Beacon
Content
News of Interest from Daymark Recovery Services
Enriching Life… Enhancing Lives Volume 3, Issue 2
The Beacon
www.daymarkrecovery.org
August 2012
GETTING AFFORDABLE CARE DURING MAJOR BUDGET CUTS
Billy R. West, Jr., MSW, LCSW Executive Director DAYMARK Recovery Services, Inc. It seems like every year I am writing an article for a staff or patient newsletter talking about budget cuts. Unfortunately, this year isn’t any different. As you may have heard on the news, North Carolina had difficulty balancing their budget. Some State dollars and associated services were eliminated from the budget in order to balance it. This year North Carolina chose to eliminate $20,000,000 Statewide for services to persons with mental illness, substance abuse and developmental disabilities. What does this mean for services to the indigent or low income? At DAYMARK we hope it will mean very little. Our organization anticipated some reduction in funding this year and took steps to expand into other areas to defray administrative costs. Therefore, we should not have to raise any of our fees or reduce any of the services we offer. While anything is subject to change due to State budget problems, we are committed to our mission to provide affordable and best practice care to our patients. As a patient or family member of a patient at DAYMARK, you can also be part of making sure we keep true to our mission and continue to offer affordable healthcare. Here are just a few things you can do to help: Get involved! Join our Client Rights Committee, write elected officials on the need for their monetary support of the services you receive, join local advocacy and support groups for those with mental illness, substance abuse and developmental disabilities. Make your appointments. Adherence to your treatment is no different than finishing all of an antibiotic for a sore throat or allowing a full six weeks for a broken arm to heal in a cast. When you miss appointments, prematurely stop treatment or do not participate in treatment your recovery time may take longer, be short lived and in most cases end up being more I N S I D E T H IS I S S U E … expensive for you in all aspects of your life. Get the care you deserve! While we cannot be all things to all people, we do strive to give you the care you need whenever possible. If you are not satisfied with the care you are receiving talk to your therapist, ask to talk to a supervisor or simply email me or our clients rights officer with your concerns. If we can make things better we will.
GET T I NG AF FO R D AB LE C AR E DU RI NG M AJ O R B UD GET CUT S UN DE RSTAN DI N G M E DI C AI D T R AI NI NG COMP ET EN CE & EX C E LLE N CE RE SE AR C H B EH AVI O R AL HE ALT H AC RO NY M S CU STOME R S AT I S FAC T I ON
Cont. on p. 2
GETTING AFFORDABLE CARE DURING MAJOR BUDGET CUTS -cont.
Make your co-pays. Yes, financial responsibility is part of treatment. Even the lowest of co-pays collectively help us to continue to offer free and reduced care to those who need it. Call or drop in! When you are not doing well or are in crisis, do not wait and suffer. This increases your cost, our cost and ultimately is not good for your health. Call us for a sooner appointment or drop in to one of our Advanced Access Walk-in Clinics to speak with someone. Collectively doing these things help you take control of your healthcare and also help you support others directly or indirectly. Thank you for taking time to read this article and choosing DAYMARK Recovery Services! Bonnie Miller, Quality Assurance Director [email protected]
PAYMENT OF MENTAL HEALTH BENEFITS IN THE ORIGINAL MEDICARE PLAN
Question – What parts of Medicare cover Mental Health Services? Answer – Medicare Part B. Medicare Part B is the Medical Insurance of Medicare and helps cover mental health services received outside of a hospital, including visits with a doctor, psychiatrist or other doctor, visits with a clinical psychologist, or clinical social worker, and lab tests ordered by a doctor and may also pay for partial hospitalization services. Question – What part does the patient have to pay? Answer – Once you have met your yearly deductible for Medicare Part B, the amount of coinsurance you will owe for mental health services will depend on the kind of service received. The initial visit will be 20% co-pay and other visits at 40% for January 1, 2012 through December 31, 2012. These rates will change between now and 2014 as indicated below. If the service was performed: й ĂƟĞŶƚ ĂLJ W W Ɛ 40% 35% 20%
RECOMMENDED WEBSITES:
