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Mental Health

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Again this year the Pennsylvania Youth Suicide Prevention Initiative (PAYSPI) and its partners will be hosting Suicide Prevention Nights at the Ballparks this year. These are the events where the students selected as the winners of the state’s youth suicide poster and public service announcement contest are publicly recognized for their work. The Philadelphia Phillies, Pittsburgh Pirates, and Harrisburg Senators have offered discount pricing, with a portion of the ticket sales through the PAYSPI links going toward suicide prevention in Pennsylvania. The Suicide Prevention Night In Philadelphia will be on April 22 (Phillies vs Atlanta Braves). For tickets at a special discount rate, with a contribution going to suicide prevention, visit this web page.

Look for information on similar events in both Pittsburgh and Harrisburg as information becomes available. In years past, provider organizations, managed care organizations, advocacy groups, and community businesses have made Suicide Prevention Nights at the Ballpark group outings for staff, consumers, and families.

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The American Academy of Pediatrics (AAP) has issued updated screening and assessment recommendations for children’s preventive health care. The AAP also continued to emphasize the need for “unfragmented continuity of care” in comprehensive health supervision. Published online in Pediatrics, the 2017 policy statement contains changes to 11 areas of care, relative to the 2016 revision of the Bright Futures Periodicity Schedule, which cover care from birth to age 21. The recommendations note that “developmental, psychosocial, and chronic disease issues for children and adolescents may require frequent counseling and treatment visits separate from preventive care visits,” they caution, adding that unusual family circumstances may necessitate additional visits.

Changes include such care areas as:

  • Depression: Screening for adolescents should begin at age 12 years. In addition, physicians should ask about maternal depression at infants’ 1-, 2-, 4-, and 6-month medical visits.
  • Psychosocial-behavioral: The update underscores that assessment should be family-centered and, in addition to a child’s social and emotional health, may include evaluation of caregivers and social determinants of health.

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Department of Human Services (DHS) Secretary Ted Dallas spoke at the RCPA Board of Directors meeting on February 22 regarding Governor Wolf’s proposal to consolidate four state health and human service agencies. If approved by the legislature, the plan would be launched on July 1, 2017.

Although the Secretary referenced approximately $90 million in savings from this process, he also affirmed that this “cannot be just about saving money.” Dallas remarked that time spent dealing with the bureaucracies as currently constructed takes time away from providing services, and so the goal is to eliminate redundancies.

RCPA members brought up key topics such as population health, licensing, and services for persons with co-existing conditions. When asked how this consolidation will affect addressing the opioid crisis, Secretary Dallas responded that the focus would be shifted to treating the whole person, rather than each individual condition.

The meeting concluded with the Secretary requesting ideas for continued efficiencies and how to ultimately better serve members. On the day of the Governor’s announcement, RCPA issued a statement expressing support for the proposal and committing to working with the administration to implement the plan in a smart and cost-effective manner.

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The next OMHSAS Mental Health Planning Council (MHPC) is taking place on Thursday, March 2, 2017, from 10:00 am – 3:00 pm at the Child Welfare Resource Center (403 East Winding Hill Road, Mechanicsburg). The joint session will run from 10:00 am – 12:00 pm. The individual committees (Children’s, Adult, and Older Adult) will meet separately from 12:00 pm – 3:00 pm. A map and directions are available for your convenience.

The agenda and PowerPoint for the joint session are available as well, in addition to the agendas for the individual committee meetings, as well as the outcomes from the December 1, 2016 MHPC meetings, listed below:

Outcomes:

Agendas:

This meeting is open to the public. There is no need to RSVP; feel free to bring anyone you think would be interested in attending. Please contact Cristal Leeper with any questions.

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On February 8, the Department of Human Services (DHS) Secretary Ted Dallas announced the availability of onboarding grant funds to help connect hospitals and ambulatory practices to the Authority’s Pennsylvania Patient & Provider Network, or P3N.

The P3N enables electronic health information exchange (eHIE) across the state through the connection of health care providers to health information organizations (HIO), and the participation of the HIOs in the P3N.

“These grants will assist providers in the efficient delivery of quality services to the individuals we serve across the commonwealth,” said DHS Secretary Ted Dallas. “As more providers participate, individuals will experience better coordination of care and a better quality of health care.”

The grant program, available to Pennsylvania HIOs to enable the connection of inpatient hospital/facilities and outpatient practice or other outpatient provider organizations participating in the Medicaid Electronic Health Records (EHR) Incentive Program, includes:

  • Up to $75,000 to connect each eligible inpatient hospital or other inpatient facility to an HIO;
  • Up to $35,000 to connect each eligible outpatient practice or other outpatient provider organization to an HIO; and
  • Up to $5,000 to enable other eligible providers that do not fit into the two categories above, but want to enable HIE participation and connect to an HIO via a portal.

Each eligible provider will connect via an HIO to the P3N.

Only a single award is permitted to any one hospital/facility or outpatient practice. The anticipated performance period for this grant runs through September 30, 2017.

