Friday, October 31, 2008


U.S. Department of Health and Human Services
National Institute of Mental Health (NIMH)
Embargoed for Release: Thursday October 30, 2008, 2:30 p.m. EDT

CONTACTS:  Colleen Labbe or Kevin Sisson, NIMH Press Office, 301-443-4536,

Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone are also effective, according to a new study funded by the National Institute's of Health's National Institute of Mental Health (NIMH) The study was published online Oct. 30, in the
"New England Journal of Medicine."

"Anxiety disorders are among the most common mental disorders affecting children and adolescents. Untreated anxiety can undermine a child's success in school, jeopardize his or her relationships with family, and inhibit social functioning," said NIMH Director Thomas R. Insel, M.D. "This study provides strong evidence and reassurance to parents that a well-designed, two-pronged treatment approach is the gold standard, while a single line of treatment is still effective."

The Child/Adolescent Anxiety Multimodal Study (CAMS) randomly assigned 488 children ages 7 years to 17 years to one of four treatment options for a 12-week period:

-- Cognitive behavioral therapy (CBT), a specific type of therapy that, for this study, taught children about anxiety and helped them face and master their fears by guiding them through structured tasks;

-- The antidepressant sertraline (Zoloft), a selective serotonin reuptake inhibitor (SSRI);

-- CBT combined with sertraline;

-- pill placebo (sugar pill).

The children, recruited from six regionally dispersed sites throughout the United States, all had moderate to severe separation anxiety disorder, generalized anxiety disorder or social phobia. Many also had coexisting disorders, including other anxiety disorders, attention deficit hyperactivity disorder, and behavior problems.

John Walkup, M.D., of Johns Hopkins Medical Institutions, and colleagues found that among those in combination treatment, 81 percent improved. Sixty percent in the CBT-only group improved, and 55 percent in the sertraline-only group improved. Among those on placebo, 24 percent improved. A second phase of the study will monitor the children for an additional six months.

"CAMS clearly showed that combination treatment is the most effective for these children. But sertraline alone or CBT alone showed a good response rate as well. This suggests that clinicians and families have three good options to consider for young people with anxiety disorders,
depending on treatment availability and costs," said Walkup.

Results also showed that the treatments were safe. Children taking sertraline alone showed no more side effects than the children taking the placebo and few children discontinued the trial due to side effects. In addition, no child attempted suicide, a rare side effect sometimes associated with antidepressant medications in children.

CAMS findings echo previous studies in which sertraline and other SSRIs were found to be effective in treating childhood anxiety disorder. The study's results also add more evidence that high-quality CBT, with or without medication, can effectively treat anxiety disorders in children, according to the researchers.

"Further analyses of the CAMS data may help us predict who is most likely to respond to which treatment, and develop more personalized treatment approaches for children with anxiety disorders," concluded Philip C. Kendall, Ph.D., of Temple University, a senior investigator of
the study. "But in the meantime, we can be assured that we already have good treatments at our disposal."

The six CAMS sites were Duke University; Columbia University/New York University; Johns Hopkins University; Temple University/University of Pennsylvania; University of California, Los Angeles; and the Western Psychiatric Institute and Clinic/University of Pittsburgh Medical Center.

Reference: Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN,
Sherrill J, Ginsburg GS, Rynn MA, McCracken J, Waslick B, Iyengar S,
March JS, Kendall PC. Cognitive-behavioral therapy, sertraline and their
combination for children and adolescents with anxiety disorders: acute
phase efficacy and safety. "New England Journal of Medicine." Online
ahead of print 30 Oct 2008: 359(17).


This NIH News Release is available online here

Thursday, October 30, 2008

Wish I Could Have Been There: From the CBHI

Got this e-mail from the CBHI;  I was seeing patients that day, and couldn't be there:

The CBHI Institute: Building a Strength-Based, Family-Driven System of Care recently gathered over 300 executive level provider staff to the DCU Center in Worcester MA to learn more about CBHI in order to help them determine the new MassHealth service(s) that they will apply to provide. The day-long institute was moderated by John O'Brien, a senior consultant with the Technical Assistance Collaborative.

