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Elizabeth.” “This house was built with her laughing(2)

Time:2019-03-12 22:39Shoes websites Click:

state Mental Health Treatment insurance

Three weeks after Elizabeth was discharged from the program, she pulled into traffic on the freeway near her parents’ house — and totaled the car. Around that time, the records show, her Kaiser psychiatrist diagnosed her with bipolar disorder. Over the next few months, he changed her medications regularly and offered her words of encouragement via email.

In response to a message she sent in which she speculated about feeling a little better, he responded: “I think its time, meds, your spirit and fight.” But a few weeks later, she was struggling again.

“I’ve tried running, I’ve tried reading, I’ve tried cuddling with my dog,” she wrote to him. “Each of them wear off too quickly. And inside I just want to cut, cut, cut. I’m confused.”

In 2013, the state Department of Managed Health Care levied a $4 million fine against Kaiser for deficiencies in providing timely access to mental health care and for violations of the state parity law related to mental health education materials. It was one of the largest fines in the department’s history.

Shelley Rouillard, the department’s director, said it regularly monitors Kaiser, and that the HMO “actually is doing very well,” meeting the settlement agreement’s benchmarks — hiring additional mental health providers and waging a mental health awareness campaign. The department surveys all health plans every three years, interviewing staff and reviewing enrollee files, in addition to tracking complaints to its help center.

But last fall, The Kennedy Forum, The Kennedy-Satcher Center for Mental Health Equity and several other organizations released a report grading state parity statutes. They gave California, along with 31 other states, an F. In December, Democratic state Sen. Jim Beall of San Jose introduced legislation to sharpen state parity laws by requiring plans to report to the state annually on their compliance with parity laws — and for the state to make those reports accessible to the public. He noted that similar legislation has failed three times, in part because it has been heavily lobbied against by the insurance industry, he said.

“It’s going to be a tough battle,” he said. “We’re all geared up for it.”

That same month, Kaiser mental health providers went on strike for five days to protest long patient wait times.At a forum organized by the National Union of Health Care Workers in the Oakland Masonic Hall, providers described not using the restroom all day and working through lunch, afraid that any call they don’t answer will leave a patient to suffer.

“The HMO is not going to go to oncology and say our next available opening is in six weeks so that’s what’s available,” said Kenneth Rogers, a psychologist with Kaiser in Elk Grove, and shop steward for the union. “We think that Kaiser is doing these sorts of things with psychiatry.” Research says psychological treatment involves weekly therapy, he said, “not interventions where you’re seeing patients six or eight weeks out.”

People on both sides of the debate agree that mental health workforce shortages are a big piece of the problem. Kaiser has hired 30 percent more therapists since 2015, and pays the highest rates in the state, said Dr. Linda Kim, chair of regional mental health and addiction medicine and recovery services for Kaiser Northern California. She said Kaiser works closely with therapists and takes “great pains to make sure our patients are getting what they need.”

“I truly believe no other organization is doing more than what we are doing, in terms of aggressively hiring and in terms of truly innovating and finding new models of care that are evidence-based,” she said. “I really don’t think there’s anyone else that can match up in terms of what we’re doing. We’re really trying to lead the nation, truly.”

Professional associations representing psychiatrists and social workers say they often don’t want to work with insurers at all, in part because of low reimbursement rates and onerous administrative burdens. A 2014 study in The Journal of The American Medical Association reported that only 55 percent of psychiatrists accept insurance — compared to an average for all health care professionals of 89 percent.

Many psychiatrists also are solo practitioners — “their receptionist might be an answering machine,” said Randall Hagar, government relations director for the California Psychiatric Association. Prior authorizations, claim challenges and other paperwork create significant administrative burdens that other providers don’t necessarily face, he said.

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