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.

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 financially.

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 www.hillcountry.org.

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 Part D.

“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 clients.” 

“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 prescriptions.”

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.”