Today marks the two year anniversary of Yolanda Torres’ death. Yolanda was a remarkable young woman who shared her story of living with mental health needs in testimony before the Mental Health and Substance Abuse Committee in May 2007.
With the support of her family, Chapter 321 of the Act of 2008 (An Act Relative To Children’s Mental Health), has become known to many as Yolanda’s Law.
Lisa Lambert of the Parent/Professional Advocacy League has posted a remembrance of Yolanda and some thoughts on her legacy.
A new year, and new useful things on the web. Take a minute to check out Lisa Lambert’s new blog: holdonitsnotover.wordpress.com.
Lisa is the Executive Director of the Parent-Professional Advocacy League (PAL), a consumer-based group for parents of children with mental health needs. PAL is also a founding member of the Children’s Mental Health Campaign.
Back in August, we wrote a blog about young people with mental health needs ending up in prison for lack of community resources.
While it doesn’t take much of an intellectual leap to imagine how inappropriate this setting would be for mentally ill youth, earlier this week, the New York Times published a story highlighting the conditions faced by these young people.
Most official estimates of the numbers of young people involved with the juvenile justice system who have mental health needs are typically in the 75% range. Talk to anyone who is familiar with the system, and they will tell you the percentage is much higher.
Locking up a mentally ill young person does not address the underlying reason why they were imprisoned in the first place, and without adequate treatment while incarcerated, the reasons are not going to go away.
As the Times article shows, youth correctional facilities are dramatically unsuited to address mental health needs of inmates.
We must get out in front of this issue – not only should we improve treatment for those behind bars, but we have to do more to identify and treat mental health needs early. Only then can we hope to reduce the numbers of young people involved with the juvenile justice system.
For the past two years, the Children’s Mental Health Campaign has held 19 forums on mental health needs of kids across the Commonwealth. While each forum has been different, one statistic universally resonates with all audiences and brings home the importance of the issue: Suicide is the third leading cause of death among children between the ages of 10 – 24; of those who commit suicide, 90% (90%!) have a diagnosable and treatable mental illness at the time of their death.
The issue of teenage vulnerability to suicide was the subject of a November 30th National Public Radio story. Psychiatric epidemiologist Madelyn Gould stated the most significant and critical red flag that predicts adolescent suicide risk is “the presence of an underlying mental health problem. In teens, that’s most commonly depression, anxiety, and alcohol or drug abuse.” Gould is currently studying 50 suicide clusters that have occurred in the United States. Gould is trying to understand why a tragedy of suicide in one town may lead to additional suicides but in another town does not.
Gould draws interesting conclusions about the role of media in the creation of suicide clusters, but from a more fundamental perspective, what is striking is the extent to which mental illness remains an unspoken cause in so many of these tragedies.
It’s not so much that 90% of young people who commit suicide have a mental illness – it’s that the illness is treatable that makes the current situation so terrible.
Maybe if mental health was not such a taboo subject - maybe if we were able to openly discuss disorders of the brain - more young people would realize that there is another way to deal with their pain.
The brain is part of the body. We need to treat it as such and not be afraid to talk about how we can make it better when it doesn’t work the way it should.
This Friday, December 11, the Children’s Mental Health Campaign will co-host a Children’s Mental Health Forum in Holyoke with the MSPCC Holyoke office. Mental health service providers, parents of children who suffer from mental illness, school counselors and more are expected to gather to share and discuss their experiences in accessing the children’s mental health care system in Massachusetts. This forum which begins at 9am will be held at the Holyoke Health Center and is open to the public.
At this forum, clinicians will speak about their experiences working in the field and offer advice on available resources and a parent will speak about their personal experiences in access mental health care. Matt Noyes, the Children’s Mental Health Campaign Manager will also present information on Chapter 321, the state’s omnibus children’s mental health bill signed into law last year to improve the system, new legislation filed to increase coordination of care and provide an update on the state’s Children’s Behavioral Health Initiative.
Please help spread the word about this event to anyone you know who might be interested in attending. Click here to view an informational flyer for the event.
Last Thursday evening, the Children’s Mental Health Campaign held its 15th regional forum in Somerville. The event, cosponsored by the City of Somerville, drew over 40 individuals from Somerville and the surrounding communities.
