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 July/Aug 1999
Published by NAMI North Carolina
North Carolina’s Voice on Mental Illness

Family-to-Family Coordinator Leaves NAMI NC

Matisha Brown, our Family-to-Family Coordinator for the past 1½ years, has left NAMI North Carolina. Matisha brought so much to the NAMI North Carolina family and has been instrumental in the growth and success of our Family-to-Family programs.

While we are saddened at losing Matisha, we are happy for her. Matisha will be joining Community Alternatives for Supportive Abodes (CASA) in Wake County. CASA is one of the most innovative and successful programs in the state providing supported housing for individuals with mental illness. Joining CASA is a wonderful opportunity for Matisha and also allows her to continue her work on behalf of people with mental illness and their families.

Matisha has offered to remain involved with NAMI North Carolina as a Family-to-Family educator, and we will take her up on that offer.

We are grateful to have benefitted from her talents while she was at NAMI North Carolina and we wish Matisha the greatest success in her new endeavor.

 

Gone Home...

The North Carolina General Assembly finishedits work and went home, mid-July, one of the earliest adjournments in recent years. During the nearly six months of the session legislators grappled with tight budget constraints, the tobacco settlement, and roughly 2000 pieces of legislation. Here is a summary of the issues affecting people with mental illness and their families.

 

State Budget:

—Provides $6 million in expansion funds for community mental health programs to address the needs of individuals waiting for services. These funds were provided in response to requests from Coalition 2001.

—$302,866 in FY 99-2000 and $609,953 in FY 2000-01 to provide mental health assessments and follow-up treatment services for residents in adult care homes identified as posing a risk to other residents during an initial assessment.

—$247,000 to expand services to individuals who are deaf and have mental illness.

—$495,000 for residential services for people with mental illness for HUD housing.

—$200,000 for Union House Clubhouse Program for people with mental illness.

—$800,000 to assist the merger of Cleveland and Gaston-Lincoln Area Programs.

—$4.35 million for the Willie M. program.

—$150,000 to provide funds for training of local area mental health Boards.

—Reduces Thomas S. Class funds by $3.9 million. A special provision, however, allows the Department of Health and Human Services to use available funds to cover service needs if necessary.

 

Long-term care safety initiative (Senator Purdue): Requires each resident in an adult care home to have an assessment and plan of care. Requires the Medical Care Commission to adopt rules for medication administration standards, staffing, and supervision. Establishes positions to determine level of care and services needed by residents and identify individuals who may need further mental health assessments and treatment. Establishes a number of new requirements as well as provisions for intervening in homes where there have been violations. Unfortunately, the bill also allows adult care homes to establish special units for people with mental illness outside of current licensing requirements. We will have to monitor implementation of this closely.

Prescription Drug Formularies (Senator Forrester): Allows physicians to prescribe drugs that they think their patients need even if they are not on the list of drugs a health plan will normally pay for. A process is required to allow physicians to do this with notification to the insurer.

Expanded Access to Specialty Care (Senator Forrester): Requires HMOs to allow a person with a serious chronic condition that requires constant visits to a specialist to see the specialist without having to constantly go through the primary care physician.

While some may view referral of a bill to a study committee as a way for legislators to avoid an issue, in fact, referral to a study committee can be very positive. With over 2000 bills to consider, legislators need an opportunity to take more time to understand more complex and controversial bills. Study bills can be considered in the next "short" session of the General Assembly which will convene in May 2000.

The following are bills NAMI North Carolina has been involved with:

Seclusion and Restraint: This legislation was developed in the aftermath of highly publicized abuses. Opposition arose because of the limited discussion that had occurred around the bill and an inability to study implications. The bill sponsor determined that the bill should receive a thoughtful hearing and has had the bill referred to the Legislative Study Committee on Mental Health.

Conditional Release: This legislation, developed hastily, generated controversy from stakeholders concerned about potential implications of the legislation that had not been thoroughly addressed. NAMI North Carolina and other groups supported having this bill sent to a study committee so that concerns can be addressed. This bill also has been referred to the Legislative Study Committee on Mental Health.

Mental Health/Substance Abuse Insurance Parity: Facing opposition from the insurance and small business lobbies, bill Sponsor Martha Alexander worked to have this bill placed in a legislative study committee to allow for thoughtful discussion, and hopefully the development of legislation with broad support.

  

Mark your calendars!

NAMI North Carolina’s

Fall Institute on the Redesign of North Carolina’s

Mental Health System

will be held on

October 23, 1999 at

Wayne Community College

in Goldsboro.

 

Plan to attend!

 

 Young Family Program — School Presentations

The number one request from young families is for support in communicating with the school system. We thought it would be helpful if we could help school personnel better understand mental illness in children and adolescents and what families need. Our aim is to facilitate effective communication between families and schools.

Chary Sundstrom, a psychologist with Wake County Public Schools, and I have written a 2-hour presentation entitled "Emotional, Behavioral, and Mental Disorders in Children and Adolescents." The presentation covers information on warning signs and difficulties in diagnosing children, classroom interventions, medication side effects, special education law, and what families need. The presentation material will also include a variety of handouts and key resource material for professionals to keep as reference material.

We need your help. If you work for the school system, or have a connection with those who do, and would be interested in helping us get on a school’s calendar, please give me a call. We hope to reach school nurses, teachers and aides, administrators, social workers, psychologists, and counselors. Thank you.

-Linda Swann

Axis IV Updated in DSM-IV

One of our readers has pointed out that the article "Axis Diagnoses Coding Explained," which appeared in the April issue of Clippings contained some outdated material. The DSM-IV, the most recent edition of Diagnostic and Statistical Manual of Mental Disorders, has a revised system for coding the Severity of Psychosocial Stressors that may affect the treatment of a patient.

Understanding the Axis Diagnoses that appear on a discharge summary has been made more specific and helpful to the physician and the patient in DSM-IV. Instead of rating the severity of non-specified stressors a patient may be experiencing, the new system categorizes those stressors as follows. Each category that is relevant is then listed on the summary in an abbreviated form. Underlined in each category is the word that might appear on the discharge summary.

Axis IV, Psychosocial and Environment Problems

Problems with primary support group.
Problems related to the social environment.
Educational problems.
Occupational problems.
Economic problems.
Problems with access to health care services.
Problems related to interaction with the legal system/crime
Other psychosocial and environmental problems.

Thank you, readers, for keeping us up to date.

 

 

Calendar of Upcoming Activities...

August 11 NC Council of Community Mental Health, Developmental Disabilities and Substance Abuse Programs Managed Care regular Work Group Meeting, 10 a.m.-2 p.m., Raleigh. For information, call (919) 755-0680.

Sept. 8 NC Council of Community Mental Health, Developmental Disabilities and Substance Abuse Programs Managed Care regular Work Group Meeting, 10 a.m.-2 p.m., Raleigh. For information, call (919) 755-0680.

October 3-9 Mental Illness Awareness Week (MIAW). Help plan and participate in your affiliate’s MIAW activities!

October 23 NAMI North Carolina’s Fall Institute in Goldsboro. All are invited to attend. More information to come in future Clippings.