Mental Health Association in New York State, Inc.
(Publication Archives)

Friday Fax from Albany

MHANYS AWARDS DINNER AND ANNUAL CONFERENCE….. A GREAT SUCCESS!! By all accounts, this year’s awards dinner and annual conference were a giant success. We would like to thank all who attended – you are the reason for this success.

Things got started on Thursday night (Oct. 20th) with the Award Dinner at which many notable people were recognized for their hard work and dedication toward bettering the lives of individuals living with mental illness. Joining us for the evening’s events were a number of special guests including members of the Governor’s staff, the Office of Mental Health, the Commission on Quality of Care and Advocacy for Persons with Disabilities, the Division of Housing and Community Renewal, and the Office of Children and Family Services. Senate

Senator Morahan

Mental Health Committee Chair Thomas Morahan gave brief remarks before the awards ceremony began.

It is truly impressive to see the incredible efforts of so many throughout our great state. While we can only honor a few each year, we honor everyone working to help individuals living with mental health needs find recovery.

MHANYS’ 2005 Awardees:

Esther Mallach Staff Leadership Award
Casey Epe, Executive Director,
Mental Health Association of the Southern Tier

Ken Steele Memorial Award for Program Excellence
Teen Challenge Clubhouse, Mental Health Association in Dutchess County

Mental Health Media Award – Electronic
John Leet and Sean Kimber, WICZ Fox 40, Binghamton, NY

Mental Health Media Awards 2005 – Print
The Daily Freeman (Kingston)

Parent Advocate of the Year Award
Kathy Fadden, Advocate/Program Director, Mental Health Association in Franklin County

Volunteer of the Year – Community Service Award
Alexandra Zimmerman, Ann Berardinelli, and Jane Desrats, Annual Walk for Mental Health

Volunteer of the Year – Programs Award
Leonard Wawrzyniak, The Place to Be Social Club, Genesee County Mental Health Association

CEO’s Award
John Allen, Director of Recipient Affairs, NYS Office of Mental Health

Caroline Cash Award
Susan Murante, MHANYS Board Member

from l to r: MHANYS’ Board Members Sylvia Lask, Susan Murante, and filmmaker Susan Smiley

After dinner, Susan Smiley presented her acclaimed documentary Out of the Shadow. Those who stayed for the viewing experienced a completely raw perspective on schizophrenia and the challenges mental illness causes family members to face. For those who were unable to stay or unable to make it, Out of the Shadow will be featured on PBS stations starting in May, which is mental health month. The highlight was clearly Susan’s passionate responses to the many questions asked by members of the audience.

On Friday morning, we started the day with an discussion of Medicare Part D, and the transition that individuals with mental health needs, most of whom are ‘dual eligible’ will have to make by January 1st. As a result of that meeting, we will be holding a series of regional forums on Medicare Part D, as well as legislative issues.

Next that morning was a lively discussion on the implementation of PROS at which information on the first phase of counties participating in PROS was shared.

The keynote address by the Spiro sisters, who were featured in the Albany Times Union just two days earlier, piqued the interest of many people in the community, resulting in 125 people attending the luncheon at which they read excerpts from their book, Divided Minds, and discussed their respective perspectives as siblings – one living with schizophrenia and one a practicing psychiatrist. Truly an inspiring story, a lively discussion with the sisters and members of the audience followed. Our thanks once again to the Spiro sisters. (See below for Michael Seereiter’s take on the Spiro sisters’ address, the impact it had on one audience member, and the outpouring from others in the audience.)

Pamela Spiro Wagner and Carolyn S. Spiro, M.D.

To finish out the day was an excellent panel presentation on the issue of juvenile justice with experts on the issue sharing their points of view on how best to deal with this population of hard-to-serve adolescents currently in the system.

We would again like to thank all who attended for helping make this event such a success. Next year we hope to build upon this success, turning this annual event into one of the premier events of the year.

Please contact us for any additional information about these panels.

A TURNING POINT? By Michael Seereiter

At last week's Annual Conference, Pamela and Carolyn Spiro's keynote address was truly inspirational for those who attended. "Lynnie" discussed her perspective as the sibling of an individual with schizophrenia, like "Pammy," and how much she longed for her sister to live as full a life as possible - without hallucinations. "Pammy" awed the 125+ people in attendance with her personal account of living in world no one else was experiencing, then demonstrating how far she had come toward recovery simply by addressing the audience so eloquently. For those not in attendance, it is truly difficult to relay the profound impact the Spiro sisters had those who shared lunch with us on Friday. However, perhaps this short story can.

