Tuesday, July 14, 2009

From the Field: The Children's Mental Health Campaign Soldiers On

You would think that passing major omnibus health legislation would be enough, but the energy of the Campaign continues to make things happen, and, given the threats of the budget in the Commonwealth, it really needs to continue to do so. So what is happening around the Commonwealth?
Well, meetings of course:
  • NAMI:  Empowering our Community by DeMystifying Mental Illness and Treatment TONIGHT at 5 PM at the Boston Public Library (Lauri Martinelli for information)
  • Blue Cross Blue Shield is planning a big conference:  Improving Access to Children's Behavioral Health Services on Thursday 29 October 2009 at 8 AM at the Landmark Center. (Free but must preregister;  contact the Foundation for details)
And the budget:  We won some, lost some and then lost some more.  Preschool mental health consultations (3000-6075) started at $2.9 million and ended up with $1 million in the final budget.  Programs are planning a 60% cut across the board, and this is causing much loss in services.  People are very worried that this will be a major hit to this field, which is in the early stages of development.  Child and adolescent mental health services (5042-5000) took a 9.5% cut, which will likely impact some child mental health services.  The Children's Behavioral Health Initiative (4000-0950) did reasonably well until it got to the Governor's office;  as we have said in previous posts, they took a 3.5% hit.  The negotiation in this matter involves the Court, and the negotiation is going on at that level-  this money may be restored as the Judge and the Court monitor look into this matter.  The Campaign has made its concerns known, and that the legislature should override the veto.  Then we heard about something that we knew little:  Circuit Breaker (7061-0012):  an account to reimburse for collaborative, including schools, for the cost of special education costs of residential schools, many of whom have mental health issues.  This is a five year program, laying  the groundwork for section 19 of Chapter 321-  the "school climate" part of the Omnibus bill.  Cutting this would ultimately hurt our work in the future, and no one is championing this at the State level.  Interesting concept:  we clearly need to figure out how this plays in the future.

So, there is lots of advocacy still in play on the FY2010 budget, but we need to start thinking about the next year.  More to follow on that.

We moved on to a discussion of the words "collateral contacts";  legislators just weren't getting what we were talking about.  Even "coordination" of care was hard to understand.  The communication folks think that it would be easier to talk about stories than it would be to get caught up in the jargon of the clinical world.  They have some stories "You are a teacher; shouldn't you be able to talk to the child's psychiatrist", that put the bill into context, and they think that this will be more effective.  We also talked about the arguments made by the insurance companies; we all agreed that we need to focus on the messages of the insurers.  You all heard me talk about that before.  Anyway, the bill is moving through the committee structure and we will need to continue to work on this as it progresses through the legislature.

We did talk about Rosie D., things that we have mostly discussed in previous postings.  400,000 families have been notified; letters have been sent.  But the letter came in a plain envelope that looked like junk mail and wasn't opened by a lot of people.  The sense in the room is that the communication has not been heard yet by the people who need to hear it.  We discussed how to get the word out to people, and promised to get feedback to the CBHI on the success or lack thereof of their initial outreach effort.

Lots of good work needs doing.  Nice to know that there are lots of people out there doing the work.

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