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Welcome to Unlimited Parenting, where we discuss having children with disabilities or special

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health care needs.

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I'm Allison, and with me today is Children's Mental Health Advocate, Brittany Shipley.

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She's here to help guide us through some of the changes to the Idaho Behavioral Health

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Plan.

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Before we get into our questions, Brittany, I was hoping you could explain your why.

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What brought you into your role?

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I have children with disabilities, and most specifically my oldest has behavioral health

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conditions.

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In navigating his systems, I realized early on that it came down a lot to who you know

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and what you know.

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As I continued to navigate it, it didn't always matter that I was told a lot that, will you

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have the skills, you're a social worker, you should know how to help your child.

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I remember being told early on that we think you can manage it.

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Even when he needed the highest level of care and had been approved for the highest level

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of care, when my child was being denied from facility after facility because of the level

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of danger he was, because he was a danger to himself and others, and facilities felt

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like he was not someone that they want to take on and have around the other children

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in their place.

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I was told, you know, we think you can handle it, and we believe you can, and you have the

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skills and the knowledge and the training, but I was a single parent with another child

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in the home.

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And I was his primary target as his only parent because his father had died when he was young.

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And so I remember having to advocate and fight.

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And so something I've said continually since he was young is if this is happening to me

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and I understand the system, then it's happening to everybody.

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And I don't want to see other parents who don't know the system and understand it get

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lost in this and feel like they don't have options.

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And so I want to help those other parents feel like they have those choices and understand

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it and have hope and help those children get the help they need and help those families

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get the help they need and not get stuck.

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Sometimes if they can get help sooner, then they have better options of being productive

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members of their society and of their home and be able to remain in their home and society.

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But sometimes they need bigger help and that's okay.

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But if we all don't at least be presented with the right options, then we're never ever

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going to get there.

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So it really takes a really strong person to be that guiding hand for everybody else.

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Not just it's not that you've been through it and you're helping people.

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It's that you're continuing to go through it and yet you still choose to help people.

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So not only are you instrumental in all the work we do here at iPoL, but you're out there

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essentially at some point door knocking, helping families, individual families holding their

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hand through the system.

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So I just wanted to add that in that we see you and we appreciate you.

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But I also want to add that just so that listeners know that you really are entrenched in systems

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and services.

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You're not just going through the systems yourself.

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You are not just helping families, but you're in the meetings.

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You're in the room where it happens to make a Hamilton reference, right?

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You know the players at the table and you continuously make yourself and your voice

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known.

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So is that a fair representation of what you're doing?

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Thanks, Allison.

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Yeah, I mean it is true.

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I do think that's huge and I guess despite being at the table with the key players, right?

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I do co-chair some of the mandated meetings for the Youth Empowerment Services, the JEPHTI

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Settlement Agreement, which is what resulted in the Youth Empowerment Services for Children's

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Mental Health in Idaho.

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And so in co-chairing them with the Director of Behavioral Health in Idaho, while I sit

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at the table with him and stuff, my goal isn't to talk about my story, but to talk about

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like families.

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And sometimes I joke when I'm in those meetings about like, I know you've all heard me say

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this a million times or I feel like I'm beating a dead horse here.

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Because I'll make arguments about like, parents say this or parents feel like this or families

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this or I myself live in a rural community.

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And so I am frequently in those meetings.

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I know Allison's heard me say this.

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I talk about like, okay, well, what about the rural and frontier communities?

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Because if people in the urban communities can't get it, what about these areas?

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Or if we're talking about these services, then let's talk about how it's accessible

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in these areas or if we're looking at children with the lower scores on a CAHMS, let's talk

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about the higher scores.

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How are they getting this now?

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And so my goal is to always represent all those needs.

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And I know another reference I use a lot is to your exact point about, you know, supporting

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others and, you know, taking a village kind of thing.

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But when you're navigating something for a child in crisis, it feels like you're drowning.

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And so most families can't keep their head above water when they're drowning.