After their presentation and readings from their book, Divided Minds, the Spiro sisters fielded a number of questions from the audience, such as "What was the pivotal moment that changed your life, Pam?" After nearly all of the questions were asked, one woman at the back of the room rose to say that she had seen the article in the newspaper two days before and because her son had been diagnosed with schizophrenia the week before, came to hear what they had to say. ....And then she broke down in tears. As one person came up to offer her a comforting arm, she asked the sisters and the members of the audience what she should do.

The response was truly overwhelming. After a short answer from Carolyn in which she recommended the woman get in touch with NAMI and Glenn providing the phone number for NAMI–NYS from memory from his days at NAMI-NYS, a line formed behind the woman. As closing comments were made and pleasantries exchanged, the line grew to nearly 10 people long. Individuals from the audience approached the woman from all over the room. They offered support, encouragement, and resources on mental illness and schizophrenia.

As the sibling of an individual with Down syndrome, I have witnessed many parents and parents-to-be go through a period of regret, fear, acceptance, and hope after learning that their child has Down syndrome. Regret – that they somehow caused their child to get Down syndrome; Fear – that their child with Down syndrome will end up living a life not worth living; Acceptance – as other proud parents show pictures and tell amazing stories of success of their children, living with Down syndrome; Hope - that their child could one day live such a life.

For the population of people living with developmental disabilities, like Down syndrome, this scenario is nearly commonplace. Perhaps for people living with mental illness, a far more stigmatized population of people no less deserving of compassion, understanding, encouragement and support, we may finally have reached that same level.

Is it going to be easy for that woman and her son? No. Neither is raising a child with Down syndrome so that they may have the opportunity to live as independently as possible, get a job, become a professional musician, or even get married. But as the science of treating mental illness improves almost daily and as we all fight for the resources with which to help people living with mental illness find recovery, more and more people with mental illness and their loved ones are realizing that there is so much possibility and so much worth living for.

I believe that as that woman left our conference on Friday, she was filled with hope not only from the personal accounts of Pamela and Carolyn, but from the overwhelming number of people who approached her afterward to offer whatever they could.

In Memory and Honor of Jerry Klein
by
Glenn Liebman

On Wednesday, all of us in the human services community lost one of our champions - Jerry Klein. Jerry was one of the true leaders of the mental health community. He served on the state NAMI board for many years and was the Board President for several of those years. In addition, he was a leading advocacy voice at the Mental Health Services Council and numerous other committees in which he was involved.

He was also a leader in Rockland County. Along with his wonderful wife Helen, they played leadership roles in NAMI-FAMILYA for many years. Jerry was also the co-chair of the Family Support Advisory Council of Rockland Psychiatric Center as well as a member of the Rockland Unified Services Council.

Those are just a few of Jerry's many achievements but they do not begin to describe the kind of man he was. Jerry was a man of dignity, intelligence, humility, tenacity and compassion. Because of the great respect people had for him, he was able to speak his mind (and he never backed off from any issue) and yet build up great trust with family members, recipients, state policymakers and other major stakeholders.

The true measure of Jerry's greatness was his many accomplishments as a leader in our community. Whether the issue was reinvestment, housing, employment or scores of other issues, Jerry was always in the forefront, helping pave the way for these reforms. Even after Jerry lost his leg, it never served as a deterrent from him coming to Albany on a weekly basis to educate legislators and policy makers about mental illness. He also had a great knack of bringing disparate voice together and helping to bring consensus on controversial issues.

On a personal level, Jerry was my friend and mentor. We had hundreds of conversations over the years that he laced with humor, intelligence and lesson building (he was always an educator even after retiring as a school principal). In all those conversations, I never heard him once say, “I want credit for this’ or ‘make sure my name is attached to that.” He made it clear that his work in enhancing recovery was never about him personally, it was about recipients and their loved ones. Anyone who ever spent time with Jerry became a better person just by knowing him. That is a true testament to the man he was and will always be to those of us who had the honor of knowing him. He will be greatly missed.

NYS OFFICE OF MENTAL HEALTH ANNOUNCES ASSISTED OUTPATIENT TREATMENT (AOT) QUALITY IMPROVEMENT PANEL MEMBERS:

November 2, 2005

Sharon E. Carpinello, RN, PhD., Commissioner of the New York State Office of Mental Health, today announced the members of a quality improvement panel, which will seek to improve upon an already successful Assisted Outpatient Treatment (AOT) program established in 1999 under Kendra’s Law.

