Tag: mental health services

Emergency Alert System Test: Share with your clients

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Several years ago, I signed up with the federal Office of Civil Rights online Privacy listserv so I would get notifications about HIPAA. I have been delighted with that subscription over the years. If you are an organization that provides healthcare services, you too should subscribe.

Today I received a new sort of notice from the listserv…one aimed at informing as many individuals as possible about an upcoming test of the federal Emergency Alert System.

Date:    Thu, 3 Nov 2011 12:11:48 -0400
From:    “OS OCR PrivacyList, OCR (HHS/OS)” <OCRPrivacyList@HHS.GOV>
Subject: First Nationwide Test of the Emergency Alert System; November 9 at 2pm EDT

FIRST NATIONWIDE TEST OF THE EMERGENCY ALERT SYSTEM
Test to Take Place November 9 at 2 p.m. EDT

Dear Colleagues;

We need your assistance in notifying everyone about the November 9th nationwide test of the Emergency Alert System.  Please help distribute this to all your stakeholders, as far and wide as possible, to ensure the entire community is aware that

As part of our larger efforts to strengthen our nation’s preparedness and resiliency, the Federal Communications Commission (FCC) and the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) will conduct the first nation-wide test of the Emergency Alert System on November 9th at 2pm Eastern Standard Time.

The national Emergency Alert System is an alert and warning system established to enable the President of the United States, if needed, to address the American public during emergencies.  It is another critical communications tool that can protect the public and strengthen our nation’s resiliency.  The National Weather Service, governors, and state and local authorities also use parts of the system to issue more localized emergency alerts.  The test is an important exercise in ensuring that the system is effective in communicating critical information to the public in the event of a real national emergency.

This national test will help federal partners and EAS participants determine the reliability of the system, as well as its effectiveness in notifying the public of emergencies and potential disasters both nationally and regionally.  The test will also provide the FCC and FEMA a chance to identify improvements that are needed to build a new, modernized, and fully accessible Emergency Alert System.

To support the disability community, FEMA has developed a toolkit that will allow you to reach out to your constituents and local partners.  The toolkits, attached here in multiple formats, allow you and your organization to quickly disseminate information about this test.

In addition, we’re also releasing two new videos created to support the outreach efforts of our disability community partners.   FEMA Administrator Craig Fugate has long been a champion of the whole community and ensuring that FEMA represents the diversity of the people we serve.  In one video, Neil Mc Devitt, from FEMA’s Office of Disability Integration and Coordination joins Administrator Fugate in outlining the need for the upcoming Emergency Alert System test and the accessibility challenges posed by the test.   The video has American Sign Language, open-captions, and is voiced throughout.   We’re also happy to provide a Spanish version of the message with open-captions.

If you have additional questions for FEMA-Office of Disability Integration and Coordination questions, please contact our office at

Marci Roth
Director
Office of Disability Integration and Coordination

 

*        FEMA Administrator’s Message – http://www.fema.gov/medialibrary/media_records/6407

*        ASL Video: http://www.fema.gov/medialibrary/media_records/6407

*        Spanish Video: http://www.fema.gov/medialibrary/media_records/6408

Please share this information with your constituencies, colleagues, friends, and families.   Remember, on November 9th at 2pm ET, “Don’t stress; it’s only a test.”

I was fascinated at using the HIPAA listserv for this purpose. As I read through the notice, it became clear that FEMA is quite concerned about insuring that disabled individuals of all sorts receive notice of this test so they are not alarmed when the test occurs. Using a listserv that reaches healthcare providers is actually an excellent use of this list. After all, most disabled individuals are in touch with healthcare providers.

Please feel free to pass this information…or even this blog…on to your clients. It is important that consumers of behavioral health and other health services realize that the event scheduled for Wednesday, November 9, 2011 at 2pm is a TEST of the Emergency Alert System.

Good for you to know it too!

Thanks for reading and sharing the information in our blog.

Happiness and Optimism: Enhancing mental and physical health

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Wednesday, May 18, 2011 is American Psychological Association’s Mental Health Month Blog Party. This post is dedicated to Mental Health and Mental Health Awareness.

This past weekend, we rode 104 miles in the BikeMS Citrus Tour 2011. One of the fun parts of the weekend was getting to spend a few hours with our friend Wayne, one of the people for whom we ride. Wayne and his wife are two of the most positive, forward-looking people I know. While they struggle through the difficult patches that MS dishes out, they maintain a positive, happy focus on life.

As a person who tends more in the pessimistic direction sometimes struggling with depressive emotions, I am always inspired by those who are naturally optimistic and happy or who have set out to become so. Last summer, I read The Happiness Project by Gretchen Rubin and in September, started my own project. While I have not completed the formal project, I learned a great deal in the process.

