A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Rosie D.: Systemic Change Doesn’t Happen Overnight

Rosie D.: Systemic Change Doesn’t Happen Overnight

May 4, 2009

The Rosie D. v Romney lawsuit, settled in 2006, laid the groundwork for significant overhaul of the way Medicaid-eligible children with mental health needs receive services in Massachusetts. For many families, the change promised by the suit couldn’t come soon enough.

Nearly three years later, some of the systemic reforms are beginning to happen: Universal Behavioral Health Screenings in pediatrician offices are being given to more than 50% of children, doubling the rate of identification of behavioral health concerns; and 32 Community Service Agencies have been contracted to provide services across the state.

This afternoon, the Legislative Mental Health Caucus held an oversight hearing on Rosie D. implementation. Hosted by Representative Ellen Story, the hearing provided an opportunity for legislators to speak directly with DMH Commissioner Barbara Leadholm, Children’s Behavioral Health Initiative (CBHI) Director Emily Sherwood, and Suzanne Fields, Director of Behavioral Health Services for MassHealth.

Several legislators were in attendance, and all are actively engaged in the Rosie D. implementation process, asking insightful and sometimes pointed questions.

Representative Mary Grant expressed concern about the seeming “cookie cutter” approach to service development and the impression that CBHI will be focused at the most severely emotionally disturbed children, effectively ignoring a large population. Suzanne Fields clarified that the services will not be focused exclusively on “high-end” kids; rather, they are meant for all MassHealth children.

Taking it a step further, Representative John Scibak said that he would like to see the CBHI model expanded further to encompass GIC and Commonwealth Choice young people as well. Commissioner Leadholm responded saying that she has been in talks with private insurers to see if there is a way that they will offer the CBHI services as part of their coverage. Leadholm said that she expects to be able to show data that demonstrates the cost effectiveness of the services.

One major theme of the hearing was that public awareness is key – major changes are coming over the next six months as a range of services will be rolled out. Unfortunately, a significant number of people have no idea what’s in store.

Information is available online through EOHHS.
Matt Noyes