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And that's realistic.

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And it's hard.

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And so sometimes at any time when there's a couple of us who can keep our head above

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water, then it's our turn to help those who can't.

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Because it's a lot.

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It's a lot when your kid's in crisis, you're in crisis, then too, you're down there with

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them.

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And so if you have the capacity, if you're one of those few who can keep your head above

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water while drowning and kind of steer that ship for the others, then, you know, it's

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your time to hold the baton and help advocate for those who can't.

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Absolutely.

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And there's always room for those people.

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If you're listening and you're one of those people, you know how to reach out to us.

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It'll be in the description box.

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If you want to help, we are actively searching for people who want to support.

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But it's okay with you.

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I'll pivot.

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And I want to ask you our first question.

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And these are questions, not only that.

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I personally have, as a parent of a child with a serious emotional disturbance, but

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also questions that I have heard from parents in our community, whether that's on a Facebook

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group or a call that I have gotten or that one of my coworkers have gotten.

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So these are genuine questions from real parents.

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And that's the lens that I suppose we'll be taking throughout the rest of these.

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So question number one, why, why, why are we doing this?

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Like we had Optum, we've had the, you know, Jephthie lawsuit, like you said, has been

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happening since the eighties.

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Why are we making the switch from Optum to Magellan?

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So that is like the biggest question.

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Everybody's mind.

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Why?

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And I think it's a good question.

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So as many people may or may not know, obviously the Jephthie settlement agreement resulted

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after, because the lawsuit has been going on now for 44 years.

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That's a really long time.

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However, the settlement agreement only happened 10 years ago.

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And so the settlement agreement occurred as a way of saying, hey, you know, we're still

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not being compliant with providing these kids the services they need.

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And so when all that happened was around the same time that Optum came into play.

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And when Optum received their contract, they've been around for 10 years.

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And so how that happens is similarly to if you are in like a construction industry.

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I think that's a really another good example for people who are, you know, maybe not in

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kind of the mental health fields or other things like that.

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Contracts have to get put out.

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And so from any state agency, contracts have to get put out for a service.

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And so when a contract is put out, whether it's like to rebuild a highway or for a large

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construction project, this is another large project, right?

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We're looking at providing behavioral health services to the entire state.

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So a state agency put out a contract.

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And so then there is bids and there's a large, very complex process that goes through with

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reviewing the bids.

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And then there is a awarding process that goes through with scoring.

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And whoever has the highest scores is who wins that contract.

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And so then the previous contract awardee was Optum.

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And so that was who had won the contract.

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Optum's contract was renewed down the line.

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So Optum held it for 10 years.

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And that's who everybody has known.

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I think whenever we look at transitioning contracts, it's scary.

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Anything new is scary.

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However, a few years ago, when it was time to put out bids for new contracts, we went

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through the same formal process.

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Many people have heard a lot about this process as there were some, you know, heated differences.

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Optum had put in for renewal again, as did Magellan and as did Beacon.

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Optum was not awarded.

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Magellan actually came in as the highest bidder.

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However, there were some differences found as they had been working with some people

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in the department on some either previous things.

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So they were found to not be able to win or not be eligible, I think is the best way to

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put that.

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And so Magellan was the highest scorer.

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And so that's to keep it as ethical as possible.

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It has to go to the highest scorer.

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It is not about any individual entity for anything, right?

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It's not about just behavioral health.

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It's just how contract bids are done, period, from state agencies.

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So we now have Magellan.

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And I think, like I said before, I think anything new is scary, but sometimes new can be really

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good too.

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And so it's not to say that Optum ever did a bad job.

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It's just we have to follow protocol whenever it's a large contract bidding process.

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That makes a lot more sense because I think a lot of families might have thought, oh,

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you know, what did Optum do wrong, right?

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To now have to switch to Magellan.

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And so I think it's really helpful to hear that it's not about really anybody doing anything

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wrong or doing anything right.