As always, the most powerful and heart-wrenching stories were those from parents. Three mothers spoke of their challenges, and in some cases success, in trying to get necessary mental health services for their children. Early Identification, communication between the schools and different agencies, coordination of care, lack of providers and effective/appropriate treatment are just some of the recurring themes we heard from the parents. More than any other advocacy effort, their accounts bring home the desperate need for reform of the children’s mental health system. What we also appreciate in these settings is the connections made between parents and families battling the same challenges, parents and clinicians in the area as well as parents and school counselors or child social workers.
The Somerville forum was unique in that it was heavily attended by young people from the city. A number of individuals in their teens and early twenties came, shared their stories, and asked for advice in getting help for themselves, family members, and for friends. For an illness that is so tied up in issues of stigma, having young people come and openly talk about the challenges that they and those around them face in dealing with mental health needs is encouraging. Only when we are able to discuss mental health in the same way that we talk about other health needs will real change be made. To borrow a phrase from HCFA’s oral health team, the brain is part of the body.
The time is NOW to end the stigma attached to mental illness.
For more information about the Children’s Mental Health Campaign and details on getting the Campaign to come to your area, please visit www.childrensmentalhealthcampaign.org. -Jessica Hamilton
On Thursday, November 5, parents, youth, clinicians, child advocates and community members will convene in Somerville to share their experiences in accessing the children’s mental health care system in Massachusetts. This forum, which begins at 5:30pm is co-sponsored by the City of Somerville, the Somerville Committee on Suicide Prevention and Mental Health and The Children’s Mental Health Campaign. The committee was developed after a 2004 suicide crisis in Somerville which has since subsided. One major issue that plagues the community now is the stigma surrounding issues of mental health, so the city has formed a teen empowerment group to address this and other issues such as immigration, economic and employment status that lead to poor mental health.
At this forum, several parents and one youth will speak about their personal experiences in battling mental health. Matt Noyes, the Children’s Mental Health Campaign Manager will also present information on Chapter 321, the state’s omnibus children’s mental health bill signed into law last year to improve the system and provide an update on the state’s Children’s Behavioral Health Initiative.
Please click here to view an informational flyer for the event. We hope you can join us!
It’s no secret that there is a workforce shortage among mental health practitioners treating children with mental health needs. In some geographic areas, up to 82% of prescriber practices are full and unable to take new patients. Currently, there are approximately 6,800 child and adolescent mental health providers in Massachusetts. In 2020, it is estimated that we will have 8,300. However, according to those same projections, it is thought that we will need 12,100 providers.
The Foundation found that things are likely to get worse, not better: of those who responded to a survey, 54% of child mental health practitioners plan to leave the field in the next five years.
What can we do?
The payment structure for child mental health clinicians conspires to discourage new providers from joining the ranks. For some reason, child clinicians are paid at a lower rate than their counterparts who work with adults. Additionally, to provide the best care possible for a child with mental health needs, a clinician often needs to talk to many people in that child’s life: parents, pediatricians, and teachers, to name a few. However, these so-called “collateral contacts” that are vital for effectively coordinated care are not billable through private insurance.
In the survey conducted by the Blue Cross Blue Shield Foundation, establishing financial support for collateral work was listed as the top priority to improve child provider work satisfaction and was the second most frequently given factor that would increase the likelihood that providers would work with children.
The Children’s Mental Health Campaign (www.childrensmentalhealthcampaign.org) is actively working to pass legislation that would provide for reimbursement to clinicians for collateral contacts. Last month, the bill was favorably reported out of the Mental Health and Substance Abuse Committee and is expected to be acted on by the Health Care Financing Committee soon.
Many thanks to the Blue Cross Blue Shield Foundation for their hard work in putting together the report. Because of their efforts, the Campaign is better able to articulate to legislators and other policy makers the need for the passage of Collateral Contacts legislation. Matt Noyes
NPR’s Morning Edition today featured a story about efforts by certain colleges to more effectively address the mental health needs of their students. A wide-ranging piece, there were some points worth pulling out and thinking about.
Stigma remains a tragically persistent barrier for many individuals and families touched by mental illness. That colleges are recognizing that this is a major issue and are devoting resources to helping their students is to be commended. Every time there is an acknowledgement of mental health needs, it is one more step we are taking toward a day when illnesses of the brain are treated no differently than those of kidneys or lungs.