The grant will:

  • Help providers deliver higher quality and more efficient care, particularly through better care coordination for patients covered by Medicaid;
  • Support provider participation in private-sector HIOs by offsetting connection costs;
  • Incentivize HIOs to join the P3N, a precondition for receiving funding;
  • Support rapid movement toward the participation in eHIE, and support various care reform efforts currently underway across the Commonwealth; and
  • Defray up-front costs for individual providers to join an HIO, thus helping to achieve meaningful use and satisfy obligations under the Medicaid EHR Incentive Program.

This program will be made possible through an $8.125 million grant from the federal Centers of Medicare & Medicaid Services (CMS). Under the terms of the federal grant, CMS will provide 90 percent of the onboarding grant, with the remaining 10 percent funded by the Commonwealth. The grant applications and supporting materials are available online here.

(Information courtesy of DHS)

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The number of adults in the United States aged 65 and older is expected to exceed 82 million by 2040. Approximately 16 million of these older adults will have a mental health or substance use condition and they will be turning to their primary care providers for care. Join this webinar to learn what integrated health care practitioners, especially primary care providers, need to know to be prepared to meet behavioral health needs of the older adults they serve. Learn how one primary care provider took steps to identify and address behavioral health concerns in older adults and hear how integrated primary and behavioral health care can guide patients toward healthy aging.

The SAMHSA-HRSA will host a webinar on Wednesday, February 15, at 1:00 pm on this topic of growing importance. Primary care providers and behavioral health professionals can register for free here.

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A new report finds that there have been substantial gains on the issue of making addiction and mental health coverage equal to physical health coverage. Much work still needs to be done, especially for children, according to Ron Manderscheid, PhD, Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) and the National Association for Rural Mental Health. “Children can’t speak for themselves on the issue of parity,” Manderscheid says. “That’s why it’s very important for the Department of Health and Human Services (HHS) and state health insurance commissioners to protect the rights of children around parity. Any child who has health insurance coverage through the individual marketplace under the Affordable Care Act (ACA), or through the ACA’s Medicaid expansion, is entitled to parity protection, but we don’t really know how well it’s working.” The estimated 8.4 million children enrolled under the Children’s Health Insurance Program, which is part of Medicaid, are not covered by parity protections, Manderscheid noted. “The field has so focused on problems with implementing parity with adults that children haven’t gotten equal attention in this process.” In October, the White House Mental Health and Substance Use Disorder Parity Task Force issued a report that concluded that overall, state-level substance use disorder parity laws have helped to increase the treatment rate by approximately 9 percent across substance use disorder specialty facilities and by about 15 percent in facilities that accept private insurance. This effect was found to be more pronounced in states with more comprehensive parity laws.

“The concept of parity is simple, but the implementation of it is incredibly complex,” said Manderscheid. The trickiest part of parity is a concept called non-quantitative treatment limitations, which are processes that managed care firms use to determine who will and won’t get care, he explains. Currently, the burden chiefly falls on the consumer to report to the federal or state government if their claims for addiction or mental health treatment are denied. “The enforcement burden should fall on HHS, state insurance commissioners, and the insurance companies themselves.”

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“Cancer doesn’t just happen to one person; it has an impact on the entire family.” “Nearly half (42%) of the partners of young breast cancer survivors (diagnosed at age ≤40 years) experience anxiety, even years after their partner’s diagnosis, according to a new survey of 289 such partners.” These are the findings of a recent study reported in Medscape in advance of the 2017 Cancer Survivorship Symposium, held in San Diego, California. Lead author Nancy Borstelmann, MPH, MSW, Director Of Social Work at Dana-Farber Cancer Institute in Boston, Massachusetts, found that maladaptive coping includes behaviors such as emotional withdrawal, denial, drinking alcohol, blaming, and aggression, adding that this behavior was “strongly” associated with higher levels of anxiety. Intervene early, she advised: “Ask partners how they are doing to bring them into the conversation.” Helpful resources include support groups, information materials on cancer, and meetings with a social worker or psychologist. Study respondents had a median age of 43 years, were mostly Caucasian (93%), working full time (94%), and college educated (78%), and were parents of children younger than 18 years (74%). A minority (29%) reported some financial stress and one third (32%) reported at least a fair amount of relationship concern.

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In recent months, Pennsylvania’s Learning Community has focused on challenges to financing and payment for mental health care in the primary care and collaborative care settings. The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) has provided the field with an array of information, presentations, and other resources related to the financing of mental health services in primary care and integrated care settings. Below are some of the resources that CIHS has made available to us here in Pennsylvania.

  • The ability to bill for both behavioral health and primary care services on the same day is an essential part of integrating care. The Center for Medicare and Medicaid Services (CMS) created the Billing Properly for Behavioral Health Services booklet to help providers understand the laws and regulations that govern billing for behavioral health services.
  • The resource also includes a checklist to help evaluate your billing procedures and identify potential errors, as well as a resource guide for your billing staff to review current guidelines, billing and coding, covered services, and compliance information.
  • Learn ways you can enhance and streamline your billing process through Improving Your Third-Party Billing System, a self-paced online course from SAMHSA’s BHbusiness initiative.

CIHS continually updates its website to present the best and newest resources and information relevant to integrated primary and behavioral health care.

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