The first portion of the day featured presentations on CBHI: Vision, Mission and Values (Barbara Leadholm, Commissioner DMH and Tom Denher, Medicaid Director), The Future of MA Mental Health Care: A Family Perspective (Dalene Basden, MSPCC and Lisa Lambert, PPAL), Systems of Care: National Lessons on Systems of Care (Bruce Kamradt, Wraparound Milwaukee), Overview of New Voices from the Field: The Family Partner/Care Coordinator Dyad (Aida Bednaz and Jennifer Moore, CCFC Springfield, J. Anthony Irsfeld and Matilde Yvette Rodriguez, Communities of Care Worcester), and An Overview of New MassHealth Services (Suzanne Fields, MassHealth Behavioral Health).

The afternoon provided participants with a series of breakout sessions where information on performance specifications for the new MassHealth services - ICC and Caregiver Peer to Peer Support, In-Home Therapy Services, Mobile Crisis Intervention and Crisis Stabilization, and In-Home Behavioral Services and Therapeutic Mentors - was provided. The sessions were conducted by a member of the MassHealth Behavioral Health leadership team, along with Patrick Kanary, from the Center for Innovative Practice, Kappy Madenwald of the Annapolis Coalition for the Behavioral Workforce, Bruce Kamradt, and Anthony Irsfeld, who shared their experiences building and implementing similar services in MA and other parts of the country.

To download CBHI Institute presentations or copies of performance specifications for the new MassHealth services, visit the "CBHI Institute Materials" section on our

Children's Behavioral Health Initiative

email us:

Wednesday, October 29, 2008

In Case You Thought That Everyone Loved Mental Health Parity

It is really hard to blog about Children's Mental Health with the election closing to a climax- I find myself drifting over to, to see how the election goes.  I have avoided such comments on the blog, but I do live in New England, and my preferences are probably predictable.  I will try to maintain focus and I look forward to Wednesday, when we can get on with the work.

For now, however, I have to share a story to remind how hard this work is.  I just found this piece in the Baltimore Sun, which seems to be generating some buzz in web.  

'Parity' through back door:   Controversial and costly mental health coverage mandate is slipped through on back of bailout bill

By Richard E. Vatz and Jeffrey A. Schaler
Psychiatric self-interest groups have tried for years to force insurance companies to cover the treatment of mental illness and addiction. Treating depression as well as disturbing and sometimes simple problems in living on the same level as cancer, heart disease and diabetes is the essence of what has come to be known as "parity."
Now, through political legerdemain, this government-mandated coverage has just become law as an amendment attached to the Emergency Economic Stabilization Act of 2008.
The parity amendment requires that mental health and substance use disorder benefits be "no more restrictive than the predominant financial requirements applied to substantially all medical and surgical benefits covered" by an insurance group health plan or coverage (if said plan covers mental illness). That has a reasonable sound to it. Unfortunately, though, this legislation, unless reversed - or at least modified to apply only to severe disorders - is likely to open up a Pandora's box for the American health care system
.  Click for rest of article
Comments, anyone?  I have to say that when I first saw this, I was thinking to myself, I really wondered if they were talking about the same bill that I worked on in DC.  I saw the bill as being supported by parents and families of folks with mental illness, who I guess are a "self-interest group"- but the language makes it sound like that is a bad thing.  I was puzzled by this, until I realized that Dr. Vatz has a PhD in "rhetoric" and is skilled at the use of language in a way that I hadn't perceived in the past.  The second sentence further shows his skill at reframing the argument:  he conflates "depression" with "problems in living" and then accuses parity of equating those with "cancer, heart disease and diabetes".  I would argue that depression is associated with a similar degree of morbidity (days of work lost) and mortality (suicide kills more thirty year olds than cancer),  but it was the conflation that troubled me:  "problems in living" seems to be his code work for "overdiagnosis of psychiatric disorders" such as adjustment disorder (cited later in the article), that he feels do not warrant treatment.  To me, of course, the proper comparison for adjustment disorder in the physical realm would be fatigue or headache- a relatively minor problem that frequently appears on my primary care docket and is covered by medical insurance as a medical problem.  Why shouldn't health insurance cover that too?
The rest of the article follows the pattern set up in the first two sentences, setting up a straw man, and following subtly inaccurate patterns of logic to the erroneous conclusion that the mental health parity bill was "snuck through" (not that it had already passed both houses and was snagged on a technicality in the Senate), and that "they" had somehow stuck it to us again.  It is interesting, however, to see how even a "no-brainer" law can evoke powerful opposition.
OK, back to my electoral obsession now.

Sunday, October 26, 2008

CSAs are out for bid: Who's in?