One troubling anecdote in the story was the way in which local police responded to a 911 call about what the caller believed to be a potentially suicidal student. Of course, the caller was 100% correct in calling for help (far better to err on the side of caution than to do nothing and risk tragic consequences) and the police did what they thought necessary to prevent a death. However, certain aspects of the police response (shouting, aggression, threats of involuntary hospitalization) show a lack of training and understanding of how to deal with mental health needs. The Parent-Professional Advocacy League has prepared a guide for police responding to youth with mental health needs that should be mandatory ready nationally.
Some of the challenges highlighted in the article are almost exactly the same as what we have found here in Massachusetts: long wait lists for young people to see mental health providers; high costs associated with care; undiagnosed mental illnesses that developed during early teen years; and a reexamination of the role of schools (either secondary or post-secondary) as health providers for students.
In state advocacy work, it’s always nice to see how what you’re doing connects to a larger, national scene. The omnibus legislation passed last session and this session’s coordination of care bill are both significant steps down the path toward addressing the very concerns raised by NPR.
Working in conjunction with the Boston Public Health Commission, the Children’s Mental Health Campaign sponsored its 16th community forum in Allston at the Gardner Pilot Academy.
It was an energetic and inspiring evening, with a mix of policy makers, elected officials, young people, parents, and advocates coming together to talk about ways to improve the children’s mental health system in Massachusetts.
Senator Steven Tolman kicked the evening off speaking about how important the issue is to him personally. Talking about the Coordination of Care legislation he sponsored, the Senator said, “Just compare the cost of passing this bill with the cost of doing nothing. We cannot afford to not get this done this session.”
Boston Public Health head Barbara Ferrer also addressed the group, highlighting her agency’s commitment to addressing the needs of children living with mental health concerns. Dr. Ferrer stayed for the remainder of the event and helped to facilitate a small group discussion about the specific needs facing the Allston community.
The most powerful speakers of the night were three young people who are part of the Spread The Word Campaign. Christine Casanova, India Clark, and Jason Villalona helped form a group through the Brookview House to help kids impacted by domestic violence and trauma. Speaking with them after their presentation, the three brought up an issue that the Campaign has heard again and again during these forums: a significant shortage of mental health providers working with children. Said Jason, “We found kids who need help, but they can’t find anyplace to go. Sometimes they try to make an appointment, but can’t get in for six months.”
In upcoming months, the Campaign will be sponsoring additional forums: in Somerville on November 5, and in Holyoke in December. For more information about these forums or if you are interested in having a forum in your community, contact Jessica Hamilton at jhamilton@hcfama.org.
On Wednesday, the Wall Street Journal published an article highlighting the benefits of providing mental health consultative services in early education settings. When these services are available, behavioral problems are more effectively addressed, children have better school experiences, and, as the article states, the classroom environment is more cheerful.
Worcester has been leading the way in implementing these ideas for several years. Together For Kids (TFK), a program of Community Healthlink, is a community network of parents, providers, and advocates that provides support for children and teachers in preschools.
Particularly in these challenging economic times, TFK found a particularly attractive additional benefit for providing mental health consultations: every dollar that is spent in an early education setting saves more than $2 the following year in reduced Special Education costs in kindergarten!
Unfortunately, however, the futures of programs like TFK are in danger. In the FY 2010 State Budget, the Legislature cut funding for mental health consultative services in early education settings by 60% -from $2.9 million to $1 million.
Recognizing that the Legislature had to make tough decisions, one cannot help but wonder if this was a case of being pennywise and pound foolish. Assuming that TKF’s findings hold up statewide (and we have no reason to believe otherwise), the almost $2 million reduction in preschool funding will mean that elementary schools will see a nearly $4 million increase in Special Education costs in the 2010-2011 school year.
In a time of crisis, it’s hard to think long term, but failure to do so could have disastrous consequences.
This afternoon, the Joint Committee on Mental Health and Substance Abuse favorably reported S. 757, An Act Relative To The Coordination of Children’s Mental Health Care. This marks an important step in the progress of the legislation as the Mental Health and Substance Abuse Committee had primary jurisdiction over the bill.
For more information about S. 757 and for a summary of the June hearing on the bill, click here.
From here, the bill is expected to get a new number and move on to the Health Care Financing Committee.
