Hi

Generally we know that ‘compliance’ for clients is a major objective of the M.H. system. But it is also true that the Feds (HCFA, etc.) have an agenda of ‘compliance’ to Medicare/Medicaid etc. regs. In this case who must comply = the 59 local mental health programs.

In CA things have come to where clients and family members participate in ‘Managed Care Oversite’, which is how state DMH enforces the Federal regs. I was recently at a training for how to use the Annual Review Protocol. I saw something which I wanted to report, which impressed me. It concerns Maria Maceira, who is (among many things) a moderator for this list, and Social Accountability Plank co-facilitator.

Question #15 under I. Quality Improvement now reads:

Is there evidence of annual training on client culture that includes a client’s personal experience?

The supporting text for compliance reviewers reads:

INDICATOR

MHP’s [that’s DMH jargon for the local M.H. Depts.] must have a process for the incorporation of client culture throughout the mental health system.

MEASURES:

Evidence of an annual training on client culture that includes a client's personal experience with:

• diagnosis/labeling
• medication
• hospitalization
• societal/familial stigma
• economic impact
• housing
• feeling different
• trauma
• culturally and linguistically incompetent services
• forced treatment

I stand amazed. I know that major reform of the system is not to be found in upgrading the Medi-Cal specialty mental health services compliance regs. But as dialogical outreach this one is truly impressive.

A special section of that training was devoted to presenting the Plan for culturally competent specialty mental health services, of which this was a component. The presenters were (1) Rachel Guerrero, who runs the Cultural Competency desk for state DMH, and .. Maria.

Way to go, Maria!

Respectfully

Andrew Phelps