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You are viewing the current Volume: 6 and current Issue: 16
SAMHSA Managed Care Tracking: August 13, 2006 - September 10, 2006


State Topic Issue
Arizona New report shows children’s psychotropic drug use rate slowing Counter to recent trends, the medication use rate is declining among children enrolled in Arizona's Medicaid program, relative to population growth. According to “Flashpoint: Children, Adolescents and Psychotropic Medications,” enrollment of children ages 0-17 in the State’s Medicaid Program increased 176% between 2002 and 2005, while mental health diagnoses increased 185%. The number of children who were prescribed psychotropic medications, however, increased 100% in the same period, which represents a 27% relative decline. The Flashpoint report details the history, efficacy and safety of the use of psychotropic medications among children and adolescents, and discusses other issues, including the impact of health care reimbursement practices and the growing shortage of psychiatrists and other mental health workers. To view the entire report, visit www.slhi.org/publications/issue_briefs/index.shtml. (PR Newswire, 8/28/06)
Florida MHA in Voluisa County to open new mental health center The Mental Health Association of Volusia County plans to open a new mental health center to reduce Volusia and Flagler counties' excessive patient population at the Northeast Florida State Hospital. Currently, the two counties are using 66 beds at the State Dept of Children & Families (DCF)-run mental hospital, but they are only allotted 41 of these beds. Officials expect the center to open by the end of 2006. The facility is one of several projects expected to receive funding from the DCF. (Orlando Sentinel, 8/21/06)
Florida Mental health workers at community agency lose jobs due to implementation of managed care More than 50 mental health workers were laid off as one of Volusia and Flagler counties’ largest mental health providers’ struggles to stay in business. The non-profit agency, ACT Corporation, is losing money as the State moves Medicaid recipients into managed care. Under the new system, ACT Corp., which had 437 employees as of last summer, will no longer receive direct funding from Medicaid. Instead, HMOs will contract with ACT, reducing the amount of revenue they are currently receiving from the State. ACT has a $20 million operating budget for the current fiscal year, $4 million less than last year. The layoffs will save ACT about $1.5 million a year. They cover 56 case managers, supervisors and education support staff that serve up to 1,000 adults and 300 children. Only five case managers will remain with the agency. They plan to form five teams of nurses, psychologists and other mental health workers who will oversee hundreds of clients. Before the layoffs, case managers were responsible for an average of 23 people each. (The Orlando Sentinel, 8/28/06)
Hawaii U.S. Magistrate recommends Federal oversight of Hawaii’s public mental health system end A U.S. Magistrate recommended that Federal oversight of Hawaii’s public mental health system end and the case against the Adult Mental Health Division be dismissed. The Special Master cited extraordinary efforts to provide quality services to consumers, to develop the system of care, and to implement the community plan ordered by the courts. The U.S. Dept of Justice lawsuit originally focused on the Hawaii State Mental Hospital in Kaneohe, however, court oversight was expanded in 2002 to include an “omnibus plan” for community mental health services. The report cited improvements in the system, saying the integrated hospital-based and community-based mental health system envisioned by the omnibus plan is now approaching reality. More than 10,000 islanders received ongoing mental health last year and another 2,000 received partial services. That compares to less than 4,500 before the community plan was implemented. In a recent National survey, Hawaii’s mental health system climbed to 11th place after being ranked 51st out of 51 States and the District of Columbia for three consecutive years. (Star Bulletin, 8/30/06)
Idaho Lawsuit over the treatment of children with serious mental illness continues A 25-year old lawsuit related to the treatment of Idaho’s children with serious mental illness is before a Federal judge again. Parents and mental health advocates say that instead of providing the required community based services under the terms of a court agreement, the State is still essentially “locking up” children with mental illness. The case began a quarter-century ago when the State was sued for institutionalizing children with mental illness instead of providing them care. Several years ago, the court settled the case on 250 action items, which the State must complete to be in compliance with the court ruling. However, today only two dozen of those requirements have been met. The plaintiffs attorney is asking a Federal judge to force the State to finish the job. (AP Alert, 9/5/06)