Jan 1, 2012 - Dec 31, 2012 Jan 1, 2013 - Dec 31, 2013 :ĂŶ ϭ͕ ϮϬϭϰ ĂŌĞƌ ĂŶĚ
http://familydoctor.org For mental health topics look under “emotional wellbeing”, but it has info on everything from childrearing to caring for the elderly. http://www.nami.org/ NAMI http://www.drugabuse.gov/ NIDA http://www.niaaa.nih.gov/ NIAAA http://www.ncdhhs.gov/mhddsas/ NC Division of Mental Health The Arc of North Carolina [email protected] Advocacy for IDD http://www.ncdhhs.gov/dma/services.htm DMA http://www.disabilityrightsnc.org/ Disability Rights
HERE ARE SOME COMMON BEHAVIORAL HEALTHCARE DEFINITIONS:
Recent LME/MCO Name Changes PBH ðCardinal Innovations Healthcare Services Crossroads ðPartners Behavioral Health Mgmt. Wake ðAlliance Behavioral Healthcare PAP Patient Assistance Program IVC Involuntary Commitment MCO Managed Care Organization
2
IT’S ALL ABOUT YOU
UNDERSTANDING MEDICAID
By Larry Elmore, MSW, MHA, LCSW “Medicaid is a health insurance program for low income individuals and families who cannot afford health care costs” according to the North Carolina Division of Medical Assistance. Medicaid is a Federal program that is administered by each State and varies slightly from State to State. The information below is only about Medicaid in North Carolina. What it covers: doctors bills, hospital bills, prescriptions (unless you have Medicare), vision care, dental care, Medicare premiums, nursing home care, medical equipment, PCS (personal care assistance), home health services, in-house care (under CAP – community alternative program), and most medically necessary services for children. Who Is eligible: to be eligible for Medicaid in North Carolina you must be: A U.S. citizen or have proof of eligible immigration status; Live in North Carolina and provide proof of residency; Have a Social Security number or have proof that you have applied for one. You are automatically eligible if: You receive Supplemental Security Income (SSI); You receive Work First Family Assistance; You receive State/County Special Assistance for the Aged or Disabled (primarily used for adult home assistance and care). Finally, there is no “physical exam “required unless you are applying for disability and, then, a medical exam may be required to establish the disability. If you are applying because you are pregnant, then you’ll need to provide proof of the pregnancy. Where to apply: You apply at your local County Department of Social Services. When you go to apply be sure to take birth certificates for all family members, proof of citizenship if you don’t have birth certificates, social security numbers for everyone who is applying, recent pay stubs, copies of health or life insurance policies, and a list of assets (things you own like cars or property). For More Information: You can obtain more detailed information by going to www.ncdhhs.gov/dma.
TRAINING COMPETENCE AND EXCELLENCE
By Bob Werstlein PhD Licensed Psychologist, Training Director Daymark invests heavily in training our staff in evidenced based treatments so they can offer you the highest quality care. In 2011-2012 fiscal year, we had 1,128 internal staff and 140 external staff for a total of 1,270 staff attends 142 trainings. The number of trainings this fiscal over 20102011 increased 45%. The number of total staff attending increased 59 %. One hundred and thirty seven (137) trainings are scheduled for next fiscal year. Over half of these trainings are training staff on evidenced based treatments. Nine (9) are approved by the North Carolina Nursing Association (NCNA), 113 by the North Carolina Substance Abuse Professional Practice Board (NCSAPPB), and 137 by the National Board of Certified Counselors (NBCC). Daymark will continue to invest in our staff’s competence and providing you excellent care.
RESEARCH
By Bob Werstlein PhD Licensed Psychologist, Training Director Daymark is committed to research in order to participate in finding and providing the most effective treatments for our clients. We are one of 150 Community Treatment Programs in the Clinical Trails Network of the National Institute of Drug Abuse. Studies in which we have participated include Brief Strategic Family Therapy (BSFT) for Adolescent Drug Abusers, Mediators and Moderators of BSFT for Adolescent Drug Use, Brief Strategic Family Therapy versus Treatment as Usual: Extended Follow-Up for Drug Using Adolescents, and HIV Rapid Testing & Counseling in Drug Abuse Treatment Programs in the US. We will continue to participate in relevant research to support our provision of excellent treatment to our clients.
3
CUSTOMER SATISFACTION How Well Does Daymark Recovery Do?