Big thanks goes out to Senator Jen Flanagan, Representative Liz Malia and their staffs for all their hard work on the legislation. -Matt Noyes
Budget cuts have real consequences for real people – consequences that will be felt for years to come. The crisis of the mental health system that the Children’s Mental Health Campaign and other advocates have spoken about in Massachusetts is one that is mirrored across the nation.
Today’s New York Times features a chilling story about the plight of young people with mental health needs who, for lack of proper resources and services, end up in prison.
The tragedy of these stories is that in many cases, incarceration could have been avoided. Early identification and treatment of mental illness is the most effective method of addressing mental health needs. Failure to take proactive measures results in a worsening of symptoms, an increase in the severity of the illness, and in some cases, involvement with the judicial system.
Estimates of the number of young people involved with the juvenile justice system who have a diagnosed mental health need run around 75%. However, in talking with officials charged with running the Department of Youth Services, many say that the actual number is much higher.
For the past year, our state has been faced with a severe economic crisis that has compelled Governor Patrick and the Legislature to make difficult budgetary decisions. The Department of Mental Health has been deeply cut, and services to its clients have been impacted.
It would be naïve to think that there will not be consequences from these cuts. Should we continue along the path we are now on, it is likely that we will see an increase in the number of children who become involved with the juvenile justice system. Prisons are not set up to provide mental health treatment. Even if the young people profiled in the article are able to complete their sentences, they will likely leave prison in worse shape than when they came in. The cycle will be harder to break.
Think for a minute about the impact – on the lives of the young people who will be locked up; on their families; on the state budget from the increased costs of imprisoning them.
Tough choices have to be made. But are we being pennywise and pound foolish? -Matt Noyes
Children’s Behavioral Health Initiative: Help Begins Today
The first of the new services promised under the settlement of the Rosie D v Romney lawsuit are being rolled out today. The suit, which was adjudicated in 2006, found that Massachusetts failed to provide community-based services for Medicaid-eligible children with severe emotional disturbance.
Over the past few years, the state has worked hard to create an infrastructure that will support new services. This effort was led by the Children’s Behavioral Health Initiative (CBHI)
Starting today, we will see how successful they have been.
As of June 30, Intensive Care Coordination, Family Support and Training, and Mobile Crisis Intervention are now available. In the fall, additional services (In-Home Behavioral Services, Therapeutic Mentoring, and In-Home Therapy) will come on line.
Click here for more information about the new services.
While families are hopeful about the potential for CBHI, budgetary decisions have become a reason for concern. Earlier this week, Governor Patrick vetoed $2.3 million in funding for CBHI. Many advocates and families are concerned that should this funding not be restored, Massachusetts may not be able to fully live up to the promises made during the settlement of Rosie D.
When the omnibus Act Relative To Children’s Mental Health (Chapter 321 of the Acts of 2008) was signed into law last year, there was one provision that was not included: reimbursement for collateral contacts by commercial insurance.
Collateral contacts can be more accurately referred to as coordination of care. When an adult is working with a mental health professional, the adult can typically express what is going on in his or her life directly to the clinician in such a way as to make treatment effective. When it is a seven year old, it’s not so simple.
Children are not little adults. To have treatment of mental health needs be effective, it is vital that the treating clinician speak to other people in the child’s life – parents, teachers, pediatrician, etc. Only through this coordination will the child have the best chance to have his or her mental health needs addressed properly.
Of course, to protect the privacy of the young people involved, this type of coordination would only be done with parental consent.
In Massachusetts, the state already reimburses mental health clinicians for collateral contacts when children are covered under MassHealth. Commercial insurance, on the other hand, does not provide this benefit. Mandating reimbursement for collateral contacts will ensure that care coordination is the standard practice rather than an exception to the rule.
The collateral contacts piece of Chapter 321 was not included in the final version of the law because a cost analysis had not been completed by the Division of Health Care Financing and Policy. The cost review was completed late last year and it found that collateral contacts are extremely inexpensive – 5.5 cents per member per month or 0.01% of total premium costs.
This piece of the original omnibus bill was refiled for the current legislative session as H. 3586 / S. 757, An Act Relative To Coordination of Children’s Mental Health Care, and was heard yesterday by the Joint Committee on Mental Health and Substance Abuse.
Testimony was given in support of the legislation by two panels.