The panel is comprised of quality improvement experts, recipients of mental health services, family members, county representatives and other key stakeholder groups, and will meet at least quarterly to review data, issues and outcomes of AOT. Both individually and as a group, members will search for opportunities for innovation as well as ways to improve and enhance the AOT program's structure and outcomes.

"Under Governor Pataki's leadership, the first five years of AOT demonstrated many positive outcomes," said Commissioner Carpinello. "We have seen improved access to mental health services, coordination of service planning, accountability and collaboration between the mental health and court systems, and a reduction in hospitalizations and incarcerations. While these success stories make it clear that Kendra's Law is working, we also want to take advantage of all opportunities for improvement. We want to further ensure that quality gaps are recognized and appropriately addressed, with input from interested stakeholders."

Kendra's Law created a statutory framework for court-ordered AOT to ensure that individuals with mental illness and a history of non-participation in treatment that resulted in hospitalizations or some degree of violence participate in community-based services appropriate to their needs. The law was named in memory of Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a man with a history of mental illness and hospitalizations.

Pat Webdale, mother of Kendra Webdale and board member of the National Alliance for the Mentally Ill-New York State, will serve as chairperson of the panel.

"I speak for my entire family when I say that we applaud the formation of a quality improvement panel focused on Assisted Outpatient Treatment, and I am honored to serve as the panel's chairwoman," said Pat Webdale. "Kendra's Law has proven to make a positive difference in the lives of many persons suffering from a serious mental illness. As more research becomes available, it is apparent that every human being has a stake in mental health issues. The formation of this panel will assure that we will progress in making AOT as viable as possible."

Other members of the quality improvement panel include: Mary E. Barber, MD, Clinical and Medical Director of Ulster Co. Mental Health Department; Phil Endress, Commissioner, Erie County Department of Mental Health; Anita Fleishman, RN, LCSW, Executive Director, Pederson-Krag Center, Inc. (Long Island); Antonia M. Lasicki, JD, Executive Director, Association for Community Living; Glenn Liebman, CEO, Mental Health Association of New York State; Hunter L. McQuistion, MD, Chief Medical Officer for Mental Hygiene Services at the New York City Department of Health and Mental Hygiene; LaVerne Miller, Director, Howie the Harp Peer Advocacy Center (NYC); Denise Reed, President of Healthcare Alternatives, Inc. (NYC); Lenora Reid-Rose, Director of Cultural Competence and Diversity Initiatives, Coordinated Care Services, Inc. (Rochester); Harvey Rosenthal, Executive Director, New York Association of Psychiatric Rehabilitation Services; James J. Rye, Executive Director, The Empowerment Center (Mt. Vernon); Brian Stettin, Asst. Attorney General in the Public Integrity Unit, New York State Attorney General's Office; Joyce Wale, Sr. Asst. Vice President, New York City Health and Hospitals Corporation; and Mary Zdanowicz, J.D., Founding Executive Director of the Treatment Advocacy Center

Additional panel members may be appointed as appropriate. The panel will review county and statewide statistics on the number of individuals receiving services through AOT; information on the demographics, engagement in services and outcomes experienced by AOT enrollees; and outcomes achieved through different approaches to program implementation.

“This data-driven project is part of OMH's continuous quality improvement agenda,” said Commissioner Carpinello. “Since Governor Pataki first enacted Kendra's Law in November 1999, OMH has been evaluating the implementation and use of AOT, and its impact on individuals with mental illness. This new continuum of review and input will go even further to ensure that appropriate individuals with mental illness receive the high quality services and supports they need to live successfully in their communities.”

Glenn Liebman, CEO of the Mental Health Association in New York State, Inc. said, “I am very appreciative of Commissioner Carpinello for choosing me to participate in the Kendra’s Law review panel. I look forward to serving on this panel and fighting for the inclusion of strength based and recovery oriented treatment plans for individuals under court order.”

MHANYS REGIONAL FORUMS: MHANYS continues to work on a series of significant issues including Timothy’s Law, access to medications, Medicare Part D, civil commitment of sexual predators, adult home reform, co-occurring disorders, housing capacity, SHU legislation, enhancements to local assistance including increased funding for rehab programs, Children’s issues including juvenile justice reform and working with family court judges and several other initiatives as well.