One of the most important things I learned is that I need to focus on happiness in order to become happier. Unless I make my own happiness and well-being a priority, it will never just happen because of events outside myself. Because of my tendency toward negative thinking and pessimism, I have accepted Gretchen’s offer of a ‘happiness’ quote in my inbox each weekday. The ‘Moment of Happiness‘ daily quotation helps me focus, however briefly, on a thought aimed at Happiness. I have collected a few of my favorites and placed them in a notepad on the desktop of my computer. I love to be reminded each time I turn on my computer of Lao Tse’s statement…one of my favorites since my teen years:

Kindness in words creates confidence.
Kindness in thinking creates profoundness.
Kindness in giving creates love.
—Lao Tse

A new favorite is a quotation from Henry James:

Three things in human life are important:
The first is to be kind.
The second is to be kind.
And the third is to be kind.
—Henry James

Reminding myself of these things daily helps correct my own natural tendency. Giving myself the structure within which to work at happiness helps me to move in that direction.

One of the most important things about this process is that it has effects on both mental health and physical health. Dr. Andrew Weil is a well known integrative medicine expert who has written widely. His blog on Monday focused on the physical health benefits of being happy. Dr. Weil reported on a study in the March 2011 issue of Applied Psychology, Health and Well-Being. The happier and more positive you are, the healthier you are likely to be and the longer you are likely to live. Positive expectations about health events seem also to be correlated with better progress after the events. It appears that working to be happier ourselves can have a significant impact on our physical and mental health.

To go a step further, Dr. Weil suggests that having happy friends is one of the best ways to increase our own happiness. Surrounding ourselves with people who have a positive focus on life and who tend toward cheerfulness can significantly increase our own experience of happiness.

None of these comments are intended to minimize the serious impact that clinical depression has on the lives of those who are so afflicted, but our own thoughts and behavior can reinforce that depression or help improve it. Working to be a happier person and to surround ourselves with other people who are happy can be an invaluable contribution to our own physical and mental health.

We strongly hope that Wayne’s positive attitude will help him stay healthy and even recover some of what he has lost.

Please share your comments below.

Mental Health Blog Party Badge

Medicaid Shrinkage: Innovation or reaction?

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Just one year ago, after passage of the Affordable Care Act (ACA), The National Council highlighted the expansion of Medicaid that would occur as a result of the ACA. To meet the law’s requirements to provide insurance coverage to the working poor who are generally not insured through their employment, do not have access to insurance groups, and cannot afford individual coverage, the Medicaid program would need to expand to provide the legally required coverage.

In November, the American electorate hired new Congressional representatives who are dead set on rolling back what they call “entitlement” programs (Social Security, Medicare and Medicaid) and returning the Federal government to what they see as its proper role: funder of national security and protector of free markets (code words for defense and corporations). In this new/old world view, individual rights consist of the right to pursue happiness and to bear arms; communal responsibility for one another appears to be non-existent.

Where does that leave those with serious behavioral health issues and the people who treat them?

The National Council works to represent community behavioral health organizations and the people they serve. They view Medicare and Medicaid as crucial to the treatment and therefore to the survival of the seriously mentally ill since “Medicaid is the single largest source of funding for America’s public mental health system.” Since early March, The Council has reported regularly on the threatened slashing of the Medicaid and Medicare systems.

In early March, The Council reported that a group of governors testified about their need for greater “flexibility” in their Medicaid programs. This group especially wanted to be exempted from the maintenance of effort (MOE) requirement under ACA that prohibits the states from rolling back Medicaid eligibility. President Obama said he would support allowing states to opt out of the law’s requirements if they could guarantee an alternative method of providing universal coverage.

On April 4, Representative Paul Ryan (R-WI) released his committee’s plan for the 2012 budget that includes a dramatic restructuring and slashing of both Medicaid and Medicare. On April 7, the National Council released a fact sheet on the potential impact of the funding decreases promised by the budget blueprint. Under Congressman Ryan’s proposal, Medicaid would be converted to a block grant program beginning in 2013 and Medicare would be converted to a privatized voucher system starting in 2022. The House of Representatives voted to adopt this framework. While it is highly unlikely the Senate will accept the blueprint, they will need to come up with one of their own and then work to reconcile it with the House’s plan.

In a Health IT newsletter by Mercom Capital Group, it was reported that on April 14, 2011, The U.S. Department of Health and Human Services (HHS) “announced four initiatives to give states more flexibility to adopt innovative new practices and provide better, more coordinated care for people with Medicaid and Medicare while helping reduce costs for states and families.” In Florida which has been providing some Medicaid services through managed care contracts, the legislature is close to mandating managed care for the entire program in spite of poor reviews for the pilot programs. “At the workshop in Hollywood, a succession of doctors, care providers, advocates and Medicaid patients all had the same message: Managed care has been a disaster.”

