450 in order to hear a public official talk to his colleagues.

Yesterday, in anticipation of this possibility, I drove up to the Renaissance Hotel in Asheville. I figured there had to be something going on as re: the state psychiatric association pertaining to NC mental health reform.

I introduced myself to the Executive Director, Robin Huffman, MD, a nice woman with a friendly smile. I should have asked her yesterday if there was a fee for sitting in on this talk. That way, I could have worn my wig and slid in.

In my student days, I scammed many an expensive conference by picking up lost name tags on the floor and slipping around corners. She was friendly again today as she advised me of the $450 fee to hear Dr. Lancaster talk. There are no one day passes, she stated.

Call me paranoid, but I had already been thrown off of the NC Psychiatric Association's listserv as associated w/ hammering on matters. Today, I had the feeling that she had talked to other members of the NCPA board and they might have said, do you know who Dr. Hammond is?

IN attempting to maybe get to some other price of admission, other than $450, I advised the clerks at the table, "I don't need any CEU's" to which one of them rather smugly replied, "We don't give CEU's...we give CME's." "Well, I don't need those either", I smiled.

In any case, I was expecting and hoping to be able to sit in on this apparently sacrocanct talk. I had my two questions in my head:

1. What happens if NC elects a Republican governor? (he's leading you know)

2. Is it possible to have some standardization of the Utilization Review departments in the LME's?

I have asked this latter question of the other NCPA, the NC Psychological Association, several times over the past year. I'm even a member, though I debate on the reason to join again. From them, I get the usual, "We'll get back to you." Never happens. No one ever gets back to me.

My devious head can pretty quickly get engaged by these kinds of barriers: I could charge it and then block it; I could write a check and cancel it; I could beg and plead but that's too painful.

Think of what a public service the NC Psychiatric Association----with its well-heeled psychiatrists could front to the interested public----think of what they could offer...what they could do if they advanced the notion that the public has a vested interest in these kinds of matters.

Nah: won't happen.

They created a massive barrier to the dessimination of information from a key player in the NC Mental Health Reform. And they did it 5 hours from Raleigh.

Just like I am not going to pay $450 for a 1.5 hour talk by a public official who is supposed to serve the public, neither am I going to drive 5 hours to Raleigh.

I can imagine that the NC Psychiatric Association needs to make its money on its conferences. I get that. This is not what I am writing about here. I am writing about the vastly neglected role of professional organizations working in a welcoming way as regards the public----whom it is they are (supposed) to serve.

All the talk about how we create licenses and medical boards has a different meaning (read: bullshit) if come the opportunity for the desimination of information----the door is shut and the professionals stay to their professional-selves.

And so, quid pro quo: I had advised Dr. Huffman yesterday about a professional red alert, the Health and Behavior CPT codes which mental health workers can utilize which pays on the 80% medical side of services instead of the grim 62.5 % psychiatric side of services. I told her I would write to her about it.

Will I? dunno. I had something to exchange with them, something of value, something that can make money for psychiatrists if they don't know about it---something that would allow them to do something other than churn out a bunch of medication-check codes. Dr. Huffman didn't know about it; how many of them don't know about it?

I wrote the 96152 Behavioral Health Code matter up for both the WNC Psychological Association newsletter and the NC Psychological Association newsletter. They didn't ask me to. It just amazed me that no one was using it or knew how to use it when the NC Psychological Association Board came to Asheville about 4 months ago. NAH: give up, other said: you can't get it through.

I have, I did, I will. (Vini Vidi Velcro as a sign in Asheville stated).

Maybe WNCPA/ NCPA will use the information I have turned up which American Psychological Association says is not supposed to be so. Or they might just spite their own selves as they have determined me to be a trouble-maker.

I am afraid that my verdict stands as re: the NC Psychiatric Association: they have had opportunities to work w/ advocates and the public and other professionals re: NC Mental Health Reform. Yesterday I stated to her that I do not believe that the NC Psychological Association does a very good job of advancing the interests of its membership.

She maintained that she and Sally Cameron, the Executive Director of NC Psychological Association, work hand in hand w/ representatives of other mental health professional organizations e.g., social workers, etc. She maintatined that Cameron is a very good representative for NC psychologists.

She stated that the mental health agenda that the mental health professional organizations utilize is to press for advances on behalf of patients---and this makes complete sense.

She bemoaned the powerful lobby associated w/ BCBSNC. I made the point that BCBSNC had been allowed to opt out of NC mental health parity. She indicated that BCBSNC had to give the green light to mental health reform before it evern got as far as it did.

I advised her of the payment for a 15 minute unit of 96152 CPT Health & Behavior code. She told me that on professional listservs professionals cannot discuss these fees as legally they can be considered to be colluding---by the health insurance agency. SSSSSSSSHHHHHHHHH : they'll slap our hands and won't take us to lunch.

Let's see: I'll discuss it right here: for 15 min of 96152 for a doctoral psychologist, I get approximately $25 x 6 units at the 80% reimbursement rate and thus also avoid the 90808, 70-90 minute therapy code which only pays me about $80.

Come and get me.

Why, given the perfect opportunity to seguae w/ other mental health professionals---the public even----many who are extremely concerned about mental health matters in NC, did NC Psychiatric Association not open the doors to the public as re: the public official, Dr. Lancaster?

Godalmighty: we don't want a riot in here. That's why the closed door.

No worry: Americans are too damned intimidated to throw tomatoes at their betters.

HOWEVER, the crazy people, those in NAMI, well they just need to stay in NAMI---over there---in their little NAMI meetings.

I found myself thinking about a George Carlin skit in which he describes how he believes it is an utter waste of time to vote given that the powers that be collude----and that he would rather stay at home and masturbate, with he stating something graphic like this: "I'll have something to show for what I did and you, the voter, what will you have to show?"

I'll wear my wig next time and I won't introduce myself.


Post a Comment

<< Home