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July 20, 2006
Cost Of The Blues
Depression is one of the most ancient and common diseases of the human
race and its cost to society is impressive. Medicine knows that
depression adversely affects functioning in all domains, but only
recently has the true impact on work productivity become clear.
A comprehensive report prepared by the National Alliance on Mental
Illness (NAMI) (www.nami.org) shows Texans
lose $16.6 billion each year in direct and indirect costs related to
Depression is a persistent mood disorder of the brain, characterized by
diminished interest in activities and insomnia, fatigue, feelings of
worthlessness and recurrent thoughts of suicide. It is far more severe
than temporary blues that everyone encounters.
The National Institute of Mental Health in
Bethesda, MD. states that 9.5% of U.S. adults suffer from depression.
People with depression not only endanger their own
health, but drain their families emotionally and their companies
Nearly 30,000 Americans kill themselves each year,
almost twice the number of homicides.
According to the U.S. Surgeon General’s
report on mental health, more than half of all Americans with a severe
mental illness fail to seek treatment. Many people do not receive
treatment for mental health problems due to lack of awareness of the
problem, fear of stigma, or lack of access to appropriate services.
“This survey pinpoints exactly how lack of
access to treatment harms the job prospects, financial situation and
personal relationships of people living with depression,” said
Dr. Ken Duckworth, NAMI Medical Director.
Employed adults with major depression come to work
but can't concentrate, losing about eight hours of productivity a
week. That makes depression the leading cause of lost workdays,
compared with people with diabetes or hypertension.
“Overall quality of life is greatly improved when a person with
depression gets an early diagnosis and receives appropriate
treatment,” said Linda Werlein, Executive Director of Hill
Country Community MHMR Center.
With an annual budget of $25 million, Hill Country Community MHMR
Center, served 5,021 adults with a mental illness diagnosis and 1,337
children with a serious emotional disturbance across 19 counties.
For more information on Hill Country and the services they
provide, visit their website at
April 18, 2006
Medicare Part D enrollment
goes smoothly for Hill Country MHMR
KERRVILLE – Medicare Part D, the new prescription drug program is
the biggest change in government health care programs in 40 years.
Although Medicare Part D is referred to as a voluntary program, it is
not really for the lowest income populations.
When Congress enacted the program, it created a tiered system in which
the poorest and sickest must enroll. About 6 million disabled or
elderly people are forced to switch from state Medicaid to Medicare
“Medicare Part D loomed as a significant event for us,”
said Linda Werlein, Chief Executive Officer of Hill Country Community
MHMR Center. “We serve more than 7,000 individuals, over 19
counties, who are suffering from mental illness, mental retardation or
substance abuse. Medications are important for our
“We estimated that over 900 individuals we serve would fall into
the “low income” category (called Dual eligibles) for
Medicare Part D so we needed to start early to insure there would be no
‘slip between the cup and the lip’ in their
transition,” said Mrs. Werlein.
Dual eligibles (persons with Medicare and Medicaid) are among the most
vulnerable groups in society.
• More than 70% of the dual eligible are limited
in at least one activity of daily living.
• About 40% have mental or cognitive impairments.
• They frequently need multiple prescriptions.
“The upside to the prescription drug plan for our clients is
huge,” said Diane Ullrich, Hill Country Community MHMR
Center’s Consumer Benefits Coordinator.
“Those who were getting their drugs from Medicaid were limited to
3 prescriptions per month. Medicare Part D has no limit on
prescriptions. Before enrollment in Medicare Part D these clients had
to make random choices about which three of multiple drugs to
fill. Our clients are seeing better health outcomes since they no
longer have to make random choices.” indicated Mrs. Ullrich.
Knowing that Medicare Part D enrollment and selection of a Drug Plan is
a complex process, Hill Country started early in 2005 to put in place
trained staff who understand the enrollment process, the available drug
plans, prescription drugs covered, the premiums or co-pays, and
pharmacies where prescriptions can be filled.
In addition, a person in a Medicare prescription drug plan could expect
to pay a $250 deductible and then 25% of their drug cost up to an
out-of-pocket limit of $2,250.
Dual eligibles, however, can qualify for a subsidy that pays the
premium and deductible for a basic plan.
“We knew that our clients would be faced with a dizzying array of
Part D drug coverage options,” said Mrs. Ullrich.
“Hill Country reviewed every eligible plan to ensure that all
medications are covered and a pharmacy is located nearby to fill the
Mrs. Werlein said, “It is important to have trained, caring staff
for our clients to sit down with, bringing in their medications and
financial information, in order to select the best plan. You have
people say the Medicare Part D will leave them worse off. I
don’t think you will hear those complaints from our clients due
to the services we provide.”
Country MHMR Provides Mental
Health Presentation to Austin Leadership
KERRVILLE – Camille Miller, President and CEO of the Texas
Health Institute toured the Kerrville Mental Health Clinic on
Wednesday, April 5th meeting with Staff and patients.
The Institute provides non-partisan policy development resources for
decision-makers, including the Legislature, primarily on the effective
and efficient delivery of healthcare.
Ms. Miller and her staff are facilitating several groups who are
charged to make recommendations to the Texas Legislature for changes to
the current mental health system.
The President’s New Freedom Commission report in July 2003
criticized each state’s mental health care system calling it
fragmented, disconnected and inadequate. It called for a
transformation of the system.
In response to the report, the Texas legislature in 2003 implemented
Disease Management as an effort to redesign the way public Mental
Health Services are delivered to adults with severe and persistent
mental illness and children with severe emotional disturbance.
“Recognizing our shared Vision of improving mental health and
the delivery of mental health services to Texans, we extended an
invitation to Ms. Miller and her staff to tour our program.
Hill Country has taken a lead role in developing a Disease Management
Mental Health Service delivery system in the state of Texas.
The system offers more effective quality care designed to help the
individual with their recovery and improving their overall
health,” said Linda Werlein, Executive Director of Hill
Country Community MHMR Center.
With an annual budget of approximately $25 million, Hill Country,
headquartered in Kerrville, provides in 19 counties a broad range of
community treatment options for over 7,000 individuals annually who are
suffering from mental illness, mental retardation, or substance abuse.
“It is a privilege to serve on the board of a quality
organization such as Hill Country. The business model
developed by our dedicated staff has insured the delivery of cost
effective and quality services to those in our community who have
serious mental illness,” said Commissioner John Kight,
Chairman of the Hill Country Board.
In comments to the group about Peer Support Services, Steve said,
“I’ve had a major mental illness for
years. Hill Country has given me the tools, beyond
medication, to improve. I now want to get better more than I
want to stay sick.”
“Under the Disease Management Model, Hill Country mental
health services are now about recovery and hope,” said
Suzanne Lindell who is responsible for Psychiatric Rehabilitation at
Representative Harvey Hilderbran praised the efforts of the Texas
Health Institute and its process of providing resources for
decision-makers. “I’m proud to represent
the Hill County. It has, through the Disease Management
model, maximized the efficient and effective use of limited resources
made available through the appropriations process.”
Also, in attendance were Julie Haeber a staff person for the Texas
Senate Finance Committee, whose responsibilities include appropriations
for the Health and Human Services Agencies, and Meghan Weller, Chief of
Staff for Representative John Davis, Chair of the Subcommittee on
Health and Human Services of the House Appropriations Committee.