Will mental-health provisions of ACA swamp the system?

Big changes to mental health-care in NEPA (Northeastern Pennsylvania) are ahead as the Affordable Care Act (ACA) takes hold.
Nominate a Top Woman in Business. Click here. Nominate an NEPA business professional under 40. Click here.

20 Under 40: JenniferDessoye

Photo: N/A, License: N/A, Created: 2016:11:17 11:10:02

Dr. Jennifer Dessoye is assistant professor of occupational therapy at Misericordia University and owner of Bright Beginnings Early Learning Academy (BBELA). Discontent with the early education curriculum and understanding of human development and neurolo (read more)

20 Under 40: Amy Hlavaty Belcher

Photo: N/A, License: N/A, Created: 2016:11:09 13:55:46

Amy Hlavaty Belcher, 39, owner and artistic director of Abrabesque Academy of Dancing, believes that for those who have been given much, much is expected. “I just try hard to do my best,” she said. I have been blessed with many opportunities and many gift (read more)

20 Under 40: Christopher Hetro

Photo: N/A, License: N/A, Created: 2016:11:14 11:21:35

Chris Hetro, 33, works hard and plays hard. “A strong work ethic is important, but finding balance outside of work is important because life is too short and you need to enjoy it,” he explained. As an electrical engineer and project manager at Borton-Laws (read more)

20 Under 40: C. David Pedri

Photo: N/A, License: N/A, Created: 2016:11:14 15:19:17

For attorney C. David Pedri, 37, it’s all about a combination of qualities that contribute to success. “My philosophy is simple: be open and honest, treat people the way you would want to be treated, with respect, and work hard to attain your dreams. The (read more)

20 Under 40: Ed Frable

Photo: N/A, License: N/A, Created: 2016:11:09 11:13:04

Ed Frable, 28, believes “if I work hard and stick to my word, good things will happen. My crew will not be deterred. We will re-evaluate our game plan and not give up until the job is complete,” explained Frable, the owner/operator of Ed Frable Constructi (read more)

20 Under 40: William H. Bender II

Photo: N/A, License: N/A, Created: 2016:11:16 13:11:08

William H. Bender II, CFP, CIMA, CRPC, loves what he does. “I’m lucky. I come to work every day excited to help the people and institutions we work with,” explained Bender, 34, first vice president at Bender Wealth Management Group, Merrill Lynch. The fam (read more)

20 Under 40: Angelo Venditti

Photo: N/A, License: N/A, Created: 2016:11:14 16:09:11

Angelo Venditti, 38, heard a call to the helping professions early on. Geisinger Northeast’s chief nursing officer answer was to volunteer for his local fire company. After high school, he became a paramedic, then enrolled in nursing school. Three years a (read more)

20 Under 40: Donald Mammano

Photo: N/A, License: N/A, Created: 2016:11:17 12:38:37

At 20, Donald Mammano began his own company, while attending the University of Scranton. Mammano, now 33, and president of DFM Properties, recalls, as a youngster, holding a flashlight while his father fixed the kitchen sink. “From that point on I was fas (read more)

20 Under 40: William J. Fennie III

Photo: N/A, License: N/A, Created: 2016:11:15 09:50:19

William J. Fennie III, 27, is always knocking on the proverbial door, because he knows one day, one will open. As an investment specialist with Integrated Capital Management (iCM) he cannot take “no” for an answer. “I make cold calls every day to invite f (read more)

20 Under 40: Marcus Magyar

Photo: N/A, License: N/A, Created: 2016:11:14 13:25:24

As an advisor at CAPTRUST Financial Advisors, Marcus N. Magyar, CFP, 30, provides comprehensive wealth management and investment portfolio services to business owners, executives, families and high-net worth individuals. His multi-disciplinary team of pro (read more)

20 Under 40: Heather Davis

Photo: N/A, License: N/A, Created: 2016:11:10 13:34:44

Heather M. Davis, 33, director of marketing and communication, is responsible for creating, overseeing and implementing a strategic marketing and comprehensive communications plan for The Commonwealth Medical College (TCMC). She is also responsible for pr (read more)

20 Under 40: Alexandria Duffney

Photo: N/A, License: N/A, Created: 2016:11:14 14:24:50

Alexandria Duffney, 30, is competitive by nature and loves a good challenge. These qualities have led her to her position as associate director of graduate admission at Wilkes University. Here she works with prospective students interested in enrolling in (read more)