From the Child Behavioral Health Initiative:
In order to ensure that Massachusetts has the infrastructure to successfully support and implement the Children's Behavioral Health Initiative (CBHI), the Massachusetts Behavioral Health Partnership (MBHP) in collaboration with the four MassHealth contracted managed care organizations (MCOs) - Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Neighborhood Health Plan*, and Network Health - is procuring a statewide network of Community Services Agencies (CSAs).

A CSA is a community-based organization whose function is to facilitate access to, and ensure coordination of, care for youth with serious emotional disturbance (SED) who require or are already utilizing multiple services or are involved with multiple child-serving systems (e.g., child welfare, special education, juvenile justice, mental health) and their families.

The CSA Request for Response is available on the websites for MBHP and the MassHealth contracted MCO's (collectively, Managed Care Entities, or MCE's).

* Beacon Health Strategies (Beacon) is the behavioral health partner for Fallon and Neighborhood Health Plan.

Children's Behavioral Health Initiative

Thursday, October 23, 2008

Worth reading: Effective Partnerships

My vacation has been (and continues to be) wonderful, but I wanted to share two tidbits that I found on my e-mails. 

First as we move into the CSA creation process, check this out from the UMass, Dept. of Psychiatry’s Center for Mental Health Services Research: a new issue brief written by Jodi Adams, MA, Joanne Nicholson, PhD, Susan Maciolek, MPP, Kate Biebel, PhD entitled, “Family Networks Implementation Study: Integrating Rigor and Relevance in Effective Research Partnerships”
The CSA RFR is out on the Mass Behavioral Health Partnership website, and we realy need to be thinking about what partnership means.

Also, we lost a bit in the current round of budget cuts;  according to Health Care for All:

9C Cuts and Children's Mental Health

Due to lower than expected state revenues, Governor Patrick announced a series of funding reductions to the FY 2009 Budget last week. Among the reductions that were made, $2.25 million was cut from the Child and Adolescent Mental Health Services account (line item 5042-5000). This includes a cut in the $250,000 that was appropriated to pilot the Massachusetts Child Psychiatric Access Project (MCPAP) in public schools. 

The Children's Mental Health Campaign is working closely with the Patrick Administration and the Massachusetts Behavioral Health Partnership to determine the impact of all funding reductions on services to children living with mental illness. We will continue to update our supporters when we learn more.
So, clearly there is some work to do.  Stay tuned for advice on appropriate action (One thing, of course, to think carefully abou tthe implications of eliminating the State Income Tax).  More later.

Monday, October 20, 2008

Upcoming Meetings

I am on the road again this week, working the Appalachians for beautiful foliage and political insight.  But this seemed of interest:

Dear Dr. Keller:

My name is Beth Andrews. I work with Dr. John Straus at the Massachusetts Behavioral Health Partnership. As part of our work at MBHP, Dr. Straus and I develop free educational programs for primary care clinicians. Often, our programs emphasize the integration of primary care and behavioral health, as is the case with our current offering.

I am forwarding to you a brochure for an upcoming forum for primary care providers and ask that you distribute this to as many of your clinical staff as possible and encourage them to attend. The dinner is free. This is an educational opportunity jointly sponsored by the MassHealth PCC Plan, MBHP and the University of Massachusetts Medical School Office of Continuing Education. There is no promotional activity associated with the forum; we simply want to make educational opportunities available to PCCs who see our patients.

The meeting is on November 6 at the Beechwood Hotel in Worcester, which has proved to be a convenient location for providers. It is an evening dinner meeting. Dinner is free and so are CMEs (for MDs and PAs) and CEUs (for nurse practitioners, nurse midwives and RNs).

Primary care providers have expressed the need to understand more about what happens in the behavioral health care world once a referral is made for a patient (particularly a child) that results from the screening process. I think you will agree that the topic is timely, given the relatively new MassHealth Mandate to screen all children who are covered by MassHealth for behavioral health needs.

The speaker for this program is Mathieu Bermingham, whom you may know, as he is a child psychiatrist at UMass Medical Center. He is also a consultant with the MCPAP team in the central region of the state. Dr. Bermingham will present four case studies. Each will describe a patient who has been referred for behavioral health care and provide an overview of what happens in providing behavioral health to that patient. In particular, he will describe specialized behavioral health services available to help each patient.

