Patient Education

New Medicare rules could affect more than two-hundred mental health centers nationwide.

 

These changes leave vital education services in doubt.

 

The Oakhaven Community Mental Health Center in Monroe shut its doors on October 1.

 

This is a major concern for some.

 

Risperdol, Haldol, Zoloft, Cymbalta; these are drugs that some people with mental health problems need to regulate their condition.

 

And making sure patients receive correct dosages is not a simple matter of dispensing.

Carl Noble is the proprietor of the Oakhaven outpatient Community Mental Health Center in Monroe Louisiana.

 

He says that patients require repeated, detailed instructions.

 

“One service that each client gets here a day is patient education, which basically talks about medication compliance. Not just their psychotropic medications but non-psychotropic medications. We talk about side effects of those medications and the importance of why you’re taking these meds.”

 

All twenty-four patients will now have to look for alternate care.  Noble says he’s shutting his doors because of changes to billing procedures.

 

“Forty percent of our clientele must be non-Medicare eligible. What that means is that we have to have a private insurance company paying the bill here, or private pay, or the clients – out of their pocket – cash. Or a client could be of indigent status, where they don’t have any insurance and we take them on as part of a community service. We can’t meet that forty-percent requirement because most insurance companies won’t pay for this type of facility.”

 

Government documents estimate there are 224 Community Mental Health Centers nationwide, serving just over 25,000 patients. The Federal Register projects the total cost of regulatory changes would cost an average Community Mental Health Center just over $18,000 for each in the first year. The extent to which the revised billing policy will affect all other community mental health centers is not yet clear: the National Association for Behavioral Health says its advocacy efforts have “reduced the severity” of payment cuts.

 

Andrew Sperling of the National Alliance on Mental Illness says mental health care providers must meet certain conditions in order to bill for their services.

 

Carl Noble says the conditions are not new to his practice, only the billing procedures are.

 

But none of that is likely to resonate with those who need assistance now.

 

Kathleen Carr is a counselor who conducts psychotherapy groups with the patients. She says the clientele is anxious about the changes, as many depend on the center’s educational services. 

  

“They learn about their illnesses, their specific diagnoses. They are educated about more appropriate ways to cope with their symptoms in order to decrease them. We talk a lot about gaining awareness and insight into what their thinking is, because their thinking generally created their emotions.”

 

Despite the disruption, Carl Noble says most of the patients have found alternative care.

 

One place that many of them may turn is St. Vincent DePaul community pharmacy.

 

John Biglane is the head pharmacist of the charity organization. It serves between five or ten mental health patients each month. Biglane expects to see more with the closure of Oakhaven.

He says each new arrival will undergo an educational process.

 

“Their prescriptions get filled and I review their medical history and their prescription medications. It’s usually a question and answer. If they’re familiar with the medication and what they’re for – whether they’re anti-depressants or anti-psychotic. And they get full counseling here.”

 

But complete care for patients is not available at St. Vincent DePaul.

 

And a full plan of psychiatric care for them is not yet in place.