'Coalition for Parity' (NOT!): Insurers Block MH Parity across the US

There has been a recent conversation amongst independent psychologists in Division 42 (Independent Practice Division) of the American Psychologist Association particularly associated w/ the 'blues' (BCBS, Blue Cross Blue Shield) companies across the US in terms of they refusing MH parity.

Indeed,in NC, BCBSNC was allowed to opt out of MH parity even though it was put into law back in 2009. You guessed it: there is a 'special liason' committee moving between the NC State Legislature and BCBSNC. Much information re: this can be found at my other blog which concerns itself w/ 'Scrutinizing BCBSNC': http://madamedefarge2scutinizingbcbsnc.blogspot.com/

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Psychiatrists, Psychologists and Mental Health Counselors Take Note: Insurers are Trying to Delay Mental Health Parity! The Whole Managed Care Industry is in Danger and Trying to Fighting Back.

A group of managed care organizations, cynically called the Coalition for Parity Inc., has filed suit in U.S. District Court to delay the implementation of the federal mental health parity bill. The Coalition claims its members were not given enough time to comment on the parity rules before they became final....."

see: http://www.carolinapartners.com/blog/2010/07/psychiatrists-psychologists-and-mental-health-counselors-take-note-insurers-are-trying-to-delay-mental-health-parity-the-wh

NC MedAssist Program: mail order central pharmacy: meds 4 free!: 1-866-331-1348

From a new blog with great information: http://www.carolinapartners.com/blog/

"Every Raleigh Psychiatrist, Every Durham Psychiatrist, Every Cary Psychiatrist and Every Chapel Hill Psychiatrist Should Know About the NC MedAssist Program

People in North Carolina who are unable to afford their medicines can now get some of them for free. The NC MedAssist program has created a mail-order central pharmacy to provide medications for free. Both generics and brand name drugs are covered. With a shout-out to Big Pharma for donating the pharmaceuticals in the first place! In 2009, the state rolled out a pilot program to give low-income North Carolinians access to needed prescription drugs. Now that program has been expanded state-wide, so I guess it has been a success thus far. The project was developed as a partnership between the NC Attorney General’s Office, NC Association of Free Clinics, and NC MedAssist. Among other medications available under NC MedAssist, low-income patients will have access to: Antipsychotics: Zyprexa, Haldol, and Seroquel; Antidepressants: Cymbalta, Prozac, Nortioptyline, and Trazadone Others: Lithium, Depakote, Clonidine, and Hydroxyzine. This program is available to North Carolinians, both adults and children, living at or below 200% of the federal poverty line; adults and children who do not qualify for Medicaid, VA, or private insurance; and/or Medicare Part D participants who fall in the infamous “Donut Hole.” One can enroll in NC MedAssist by downloading an enrollment packet at www.medassist.org, or by calling 1-866-331-1348....."

Public Health Improvement Program: Feds give almost 2 million to NC DHHS: how will they spend it?

I'm all for what the Feds state this money is to do, in part: "improve networking, coordination, and cross-jurisdictional cooperation for the delivery of public health services ." 48 states and jurisdictions received money and NC was in the top 10 of amount received.

I might imagine, however, that such monies are going to go to the larger private mental health care companies whom will simply utilize it in order to fold in more of the mental health care 'consumers' in order to provide yet more 'administration' of public mental health-----when what is called for is money to providers who work f2f (face to face) w/ citizens experiencing mental health challenges.

In the best of all possible worlds, I might imagine the creation of a HIPAA compliant, internet portal, such that providers could actually efficiently correspond w/ each other about clients' needs-----like I did yesterday afternoon when I was able to reach the very efficient Nurse Practitioner on the phone for a quick change in meds for a client of mine with a SPMI (Severe Persistent Mental Illness).

I figure I save NC DHHS a bunch of money by keeping these kinds of people OUT of the hospital by utilizing strategies like this as well as sending encrypted e mail (watching out for HIPAA) via WORD as per its Security 'Save As' device.

I wish I was a more optimistic kind of person.
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http://www.thegovmonitor.com/world_news/united_states/u-s-invests-42-5-million-for-public-health-improvement-programs-38934.html

U.S. Invests $42.5 Million For Public Health Improvement Programs
Source: Department of Health & Human Services Posted on: 21st September 2010

"......This new 5-year cooperative agreement program entitled, Strengthening Public Health Infrastructure for Improved Health Outcomes, will provide health departments with needed resources to make fundamental changes in their organizations and practices, so that they can improve the delivery of public health services including:

Building and implementing capacity within health departments for evaluating the effectiveness of their organizations, practices, partnerships, programs and use of resources through performance management

Expansion and training of public health staff and community leaders to conduct policy activities in key areas and to facilitate improvements in system efficiency