Through the leadership of Sylvia Lask of our board of directors, we are beginning to hold forums around the state to discuss what the priorities are of MHAs throughout the state. We held the first forum in Buffalo on Monday. Special thanks to Roger Stone of MHA of Erie County for sponsoring the event. There was great interest voiced about Timothy’s Law, PROS, housing, rate enhancements and several other concerns.

Anyone interested in holding a forum in their area should get in touch with Lillian Lasher at (518) 434-0439, ext. 22.

THE MEDICARE PART D DRUG BENEFIT –
WHAT IS IT AND WHAT DOES IT MEAN FOR YOU?

Presented by Karyn Krampitz, Director, Special Projects, and Bill Zeiser, Program Associate - Coalition of Voluntary Mental Health Agencies
Hosted by NAMI-NYC Metro
Co-sponsored by the Postgraduate Center for Mental Health

A one-hour presentation for NAMI volunteers, family members and consumers, followed by a one-hour Q&A session. Come learn how this major new benefit will impact the mental health community. Find out what you need to know about how to sign up, how to choose a plan and where you will be able to get help in signing up.

Date and Time: Monday, November 7, 6 pm to 8 pm
Location: The Auditorium at the Postgraduate Center for Mental Health:
344 W. 36th St. (between 8th & 9th Avenues)
New York, NY

THIS EVENT IS FREE AND OPEN TO THE PUBLIC. Call the NAMI-NYC Helpline at (212) 684-3264 for more information.

MEDICARE RIGHTS CENTER PRESS RELEASE – “AVOID BUSH ADMINSTRATIONS MEDICARE PRESCRIPTION DRUG PLAN FINDER, CONSUMER GROUP WARNS”: The Medicare Rights Center is warning people with Medicare, their caregivers and professionals who assist them, to avoid using the Internet-based Medicare Prescription Drug Plan Finder that the Bush Administration launched earlier this week.

The tool is misleading at worst, useless at best, until it includes accurate information about what medications are covered by the drug plans, said Robert M. Hayes, president of the Medicare Rights Center, a national consumer service group. “Obviously, drug plans will cover different drugs and have different premiums, deductibles, cost-sharing requirements, and prior authorization rules, Mr. Hayes said. “Perhaps the most important consideration for a patient is whether a drug plan covers the medications the patient needs. But the Drug Plan Finder offers no information to a patient on what drugs specific plans cover or what a consumer will pay for those drugs,” Mr. Hayes said.

The Medicare Rights Center, like community organizations across the country, has recruited volunteers who are ready to help older Americans better understand this drug benefit, said Mr. Hayes. Our phones are ringing off the hook, but without the promised tools like the Drug Plan Finder, the Administration is compounding the frustration of volunteers and consumers alike.

The Medicare Rights Center also warns that another Centers for Medicare and Medicaid Services tool, the Formulary Plan Finder, is not much help either. This web tool lets users enter the medications they take and see which plans cover them, but it does not tell them how much the consumer will pay for the drugs under the various plans.

Additionally, the consumer group warns that the Medicare Prescription Drug Plan Cost Estimator is extremely misleading. The savings it estimates is based on the lowest premium in the region, does not take into account if the drugs are covered in that lowest premium plan or what the cost sharing for each drug will be.

“The structure of this benefit could not be more unfriendly to consumers,” said Mr. Hayes. “These false starts in helping people navigate the benefit make it worse.”

IN THE NEWS:

Aetna to Pay for Program to Manage Depression. By Milt Freudenheim
The New York Times, November 2, 2005

A widely tested approach to diagnosing and treating depression, one of the nation's most prevalent and costliest afflictions, is moving into the mainstream of insurance coverage.

Prompted in part by employers who cite depression as a frequent cause of absenteeism and low productivity, the big insurer Aetna plans to announce today that it will begin paying for a depression management program in dozens of medical offices around the country.

Under the plan, Aetna will pay primary care doctors additional fees to screen patients for depression and to provide follow-up consultations for patients who are either put on antidepressants or, in more severe cases, referred to psychiatrists or psychologists. Aetna plans eventually to offer the program nationwide.

The additional costs of identifying and treating depression, Aetna said, can in many cases be more than offset in avoiding the larger financial costs associated with the disease - and the higher medical expenses that often arise when other chronic conditions, like diabetes and heart disease, are compounded by depression. Depressed patients with such diseases often stop taking their medications or fail to carry out recommended exercise and diets.