I am hoping clinicians at your organization will find this program of interest, and that as many as possible will attend.

Will you kindly forward the attached brochure to them electronically and encourage them to register? It’s easy to register; just fax in the completed registrations to 617-350-1982.

Thanks very much for you assistance.


Beth Andrews

P.S. Please feel free to contact me if you have questions. eja

Elizabeth J. Andrews, MPH
Director, Primary Care Clinician Plan
Performance Improvement Management Services (PIMS)
Massachusetts Behavioral Health Partnership
150 Federal Street, Third Floor
Boston, MA 02110

Phone: 617-350-1954
Fax 617-350-1982
I can't post the brochure, but I sure that she will mail it to you.

Friday, October 17, 2008

Government Moves in Mysterious Ways

Did you all notice that the bailout legislation that passed Congress last month was titled "The Paul Wellstone and Peter Domenici Mental Health and Substance Abuse Parity Bill"?  When I was in Washington last month, that is one of the bills of interest that the AAP had us highlight in our "Hill Visits" with legislators, which happened on September 29th, the day that the House was voting to reject the initial "Bailout Bill".  It was an interesting time to meet with legislators to discuss health care legislation; all eyes were focused on the meltdown of the economy, and we were probably the only folks discussing anything else on the Hill.  We heard a lot of different things from different offices about the Mental Health Parity bill, which had actually passed both houses, but was defying reconciliation because the Senate had attached a tax bill to it that the House had rejected, and both sides were adamant that it would not pass.  We debriefed at the AAP's Washington Office, as the "bailout" died on C-SPAN behind us on the wall.  One office reported that they thought that the bill had already passed, several said that Congress would pass it after the election and a few said that it would not make it out this session.  The AAP Staff decided that it would be worthwhile to send our membership a request for letters through the FAAN network, a call that I echoed on the blog at the time.  Two days later, the bill passed.  What I didn't realize at the time, was that the AAP blast generated 1000 letter to various offices of Congress on Tuesday, as the Senate was beginning to deal with its versionof the bailout.  Now the Senate CAN'T originate a money bill (according the Constitution);  they needed to attach it to something.  They picked the Parity Bill, attached the money bill to it and the rest is history.  That's the base of the bill that the President signed, and Parity is now the law of the land.

Did those 1000 letters arriving on a day when ALL of the other pundits were talking money and economics have an impact on which bill the Senate picked as its vehicle?  Or was it just that the Senate knew that the House liked this bill, having passed it by a lopsided majority earlier in the session?  We will never know.  On the other hand, I like to think that the AAP had some part in the rescue of the economy on that September Monday, and that we managed to do some good for children at the same time.

Wednesday, October 15, 2008

A Community Forum on Mental Health Reform

I arrived late, and just got access the net, so now I am blogging live from the Community Forum that MSPCC is holding in Worcester this morning.  Matt Noyes  from Health Care for All and Emily Blair from MSPCC began by reviewing the impact of CHAPTER 321 (AKA a bill relative to Children's Mental Health) on the future of child mental health practice in Massachusetts.  The law, in many ways, is about establishing a process, that involves committee reports and  deadlines, setting goals for change , but leaving the hard questions about the allocation of resources for future advocacy.  There will be many opportunities for us to participate in the process-  the Campaign is currently engaged in a process of engaging participants from around the state in the process going forward.   This law is not the be-all and end-all of our problems with in helping children and families - rather it is a opportunity for us to work with the State to build a better system. The rooms was packed with people from many of the agencies engaged in work on Children's Mental Health within Worcester County.  