Maximizing the public health system to improve networking, coordination, and cross-jurisdictional cooperation for the delivery of public health services to address resource sharing and improve health indicators

Disseminating, implementing and evaluating public health’s best and most promising practices

Building a national network of performance improvement managers that share best practices for improving the public health system....."
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This is what was allocated for NC:

"$1,903,858 to North Carolina State Department of Health and Human Services"

Adult Care or Family Care Homes: the New Prison for Those w/ Mental Health Challenges

I'm on my way to see two of my clients in their Adult Care Homes (ACH) also known as Family Care Homes. Chris Fitzsimmons of NC Policy Watch has recently written about the trajectory of how people w/ mental health challenges usually end up in such a place and this is certainly my experience. They get into a pickle related to their mental health behaviors, there is nowhere to go, and so they get warehoused in the ACH's.

If you don't think they sometime function like prisons, remember I was threatened to be arrested by the Buncombe County Sheriff's Department for rendering therapy to a client of one of these homes in Western NC a year and a half ago. I took the matter to the Buncombe County DSS where they allowed the manager of the home to try and dress me down with the Adult Care Licensure people sitting mutely in the room (see their rules and regs here: don't bother with making a complaint for it will come back 'groundless': http://www.dhhs.state.nc.us/dhsr/acls/index.html)

While there are some exceptions, usually they are run like petty fiefdoms with the residents having little privacy. The residents have no spending money as their disability checks are consumed by the owner of the ACH, except for $66 (mark of the beast, ya know), minus their co-pays for their medical prescriptions and doctor's visits, every month. That would leave most of them about $45 for the month.

As per the state guidelines, the cost of staying in such a home is about $1300/ month and this includes a room (usually shared), a 24/7 Supervisor-in-Charge or SIC (they have a terrible burn-out rate given that they usually live there themselves), food on the table (gets pretty grim sometimes and is completely dependent on the ability of the SIC to cook), and plenty of boredom.

99% of these people are not working either because they are too disabled (and the longer they don't work the more likely it is that they willn ot work) or have no way to get to a supported employment facility such as Haywood Vocational Opportunities in Waynesville, NC (a good place for people to work, for the most part), or they would lose their disability checks if they go over a 'bright line' of earned income which is approximately $12,000/ year.

So, if they're working, they could earn 1 million $$ or $12,001-----the results would be the same: they would lose their disability checks until the entire sum of what they earned was paid back. Talk about a complicated system that will chew you up......

If NC wants to do something about warehousing these people, which is what is taking place---and yes,these are the new state mental health hospitals.....only privatized......what has to be addressed is a significant way to improve the quality of life of these people and that would include they being able to work and feel like functioning people within the community.

Oh, that would mean there would have to be more jobs of course......and more sheltered workshops.

Below is what Fitzsimmons has to say. Additionally, here are some of the links to my previous notes on the problems w/ the Adult Care Homes also known as Family Care Homes, in NC:

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Wednesday, April 08, 2009

WNC (Family Care) Homes: DSS Buncombe finds rule violation as re: mental health client re: opening of private mail
see: http://madame-defarge.blogspot.com/2009/04/wnc-family-care-homes-dss-buncombe.html

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Wednesday, May 13, 2009

NC Family Care Homes: mental health issues go unaddressed & providers are banned from premises: defacto mini-prisons
see: http://madame-defarge.blogspot.com/2009/05/nc-family-care-homes-mental-health.html

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(what the Adult Care Home people do during the day time----or not-----as re: the local library system; they take a lot of medication that has, as a side effect, fatigue):

Buncombe County Library system: No place for the sleepy
by Marsha V. Hammond in Vol. 16 / Iss. 17 on 11/18/2009
see: http://www.mountainx.com/opinion/2009/111809buncombe_county_library_system_no_place_for_the_sleepy
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What Fitzsimmons recently wrote about these homes:

http://www.ncpolicywatch.com/cms/2010/09/15/north-carolina%E2%80%99s-broken-emergency-mental-health-system/

"......
Because there were no beds available at any of the State's psychiatric hospitals he stayed handcuffed to a stretcher in the emergency department with a 24-hr. police detail. Finally, after 96 hours without treatment, he calmed down and was discharged but his elderly parents were afraid to let him come home. His options - live on the streets - homeless - or find a bed in an adult care home (ACH). Either choice left him without treatment for his mental illness increasing the chance that it would happen again.

Sadly, this is not an isolated story. Over 6,000 adults with mental illness live in ACHs in North Carolina. And that number only reflects people with a known mental illness. There isn't an accurate count of the number of people who would rather be homeless than live in an institutional setting like an ACH or who are not receiving any services at all. With extreme cuts in funding, that number is likely to grow and include more people with other types of disabilities......"