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NAMI CA Town Hall with the Department of Managed Health Care (DMHC) - Shared screen with speaker view
Liz Vice
28:09
CCJBH - Elizabeth.vice@cdcr.ca.gov
Janet Caton
28:32
no
Douglas Dunn
28:48
no
Titilayomi Osoba
28:48
No
Lana Sue Sawyer - Ventura Cty
30:22
I thought HICAP protected Consumer Rights about Healthcare
Douglas Dunn
34:48
OK
Diane Rivera
34:51
good
Janet Caton
35:02
ok
Laura Beile
37:49
HICAP primarily works with Medicare beneficiaries
Lana Sue Sawyer - Ventura Cty
38:21
Thank you, Laura
Lana Sue Sawyer - Ventura Cty
41:25
My daughter's employer is based in CA, her PPO Plan is based back East. There is a communication gap between the employer and their insurance provider.
Diane Rivera
43:41
denial of serice with follow through
Janet Caton
43:48
Separate appointments for care
Allie Mink
45:01
Lana, that should be an internal issue, but not your daughters. Services should be timely no matter where they are based.
Allie Mink
46:13
Some of this is absolutely relevant to specific providers
Allie Mink
46:49
Barbara I hear the same issue being echoed often
Brianna Vargas (she/her/hers)
51:50
1 (888) 466-2219
Brianna Vargas (she/her/hers)
52:08
DMHC Help Center
Allie Mink
58:30
This is great information...
Amparo Ostojic
01:01:14
This information is very helpful, Thank you!!
Douglas Dunn
01:02:32
Yes, absolutely!
Diane Rivera
01:02:39
This did not happen
Liz Vice
01:02:52
Does DMHC keep track of these overturns to identify Plans who regularly deny and perhaps let the Plans know that they need to evaluate their policies?
Allie Mink
01:03:04
Always thought this was a no brainer..that it would make sense for the health plan AND their members
Allie Mink
01:04:22
This was a blessing
Douglas Dunn
01:04:58
Unfortunately, only in theory, not in practice!
Allie Mink
01:06:07
But at least it's on the books...at least it begins with the premise that mental health is health..
Douglas Dunn
01:06:12
Again, in theory not in practice!
Allie Mink
01:06:46
This is so important..
Allie Mink
01:07:25
Sneaky...
Douglas Dunn
01:08:18
What happens if the ACA is declared unconstitutional?
Lana Sue Sawyer - Ventura Cty
01:10:11
And so many patients with severe mental illness often end up in another state without their parent's knowledge who have an LPS Conservatorship, only to find out that California does not cooperate with other states, reciprocity
Lana Sue Sawyer - Ventura Cty
01:10:19
This needs to be changed
Douglas Dunn
01:17:03
Sounds great. However, can be extremely difficult with enrollees who totally lack insight into their mental health condition.
Douglas Dunn
01:17:37
Yes
Diane Rivera
01:17:38
Yes
Janet Caton
01:17:52
Yes
Diane Rivera
01:18:18
Yes
Janet Caton
01:18:21
Yes
Allie Mink
01:18:49
It probably depends on which service exactly
Douglas Dunn
01:18:53
Possibly Yes. At the same time, the jury is still out on this issue.
Amparo Ostojic
01:18:56
Yes, because a lot of people with SMI have anxiety
Allie Mink
01:18:57
For a refill sure
Amparo Ostojic
01:19:05
Especially with covid-19
Allie Mink
01:19:25
For a first assessment...not so much
Lana Sue Sawyer - Ventura Cty
01:19:53
As a disabled senior, age 71 who is hunkered down, Zoom has opened up a world of help and access to me. Also, there are so many who cannot drive themselves to providers,
Lana Sue Sawyer - Ventura Cty
01:20:00
Telehealth is a God Send
Barbara Wilson
01:20:22
telementalhealth is not really great for people with Serious Mental Illness,delusional
Brianna Vargas (she/her/hers)
01:20:23
Thanks for that input Lana!
Allie Mink
01:20:43
Timely care and access to practitioners that a patient might otherwise not be able to reach..may make up for some of the issues of not being in the room and less personal
Diane Rivera
01:20:46
Continuity of care
Amparo Ostojic
01:21:20
I would like to share
Diane Rivera
01:21:31
Resistance for care from my loved one
Amparo Ostojic
01:21:32
I can’t raise my hand
Barbara Wilson
01:21:45
I love the sound of the mental health investigations.
Janet Caton
01:22:06
Appointments same day for therapy and doctor psyhartist.
Barbara Wilson
01:22:35
one of my concerns is the rapid change of mental health personnel who engage with clients
Lana Sue Sawyer - Ventura Cty
01:22:50
Change the HIPPA Laws and CA reciprocity. These two items have been held by consumer advocate groups and they are huge barriers to family members who want to help their adult children with SMI, even more so due to Covid 19
Diane Rivera
01:22:53
Having to look for the police department personnel as a provider to service without any follow with family.
Barbara Wilson
01:23:56
Also have concerns that people with medi cal only are disallowed verbal therapy unless it’s crisis.
Allie Mink
01:24:18
That's because they have been sued....She's right
Janet Caton
01:24:33
Better follow up care.
Diane Rivera
01:24:48
Education within the County about Mental Health/Addition. I know I am preaching to the choir. But I experience a very strong lack of Political will.
Allie Mink
01:25:08
Amparo..you are so right!!!
Barbara Wilson
01:25:27
many private hospital emergency rooms screen out medical only mental health consumers
Lana Sue Sawyer - Ventura Cty
01:25:30
Family members need to be more involved with their healthcare of their adult children with SMI. Do you all remember when in the late '90s or early 2000's many county had Family Advocates going around with Family Members to county behavioral health clinics? And who held Stakeholder meetings with Family members?