Part of Daymark Recovery’s mission is to provide ‘quality care”. In order to determine if we are meeting that goal, Daymark surveys a percentage of its customers or consumers about the quality of the service provided. In May of this year, we surveyed 2,288 consumers (a 5% sample). Below are the results of that survey. In addition to recording positive responses to specific questions like you see above, we also ask our consumers to tell us of any specific concerns they have about our services. This year, like previous years, we got an earful! Specifically, a number of consumers said they were concerned about:
The length of time required to see a physician. A lack of awareness of who to contact if they have a question or concern.
Both of these items will be turned into a Quality Improvement project and monitored on an ongoing basis. We are proud of our Satisfaction results and work very hard to maintain that 96% level.
COMPARATIVE ANALYSIS FOR ALL PROGRAM SITES BY SURVEY QUESTION
SURVEY QUESTIONS AVERAGE
Services were available at a time of day that was good for me. I was able to fully participate in decisions about my treatment plan. I made progress toward accomplishing the goals on my treatment plan. Daymark employees treated me with courtesy and respect. Daymark employees were sensitive to my cultural/ethnic background. I could reach Daymark 24 hours/day for crisis and telephone screening. I know who to contact if I have a question, concern, or complaint about services or my rights. I was able to see the doctor within 4-6 weeks of when I wanted. My questions were answered regarding my medications and possible side effects. I feel better able to control my life as a direct result of treatment. The quality of my life has improved as a result of services at Daymark. I would recommend Daymark to others.
CUMULATIVE AVERAGE
97% 97% 95% 98% 98% 97% 95% 93% 96% 94% 93% 97%
96%
Mission Statement:
Daymark Recovery Services, Inc. is a mission driven comprehensive community provider of culturally sensitive mental health and substance abuse services. The Daymark goal is for skilled medical and behavioral healthcare professionals to support citizens of all ages and their families with the greatest opportunity for recovery, independence and the highest quality of life. We are committed to using the most current best practices and effective research-based treatment programs to assist all citizens working toward achieving optimum health and recovery.
We hope this publication proves useful and we invite your thoughts regarding its content, format and distribution. Please contact Quality Assurance Director Bonnie Miller ([email protected]) for comments and suggestions, or to request topics for future issues.
4
Enriching Life… Enhancing Lives Volume 3, Issue 2
The Beacon
www.daymarkrecovery.org
August 2012
GETTING AFFORDABLE CARE DURING MAJOR BUDGET CUTS
Billy R. West, Jr., MSW, LCSW Executive Director DAYMARK Recovery Services, Inc. It seems like every year I am writing an article for a staff or patient newsletter talking about budget cuts. Unfortunately, this year isn’t any different. As you may have heard on the news, North Carolina had difficulty balancing their budget. Some State dollars and associated services were eliminated from the budget in order to balance it. This year North Carolina chose to eliminate $20,000,000 Statewide for services to persons with mental illness, substance abuse and developmental disabilities. What does this mean for services to the indigent or low income? At DAYMARK we hope it will mean very little. Our organization anticipated some reduction in funding this year and took steps to expand into other areas to defray administrative costs. Therefore, we should not have to raise any of our fees or reduce any of the services we offer. While anything is subject to change due to State budget problems, we are committed to our mission to provide affordable and best practice care to our patients. As a patient or family member of a patient at DAYMARK, you can also be part of making sure we keep true to our mission and continue to offer affordable healthcare. Here are just a few things you can do to help: Get involved! Join our Client Rights Committee, write elected officials on the need for their monetary support of the services you receive, join local advocacy and support groups for those with mental illness, substance abuse and developmental disabilities. Make your appointments. Adherence to your treatment is no different than finishing all of an antibiotic for a sore throat or allowing a full six weeks for a broken arm to heal in a cast. When you miss appointments, prematurely stop treatment or do not participate in treatment your recovery time may take longer, be short lived and in most cases end up being more I N S I D E T H IS I S S U E … expensive for you in all aspects of your life. Get the care you deserve! While we cannot be all things to all people, we do strive to give you the care you need whenever possible. If you are not satisfied with the care you are receiving talk to your therapist, ask to talk to a supervisor or simply email me or our clients rights officer with your concerns. If we can make things better we will.
