The state of Kansas has made a decision to let outside agencies pause or delay the prescription of psychotropic drugs to patients and instead alter them with a state led metric in order to keep costs in check.
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Mental health drugs are different. Since 2002, state law has allowed Medicaid patients access to whatever behavioral health drugs their physician or psychiatrist sees fit to prescribe.
Gov. Sam Brownback’s administration wants to change that.
“What this all boils down to is money,” said David Wiebe, president of the Kansas Mental Health Coalition advocacy group and recently retired executive director of the Johnson County Mental Health Center.
“Our concern is, and always has been, that the best choice of drug therapy decisions are made between the prescriber and the consumer; not by someone who’s looking at a piece of paper somewhere saying, ‘No, you have to try this (drug) first because it’s cheaper,’” Wiebe said.
The state of Kansas contends that this move is to keep dangerous drugs out of the treatment of children with mental health issues; drugs that are often prescribed off-label and should be replaced with "other alternatives".
The session held before the senate featured 15 in opposition and 5 who spoke in favor of the bill.
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The committee’s chairwoman, Sen. Mary Pilcher-Cook, a Republican from Shawnee, set aside 20 minutes for the bill’s proponents, 20 minutes for its opponents and 20 minutes for questions.
The 15 opponents’ comments were each limited to about 90 seconds, while the five proponents were limited to four minutes.
“I’m sorry, but we have so many people who’ve signed up to testify that’s all the time we have,” said Pilcher-Cook, addressing a packed hearing room.
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The question of off label use of drugs, especially mental healthcare drugs has been a pressing one for many. To give an idea, above is pictured about 2 months worth of the treatment regimen for our son, age 15.
Kansas legislators, concerned about these treatments however, decided that the fact that the drugs are being dispensed is the problem - and that some form of alternate care provided outside of the doctor patient framework is preferred.
- See more at: http://www.khi.org/...
“The management of these medicines ultimately revolves largely around cost,” said Dr. Eric Atwood, a child psychiatrist with the Family Services and Guidance Center of Topeka. “This is a false economy, in my opinion, because what is saved on the medication level is only going to shift expense onto something else that is often more expensive.”
Atwood questioned the propriety of KDHE and KDADS officials asking legislators to repeal the current law without first explaining how mental health drugs would be prescribed under the new system.
“This is a very blunt instrument without a lot of – without any – forethought or planning on the specifics of how this would be managed,” he said.
Today, she said, six-day waits on prior-authorization decisions for physical health drug prescriptions through KanCare are not unusual.
Similar delays for mental health drugs, Gatewood said, would be disastrous.
“Most of my patients will not wait for their (mental health) medications,” she said. “They don’t know what prior authorization is; they don’t understand why they can’t be treated. They don’t have transportation.”
In an effort to pronounce concern over the treatment of children and others with "too much medication" the Kansas Senate is doing exactly what Republicans have been blaming President Obama with: chosing the medical care you get through political authority.
A panel, consisting of no doctors has made the decision that doctors in prescribing these medications aren't the final arbiter and the state should get between the patient and doctor.
For many - especially parents of special needs children, and those with significant autism related issues - all medications at this point are 'off label'. There are no 'on label' autism treatment medications, but medications exist which can help significantly control issues such as: Self Harming, Violent Agression toward others, Mania, Bipolar concerns, sleeping disorders, hyper sexualization, etc.
Mental Health advocates also voiced concern over those with Schizophrenia, those who 'hear voices' and suffer from PTSD and other conditions. The delay on reception of drugs, as well as deciding a state rubric on approved and non-approved drugs for treatment of a field where there are no cures instead only treatment presents complexities that the Kansas State Senators feel as though they have the right to decide without a medical degree.
Jim Denning (R-Sen District 8) voiced his concerns as well:
“Pre-authorization, that’s my biggest concern with the bill,” he said. “As a patient, it’s annoying for me to have to wait, but I have a car and I can come back. But with these patients, if there’s a 24-hour or six-day breakdown, in my district, they’ll overwhelm the Rainbow crisis center first; then they’ll overwhelm the jail second.”
What Sen. Denning leaves out of that equation will be those harmed and potentially injured who are not patients. And that problems go far beyond the patient themselves who will suffer the indignities of a system that puts them at risk for acts that might send them into the arms of law enforcement.