Researchers said that 33 million Americans require treatment for depression each year, and at least one in six people have the disease, with varying degrees of severity, at some point in their lives.

The total economic cost of depression has been estimated at more than $83 billion a year in this country, with more than half of that incurred by employers in lowered productivity, absenteeism and disability, according to a 2003 study in The Journal of Clinical Psychiatry.

From an employer's standpoint, "depression has the greatest negative impact on productivity for nonmanufacturing companies," said Daniel J. Conti, vice president for the employee assistance program at J. P. Morgan Chase, for which Aetna is an insurer. "It is like the perfect storm for the jobs in today's workplace, the same way a bad back limited a worker on the job for my father in a factory."

John W. Rowe, Aetna's chief executive, plans to announce the company's program tonight at a meeting of mental health experts in Atlanta.

In a parallel approach to depression, Kaiser Permanente, the big nonprofit managed care company, has assigned a mental health aide to each of its salaried primary care physicians in Northern California.

A few companies, like Caremark Rx, which specializes in managing care for patients with chronic conditions like diabetes and heart disease, routinely screen these patients for depression, which frequently accompanies those diseases.

The announcement by Aetna comes after a report on mental health and substance abuse issued yesterday by the Institute of Medicine of the National Academies, a nonprofit public policy advisory group. That report calls for greater collaboration between mental health specialists and family care doctors, who are typically the first physicians that depressed patients turn to, reinforcing a recommendation in 2003 by a presidential commission on mental health.

Studies have found that in many cases depressed patients receive only cursory attention in the offices of overworked family physicians and other primary care doctors, who nevertheless write an estimated 65 percent to 75 percent of the nation's prescriptions for Prozac and other antidepressant drugs.

"People with depression are sitting around, not getting identified, impacting the business community," said Laurel Pickering, president of the New York Business Group on Health, an employers group. "What Aetna is doing is going to be a help."

The approach has been tested in some research-financed programs already in place by other organizations, which involve family physicians and other primary care doctors who are trained to identify depression and counsel patients. Specially trained nurses call to encourage patients and remind them to take their medicines. Mental health specialists advise primary doctors on difficult cases, and patients with symptoms of severe depression are referred to psychiatrists or psychologists.

"The clinical part of it is a no-brainer; it clearly helps patients," said John W. Williams, an associate professor of medicine and psychiatry at Duke University, who is one of the principal investigators for a program on depression and family care doctors for the MacArthur Foundation. "It also helps employers," he said.

Part of the Aetna screening will involve a written test that has already been in use elsewhere, the Patient Health Questionnaire, or PHQ-9, which was developed at Columbia University and tested by researchers in the MacArthur Foundation program at Dartmouth College and Duke University.

Peter Amann, a family practice doctor in Scarborough, Me., has been using the questionnaire in a program organized by MaineHealth, a hospital group, with research grants from MacArthur and the Robert Wood Johnson Foundations.

One of his patients, a 60-year-old retired nurse who spoke only on condition of anonymity, said she had felt weighed down by problems. Her husband has had two strokes; her mother-in-law, who is 98, is also ill; and her rebellious teenage son left home and is now in Iraq with the Army Striker Force.

After Dr. Amann identified her depression last winter by her answers to the questionnaire, he gave her a prescription for a generic version of Prozac, and she got a follow-up call from a nurse who asked how she was doing. "It was so uplifting, it really feels good that somebody was caring," she said.

With encouragement from the doctor, she began to "get out and bike again, walk again," and she resumed volunteering at Saint Maximilian Kolbe Church.

"I'm optimistic, Dr. Amann is optimistic," she said. "I made some strides in the right direction."

Aetna is starting its program by increasing payments by 30 percent to 40 percent for selected primary care doctors that it has been training in a depression care program in six states: New Jersey, Pennsylvania, Maryland, Virginia, Texas and Oklahoma, as well as the District of Columbia. Aetna said it would add $15, on average, to a doctor's $40 fee for a routine visit, when physicians use the screening questionnaire.

"The reimbursement is a good step" because the program involves costs for the doctor, said Dr. Michael Klinkman, a family physician at the University of Michigan Depression Center in Ann Arbor.

Helen Darling, president of the National Business Group on Health, an organization of large employers, said patients' preference for consulting their primary care doctors on such matters was understandable. "They don't want to say they are going to see a psychiatrist," she said.