GET T I NG AF FO R D AB LE C AR E DU RI NG M AJ O R B UD GET CUT S UN DE RSTAN DI N G M E DI C AI D T R AI NI NG COMP ET EN CE & EX C E LLE N CE RE SE AR C H B EH AVI O R AL HE ALT H AC RO NY M S CU STOME R S AT I S FAC T I ON
Cont. on p. 2
GETTING AFFORDABLE CARE DURING MAJOR BUDGET CUTS -cont.
Make your co-pays. Yes, financial responsibility is part of treatment. Even the lowest of co-pays collectively help us to continue to offer free and reduced care to those who need it. Call or drop in! When you are not doing well or are in crisis, do not wait and suffer. This increases your cost, our cost and ultimately is not good for your health. Call us for a sooner appointment or drop in to one of our Advanced Access Walk-in Clinics to speak with someone. Collectively doing these things help you take control of your healthcare and also help you support others directly or indirectly. Thank you for taking time to read this article and choosing DAYMARK Recovery Services! Bonnie Miller, Quality Assurance Director [email protected]
PAYMENT OF MENTAL HEALTH BENEFITS IN THE ORIGINAL MEDICARE PLAN
Question – What parts of Medicare cover Mental Health Services? Answer – Medicare Part B. Medicare Part B is the Medical Insurance of Medicare and helps cover mental health services received outside of a hospital, including visits with a doctor, psychiatrist or other doctor, visits with a clinical psychologist, or clinical social worker, and lab tests ordered by a doctor and may also pay for partial hospitalization services. Question – What part does the patient have to pay? Answer – Once you have met your yearly deductible for Medicare Part B, the amount of coinsurance you will owe for mental health services will depend on the kind of service received. The initial visit will be 20% co-pay and other visits at 40% for January 1, 2012 through December 31, 2012. These rates will change between now and 2014 as indicated below. If the service was performed: й ĂƟĞŶƚ ĂLJ W W Ɛ 40% 35% 20%
RECOMMENDED WEBSITES:
Jan 1, 2012 - Dec 31, 2012 Jan 1, 2013 - Dec 31, 2013 :ĂŶ ϭ͕ ϮϬϭϰ ĂŌĞƌ ĂŶĚ
http://familydoctor.org For mental health topics look under “emotional wellbeing”, but it has info on everything from childrearing to caring for the elderly. http://www.nami.org/ NAMI http://www.drugabuse.gov/ NIDA http://www.niaaa.nih.gov/ NIAAA http://www.ncdhhs.gov/mhddsas/ NC Division of Mental Health The Arc of North Carolina [email protected] Advocacy for IDD http://www.ncdhhs.gov/dma/services.htm DMA http://www.disabilityrightsnc.org/ Disability Rights
HERE ARE SOME COMMON BEHAVIORAL HEALTHCARE DEFINITIONS:
Recent LME/MCO Name Changes PBH ðCardinal Innovations Healthcare Services Crossroads ðPartners Behavioral Health Mgmt. Wake ðAlliance Behavioral Healthcare PAP Patient Assistance Program IVC Involuntary Commitment MCO Managed Care Organization
2
IT’S ALL ABOUT YOU
UNDERSTANDING MEDICAID
By Larry Elmore, MSW, MHA, LCSW “Medicaid is a health insurance program for low income individuals and families who cannot afford health care costs” according to the North Carolina Division of Medical Assistance. Medicaid is a Federal program that is administered by each State and varies slightly from State to State. The information below is only about Medicaid in North Carolina. What it covers: doctors bills, hospital bills, prescriptions (unless you have Medicare), vision care, dental care, Medicare premiums, nursing home care, medical equipment, PCS (personal care assistance), home health services, in-house care (under CAP – community alternative program), and most medically necessary services for children. Who Is eligible: to be eligible for Medicaid in North Carolina you must be: A U.S. citizen or have proof of eligible immigration status; Live in North Carolina and provide proof of residency; Have a Social Security number or have proof that you have applied for one. You are automatically eligible if: You receive Supplemental Security Income (SSI); You receive Work First Family Assistance; You receive State/County Special Assistance for the Aged or Disabled (primarily used for adult home assistance and care). Finally, there is no “physical exam “required unless you are applying for disability and, then, a medical exam may be required to establish the disability. If you are applying because you are pregnant, then you’ll need to provide proof of the pregnancy. Where to apply: You apply at your local County Department of Social Services. When you go to apply be sure to take birth certificates for all family members, proof of citizenship if you don’t have birth certificates, social security numbers for everyone who is applying, recent pay stubs, copies of health or life insurance policies, and a list of assets (things you own like cars or property). For More Information: You can obtain more detailed information by going to www.ncdhhs.gov/dma.
