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The committee was more active this
year with the emphasis on Alcohol and Substance Abuse. We were supportive
of the efforts to include treatment for alcohol and substance abuse in the revisions
to the Parity Bill, which passed the legislature and will help to expand
availability for treatment to at least some Delawareans.
We met with Renata Henry, Director
of the
Division of Substance Abuse and Mental
Health and also with the Director of the Addictions Coalition to see how we
might interface to champion the need for more long-term inpatient beds for
people needing treatment for substance dependence. Much discussion
centered on the issues of education for primary care physicians (PCPs) to
improve skills in diagnosing these disorders, as well as to try to develop a
referral sheet for the PCPs. It appears to the Committee that the medical
community fails to diagnose many who suffer with these disorders, especially
those patients who appear "functional" and continue to work and
maintain their marriages.
We continued to provide input to
the Legislative Action Committee. In looking at the impact of the Mental
Health Parity Bill on patient access, it appears to have made little difference
(as was expected) due to the high number of ERISA exempt employers in Delaware.
Nonetheless, it is an important bill and as ERISA gets reinterpreted by
the courts, it is anticipated that Parity Legislation will be meaningful.
The Committee has a special interest in efforts to regulate and to limit
who can prescribe scheduled medications, especially Methadone and Oxycontin.
The other issue affecting patient
access to treatment has been a move by many psychiatrists to leave managed care
in whole or in part. Thus, the number of psychiatrists on many of the
provider panels has fallen substantially causing some insurers to open
previously closed panels, to advertise for psychiatrists to join panels or to
become employees of the managed care company and to raise reimbursement rates.
Nonetheless, many psychiatrists are finding life without managed care to
be quite agreeable and would be happy to share our experience with our
physician colleagues.
Neil
S. Kaye, M.D., F.A.P.A.
Chairman