20 Under 40: John Culkin

Photo: N/A, License: N/A, Created: 2016:11:07 17:18:26

John Culkin’s tenets inform: “Less haste equal more speed; the same boiling water that softens the potato hardens the egg, it is all about what you are made of, not the circumstances surrounding you; and don’t ask someone to walk a mile in your shoes, bef (read more)

20 Under 40: Conor O'Brien

Photo: N/A, License: N/A, Created: 2016:11:14 17:19:58

“What could be worse than getting to the end of your life and realizing you hadn’t lived it,” mused Conor O’Brien.” As co-founder and executive director of the Scranton Fringe Festival, O’Brien, 25, is responsible for leading the development of the overal (read more)

20 Under 40: Jessica Siegfried

Photo: N/A, License: N/A, Created: 2016:11:10 14:12:08

Jessica Siegfried, 38, is senior designer with BlackOut Design Inc., where she is responsible for all creative design at the full-service agency, from traditional branding and print to collateral and front end web design. “I’ve always had an interest in t (read more)

20 Under 40: David Johns

Photo: N/A, License: N/A, Created: 2016:11:08 10:15:37

David Johns’ career path has been shaped by his diverse experiences. As director of structural engineering at Greenman-Pedersen Inc., Moosic, Johns, 39, ensures that his engineering and consultant teams provide clients with their best effort. “We complete (read more)

20 Under 40: Robyn Jones

Photo: N/A, License: N/A, Created: 2016:11:14 12:41:32

Robyn Jones, 38, president of ReferLocal LLC, has learned just as many lessons from her business successes as she’s had from her failures — and she believes it’s important to share that knowledge with her employees. After graduating from American Universi (read more)

20 Under 40: Nisha Arora

Photo: N/A, License: N/A, Created: 2016:11:14 10:02:06

Nisha Arora, 36, tries to be the best version of herself every day. As general counsel for ERA One Source Realty Inc., she realized she cannot control other’s behavior so “I try to focus on myself and how I can be better,” she explained. Arora’s responsib (read more)

20 Under 40: Justin Sandy

Photo: N/A, License: N/A, Created: 2016:11:10 14:59:27

Starting at a young age in Hazleton, Justin C. Sandy, 33, found a passion for running. He became a member then a coach for Misericordia University’s cross country and track and field programs. “It was at Misericordia that I also garnered the profound sati (read more)

20 Under 40: Dr. Ariane Conaboy

Photo: N/A, License: N/A, Created: 2016:11:16 09:38:07

As a doctor of internal medicine at Physicians Health Alliance, Dr. Ariane M. Conaboy, 34, realizes the importance of human life and how fragile it can be at times. Conaboy graduated from Scranton Prep and the University of Scranton with a double major in (read more)

Find us on Facebook!

Photo: N/A, License: N/A

"Like" us on Facebook for all of the latest news! (read more)

Follow us on Twitter!

Photo: N/A, License: N/A

Follow us for constant updates! (read more)

Fed announces a start to modestly reducing its bond holdings

WASHINGTON (AP) — The Federal Reserve will begin shrinking the enormous portfolio of bonds it amassed after the 2008 financial crisis to try to sustain a frail economy. The move reflects a strengthened economy and could mean higher rates on mortgages and other loans over time. (read more)

Article Tools

Font size
+
Share This
EmailFacebookTwitter

Photo: Source: www.samhsa.gov, License: N/A

Chart source: Substance Abuse and Mental Health Services Administration, www.samhsa.gov

Big changes to mental health-care in NEPA (Northeastern Pennsylvania) are ahead as the Affordable Care Act (ACA) takes hold.
The ACA builds on existing legislation — the Mental Health Parity and Addictions Equity Act — which expanded mental health and substance abuse disorder benefits. ACA requires new health plans to cover preventive services for mental illness, such as depression screenings for adults and behavioral assessments for children, at no additional cost. Additionally, beginning in 2014, insurance companies will no longer be able to deny health-care coverage to anyone because of a pre-existing mental health condition, and individual insurance policies will require mental health treatment to be covered.
Concurrently, a regional expansion of mental health services is taking place.  
Commonwealth Health is opening a crisis response and recovery center, which is being billed as a community-based mental health program on the campus of Wilkes-Barre General Hospital.
Commonwealth is promoting the facility as the first center in the region that will provide rapid stabilization for individuals who are experiencing mental health or substance abuse crises, depression and anxiety, mood disturbance, medication non-compliance, cognitive impairment, intellectual disability, and the consequences of drugs and alcohol abuse. An eight-bed unit and crisis triage area highlights the facility.