TRAINING COMPETENCE AND EXCELLENCE
By Bob Werstlein PhD Licensed Psychologist, Training Director Daymark invests heavily in training our staff in evidenced based treatments so they can offer you the highest quality care. In 2011-2012 fiscal year, we had 1,128 internal staff and 140 external staff for a total of 1,270 staff attends 142 trainings. The number of trainings this fiscal over 20102011 increased 45%. The number of total staff attending increased 59 %. One hundred and thirty seven (137) trainings are scheduled for next fiscal year. Over half of these trainings are training staff on evidenced based treatments. Nine (9) are approved by the North Carolina Nursing Association (NCNA), 113 by the North Carolina Substance Abuse Professional Practice Board (NCSAPPB), and 137 by the National Board of Certified Counselors (NBCC). Daymark will continue to invest in our staff’s competence and providing you excellent care.
RESEARCH
By Bob Werstlein PhD Licensed Psychologist, Training Director Daymark is committed to research in order to participate in finding and providing the most effective treatments for our clients. We are one of 150 Community Treatment Programs in the Clinical Trails Network of the National Institute of Drug Abuse. Studies in which we have participated include Brief Strategic Family Therapy (BSFT) for Adolescent Drug Abusers, Mediators and Moderators of BSFT for Adolescent Drug Use, Brief Strategic Family Therapy versus Treatment as Usual: Extended Follow-Up for Drug Using Adolescents, and HIV Rapid Testing & Counseling in Drug Abuse Treatment Programs in the US. We will continue to participate in relevant research to support our provision of excellent treatment to our clients.
3
CUSTOMER SATISFACTION How Well Does Daymark Recovery Do?
Part of Daymark Recovery’s mission is to provide ‘quality care”. In order to determine if we are meeting that goal, Daymark surveys a percentage of its customers or consumers about the quality of the service provided. In May of this year, we surveyed 2,288 consumers (a 5% sample). Below are the results of that survey. In addition to recording positive responses to specific questions like you see above, we also ask our consumers to tell us of any specific concerns they have about our services. This year, like previous years, we got an earful! Specifically, a number of consumers said they were concerned about:
The length of time required to see a physician. A lack of awareness of who to contact if they have a question or concern.
Both of these items will be turned into a Quality Improvement project and monitored on an ongoing basis. We are proud of our Satisfaction results and work very hard to maintain that 96% level.
COMPARATIVE ANALYSIS FOR ALL PROGRAM SITES BY SURVEY QUESTION
SURVEY QUESTIONS AVERAGE
Services were available at a time of day that was good for me. I was able to fully participate in decisions about my treatment plan. I made progress toward accomplishing the goals on my treatment plan. Daymark employees treated me with courtesy and respect. Daymark employees were sensitive to my cultural/ethnic background. I could reach Daymark 24 hours/day for crisis and telephone screening. I know who to contact if I have a question, concern, or complaint about services or my rights. I was able to see the doctor within 4-6 weeks of when I wanted. My questions were answered regarding my medications and possible side effects. I feel better able to control my life as a direct result of treatment. The quality of my life has improved as a result of services at Daymark. I would recommend Daymark to others.
CUMULATIVE AVERAGE
97% 97% 95% 98% 98% 97% 95% 93% 96% 94% 93% 97%
96%
Mission Statement:
Daymark Recovery Services, Inc. is a mission driven comprehensive community provider of culturally sensitive mental health and substance abuse services. The Daymark goal is for skilled medical and behavioral healthcare professionals to support citizens of all ages and their families with the greatest opportunity for recovery, independence and the highest quality of life. We are committed to using the most current best practices and effective research-based treatment programs to assist all citizens working toward achieving optimum health and recovery.
We hope this publication proves useful and we invite your thoughts regarding its content, format and distribution. Please contact Quality Assurance Director Bonnie Miller ([email protected]) for comments and suggestions, or to request topics for future issues.
4