Iowa New Federal grant for children's mental health services in community and home settings Iowa officials selected a 10-county northeast region of the State to launch a new Federal grant to implement a “systems of care” approach to services for children and youth with serious emotional disturbances. The service system will be based on the recognition that the mental health needs of children with serious mental health needs can best be met within their home, school, and community, and that families and youth should be the driving force in the transformation of their own care. The grants will be used to provide a full array of mental health and support services organized on an individualized basis into a coordinated network. Iowa, one of five states awarded a grant by the Substance Abuse and Mental Health Services Administration, will receive approximately $9 million over six years. The University of Iowa’s Child Health Specialty Clinics will operate the programs. Local nonprofit children's service agencies will also participate. (Des Moines Register, 9/8/06)
Iowa Magellan expands mental health options for Medicaid enrollees Magellan Health Services, Inc. is implementing a new mental health Self-Directed Care Program for Medicaid recipients. It includes person-centered planning, life coaching, recovery purchasing plans, and expanded provider network and service options. The program is being implemented in partnership with Hope Haven, a Midwest rehabilitation facility. Enrollees with serious mental illness will have resources through the partnership that enable them to actively participate in their own recovery. Magellan, Iowa’s managed care contractor for the State’s Medicaid mental health and substance abuse plan for adult recipients, is the first organization to implement such a program in the managed care environment. (NewsRx Pain CNS, 9/11/06)
Louisiana Dept. of Health and Hospitals receives $34.7 million grant for mental health services The Louisiana Dept. of Health and Hospitals announced that they have received a $34.7 million Federal grant for crisis counseling. The grant, one of the largest ever awarded by the Federal Emergency Management Agency, will provide for the continuation of mental health services through Louisiana Spirit to residents affected by last year's hurricanes. Louisiana Spirit, the Federally funded Crisis Counseling Assistance and Training Program (CCP) for individuals, families and groups most affected by Hurricanes Katrina and Rita, focuses on addressing post-hurricane disaster mental health needs and other long-term disaster recovery initiatives. The State Dept. of Health and Hospitals announced last week that it has re-opened 10 adult acute care beds at the New Orleans Adolescent Hospital, and over the next few weeks, officials expect 10 more beds to open. (US States News, 8/17/06)
Louisiana New Orleans mental health system has fewer psychiatrists and hospital beds since Hurricane Katrina While other parts of the New Orleans health care system have begun to improve, the shortage of inpatient psychiatric beds remains the biggest hole in a safety net that was destroyed by Hurricane Katrina. In July 2006, the Louisiana Dept. of Health and Hospitals (DHH) found that only 42 of 208 psychiatrists in the four-parish New Orleans area were currently practicing. DHH also found that the number of psychiatric hospital beds in the region had fallen from 462 to 190 since the Hurricane. DHH decided not to reopen the badly damaged Charity Hospital, which served as the anchor of the public mental health system for low-income residents. Instead, LSU wants to create a system of community-based medical facilities. In 2007, LSU plans to open psychiatric beds at University Hospital, which was also damaged in the Hurricane. The private sector has shown little interest in filling the void. Lawmakers have tried to ease the financial burden on private facilities by paying them to take uninsured patients. However, the facilities say the payments don’t come close to covering their costs. Regardless of the costs involved, hospital administrators say they are not equipped for an influx of psychiatric patients. At one medical center, the number of emergency room patients with psychiatric problems has climbed fourfold since Katrina. (New Orleans Times Picayune, 9/5/06)
Nebraska Governor outlines proposal to restructure the State’s Health and Human Services System (HHSS) The Governor outlined a proposal that would create a super health and human services agency, combining three distinct agencies into a single structure. The single agency would consist of six departments, including the Departments of Public Health, Medicaid, Behavioral Health, Children and Family Services, Developmental Disabilities, and Veteran’s Homes. Currently, the system is divided into three departments, including HHS Services, HHS Regulation and Licensure and HHS Finance and Support. The system is led by a policy cabinet made up of directors of the three agencies and a policy secretary. A key aspect of the restructuring proposal involves the creation of a separate Department of Children and Family Services. To view the entire proposal, visit www.gov.state.ne.us/news/pdf/hhss_proposed.pdf. (US States News, 8/24/06)