Matt and Emily gave a nice presentation, pointing out the the legislation would need to be monitored carefully to be sure that it was actually being implemented.  I went through the details of the bill in an earlier post, and won't repeat it here. They saw the major tasks of the Children's Mental Health Campaign as:
MONITORING IMPLEMENTATION:  The Campaign will be the public monitor to insure that the State is actually doing what is supposed to happen. 16 sections of the law require some sort of public monitor, and we need to translate the language into specific objective, and to determine who will be held accountable for progress. The Campaign needs to work this out with Secretary Bigby, and will be forming task forces to address each of these 16 points.
UNFINISHED BUSINESS:  We were surprised that this bill actually passed. 7000 bills were introduced; only 2% of the “bills of substance” passed. This bill lost only one major of it's major components:  the part about the payment for collateral meetings, so important in the provision of services to children.   So, that portion of the original bill will be reintroduced in the next legislative session. We will all need to be there to support it.
The Campaign has also begun to encourage EOHHS to help with the case management process by creating a directory that monitors the availability of beds for children with mental health problems statewide.  Hospital social workers spend a lot of time looking for beds, requiring individual phone calls around the state.  
Finally, they have recognized the need to encourage the development of improved capacity for care throughout the Commonwealth.   Currently, MBHP manages care for the most vulnerable kids on MassHealth and even they had have trouble finding the resources to help their families.  They have started an “access committee” and created a performance issue to measure the ability of families to identify appropriate providers. We need to work on creating a capacity to meet this demand.
BRANCHING OUT:  Today's meeting was part of an effort to work on  establishing a listening network. We spoke of the need for reaching to other groups, in the 4 corners of the Commonwealth as well as within a number of racial and ethnic groups.  Task force groups, advisory groups and other groups have all are an opportunity for participation.

There were lots of questions, about co-morbidity and co-payment, workforce development and inclusivity of project development.  In the course of the questions, it was pointed out that there are several opportunities for folks from Central Mass to get involved, in Boston and in Central Massachusetts:

Children's Mental Health Campaign
Regional Forum:  Framingham Legislation Forum
Blumer Room, Memorial Hall, 
Friday, Oct 24, 9-10:30 AM
State Meeting:  9th Floor, 30 Winter St, Boston
Tuesday, Nov 18, 9:30-11 AM

Children's Mental Health Interagency Forums:  
These local regularly scheduled meetings are an opportunity to iron details of collaboration on cases shared between multiple agencies.  
Regional Meeting:  Worcester Regional DCF Office
First and Third Monday of the month.
Contact Kimberly Ferrecchia-Rivas for more information
Local meetings at North County (DMH Fitchburg), Worcester local (Worcester DCF office)  and in the South County (Whitinville DCF office) every month.  
Contact Richard Breault or Rasa Chiras for more details.

Integrated Levels of Care Meeting 
Convened by the Mass Behavioral Heal Partnership, this group is working to design what an integrated mental health care system would look like in Central Massachusetts.
Friday, 17 Oct, 10-12 PM
MBHP, Central Mass
120 Front Street, Suite 315,  Worcester, MA
Contact Elizabeth O'Brien for more information.

As I have said before, there is clearly too much going on.  And I have yet to share my stories from the AAP meeting last weekend.

Friday, October 10, 2008

AAP National Meeting: Children's Mental Health is a National Issue.

I've been preoccupied this week with watching the culmination of the Reagan Revolution (OK, my political biases are finally revealed) and preparing to give an inspirational talk to the Resident Section of the American Academy of Pediatrics.  It has taken me a bit off the topic of mental health, so I thought it worthwhile to share the following with all you Rosie D fans out there in the audience:
Dr. Keller,

I learned of your interest in Rosie D. from your blog. I wanted to let you know about a model for implementation through support from a web-based decision support system called CHADIS. A group of 40 pediatricians and 40 child psychiatrists met in Maryland this summer to review the Mass MCPAP program and how to move further toward a full Rosie D like screening and communication effort. The majority agreed to a plan using a web-based decision support tool called
CHADIS for both pediatricians and child psychiatrists. Thirty pediatric offices are using it now in Maryland and more elsewhere and a number of child psychiatrists coming on board. CHADIS contains both standard tools for primary care screening and follow diagnostic work including CANS now. In addition the conclusions from CHADIS are linked to decision support in the form of a point of care e-textbook or guidelines and to thousands of resources that turn into handouts. We will be demonstrating CHADIS at booth 1026 at the AAP meeting this weekend. We would love to speak with those interested in implementing Rosie D. on Sunday afternoon at 2PM or at other times when the booth is open. Please pass this on to other pediatricians interested in Rosie D implementation.
Thank you. I look forward to meeting you.
Raymond Sturner MD
Associate Professor of Pediatrics,
The Johns Hopkins U School of Medicine
Center for Promotion of Child Development through Primary Care

So, if you are reading this, and are in town for the AAP meeting, stop by booth 1026 in exhibit and see if CHADIS would make your life easier.  I'll let you know what I think.

Wednesday, October 8, 2008

Progress: Feels like winning...