On the first panel, Dr. David DeMaso, Psychiatrist in Chief at Children’s Hospital Boston and Professor of Psychiatry and Pediatrics at Harvard Medical School, illustrated the importance of coordination of care by asking Senate Chair Jen Flanagan to imagine herself as a third grade teacher with a student displaying mood swings and classroom outbursts. In an effort to more effectively attend to the behaviors while also teaching the other students, isn’t it a good idea to talk with the child’s psychiatrist, Dr. DeMaso asked.
Similarly, Dr. DeMaso asked House Chair Liz Malia to put herself in the shoes of a pediatrician treating a young woman with severe asthma. Before changing her patient’s medication to address her asthma, wouldn’t it be responsible for her to speak to her patient’s mental health clinician to avoid a potentially dangerous interaction with her antidepressant medication?
The second panel featured testimony from Central Massachusetts: Cathy Apostolaris from the Winchendon Project, Tony Poti from the Choices Program, and Dr. David Keller, a pediatrician from Webster. For all three of these individuals, care coordination has been vital to the success of their work.
Passage and enactment of An Act Relative To Coordination of Children’s Mental Health Care is the top legislative priority of the Children’s Mental Health Care. More effective coordination of care is an important step in addressing the mental health needs of Massachusetts’ children. -Matt Noyes
After 14 regional forums from Pittsfield to Hyannis, the Children’s Mental Health Campaign participated in a forum in Boston last night. Hosted by the Boston Public Health Commission, the forum took place at Boston English High School in Jamaica Plain.
The evening agenda brought out new constituencies, especially young people. More than 20 were in attendance – many of who shared their personal stories and asked questions of the panels.
Particularly timely were the comments of Marilyn Morrissey, a school nurse in Boston. One of the major shortcomings in the system of care for children with mental health needs is the lack of communication among the various adults in the child’s life, she said. This is precisely the issue that the Coordination of Care legislation, which was heard by the Mental Health and Substance Abuse Committee last week, aims to address.
Over the past year, the children’s mental health forums have provided important insights into local community needs. To be sure, there are many issues that are consistent across the state – stigma around mental illness, lack of capacity in schools to address mental health needs, and provider shortages, to name a few.
Still, the local community needs of Boston are quite different from those of Amherst. As the Campaign moves forward on implementation, the specific local needs will become even more important. Reform of the Massachusetts children’s mental health system cannot be a one-size-fits-all process.
The forum at Boston English High is only the first one for Boston. The Boston Public Health Commission is in the process of planning other forums for Alston-Brighton and Charlestown for the fall. Stay tuned for more details. -Matt Noyes
The Bell Ringer recognizes excellence in communications and public relations work in every field and industry, and across all media – print, broadcast, and online. It remains the region’s premier competition for public relations and communications professionals.
The CMHC team received a merit award in the Public Affairs Campaign for its work on Yolanda’s law. Yolanda Torres was a courageous teen from Plymouth who testified in support of the bill on Beacon Hill in May 2007. Sadly, she took her own life in January 2008 and never saw the bill signed into law later that year.
Last night’s recognition of the team that put together a thoughtful and inspiring media campaign to raise awareness about children’s mental health and that ultimately helped to convince the Legislature to sign the bill into law belongs as much to Yolanda and her family as it does to the team that attended the event at the Westin Waterfront. -Julia Christopher
When the omnibus Act Relative To Children’s Mental Health (Chapter 321 of the Acts of 2008) was signed into law last year, there was one provision that was not included: reimbursement for collateral contacts by commercial insurance.
Collateral contacts can be more accurately referred to as coordination of care. When an adult is working with a mental health professional, the adult can typically express what is going on in his or her life directly to the clinician in such a way as to make treatment effective. When it is a seven year old, it’s not so simple.
Children are not little adults. To have treatment of mental health needs be effective, it is vital that the treating clinician speak to other people in the child’s life – parents, teachers, pediatrician, etc. Only through this coordination will the child have the best chance to have his or her mental health needs addressed properly.
Of course, to protect the privacy of the young people involved, this type of coordination would only be done with parental consent.
In Massachusetts, the state already reimburses mental health clinicians for collateral contacts when children are covered under MassHealth. Commercial insurance, on the other hand, does not provide this benefit. Mandating reimbursement for collateral contacts will ensure that care coordination is the standard practice rather than an exception to the rule.