New York Journal articles focus on State’s FEMA-funded crisis counseling program The September 2006 issue of Psychiatric Services features a set of 15 articles on Project Liberty, NY State’s FEMA-funded crisis counseling program that was the State’s mental health response to the Sept. 11, 2001 terrorist attacks. The articles summarize evaluation findings related to a number of program elements, ranging from service utilization and demographic characteristics of individuals receiving services, to outcomes data and service effectiveness. Seven hundred counseling and educational sessions were provided in Sept. 2001, and service volume steadily increased over the program’s first seven months. The program reached a monthly volume of 41,000 sessions in May 2002, and sustained that level until Aug. 2003 when Project Liberty’s phase-down began. As the State’s mental health authority, the Office of Mental Health administered and oversaw the design, implementation and evaluation of Project Liberty. The program was a successful collaboration between OMH, local governments, and nearly 200 local agencies that provided free and anonymous disaster mental health services. For more information visit, http://psychservices.psychiatryonline.org/. (NYS Office of Mental Health; www.nyaprs.org )
North Carolina Many adult care home residents have documented mental illnesses Many of State’s residents with mental illness are living in adult care homes, even though most are not adequately equipped to meet their treatment needs. The State Dept. of Health and Human Services recently analyzed data from 582 adult care homes across the State. Census data revealed that over half of the residents in up to 115 of these homes had documented mental illnesses. North Carolina, like many other States, has moved individuals with mental illness out of hospitals and large institutions into smaller settings. However, the State has struggled to provide adequate funding in these settings. (See BHH database, NC/State reform). Last year, a state-sponsored study recommended that lawmakers provide $2.4 million to hire 37 specialists to teach rest home staffers how to manage residents with mental illness. Another study recently completed found that State, Federal and County governments would need to spend as much as $198 million to upgrade staffing and care in the N.C.’s public mental health system (See BHH database, NC). Advocates have pressed for changes, and agree with most State officials that a comprehensive solution is needed. (The Charlotte Observer, 9/4/06)
Ohio ADAMH board expanding services After years of cuts, the Franklin County ADAMH board will spend nearly $2.7 million next year on new programs to reach seniors overwhelmed by loneliness, teenagers with severe mental illness who are aging out of foster care, and refugees tormented by memories of war. The Board’s trustees approved a measure to spend 4% of its new levy money on 20 behavioral health programs that serve the county’s most underserved populations. Altogether, the agency’s providers hope to reach more than 10,500 new clients. Last November, county voters approved a 10-year, 2.2-mill levy that will generate nearly $65 million a year for the board. A majority of the new money will be used to maintain services, but ADAMH hopes to invest $6.6 million over the levy’s 10-year life in additional treatment, $6.5 million in new prevention services, and $800,000 to build 250 apartments for people. (The Columbus Dispatch, 8/24/06)
Texas Hurricanes stretch mental health resources According to the Chief of Psychiatric Services for the Harris County Hospital District, the crisis in mental health care was dire before 150,000 evacuees from Hurricanes Katrina and Rita arrived in the Houston area. Today, it is a network stretched to the breaking point. Psychiatric patients in crises remain in general hospital emergency rooms waiting for beds to become available. According to county officials, for every million people who move to Harris County, between 7% and 10% have a major mental disorder. The figures increase if people with substance use disorders are included. Experts predict continued difficulties in meeting individuals' needs because the existing public mental health system operated at or beyond capacity before the Hurricane. Projects to help evacuees can fill important gaps, but can not repair the overburdened system, according to officials. (Houston Chronicle, 8/21/06)
Texas Teen crisis center proposed for Dallas County Dallas County mental health leaders are proposing a new crisis center for adolescents with mental health and behavioral problems. Currently, children as young as 5 are being placed in psychiatric wards with potentially violent adults with severe mental illnesses. The new 24-hour crisis center would serve children between the ages of 13 and 17. Children's Medical Center of Dallas has agreed to accept children 12 and younger. The center would cost $678,900 a year to operate and would provide emergency evaluation. The proposal calls for the crisis center to have 12 beds available for up to a 5 day stay. The proposal has received broad support from many groups, including local police chiefs and juvenile justice officials. (Dallas Morning News, 8/16/06)
