On mental health change and money: Oregon’s Medicaid Advisory Committee

 MindFreedom Oregon News – urgent

 About Oregon, Changing the Mental Health System, Buzz Phrases and  Medicaid

 How You Can Speak Out About More Creative Funding of Mental  Health In Oregon

 by David W. Oaks, Director, MindFreedom Inernational

AT BOTTOM is a forwarded notice about Oregon’s next Medicaid Advisory  Committee Meeting (MAC) – THIS Wed. morning, 22 April 2009 in Salem.

Please try to attend, speak out during public comment, and whether or  not you attend submit written testimony, which you can do by e-mail.

On their agenda this Wednesday will be the subject of mental health.

And this time mental health consumer/psychiatric survivors will also  speak out. We wish them well!

MindFreedom has been asking for this opportunity for two years.

I know people’s eyes can tend to glaze over when they think about the  subject of Medicaid, unless those eyes belong to, say, a full-time  MBA specialist on Medicaid-funding who works for a huge corporate  health care provider. Such big corporations can and do influence  Medicaid rules every work day.

So how about the citizens who actually pay for the Medicaid?

BACKGROUND ON OREGON, MEDICAID AND MENTAL HEALTH

An enormous part of mental health services are, of course, funded by  Medicaid.

According to one of the main Medicaid experts MindFreedom has worked  with for years, each and every US State has a surprising amount of  discretion about *how* that Medicaid money ought to be spent.

Some states are *far* more creative than Oregon in spending Medicaid  money, for example, on mental health peer-support activities, public  education, etc.

While local officials like to say that their hands are completely  tied by federal rules, the fact is that a State is more empowered  than that.

Where these issues are supposed to be discussed is the State of  Oregon’s “Medicaid Advisory Committee” (MAC).

For two years, MindFreedom Oregon has requested that Oregon’s MAC  directly address these topics. I’ve spoken during their public  comment about their need to do this.

There’s bad news and good news.

The bad news is, MAC has refused to put our EXACT topic of  empowerment and peer-support alternatives in mental health on the  agenda.

The good news is, this next MAC meeting — in two days, this  Wednesday, 22 April — the issues can be brought up.

Indirectly.

Possibly.

That’s because this MAC meeting will be on mental health, but on a  particular sub-topic of mental health. It’s the “buzz phrase” of the  moment throughout the mental health system, from international  systems to county systems.

And that buzz phrase is:

“Integration of mental health and physical health.”

I’ve been doing this work for 33 years, and where these buzz phrases  originate from is a bit puzzling to me. For a while years ago the  buzz phrase was “community mental health.”

And there were the years when the buzz phrase was “transformation.”  Everywhere you went, the mental health system was talking about  “transformation.”

Then there was a flurry of buzz phrases about “recovery,” and that  was hopeful.

In any case, whoever is “Global Commissioner of Buzz Phrases in  Mental Health” has chosen “integration” of physical and mental health  as the flavor of the day.

Now, what this means exactly is open to interpretation. There is no  technical definition of this “integration.”

But it can mean when the rubber hits the road, for example, making  mental health services more available inside physical health  clinics… and adding physical well being care such as check-ups into  some mental health clinics.

This can be good.

It can be bad.

But as usual, like countless minor reforms for 200 years in mental  health, it means MORE MONEY going to mental health care.

According to a World Health Organization recent report, when a small  village in India that tried “integration,” what it meant was a  massive increase in psychiatric drug prescriptions, without adequate  advocacy, information and alternatives.

Here in Oregon, if a physical health clinic “integrates” mental  health, then what about the voice of mental health consumers/ psychiatric survivors? Often they do such clinics even know that this  voice is important, and why?

But to make a long story shorter, the MAC meetings lately are  addressing mental health by focusing on this “integration” buzz phrase.

I wish they were addressing “Empowerment of Mental Health Clients,”  or “More Peer Support Non-Drug Alternatives for Mental Health  Consumers,” or “Rights of Psychiatric Survivors,” but that is not the  flavor of the day.

WHY DOES THIS ALL MATTER?

Yes, too often the complicated rules can make it challenging (or  boring) to get involved in Medicaid issue.

I call it Medicaid’s “Curtain of Complexity.” But look behind the  curtain:

The reality is, these issues can impact lives.

This past Saturday, MindFreedom and several other groups united  through the Opal Network in Lane County to have a TOWN HALL MEETING,  with State Sen. Morrisette, Mayor Kitty Piercy and two other elected  officials. More than 80 people packed the room, many of them  psychiatric survivors and mental health consumers.

We heard passionate testimony about how the SAFE/WONDERLAND/VALIA  center — a unique, entirely peer-run mental health community center  and clinic — may be destroyed by Lane County by suddenly deciding  they do *not* qualify for Medicaid funding they have received for two  years. The cancellation letters have already gone out to more than  100 clients.

The fact is, Medicaid rules already allow activities like SAFE/ WONDERLAND/VALIA.

But changing Oregon’s rules to make this even more clear would help.

So the MAC meeting can, in the long run, make a huge difference. A  Columbia River sized amount of federal mental health dollars flow  through Oregon… let’s do what we can to have it fund good programs.

MindFreedom has been asking for consumer/survivor input for a year so  we hope this Wednesday goes well! We hear Beckie Child is one of the  consumer/survivors to speak, so we expect Beckie to tell it like it is.

There is always a public comment period at these meetings, too, if  people want to go (usually toward end of event, hard to say exactly  when that is).

If people want there might be an opportunity to listen in and comment  via teleconference, but better ask soon.

Note that below forwarded notcie also encourages written testimony,  which can be submitted by e-mail, to the e-mail address provided.

By the way, someone interested in this at the end of his life was the  long-time activist Dave Romprey. So one way to help fill Dave’s huge  shoes would be to take a little action on this, so here we go:

ACTION ACTION ACTION

* ATTEND

* WHETHER OR NOT YOU ATTEND: Consider written testimony. Identiy  yourself with name and postal address, etc., and submit testimony  about the need for Oregon to be more creative in funding peer-based  services and other alternatives in the mental health system! Even a  brief message will help, but you can make your message as long as you  would like, and it will be part of the public record.

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FORWARDED MESSAGE FROM STATE OF OREGON:

PUBLIC NOTICE

MEETING PLACE: Oregon State Library

Room 103

250 Winter St. NE

Salem 97301

MEETING DATE: Wednesday, April 22, 2009

MEETING TIME: 9:00am – 12:00pm

Dr. David Pollack from Oregon Health & Science University will give a  presentation on best practices, considerations, and recommendations for physical and behavioral  health integration. The Committee will also hear testimony from a panel of behavioral health consumer advocates  on the accessibility of physical health care. The meeting will conclude with a legislative update. Please submit written testimony electronically to Nicole Merrithew at  Nicole.Merrithew@state.or.us.

************************************************************************ *************************************

Please visit the Committee’s website at http://www.oregon.gov/OHPPR/ MAC/MACwelcomepage.shtml for minutes, reports and updates.

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– end of forwarded message –

Forwarded by MindFreedom Oregon

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