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Rally to Restore MassHealth Adult Dental Benefits

Speak Up for Oral Health


Rally to Restore MassHealth Adult Dental Benefits


Oral health is a crucial part of overall health. Cuts to MassHealth adult dental benefits put vulnerable populations at risk and costs the state more money in the long run.

Join us at the State House to make sure that public officials know that oral health IS health, and that they must make dental care a priority.

Thursday January 13th 1:00 pm

Massachusetts State House, Grand Staircase

Boston

To learn more about the Oral Health Advocacy Taskforce and ways to get involved, please contact Courtney Chelo, Oral Health Advocacy Taskforce Coordinator, at (617) 275-2935 or cchelo@hcfama.org.

Health Care for All of Mass

Oral Health Advocacy Taskforce

SSI – An Important Life-Line For Youth With Mental Illnesses

December 22, 2010

SSI – An Important Life-Line For Youth With Mental Illnesses

The recent Globe series on the challenges in administering the Supplemental Security Income (SSI) program raised many important issues regarding eligibility, oversight and disincentives to work.  However, we are concerned that the series may have inadvertently fostered misinformation, faulty stereotypes and prejudice towards youth diagnosed with serious mental illnesses.

The SSI program was established by President Nixon in 1972 to provide income supports to youth and adults with severe disabilities who are impoverished.  Additionally, in most states including Massachusetts, eligibility for SSI results in eligibility for Medicaid, a program vital to helping pay for needed medical care.

Mental illnesses among children and youth are as real and disabling as physical illnesses such as epilepsy and juvenile diabetes.  The National Institute of Mental Health observes that half of all psychiatric illnesses begin by age 14 and calls them “the chronic conditions of the young.”  The World Health Organization has identified five of the top ten causes of disability and lost productivity in the world as being caused by psychiatric disorders.

Psychiatric impairments can affect a child’s learning, growth, socialization, and development as profoundly as it affects an adult’s ability to work.  For example, adolescents with psychiatric disabilities have more than double the rate of dropout from high school than the general population.

These conditions often do respond to services and treatment, which makes access to proper diagnosis and treatment pivotal. While Massachusetts has made wise choices that have led to 99.8% of all children having health insurance, access to psychiatric care is far more precarious.  There is a significant shortage of child psychiatrists in Massachusetts and even fewer who accept MassHealth.

The prejudice associated with psychiatric impairments in our society compounds these challenges and hinders parents’ efforts to secure appropriate care. Negative attitudes frequently delay getting needed help for years, and in some cases, for decades.  Getting access to a comprehensive assessment, is the first step on the road to understanding the child’s strengths and weaknesses, and developing a plan to improve outcomes

SSI and Medicaid are important lifelines to evidence-based psychiatric treatment and services for youth.  Psychiatric medications, when properly prescribed and monitored, are an important component of these services and have proven effective in reducing disability and fostering recovery among youth with mental illnesses.  Health conditions are exacerbated by the consequences of poverty, so getting stable resources to low-income children with mental illnesses is of vital importance.

Careful oversight of the SSI program to ensure proper administration and accurate disability determinations is an important national objective.  So too is protecting access to SSI and Medicaid for vulnerable youth with disabling mental illnesses.   Access to these benefits can make all the difference in ensuring that youth with mental illnesses are given the chance to thrive, succeed in educational settings, and live productive lives.

Kenneth S. Duckworth, MD

Dr. Duckworth is the National Medical Director of the National Alliance on Mental Illness, the Medical Director of Vinfen, the largest human services agency in Massachusetts and the former Acting Commissioner for the Department of Mental Health.

Laurie Martinelli, Esq.

Ms. Martinelli is the Executive Director of NAMI Massachusetts.