The collateral contacts piece of Chapter 321 was not included in the final version of the law because a cost analysis had not been completed by the Division of Health Care Financing and Policy. The cost review was completed late last year and it found that collateral contacts are extremely inexpensive – 5.5 cents per member per month or 0.01% of total premium costs.
This piece of the original omnibus bill was refiled for the current legislative session as H. 3586 / S. 757, An Act Relative To Coordination of Children’s Mental Health Care, and was heard yesterday by the Joint Committee on Mental Health and Substance Abuse.
Testimony was given in support of the legislation by two panels.
On the first panel, Dr. David DeMaso, Psychiatrist in Chief at Children’s Hospital Boston and Professor of Psychiatry and Pediatrics at Harvard Medical School, illustrated the importance of coordination of care by asking Senate Chair Jen Flanagan to imagine herself as a third grade teacher with a student displaying mood swings and classroom outbursts. In an effort to more effectively attend to the behaviors while also teaching the other students, isn’t it a good idea to talk with the child’s psychiatrist, Dr. DeMaso asked.
Similarly, Dr. DeMaso asked House Chair Liz Malia to put herself in the shoes of a pediatrician treating a young woman with severe asthma. Before changing her patient’s medication to address her asthma, wouldn’t it be responsible for her to speak to her patient’s mental health clinician to avoid a potentially dangerous interaction with her antidepressant medication?
The second panel featured testimony from Central Massachusetts: Cathy Apostolaris from the Winchendon Project, Tony Poti from the Choices Program, and Dr. David Keller, a pediatrician from Webster. For all three of these individuals, care coordination has been vital to the success of their work.
Passage and enactment of An Act Relative To Coordination of Children’s Mental Health Care is the top legislative priority of the Children’s Mental Health Care. More effective coordination of care is an important step in addressing the mental health needs of Massachusetts’ children.
First, please watch the video below, highlights from today’s inspirational, packed “Stop The Cuts” rally at the State House. The speakers include Harris Gruman of SEIU and the Stop the Cuts Coalition; Lisa Wong, Mayor of Fitchburg; John Bennett of Mass Senior Action; and Lynn Norris of Neighbor to Neighbor.
Next, call your State Senator (not sure who that is? look it up here) and urge him or her to support expanded revenues and HCFA’s key budget amendments to restore critical health care programs. The Senate will be starting its budget debate on Tuesday.
Adult Dental Benefits (Amendment EHS 473)
Senator Chandler
Eliminating adult dental benefits from MassHealth and Commonwealth Care will affect nearly 800,000 individuals throughout the state. Oral health is a critical part of overall health - studies show that chronic oral infections are associated with complex health problems such as heart disease, stroke, diabetes, low-birth weight, and premature infant births. Approximately one-ninth of Massachusetts’ population will be affected by this cut, including more than 120,000 low-income seniors and 180,000 disabled individuals on MassHealth and 91,000 individuals on Commonwealth Care.
Commonwealth Care Coverage (Amendment EHS 656)
Senator Chang-Diaz
Some 28,000 “special status” legal immigrant adults are enrolled in Commonwealth Care. They pay sliding-scale premiums, and are enrolled in private managed care plans. Coverage for this group, whose health needs was previously covered by episodic coverage via the Uncompensated Care Pool, was a provision of health reform. Ending eligibility for special status immigrants will leave over 28,000 Massachusetts residents without the comprehensive health coverage they need, and increase costs in other programs.
Office of Oral Health (Amendment EHS 465)
Senator Chandler
Line item 4512-0500
This amendment will provide equitable funding the Department of Public Health’s Office of Oral Health to bring needed oral health education and care to children and adults in underserved parts of the state, including dental care for persons with disabilities.
Child and Adolescent Mental Health Services (Amendment EHS 500)
Senator Spilka
Line item 5042-5000
This amendment restores funding to the primary account under the Department of Mental Health that provides services to children and young people with behavioral health needs. Included in this line item is funding for the Massachusetts Child Psychiatric Access Project, a model program that provides mental health consultations to pediatricians.
Office of Health Equity (Amendments EHS 597 and EHS 690)
Senator Fargo
Line item 4000-0300
These amendments add language to maintain the Office of Health Equity in the Executive Office of Health and Human Services. The Office of Health Equity oversees comprehensive efforts to eliminate health disparities, providing leadership and coordination of all state agency efforts. The Office is developing interagency disparities initiatives, preparing an annual health disparities report card, and evaluating the effectiveness of interventions.