Policy consolidations

Marie C. Gray, Ph.D., serves as CEO of Cornerstone Counseling & Consulting Specialists. She confirms the ACA will not allow separation between mental and physical health needs, even though previous laws used to allow separate and individual policies.
She does not believe the mental-health provisions of ACA will overload America’s mental-health system. Dr. Gray has found that many people who genuinely need mental-health care will never use pursue treatment, primarily because of the stigma that still attaches to admission that a patient needs mental-health care.
“In my experience, 40 percent to 50 percent of hospital visits have some form of mental-health connection,” says Dr. Gray. Additionally, the overall future of mental-health care is cloudy. Dr. Gray says that large numbers of providers need proper credentialing and psychiatrists, as a profession, are a dying breed because of malpractice costs. This scenario is especially true in Pennsylvania.
“Today, family physicians often prescribe medications for mental-health problems, but  may do so without the necessary expertise,” says Dr. Gray.
As she looks ahead, Dr. Gray forecasts that needs for mental-health problems are sure to grow. Substance abuse probably will continue to soar, along with the associated physical health ramifications, and incidences of anxiety and mood disorders will increase.
In addition, patients with PTSD and complex iterations of the disorder, particularly among  military veterans, plus their families who must cope with the disease, will be looking for help. Substance abuse commonly accompanies PTSD, and must also be treated.
“Paranoia and schizophrenia also are very real problems, and we need more awareness of these illnesses,” says Dr. Gray.

Additional burdens

Medicaid expansion through the ACA is also likely to create burdens for mental-health providers, warns Allen Minor, D.B.A., assistant professor and director of the health care management program at Misericordia University. As individual insurance policies add a mental-health component, patient loads for providers are sure to increase, particularly in regard to patients with Alzheimer’s disease and drug and alcohol counseling, which are badly needed in NEPA.
“A huge concern involves is whether these patients are taking their medications, especially if they are bipolar,” says Minor. He also warns that pay for psychiatrists has lagged, especially from Medicaid, creating incentives for medical students to avoid this path. This trend may actually be true for all mental health providers, adding to a shortage of qualified caregivers.
Increased numbers of patients with insurance may translate into skyrocketing co-payments  and deductibles, according to Brooke Egbert, Ph.D., an independent psychologist based in Wilkes-Barre. This will be especially common with  addiction recovery, as well as the dual diagnoses of depression and addiction.
Dr. Egbert adds that depression and anxiety are the most common adult ailments she  treats, and that media advertisements of prescription drugs as quick fix fuels improper treatment.
“NEPA also lacks mental-health providers, — existing therapists often have to turn new patients away,” says Dr. Egbert. “Imagine this scene as ACA takes hold.”
Celeste Curley, senior director of product management with Blue Cross of NEPA (BC NEPA), points out that the changes to mental-health care demanded by ACA have roots in previous legislation. She says BC NEPA already offers applicable coverage  to all groups and ACA won’t cause any notable policy changes.
“The real change will now be the offering of essential mental health insurance benefits, by law, across the board,” says Curley. “This will probably cause costs to rise, but not as  much as we will deal with from other ailments.”
Colleen Morris, senior product specialist with Blue Cross, supports identifying and treating mental health issues as early as possible. “Benefit costs are sure to rise when care is initially postponed,” explains Morris.

Poverty exacerbates situation

Joe Rogan, Ph.D., professor of education at Misericordia University, warns that concerns about increased mental health treatment costs because of the ACA are minimal compared to the onrushing costs for the treatment of obesity. He calls obesity the real line item to be feared because it surely will suck up massive amounts of future health care dollars.
At the same time, Dr. Rogan confirms that mental illness in children definitely has  increased. In his opinion, these cases are often not naturally produced, but are the result of pathological families and dysfunctional communities. “Poverty also amplifies any type of mental health problems and, as school class size has increased, it’s hurting the borderline kids with problems,” says Dr. Rogan.
David Isgan, PA-C., adjunct teaching faculty at Marywood University, boasts a career resume that includes a career in a private medical practice that specialized in gastroenterology. He says that digestive ailments and mental health issues are often connected. Effective treatment for these patients means dealing with inter-related medical problems. Provider shortages may make that difficult. “Effective mental-health treatment requires a multi-faceted approach, often with both medication and therapy,” says Isgan. “In the years ahead, who’s going to do this?”

We welcome user discussion on our site, under the following guidelines:

To comment you must first create a profile and sign-in with a verified DISQUS account or social network ID. Sign up here.

Comments in violation of the rules will be denied, and repeat violators will be banned. Please help police the community by flagging offensive comments for our moderators to review. By posting a comment, you agree to our full terms and conditions. Click here to read terms and conditions.