Links to the three part series in the Boston Globe titled The Other Welfare, written by Patricia Wen.

http://www.boston.com/lifestyle/family/articles/2010/12/12/with_ssi_program_a_legacy_of_unintended_side_effects/

http://www.boston.com/news/health/articles/2010/12/13/follow_up_process_lacking_in_ssi_disability_program/

http://www.boston.com/community/moms/articles/2010/12/14/teenagers_in_ssi_program_face_a_cruel_dilemma/

Experiences of a Certified Peer Specialist on a PACT Team

Experiences of a Certified Peer Specialist on a PACT Team

by Mary Morin

When asked to write this, I had originally thought that the working title could be, “The Typical Day of a Certified Peer Specialist”.  However, in my experience, there was no typical day!  My assignments and responsibilities were many, and varied greatly from one moment to the next, so the title has changed, to that as it appears above.

A PACT Team (Program for Assertive Community Treatment) is for people who suffer from severe and persistent mental illness.  It’s often referred to as a “hospital without walls”, and ideally, is the most rehabilitative treatment for those with psychiatric disorders.  Because the person who is still in the situation in which he/she is experiencing problems (as contrasted to being in the hospital, where the person is removed from the stressor), the person learns how to deal directly with stressors, which may have been the cause of duress..

In many cases, my peers (clients in the program) would be living at home and would be treated, individually, by different specialists on the team.  Each specialist on the Team would have a different perspective and approach, when working with the individual.  Specialists include Psychiatrists, Social Workers, Nurses, Licensed Mental Health Workers, Peer Specialists, and Rehabilitation Specialists.  The Peer Specialists might well provide an accurate perspective of how someone with a mental illness might think and feel in a situation.  The Peer Specialist may have encountered similar problems, and has probably walked a similar walk to that of the person in crisis.  Because of this, the Peer Specialist may be the one who can “reach” his/her peer.  The rapport between the Peer Specialist and the peer, might be more readily developed, thus the Peer Specialist may be more able to effect change.

As a Certified Peer Specialist, my primary responsibility in all situations was to instill hope, in the mind of the psychiatrically disabled peer. To help do this, I frequently told my “Recovery Story”.  This story is about my learning experiences and growth in dealing with my mental illness, culminating in a positive ending, so the client would be inspired to continue in their struggle.

Multiple- hour staff meetings happened every Monday, Wednesday and Thursday morning. Every meeting, the staff reported on their interactions with the client and the status of the client, during the interaction. Individual Treatment Plans were constructed on one particular day of these three, and most of the three (or four!) hours were devoted strictly to this after reporting on the clients.  The Peer Specialist ideally functions as an equal to the rest of the team, advocating for the client, educating the team and providing his or her unique perspective on what issues the client may be facing, that others may not be sensitive to.

Most of my responsibilities were related to individual meetings with the client.  I would often start the day by delivering medication to the clients (who were predetermined to need monitoring).  Other tasks completed with the clients generally included, activities of daily living (such as grocery shopping, light household cleaning, and transporting to appointments) as well as recreational activities.  Inevitably, I drove many miles everyday, but received reimbursement for it.  What was interesting was that conversations between the peer and me would turn into talks that heal, while some of these activities occurred.  That is the beauty of the PACT model.  Healing and learning occur in the least expected times.

No day was like another day.  There was no such thing as a routine.  I received many last minute calls to transport someone, or assist someone in some way.  One thing for sure though, there was never a dull moment.

EOHHS FY2012 Budget Hearing

EOHHS FY12 Budget Hearing

The Executive Office of Health and Human Services (EOHHS) will be conducting a public hearing on the upcoming Fiscal Year 2012 budget. Secretary JudyAnn Bigby, M.D., and the Assistant Secretaries at EOHHS are looking forward to hearing the views of members of the community regarding the agencies under their purview.  The hearing will be held on:

Wednesday, December 29, 2010

Department of Mental Health

Western Mass Area Office

Haskell Building

Second Floor Large Conference Room

1 Prince Street

Northampton, MA 01060

10am to 2pm

The hearing will be tentatively divided as follows:

10am to 11am

Children, Youth and Families – DCF, DYS, ORI, DTA

11am to 12pm

Health Services – DMH, DPH, DHCFP, MassHealth

12pn to 1pm

Veterans, Elder Affairs, Soldiers’ Homes

1pm to 2pm

Disabilities & Community Services – MCDHH, MCB, MRC, DDS

Since the start of the budget crisis, the Administration has worked with you to solve deficits totaling nearly $13 billion.  As FY12 approaches, we are facing the expiration of federal stimulus funds and reduced rainy day funds and even though revenues started to grow in FY11, revenue collections historically lag behind national economic growth and will remain moderate over the next two fiscal years.

