Wednesday, August 27, 2008

Testimony from the Worcester Mental Health Network: Delivered at EOHHS Budget Hearing 8/27/08

The Worcester Mental Health Network identifies communities underserved by existing mental health services and, through advocacy, seeks to remove barriers to care.”
Affiliated Organizations:
Central Mass AHEC, Central MA Communities of Care, Central Massachusetts Medical Home Network, Children and Family Law, Community Healthlink, Court and Family Law, Great Brook Valley HC, Health Law Advocates,Legal Assistance Corporation of Central Mass, MSPCC/ Central Mass, Parent Professional Advocacy League/ Central MA, South County Pediatrics/UMMHC, The Health Foundation, The Willis Center, Youth Opportunities Upheld INC
Please note:  Affiliation with the Network does not mean that this statement was formally approved by each of these organizations.

August 27, 2008

Secretary JudyAnn Bigby, MD
Executive Office Of Health and Human Services
One Ashuburton Place, Room 1109
Boston, MA 02108

Dear Secretary Bigby:

Thank you for the opportunity to speak today, as you begin the development of the FY2010 budget. I am a pediatrician, who has practiced for the past 17 years at South County Pediatrics in Webster. For the last 4 years, I have been working with the Worcester Mental Health Network, a group of 15 provider, consumer and advocacy organizations in Worcester County working to identify communities underserved by existing mental health services and, through advocacy, seeks to remove barriers to care.

On behalf of the Network, I first wanted to thank EOHHS for the Child Behavioral Health Initiative. Emily Sherwood and her colleagues have brought that effort to life, breaking down many of the traditional silos that have confronted families with a system so complex that even the most highly educated parents have trouble navigating it.

Over the past 10 years, we in the Pediatric community have witnessed an explosion in the need for mental health services for children, ranging from the need for Behavioral Management for out-of-control toddlers to adolescents with depression, anxiety and bipolar disorder. While this is a problem in Worcester and Boston, where services are overwhelmed, it is worse in Webster and throughout most of the small towns of the Commonwealth, where services are fragmented and hard to reach without a car. This year, we began to build a system, though the implementation of the Rosie D. settlement, and the passage of An Act Relative to Children’s Mental Health (Chapter 321) Next year’s budget needs to build on this year’s success, if we are to serve all of the children of the Commonwealth.

What do I mean? Families of children with mental illness need support. From care coordination within a primary care setting to wraparound services like Communities of Care and MSSBY, we can make a difference for families. Let me talk about a few patients from my practice:

• A 6 year old with a serious chronic medical condition, ADHD and possibly bipolar disorder, who receives care from specialists in Springfield, Worcester, Boston and Southbridge. He is involved with DCF, DDD, DTA and the public schools, all of which must coordinate their efforts through the parents. There are no child psychologists in South Worcester County who can work with the family to develop and implement to the behavior plan that this child needs. This family needs support; ensuring adequate funding for the CBHI will help us help them.

• A 10 year old hospitalized last fall with acute psychosis after being taken from school out of school for “meltdowns” on a weekly basis. His parents both work in towns 30 miles from his school; coordinating care from a psychiatrist and a therapist means time off from work and more miles on the car. This family needs support; ensuring adequate funding for the CBHI will help us help them.

I could name others, but I want to stop here, because the message is clear. Funding services that bring together the resources of the community and the resources of the family will go a long way to reducing the burdens on our courts and the children stuck in the mental health system.

What is adequate support? It’s complicated; we certainly endorse the proposals of the Children’s Mental Health Campaign (see below), but we want to be sure that those initiatives reach past the urban centers to Worcester County and beyond. It seems to us in the service delivery system that the children of the Commonwealth would benefit from policies that encourage co-location of mental health and primary care providers; this model works well within Community Health Centers, but could be expanded to many of the private offices that treat our MassHealth patients. We know that the diverse population of the Commonwealth demands the development of a multi-cultural and multi-lingual workforce; we need pilot programs to develop a pipeline from within and outside of the Commonwealth to address those needs.

We hope to continue this conversation; we invite you to join us sometime in Worcester or perhaps even Webster to discuss ways in which EOHHS can leverage its dollars to support the family-centered multi-disciplinary approach at the center of the CBHI. If you have any questions or would like more information, please contact David Keller MD, Facilitator of the Worcester Mental Health Network at


David Keller MD
Worcester Mental Health Network

Clinical Associate Professor of Pediatrics
UMass Medical School

From the Children’s Mental Health Campaign- specific budgetary requests:
• Mental Health Consultative Services To Schools (line item 5042-5000) – an increase of $2.75 million.
• Behavioral Health Consultation for the Department of Early Education (3000-6075) - an increase of $1.1 million.
• Children’s Behavioral Health Advisory Council and Children’s Behavioral Health Research Center (4000-0300) – an increase of $500,000.
• School Capacity Pilot and Evaluation (4590-0250) – an increase of $500,000.

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