As a small business owner who buys health insurance in the private marketplace for a very small group of employees, these proposals are extremely frightening. My health insurance premium at age 60 is already more than the proposed Medicare plan would pay once I become eligible at age 65, and my premiums will certainly not get any lower if I need to buy insurance in the private marketplace. If I, as a pretty healthy 60 year old, am so concerned about these changes to Medicare, I can only imagine the panicky reactions being experienced by those persons represented by the National Alliance on Mental Illness (NAMI) who are dependent upon Medicaid and Medicare to pay for their treatment.

How do you see these proposed changes impacting you and your organization? Do you agree with this method of limiting spending? What ideas do you have for controlling the growth of costs of Medicaid and Medicare? How do you propose that we proceed?

Please share your comments below.

Trauma-informed Care . . . for most of your clients

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On February 24, 2011 I received an email letter from Linda Rosenberg, National Council President and CEO. The letter was entitled Trauma-informed Care: A Call to Arms. I was delighted to read it.

In my previous life, when I worked as a psychologist, I practice Feminist Therapy. Somehow, my practice had developed into one in which I saw mostly women. By the time I retired from practice in 1993, some 90% of my clientele were the survivors of some form of abuse. After 18 years out of direct service delivery, it has become obvious that women and girls do not begin to be the only people who are abused during their lives. Boys and men also suffer physical, emotional and sexual abuse. And every person who is abused experiences an impact on their lives from that abuse. Those who are abused repeatedly feel the greatest impact.

Linda’s letter presents a simple challenge: rather than ask clients what is wrong with them, she suggests that we ask what happened to them. This formulation was presented by a survivor named Tonier Cain who, after 83 arrests and 66 convictions, is now a team leader with SAMHSA’s National Center for Trauma Informed Care. She shares her story in speeches around the country and is the subject of the documentary “Healing Neen.”

The Adverse Childhood Experiences study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente reports the outcome of interviews with more than 17,000 individuals undergoing a comprehensive physical exam who chose to provide detailed information about their childhood experiences of abuse and family dysfunction. Almost two-thirds of the participants reported at least one experience; 20% reported three or more. The greater the number of adverse experiences, the greater the risk for health problems like alcoholism and alcohol abuse, chronic obstructive pulmonary disease, depression, fetal death, illicit drug use, ischemic heart disease, liver disease, intimate partner violence, suicide attempts, and unintended pregnancies, with risk increasing directly based on experiences. Trauma-related difficulties take a huge toll on individuals and our society.

Ms. Cain is one of many survivors of abuse who have recovered from their trauma and continue to progress by helping others. . .a standard part of the “recovery” model of care. But the recovery model is not enough. It is essential that providers become informed about trauma and learn the most effective ways of intervening. A good resource to start down this path is the report Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services.

Is it time for you and your organization to focus on “what happened to you” rather than “what’s wrong with you?”

Please share your organization’s approach to trauma. This old feminist would love to hear some inspiring stories. And, if you do not use trauma-informed methods, please let us know the bases for that decision. Just enter your comments below.

Parity Act Slow to Catch On

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In January 2011, the American Psychological Association (APA) reported that nearly 90 percent of Americans have never heard about mental health parity or of the Mental Health Parity and Addiction Equity Act of 2008. In a survey conducted for the APA in December 2010 by Harris Interactive, 89% of those surveyed said they had not heard about the federal law that affects people who have health insurance through a group or employer plan. Only 7% even recognized the phrase ‘mental health parity.’

The American Psychiatric Association(aPa) participates in the Mental Health Parity Watchalong with 11 other organizations. This organization is aimed at educating the public about parity, recording and appealing problems experienced by consumers in accessing mental health benefits, and in general facilitating the broad dissemination of information about the parity law. The aPa reportedon it’s intervention with BCBS-IL regarding their new requirements for preauthorizations for mental health treatment. While BCBS-IL rescinded their requirement for 2011, it is this kind of action by insurers that the law was meant to prevent.

Companies like Aetna have added pages to their web sites on mental health parity. These are designed to communicate directly to members and panel providers what positions the company has decided to take relative to the law. This can be an excellent way for consumers who have health insurance to learn how their insurer plans to address the requirements of the law.

As part of the parity implementation coalition mentioned above (Mental Health Parity Watch), the National Council has produced fact sheets and other resources aimed at educating consumers and answering questions about the law. Their are additional resources available on their blog page including summary of the law, FAQ, and a Parity Toolkit.

What has been your organization’s experience with the parity legislation so far? Have you found that insurers are moving forward with equivalent benefits and preauthorization policies for both physical and mental health? If you have run into difficulties, what have they been and how have you handled them.

Please share your experience to date. Thanks for your comments!