To overcome this budget challenge, we will need to work together to reexamine all public services and their delivery and find innovative solutions so that we can continue our mission with minimal disruption. Governor Patrick, Secretary Bigby and all of us at EOHHS are seeking your input to identify potential efficiencies, cost-saving initiatives and partnership opportunities that will preserve core services to the fullest extent possible without additional expenditures.

Due to the number of individuals anticipated to attend, oral testimony will be limited to three minutes.

Following are three questions we want you to address in your testimony or as a supplement to your testimony.  Please do your best to address each question specifically.

1. Are there areas where you believe EOHHS can regionalize, consolidate or streamline services, programs or offices to better serve clients, increase efficiencies and achieve savings?

2.  Are there areas where you believe EOHHS can use technology to better serve clients, increase efficiencies and achieve savings?

3.  Are there ways you believe EOHHS can reduce expenditures while maintaining essential and core services?

In the interest of time, representative panels are welcome.  If you need accommodations please call 617-573-1600 and let the receptionist know.  In addition, written testimony is strongly encouraged and may be mailed to:

Secretary JudyAnn Bigby, EOHHS

One Ashburton Place, Room 1109, Boston, MA 02108

Or emailed to: eohhshearings@massmail.state.ma.us

Additionally, EOHHS will be conducting a second public hearing on the FY12 budget in Western Massachusetts.  More details on this hearing will be distributed shortly.

Thank you and we look forward to hearing your feedback.

Open forums about Current Mental Health/Addictions Services & new directions in Mass

The Massachusetts Behavioral Health Partnership (MBHP)

The Partnership that Works

Please join us for an open forum about current mental health and addictions services and new directions in Massachusetts.

MBHP continues to develop and implement many innovative supports so that people with lived experience can lead lives of safety, stability, community, and accomplishment. This forum is an opportunity for us to hear from you about what is working and to hear your suggestions for improvements.

We value the lived experience and the contributions of our many stakeholder partners, including consumers, families, providers, advocacy groups, human service agencies, and legislators. MBHP would like to strengthen these partnerships by hearing from those who use services, provide services, and/or provide advocacy for our public behavioral health system.

Please let your voice be heard by attending and sharing your ideas at one of the sessions listed below.

Sessions: (Please click each location for directions.)

Tuesday, December 14, 2010: Marriott, Springfield

Wednesday, December 15, 2010: Marriott Courtyard on Tremont, Boston

Thursday, December 16, 2010: Hilton Garden Inn, Worcester

10:30 a.m. to 12:30 p.m. Lunch will be provided. Parking is complimentary.

Gift cards will be distributed to all attendees.

To help us plan for space and lunch, please let us know which session you will be attending by e-mailing MBHPforum@valueoptions.com or leaving a message at (617) 350-1942.

If you require Spanish interpretation or American Sign Language (ASL) services, please notify us by Thursday, December 9th.

Welcome and Introductions:

Nancy Lane, Chief Executive Officer, MBHP

Facilitators:

Richard Sheola, ValueOptions® Senior Leadership Team

Clarence Jordan, Director, Recovery & Resiliency, ValueOptions® of Tennessee

Clara Carr, Director, Rehabilitation and Recovery, MBHP

Dept. of Mental Health Public Forums

Department of Mental Health

ANNOUNCING A SERIES OF PUBLIC FORUMS

“Community First and Our Future”

The Department of Mental Health will hold a series of public forums throughout the state to discuss and gain input on the Department’s vision and goal of Community First and the future of the public mental health system.

The forums will be led by Commissioner Leadholm and Area leadership staff. We hope to engage in conversation about the changes the Department has experienced fiscally and organizationally and most importantly about our commitment to Community First and how the new DMH hospital aligns with our goals. The redistribution of DMH continuing care beds statewide presents us with options to consider within the constraints of our budget. It is critical that the mental health community participate in the discussions around these options as the Department prepares to open the new hospital in 2012.