Allie Mink
01:25:54
It's so hard to reach out for help and then to have doors closed because you can't push through the barriers..
Allie Mink
01:26:24
Absolutey LANA!!!!!!!!
Barbara Wilson
01:26:59
big barrier to care: transportation
Allie Mink
01:27:10
There is nothing that can replace the involvement of strong family involvement
Amparo Ostojic
01:27:16
Yes I am willing to provide any information on this subject. I currently pay out of pocket to see my Psychiatrist because Kaiser could link me with care as often as I needed it. My contact information is amparoostojic@gmail.com
Diane Rivera
01:27:21
What I think is: It the city is not large (under 150K) it is easier to sub contract service to larger groups (who in most cases are knowledgeable) however, the Council/supervisor do not have a real feel for what is going on.
Brianna Vargas (she/her/hers)
01:27:24
Thank you Amparo!
Lana Sue Sawyer - Ventura Cty
01:28:05
The Family Advocates had a slide presentation explaining to clinicians in the county BH system how much better things go for the patient with more involvement with the family.
Allie Mink
01:28:23
That's where Telehealth has its strength
Diane Rivera
01:28:24
#! Let seniors know that Medicare will pay for therapy with small co pays.
Amparo Ostojic
01:29:25
I am currently working with a Mental Health Parity Advisory Cohort. Our group has Clinicians, clients and Lawyers
Allie Mink
01:29:54
NAMI is incredible!!! So glad you are connecting with us.
Carol Gosho
01:29:59
I will
Barbara Wilson
01:30:12
most of the services I provide as a clinician are not covered by most insurance companies. the billing system is built ona clinic model rathe than outcomes model. I transport my clients who have Serious Mental Illness as they utilize the dpss and other agencies that they have to access.
Lana Sue Sawyer - Ventura Cty
01:30:16
If you have an insurance provider from back East, and the employer is based in CA, the communication can be very poor with H/R. Also, if the Medi-Cal system becomes involved with the same patient as the PPO, that out of state provider, they often do not show up in the CA data search system,
Diane Rivera
01:30:20
I would be willing to share our experience.
Lana Sue Sawyer - Ventura Cty
01:30:43
So, Medi-Cal can get approved, only later to find out that the patient has a PPO back East
Lana Sue Sawyer - Ventura Cty
01:31:05
This is confusing to all parties
Lana Sue Sawyer - Ventura Cty
01:31:29
I would be willing to share as well
Barbara Wilson
01:31:51
it reassures my clients and I then am informed about the next steps required. yet insurance won’t cover that. it might all day but the payoff is that we get better outcomes,reduction in emergency services
Diane Rivera
01:31:59
In my experience, a lack of family that live close by and can assist in the healing is a major point to help the recovery.
Lana Sue Sawyer - Ventura Cty
01:32:02
I work on the NAMI Resource line steadily, and listen to the plight of a lot of families
Carol Gosho
01:32:02
How about having local mental health ombudsmen to feed info to you?
Barbara Wilson
01:32:07
barbara b wilson LCSW
Barbara Wilson
01:32:27
mentalhealthhookup.org
Jennifer Phillips
01:33:55
Issues: HIPPA and inability to get SMI hospitalized for effective life saving care.
Carol Gosho
01:34:07
Could we get a list of the 25 services?
Barbara Wilson
01:34:13
you should include contacting Adult Residential Facility owners address well
Diane Rivera
01:34:21
Our social worker who works with our HOT has been the very best decision that has been made. Still there are many barriers
Lana Sue Sawyer - Ventura Cty
01:34:41
Also, more provider training (the whole dept or office) on suicide prevention
Carmen Venegas
01:34:56
Great
Barbara Wilson
01:35:23
as well, not address well
Jennifer Phillips
01:35:27
Do you have position papers regarding HIPPA and AOT?
Douglas Dunn
01:35:53
Need to contact Board & Care facilities, esp. the operators?
Carol Gosho
01:35:56
Could Mr Southard check in quarterly with us?
Allie Mink
01:36:19
Thank you for this session...
Diane Rivera
01:36:25
excellent information!! Thank you
Barbara Wilson
01:36:42
thank u for having this presentation
Brianna Vargas (she/her/hers)
01:36:43
namica.org/townhall
Brianna Vargas (she/her/hers)
01:37:02
https://www.surveymonkey.com/r/DMHCtownhall
Lana Sue Sawyer - Ventura Cty
01:37:09
The Townhalls are all outstanding! Great information. Paves way for better advocacy.
Stef McDonald
01:37:15
You can also see replays of previous Town Halls: http://www.namica.org/townhall
Jennifer Phillips
01:37:23
Thank you!
Brianna Vargas (she/her/hers)
01:37:32
https://namica.org/events/2020-annual-conference/
Brianna Vargas (she/her/hers)
01:37:53
https://namica.org/events/advocacyday2020/
Lana Sue Sawyer - Ventura Cty
01:38:06
Visit also Suicidology.org
Brianna Vargas (she/her/hers)
01:38:28
Thank you Lana! Yes, #NationalSuicidePreventionAwarenessMonth
Stef McDonald
01:39:03
https://namica.org/blog/suicide-prevention-month-2020/
Carol Gosho
01:39:18
Thank you Mr Southard for being here!
Lana Sue Sawyer - Ventura Cty
01:39:22
Suicidology last weekend held a Mental Health Academy. Ten 1.5 hour live presentations. Go to their website for recordings.
Irene [Ventura Co] w/sons [Los Angeles Co]
01:39:34
Thank you all for the information!