Rose D: One Year Into the Settlement.

It was good to get away.    The mountains were wonderful, but I need to get back to the world now, and to catch up on a few things.

For the folks who like to wade through documents, take a look at the recently filed progress report filed by the Child Behavioral Health Initiative here. There has been a lot of activity over the past year, mostly around the issues of implementing screening programs.  Faithful readers have been hearing a lot about that now-  we screen children for mental health problems in Pediatric practices, and we continue to identify families that need mental health services.  As one reads through the first 17 pages or so, one marvels at the rapidity with which the system has been rolled out.  As a long time primary care provider in Massachusetts, I have to applaud the CBHI staff for all of their work;  they have been working hard to get us to identify the children at the root of this lawsuit, and we have, I think, mostly responded favorably.

How to handle the children we find, however, is still a work in progress.  Key parts of the CANS have been adopted as a means of implementing the program, and trainings have begun around the state, but the details of how it will all fit together are still under discussion.

Implementation is summarized in paragraph 38;  in fact, large chunks of the report are text from the settlement followed by "See response to paragraph 38 below."  Paragraph 38 says, in essence, that the CBHI has created a complex and inclusive management structure, with more than 80 people from within and outside of state government, serving as the core people on this process.  They have solicited input in all possible ways and is waiting on the word from Washington before implementation can began.  Once that happens, the state has all of the pieces standing by, waiting to implement.  And at that point, we will know what this is going to cost.

So we wait.  One hopes that CMS responds soon;  kids are waiting for this moment to arrive.  Kind of reminds me of waiting in Casablanca for the plane to Lisbon.  Here's looking at you, kid.