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Metro North Psychiatric Leadership Meeting

Metro North Psychiatric Leadership Meeting
February 24, 2011
Present: Lesley Omary, M.D. (Asian Human Services), Jerry Gibbons, M.D. (Kenneth Young), Dan Martinez, M.D. (Lutheran Social Services of IL

1.  Briefly discussed new atypical AP Latuda (supposedly with good efficacy relative to Zyprexa and more favorable metabolic profile), and also the AP Zyprexa Relprevv which is an extended release injectable.  Relprevv requires that the patient remain in the doctor’s office for at least 3 hours after the injection due to the possibility of “post-injection delirium sedation syndrome.”

Lesley said there has been a shortage of Haldol Decanoate.  We shared some of our experience with the depot medications.

2.  Dan mentioned that his www.discoverccs.org website contains information on IMPAC, the Illinois Mental Planning and Advisory Council.  This council is supposed to oversee block grant dollars and is made up of patients, advocates and providers.  Dan is a provider-member.  He said he added to the site the algorithms developed by State of Illinois Psychiatrists on use of various types of psychotropic medications such as anti-psychotics.  He invited us to take a look at the site and write pertinent articles he could post there.  I didn’t understand what he had in mind by “articles.”

3. We discussed the overall state of mental health funding in Illinois and also management of Medicaid, in particular getting authorization for additional sessions for Medicaid clients once their yearly number of “service units” has been exhausted.  All agencies are trying to figure out what the Collaborative reviewers are looking for so that requests for re-authorization are more likely to be approved and not rejected.

4. Dan said he knows the Medical Director of the “Collaborative,” whose name is Dr. Todd Kasdan.  They went to medical school and residency together.  Dan has been talking to Dr. Kasdan and briefly toured the Collaborative offices in Chicago located at Wells and Monroe.

Could this connection to Dr. Kasdan be helpful in understanding what the Collaborative reviewers are thinking and looking for when they review an agencies requests for authorization of additional service units?

How secretive are the Collaborative reviewers’ guidelines?

-Lesley suggested adding a sentence to psychiatrist notes supporting additional sessions or “service units” for patients.  For example, “Recommend patient continue in PSR.”  If the psychiatry notes are attached to reauthorization requests, maybe the sentence would carry some weight with the Collaborative reviewer, esp. when establishing “medical necessity.”

-Lesley thinks her agency may have some written authorization guidelines which may be guidelines actually used by the Collaborative reviewers.  She will find out and share them if they exist.

-Dan said agencies he has worked with have requested authorization of additional services PRIOR TO 01/10/2011, which is when management of Medicaid started.  He will find out and share what he learns.

-The Collaborative seems to like use of the words “recovery” (as in “recovery plan” rather than “treatment plan.”).

5.  We agreed to meet again 04/14/11, Thursday at 9 AM in Wilmette.

Jerry Gibbons, M.D.



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