Now this feels like progress.  I hope they let observers (like me) in;  I'd love to get a sense of what these services are going to look like:

Children’s Behavioral Health Initiative (CBHI) Institute:
Building a Strength-Based,
Family-Focused System of Care

The Executive Office of Health and Human Services (EOHHS) is sponsoring a one-day
Institute to offer prospective providers comprehensive information on services that are being
developed by the Children’s Behavioral Health Initiative (the undertaking by EOHHS and
MassHealth to implement the Order in a lawsuit known as Rosie D. et. al. v. Romney). This
is not a bidders’ conference but rather a unique opportunity for prospective providers to learn
more about this major initiative and to help them determine the services for which they will
apply to provide. During the day, providers will have the opportunity to learn from people who
have implemented similar services in Massachusetts and other states.
Tuesday, October 28th
8:30 a.m. - 5:00 p.m.
DCU Center
50 Foster St.
Worcester, MA 01608
Detailed information about the CBHI Institute and registration will follow.
The CBHI Institute is intended for executive directors, chief fi nancial officers, chief operating
offi cers, and directors of clinical services. Organizations are asked to send no more than two
people to the Institute. The structure of the Institute will allow each attendee to participate in
all presentations. The CBHI Institute will be held:
Tuesday, October 28th
8:30 a.m. - 5:00 p.m.
DCU Center
50 Foster St.
Worcester, MA 01608
Detailed information about the CBHI Institute and registration will follow.

Monday, October 6, 2008

We Won: Why Doesn't It Feel Like It Yet?

Today, the markets tanked again, despite the passage of the massive rescue or bailout bill that made it out of Congress last week.  It is a bit frustrating;  the bailout (which, incidently was the vehicle for the passage of the Wellstone-Domenici Mental Health and Substance Abuse Parity Law) apparently is not sufficient to stabilize the economy once it start wobbling.  It is, rather, a vehicle that, if we use it properly, may be able to stabilize the economy.  
I think that feeling of "we won, what do we do now?" is present among many of us who have been working for the Children's Behavioral Health Initiative and the Children's Mental Health Campaign.  We won a lot last year, but the legislative and judicial victories need to be implemented in order for us to see results.  Meanwhile, I still have patients with anxiety disorder  who I can't get to into Cognitive Behavioral Therapy, and kids with multiple medications who should see a psychiatrist, and families that just don't believe that it is possible to do anything that will make a difference in their child's life.  So, while it will take a while to establish the committees and develop the protocols and figure out the paperwork that will allow children with mental illness to be appropriately managed, we need to get started with the task.
Tomorrow, the Worcester Mental Health Network is meeting to discuss how we can begin to build culturally competent, accessible levels of care.  We will see how it goes.

Friday, October 3, 2008

Progress: Mental Health Parity Moves in the Senate

In the current environment in Washington, it is hard to keep track of what is going on.  

FOR IMMEDIATE RELEASE CONTACT: Anthony Coley/Melissa Wagoner
October 1, 2008 (202) 224-2633

Kennedy Statement on Mental Health Parity

HYANNIS PORT, MA - Senator Edward M. Kennedy tonight released the following statement on the Senate's passage of legislation that will fundamentally change how tens of millions of Americans with mental illness are treated and cared for. The legislation was included in the Renewable Energy and Job Creation Act, the so-called tax extenders bill that passed the Senate last week and again tonight. Senator Kennedy has worked on the bill for more than ten years.

“Tonight, the United States Senate passed mental health parity legislation, requiring insurance companies to cover mental health and physical health equally. There is renewed hope for millions of Americans facing mental illness. The bill now goes to the House of Representatives, and I urge them to act now to end discrimination and prejudice. Millions of Americans are waiting – and they've waited too long already.”

To access an audio recording of this statement, dial 1-800-511-0763, ID 3086.

Apparently this is part of the "bail out" package, according to CQPolitics.  We'll see if this gets it done.

Wednesday, October 1, 2008

More on the Federal Mental Health Parity Bill

On a national note:  Just noticed that the New York Times and I agree:  please get your legislator, when he or she is not busy saving us from complete financial meltdown, to pass the Mental Health Parity Bill now stuff in the US Senate on a procedural problem.  
Don't let them go home without passing it.
Don't worry- I'll refocus on the state again soon.  I heard that the Medicaid waiver was approved yesterday.  I can't yet tell how that affects the Child Behavioral Health Initiative.  But, when I figure it out, I will let you know.

FEEDJIT Live Traffic Map