Texas Baylor University addresses mental illness on college campuses With a nationwide increase in mental illness among college campuses, Baylor University is no exception. University officials say the Counseling Center scheduled more appointments last year than in any year before. The Director of the Baylor Counseling Center said students entering college today have a 50-50 chance of becoming depressed or experiencing some other serious mental health problem. According to university officials, there are three reasons for the increase in cases—less of a social stigma, better medications, and treatment before college. To address the rising trend, the Counseling Center will work with other divisions at the University to debut a 2006 Mental Health Summit for faculty and staff. The goal is to help faculty and staff to be more informed about early signs and symptoms of emotional distress and mental illness, and to provide information about available resources for treatment on campus. (U-Wire, 9/4/06)
Wisconsin Milwaukee County proposes housing initiatives Milwaukee County is dramatically shifting its focus in mental health care to provide permanent housing for hundreds of people who now live in substandard conditions. The move comes five months after a Journal Sentinel newspaper series chronicled the deplorable and sometimes deadly living conditions for people under the care of county psychiatric case managers. The County Executive said he is proposing to spend nearly $250,000 in next year’s budget to enhance housing programs for people with chronic mental illness, at a time when other county programs are being substantially trimmed. His plan calls for some realignment of county agencies, including the creation of a housing section specifically for the Behavioral Health Division. The County is proposing to sell the Behavioral Health Complex in Wauwatosa and use proceeds to develop the housing program. The proposal also calls for providing on-site staff to help those living in private apartments and creating a 10-year housing master plan. (The Milwaukee Journal Sentinel, 8/22/06)
National States list methamphetamine offenders on Web In an effort to stem the growth of toxic methamphetamine labs, several states are creating Internet registries to publicize the names of people convicted of making or selling the drug. The registries are similar to the sex-offender registries operated by every state. In the past 18 months, meth registries have been approved in Tennessee, Minnesota, and Illinois. Montana has listed those convicted of operating illegal drug labs on its Internet registry of sexual and violent offenders since 2003. Meth-offender registries are being considered in Georgia, Maine, Oklahoma, Washington State, and West Virginia. (USA Today, 8/23/06)
National SAMHSA and Ad Council launch new ads to offer mental health services to hurricane survivors The Substance Abuse and Mental Health Services Administration and the Ad Council are distributing a series of public service announcements to media outlets nationwide to encourage individuals who may be experiencing psychological distress from last year’s hurricanes to seek mental health services. The PSA’s, the latest ads for the Hurricane Mental Health Awareness Campaign, are being distributed to coincide with the one-year anniversary of Hurricane Katrina. The Hurricane Mental Health Awareness Campaign launched last fall is designed to help adults, children and first responders who have been affected by the hurricanes and who may be in need of mental health services. To view the ads, visit www.samhsa.gov or www.adcouncil.org and click on the Katrina PSA link. (SAMHSA News Release, 8/29/06)
National More than half of inmates report mental illness at high levels A new survey by the U.S. Dept. of Justice found more than half the inmates in the country’s prisons and jails reported mental health problems within the last year. The findings, based on a sample of about 25,000 inmates, were drawn from personal interviews and prisoners’ own reports of symptoms, psychiatric treatments or medications. The figures are higher than reported in past studies because inmates describing any type of symptoms were counted along with inmates actually diagnosed with psychiatric disorders. Further evaluations would be required to make an official diagnosis of a mental illness. Experts said the findings underscore what prison administrators’ have known for a long time—that large numbers of individuals with mental health problems are cycling through their facilities. The findings also suggest the need to connect released prisoners with mental health treatment in the community. (NY Times, 9/8/06)
National Rate of mental illness doubles among hurricane survivors According to a Harvard University based study, in the six months after Hurricane Katrina, the rate of serious mental illness among the storm’s survivors doubled. The findings also show that the number of people contemplating suicide did not change. Most survivors said they had found a new sense of purpose, strength and community through coping with the disaster. The study found that about 11% now have severe mental illness, compared with 6% before the Hurricane. Nearly 20% said they had mild to moderate mental illness, compared with 10% before the storm. More than 820 participants in that survey lived in the region hit hardest by Katrina. (USA Today, 8/29/06)


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