Testimony to Support House Bill 3586

Dear Members of the Mental Health and Substance Abuse Committee:

I am a Licensed Mental Health Counselor. I present my testimony based upon my professional experiences counseling families in an outpatient clinical setting.
I support House Bill 3586, An Act Relative to the Coordination of Children's Mental Health Care that will be heard this Wednesday, May 27th at the State House in Boston. This proposed bill will require commercial insurers to pay for collateral contacts for children with mental health needs. Collateral contacts refer to scheduled, in-person or telephonic consultations between a therapist and other individuals in a child’s life (parents, teachers, pediatricians, guidance counselors, etc) who can help withcoordination of care and help the therapist better understand how the child is responding to the treatment.

Currently, Mass Health pays for collateral contacts. As a clinician, I have found collaborating with the above professionals very helpful in coordinating the best care for these children who were involved with a variety of providers. For example, this past year, I attended a meeting at an inpatient residential facility for boys, ages 5 years old and up. My client who is a tween, between eight to twelve years old, was admitted for a ten day evaluation for acting out in school. The staff psychologist invited me to a meeting with his teachers and with parents to discuss an action plan to discharge this client back into his community and to live at home with services in place. If it wasn’t for Network Health paying for my time to attend this one hour meeting, the client’s action plan would have been incomplete for servicing his mental health needs. A residential facility can not discharge a child unless his/her action plan includes provisions for counseling services in the community.

Unfortunately, for those children on commercial insurances, I have declined attending meetings with their schools due to not being reimbursed for my time. For example, last month (April 2008), I declined attending a team meeting at my client’s school due to her commercial insurer not paying for my time. Please note that due to an ethical responsibility to service my client’s mental health needs, I did speak to the school personnel via telephone for less than twenty minutes. However, the client’s behavior did not improve in school and I was not able to attend further meetings in school. As a result, the parents decided to seek counseling services in school and terminated their child’s mental health services with me at the clinic.

Children are children no matter what health insurance provider covers their mental health needs. In spirit of the Children’s Behavioral Initiative to cover collateral contacts for children on Mass Health, I ask this committee to please support House Bill 3586, An Act Relevant to the Coordination of Children’s Mental Health Care.

I have asked parents on commercial insurances to please contact their legislators to support the above bill that will provide quality services for their children's mental health needs.

Respectfully submitted,

Robbin Miller, LMHC
Facilitator for www.therapistsforchange.blogspot.com

Is Raising Taxes the Answer to Avoiding Cuts to Core Services?

Health Care For All's Healthy Blog (May 15th, 2009) published this information on their website, http://www.hcfama.org/, in justifying why raising taxes is a good idea for the Commonwealth of Massachusetts. I support raising taxes and major reform on how our state spends taxpayers' funds for core services and infrastructure projects. I also believe that our welfare and SSI systems needs to be scrutinized as abuse is quite rampant by many residents.

Unfortunately, some residents believe that being on welfare and getting a SSI check for their child's diagnoses is the answer to supporting their families and continuing to practice unhealthy behaviors in their homes and in their communities. What do you think?

Robbin Miller, LMHC
Facilitator

Here is the information from Healthcare for All's Healthy Blog:

"Economic theory and historical experience both show that raising taxes during a downturn—particularly taxes that affect only higher-income families—is generally better for a state’s economy, and better for its citizens, than sharp budget cuts.

The reasons are simple. Almost every dollar that states and localities spend on aid for the needy, salaries of public employees, and other vital services enters the local economy immediately. So if states cut their spending in these areas, overall demand suffers at a time when demand is already too low and support services are most needed.

The alternative—raising taxes—also reduces spending, but by less than budget cuts of comparable size. And by targeting these taxes appropriately, their negative effects can be minimized.…Keeping budget cuts to a minimum can also benefit the states in another way. Well-designed investments in education, health care, transportation, the environment, and other areas strengthen the economy over the long term. States with educated, healthy workforces, strong infrastructure, and a high quality of life will be best positioned to benefit from the economic recovery.

In short, we believe that maintaining many of the services provided by state governments is critical to an economic recovery, and that cutting those services would harm those who are most in need. "

Speak Now for Kids

Below is my testimony I submitted to www.speaknowforkids.org.

Children's Mental Health Law:


To Congress:

Please modify the inequitable system on how mental health clinicians are reimbursed for their time in counseling children in outpatient clinics. Currently, mental health clinicians with masters degree and above and with/out licensure are underpaid; not reimbursed for clients on Medicaid; and have to endure unfair and stringent productivity requirements to be paid on a salary as opposed to fee for service. In Massachusetts, the new Children's Mental Health Law under the Rosie D vs. Romney suit, does address the mental health needs of children with severe emotional disturbances but fails to put improve the quality of services for children who need outpatient services that don't have serious emotional disturbances.

Respectfully submitted:

Robbin Miller, LMHC
Citizen-Therapist

Community Organizing

Yesterday, May 5th, 2009, advocacy groups, advocates, and agencies serving persons with disabilities packed Worcester City Hall to attend a City Council meeting to have their voices heard. The City of Worcester has eliminated two positions in the Office of Disabilities due to budget cuts and have merged their services with the Office of Human Rights. Advocates are outraged as this office has no staff person trained on disability issues to service their complaints and their issues under the American with Disabilities Act(ADA).

One of the City Councilors called on the City to seriously consider their decision to eliminate the operations of the Office on Disabilities and to think about how the needs of Disability Community will be met under the Office on Human Rights. Only one advocate was allowed to speak on this issue due to a heavy plate of agenda items that the Council had to finish before another meeting took place afterwards. The advocate spoke with disgust on how the City did not notify the above parties that the Office on Disabilities would be eliminated. The advocate felt that the City could have done a better job in communicating their intentions to close this office and to ask for feedback from the community on how the disability community's needs would be impacted.

To further add to advocates' frustration, The City Manager has not communicated with one disability agency to meet with them to discuss the above issues including who will serve as the ADA Coordinator for the City of Worcester.

As a member of a disability advocacy group who attended yesterday's meeting, I emailed all the City Councilors a few weeks ago to ask them to return the clerk who was laid off to work with the Office of Human Rights in an expert capacity on ADA issues for the disability community. Unfortunately, the City did not reinstate this clerk's position to this office.

The advocates, disability agencies and advocacy groups have to continue to strategize to have their voices heard. I will keep you posted as we move along.

Robbin Miller, LMHC
Facilitator