Tuesday, January 13, 2009

The Campaign Continues: A Few Thoughts from the CMHC meeting

There were about 30 people around the table at today's meeting of the Children's Mental Health Campaign, and there was less cheer than one would expect from a group that successfully passed an Omnibus Bill in a single legislative session.  Why?  To quote a former President, "It's the economy, stupid".  
The Budget:  The Governor is going to announce another batch of 9C cuts soon, and noone knows what is going to be cut, creating much anxiety.  People speculated about this and that, but the bottom line is that things are going to be cut, we don't know what and when it happens, it will likely affect the marginal folks.  The last cuts created a "trickle down" effect- bits of this and that that create the system out of the pieces of care provided were lost, but agencies have rallied to make the impact much less than it could have been.  It is also complicated because the discussion around these cuts will roll into the discussion around next years budget.  We were also cautioned to watch for "silent cuts"-  freezing new enrollments in DCF daycare, for example, will hurt new kids entering the DCF system and gradually erode the system across the state.  We all agreed that we need to show the impact of these cuts in real life- we need to collect the stories that illustrate the impact these cuts and make sure that people know about them.
Implementing Chapter 321:  After that somewhat depressing set of thoughts, we moved onto the meat of the meeting.  Early returns say that the system is lining up behind the system change embodied in Yolanda's Law.  Members of the group have met with several Secretaries, a few Commissioners and some insurers, all of whom are supportive of the process going forward.  It is complicated- figuring out who is responsible for which services is not at all easy to do.  There are, as one would expect, some push back, as the bill requires a lot of reports and commissions.  As mentioned above, state government is cutting people, and people are needed to make this happen.  At many of these meetings, there was an effort to figure out how to integrate this process with the parallel process that is going on with Rosie D.  The most interesting report that I heard was about the implementation of the Mental Health Parity law;  the Commissioners of Insurance and Mental Health are hard at work to develop the language to define what Mental Health parity is in the Commonwealth.  One of the group joked, "I just love going to meetings", and it seems that that is good- the Administration seems to be trying really hard do the right thing.
Several of the sub-committees have started within the coalition; one on the school-mental health collaboration and another on interagency teams.  The Coalition seems to be lining itself up with the various subgroups that are developing the response to Chapter 321 in a way to assure that the regulations reflect the intent of the legislation.  All of the state agencies involved are wrestling with the notion that this is a parallel process to the implementation of the Rosie D. initiative, and want to make it into a seamless system that focuses on the child.
Re-Filing the Collateral Bill:  This was the only part of the Omnibus Bill that didn't get through, and it will be re-filed.  As we found last summer, the cost of this to the insurer's would be minimal;  it is going to be submitted again, by Representatives Balzer and Tolman, named "An Act Relative to the Coordination of Children's Mental Health Care", and one should stay tuned for future developments.
Forums in Boston:  The Campaign is working with the Boston Public Health Commission to put out a series of forums across the city, highlighting the problem of children's mental health.
So, despite the fiscal doom and gloom, we ended on a pretty upbeat note.  The Bill is being implemented, but the process is slow;  we all are really looking forward to seeing some benefits accrue for the children.  

The action steps?
1)  Watch for and document the ways in which 9C cuts are affecting the mental health of Children in your community.  
2)  Watch for and push for the passage of the "An Act Relative to the Coordination of Children's Mental Health Care".
3)  Join a working group that developing the plan to move forward with Yolanda's Law.

And stay tuned.

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