The Department’s Community First initiative strengthens consumer choice; is family-focused and driven by client outcomes; achieves person-centered care; and relies on the development of an extensive peer workforce.  Enhanced ability to move through the community and inpatient systems of care is another hallmark of Community First. The following guiding principles inform Community First:

  1. Individuals with mental illness are empowered to live with dignity and independence in the community.
  2. Consumers have access to a full range of quality services and supports to meet their mental health needs.
  3. The Department continuum of care enables individuals to live, work and participate in their communities.
  4. The Department system of care is consumer-centered and recovery-oriented.
  5. Services are flexible, recovery-based and person-centered and support consumer choice.
  6. Individuals transitioning from institutional settings to the community are supported in the most appropriate manner.
  7. Limited resources are used and managed effectively.

We invite everyone interested in the Department’s work and the delivery of mental health services to join the conversation. The forums are open to all stakeholders – staff, consumers, providers, DMH citizen board members, advocates, state agencies and members of the Legislature – with the hope to solicit your ideas and have a shared understanding around the Department’s Community First initiative and the future of public mental health care in Massachusetts.

We will hold public forums on the following dates and locations:

Department of Mental Health

“Community First and Our Future”

A Public Conversation

December 2010 Public Forums

Date Time Location
Wednesday

Dec. 8, 2010

4:30 to 6:30 p.m. Second Floor Large Conference RmHaskell Building1 Prince St. Northampton
Thursday

Dec. 9, 2010

6 to 8 p.m. Boston University School of Medicine

72 East Concord St. Boston, Rm L110, first flr

(Parking Garages & limited on-street parking are available.)

Tuesday

Dec. 14, 2010

6 to 8 p.m. Northern Essex Community CollegeLecture Hall A

100 Elliott St., Haverhill

Wednesday

Dec. 15, 2010

6 to 8 p.m. Worcester State UniversityStudent Center

Blue Lounge 486 Chandler St., Worcester

Proposed Closure of the Psychiatric Beds at HealthAlliance’s Burbank Campus

December 1, 2010

John Auerbach, Commissioner, Department of Public Health, 250 Washington Street Boston, MA  02108

Re:  Essential Services testimony for the proposed closure of the Psychiatric Beds at HealthAlliance’s Burbank Campus

Dear Commissioner Auerbach:

I submit this testimony on behalf of the National Alliance on Mental Illness of Massachusetts (NAMI Mass).  The mission of NAMI Mass is to improve the quality of life for people with serious mental illness and their families.

I am writing today to register NAMI Mass strong opposition to the proposal by HealthAlliance to close a 15 bed psychiatric unit at their Burbank Campus. We oppose this measure because such action will adversely affect families in northern Worcester County.  We also oppose this measure on grounds that our safety net hospitals are being eroded and there simply aren’t sufficient numbers of acute care inpatient psychiatric beds in the system.  Unfortunately, the proposed closure of 15 beds at the Burbank Hospital only adds to this dilemma.

We oppose this closure for the following reasons:

1.      NAMI Mass is concerned that the Commonwealth is not fulfilling its commitment to provide a full spectrum of services for people with mental illness that includes acute care inpatient psychiatric beds.  Where will people who are in psychiatric crisis be admitted when these beds close?

Last year, Cambridge Health Alliance closed 35 acute care inpatient psychiatric beds.  Westborough State Hospital recently had a 120 bed reduction and now the Department of Mental Health tells us they need to cut another 100 acute care inpatient psychiatric beds.

It is the responsibility of the Commonwealth to ensure a sufficient level of access to acute care inpatient psychiatric beds. We feel the Commonwealth has abdicated this responsibility.

2.      “Alternative sites” are too far for patients and families to travel and public transportation options available are few, if any.