Children’s Medical Security Plan (Amendment EHS 621)
Senator Eldridge
Outside Section
This amendment standardizes administration of the Children’s Medical Security Plan (CMSP), to bring the program into line with other programs administered by MassHealth. Additionally, it gives EHS the option to reexamine benefits offered under CMSP and to eliminate unrealistic caps on services (such as the currently-mandated $200 annual cap on prescription drugs for children).
DEEC Consultative Mental Health Services (Amendment EHS 617)
Senator Flanagan
Line item 3000-6075
This amendment restores the line item and funding for mental health consultative services to preschools. Massachusetts ranks 9th nationally for the rate of expelling young children from early education settings. Providing behavioral health consultative services has been shown to reduce the rate of expulsions and to reduce special education costs for children the following year in kindergarten.
DPH Quality Programs (Amendment EHS 686)
Senator Fargo
Line item 4510-0710
Last year Massachusetts made huge strides in improving the quality of health care in the Commonwealth by passing Chapter 305. Among its important duties, the Division of Health Care Quality gathers information and issues reports on Serious Reportable Events and infections to help hospitals improve the delivery of health care and save lives. Proposed cuts would slash this program.
Prescription Advantage (Amendment EHS 697)
Senator Montigny
Line Item 9110-1455
This is a state sponsored prescription assistance program for the elderly and some individuals who are disabled. It currently has 64,000 enrollees and this cut will cause 14,600 enrollees to lose their prescription drug assistance that keeps our seniors healthy, independent and out of more expensive care.
FMAP Transparency (Amendment EHS 700)
Senator Montigny
The United States federal government’s economic stimulus package will give states additional money for urgent health care needs. The enhanced Federal Medical Assistance Percentage (FMAP) funds are intended to be invested in MassHealth, health care, and public health. This amendment creates an identifiable, transparent FMAP fund to: secure jobs; maintain health care reform’s achievements; protect essential safety net services; preserve funding for our hospitals and community health centers; and fund cost-effective public health initiatives.
Evidence-based outreach and education program (Amendment EHS 702)
Senator Montigny
Line item 4510-0716
The evidence-based outreach and education program, also referred to as “Academic Detailing” would provide doctors with unbiased evidence to guide them in their prescribing decisions. Such programs have demonstrated to provide immediate savings that far exceed the cost of the program. This amendment restores this cost-saving program.
A detailed list of HCFA-supported amendments are here.
The Rosie D. v Romney lawsuit, settled in 2006, laid the groundwork for significant overhaul of the way Medicaid-eligible children with mental health needs receive services in Massachusetts. For many families, the change promised by the suit couldn’t come soon enough.
Nearly three years later, some of the systemic reforms are beginning to happen: Universal Behavioral Health Screenings in pediatrician offices are being given to more than 50% of children, doubling the rate of identification of behavioral health concerns; and 32 Community Service Agencies have been contracted to provide services across the state.
This afternoon, the Legislative Mental Health Caucus held an oversight hearing on Rosie D. implementation. Hosted by Representative Ellen Story, the hearing provided an opportunity for legislators to speak directly with DMH Commissioner Barbara Leadholm, Children’s Behavioral Health Initiative (CBHI) Director Emily Sherwood, and Suzanne Fields, Director of Behavioral Health Services for MassHealth.
Several legislators were in attendance, and all are actively engaged in the Rosie D. implementation process, asking insightful and sometimes pointed questions.
Representative Mary Grant expressed concern about the seeming “cookie cutter” approach to service development and the impression that CBHI will be focused at the most severely emotionally disturbed children, effectively ignoring a large population. Suzanne Fields clarified that the services will not be focused exclusively on “high-end” kids; rather, they are meant for all MassHealth children.
Taking it a step further, Representative John Scibak said that he would like to see the CBHI model expanded further to encompass GIC and Commonwealth Choice young people as well. Commissioner Leadholm responded saying that she has been in talks with private insurers to see if there is a way that they will offer the CBHI services as part of their coverage. Leadholm said that she expects to be able to show data that demonstrates the cost effectiveness of the services.
One major theme of the hearing was that public awareness is key – major changes are coming over the next six months as a range of services will be rolled out. Unfortunately, a significant number of people have no idea what’s in store.
Information is available online through EOHHS. Matt Noyes