What happens when “alternative acute care inpatient psychiatric beds” are so far away that family members can’t easily get to them to visit their loved one?  Many of these “alternative sites” are not on public transportation so family members may not be able to visit their loved ones.  What happens when a psychiatric system is no longer robust and cannot ensure timely access to an acute care inpatient psychiatric bed?

Guy Beales of NAMI Mass testified earlier about the long distances people must travel to visit their loved ones in psychiatric units around the state. And this mileage does not reflect traffic or workday commutes when it takes much longer to get to a desired destination or the insufficiency of public transportation.

3. NAMI Mass is concerned that there are not sufficient alternative sites for patients in northern Worcester County to go to if these psychiatric beds close.  Many of the alternative hospitals with psychiatric units have high average daily census and cannot accommodate more patients.

For example, Emerson Hospital in Concord has 29 licensed inpatient psychiatric beds and has an average daily census of 27 patients on the unit.  The University of Massachusetts in Worcester has 53 licensed beds; 27 beds in the Psychiatric Treatment Center and 26 beds in 8 East.  The average daily census for these beds is 27 and 26 respectively.

This list goes on but the point is:  where will people who need acute care inpatient psychiatric hospitalization be admitted? The waiting time in emergency rooms will only get longer and emergency rooms are not the appropriate place for an individual with a serious mental illness in crisis.

4.   We have several concerns when HealthAlliance insists there are plenty of “alternative” sites.  None of their explanations equal an Access Plan and, after analysis, the Department should agree with our conclusion.  For example,

  • HealthAlliance reports there will be new mental health services at the Emergency Department at Leominster Hospital. Although we applaud any new mental health services, it is well documented that Emergency Departments are not able to provide the services of an inpatient unit. Short term acute treatment in an emergency room cannot be compared with longer term chronic care that an inpatient unit provides for an individual with mental illness.
  • Community HealthLink has increased its overnight stabilization beds at 40 Spruce Street in Leominster to be closer to HealthAlliance and to provide these necessary mental health services.  Again, we applaud these measures, but six new stabilization beds are not equivalent to and will not replace an inpatient psychiatric unit.  Patients who use these overnight stabilization beds will not be the same patients who use the services of a psychiatric unit at Burbank where the average length of stay is 5.2 days, according to Lisa Capone, RN, Corporate Vice President at HealthAlliance.

HealthAlliance tells us that Henry Heywood Hospital in Gardner is considering plans to expand its psychiatric unit. This is great news but any new inpatient psychiatric facilities constructed at Henry Heywood Hospital will take years to build.

So, while all these measures are good, they do not replace the inpatient psychiatric beds HealthAlliance proposes to close at the Burbank Campus.

The “essential service” regulations, 105 CMR 130.020, require the Department, based on the evidence collected at the hearing (and other evidence submitted to DPH), to determine whether discontinuation of the inpatient psychiatric unit “will jeopardize access to the services and the health status of the hospital’s service area.” NAMI Mass gives a resounding “yes.”  Discontinuation of the psychiatric unit at the Burbank campus will jeopardize access and the health status of the hospital’s service area.  We respectfully request the Department to require the submission of an “Access Plan,” to assure access to these services.

Because NAMI Mass is concerned about travel, distances and lack of public transportation options to other inpatient psychiatric units, we request that the post-closure monitoring report that the Department must produce one year after the proposed closure evaluate the distance that patients and families have to travel to be admitted to or visit these other psychiatric units.

Thank you for the opportunity to testify.

Laurie Martinelli

Executive Director

Cc:  Barbara Leadholm, Commissioner, Department of Mental Health, Ray Cryan, Department of Public Health, Division of Health Care Quality

Bob_Antonioni_101130_Burbank_closure (PDF)

Burbank_Hospital_HLA_letter (PDF)

HealthAlliance CEO: We have a plan for mentally ill. Emergency-room treatment will be key. Read more: http://www.sentinelandenterprise.com/ci_16738723#ixzz17MEDAxuy

Mass Nurses – Attend a Department of Public Health Hearing On the Proposed Closure of a 15-Bed Psychiatric Unit Health Alliance Hospital, Burbank Campus http://bit.ly/haVZeI