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It's following the processes that we have in place to make sure things don't slip through

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the cracks and that we are, as a state, providing the best services to everybody that we can

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possibly can through a scoring system.

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So I think that that's really helpful.

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And I just want to say, you know, Magellan is having those listening sessions for parents

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where they were seeking that information and input.

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So it's not, you know, a new guy coming in trying to shake up and change everything.

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It's just how do we provide the best to everybody?

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Now that I mentioned shaking things up and changes, do you, and again, I want to just

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point out, you know, Brittany is not a Magellan employee.

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She's a parent just like the rest of us, but she is at these tables.

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So do you know if there's going to be any changes or effects on the assessments that

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our kids get for this system?

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You know, the comprehensive diagnostic assessment, the CDA or the CANS tool that we use?

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Are there any big changes now?

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So there will be some changes, but nothing super significant because a lot of those things

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are requirements of that settlement agreement.

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So a lot of that stuff is printed out and those are just requirements we have to follow.

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And so, for example, with our, you know, CANS tool that we use, those are done every 90

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days.

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That's not, that won't change.

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Now with the caveat that they are done every 90 days or as needed, right?

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If there is a significant life change, if your child goes into an acute care center

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after having a crisis, that is a significant life change.

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Your child may need another CANS.

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So when we look at it from that perspective, they're probably going to have more than every

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90 days.

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But, and your CDA is done annually.

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Again, traditionally, if your child maybe was in a residential placement and returns

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home, they're probably going to have one sooner than that one year mark because you're adjusting

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back to a home setting and you're probably going to want one to say, okay, let's look

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at what our new goals are going to be and how is this look in our home and community

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environment.

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That being said, your yearly CDA, your, you know, average CANS, those things will remain

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and they're still going to be following all of those traditional protocols.

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I would add though, we are looking at rolling out the Department of Health and Welfare's

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Division of Behavioral Health has a TCOM Division, which is what oversees the CANS and we're

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working on rolling out the CANS 3.0 and they have a lot of parent involvement in that.

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In fact, we're working with Allison to get her parent voice involved in that as well.

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And I think that's really important to note because I don't know how many families out

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there have maybe not had the best experience with the CANS in the past, but those who have,

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we really wanted to remove some of that not strength-based, non-trauma or, and the trauma

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portions of it because sometimes those don't go as planned.

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And when that happens, that was never the goal, right?

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The CANS is meant to be a strength-based assessment of your child's needs and strengths, right?

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So when they don't go that way or if the emphasis is more on the kid's behaviors, things like

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that.

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So the launch of the CANS 3.0 is happening tangentially with the launch of Magellan,

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but this is meant to be a good thing.

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And there has been a lot of parent involvement behind the scenes of this with a lot of training.

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And Dr. Lyons, who's actually the inventor of the CANS has been working really hard with

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the Idaho team on this.

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And that's something we're actually really excited about as it will really work with

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the families and with the children.

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And it actually is going to shorten the CANS significantly.

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So it won't be so long.

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It will actually remove that whole section on behaviors.

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So while I know that might sound daunting, I know even myself at first was like, well,

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hang on, I'm a really high behavioral kid.

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But you need to know that the reality is, as anybody who does a CANS to fidelity, there's

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a whole narrative section under each part.

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And so when they're scoring it and talking and engaging with you as it should, it should

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feel like a conversation and not a test, then they're going to collect that data and it's

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going to be reflected.

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And so I'm really excited.

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So yes and no, they should still happen in the same amount of time that they were happening.

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However, the CANS will change, but for the better, we believe.

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And well, first off, I'm really excited to hear all of that.

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And the Department of Health and Welfare has also released a YouTube, a short YouTube video.

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It's just under four minutes on some of the updates for the new CANS.

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And we do have that shared on I-Pulse Facebook page.

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And it's linked also through the Department of Health and Welfare.

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I love the update.

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It's included about asking about access to technology to see if telehealth is a potential

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option.

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It's ushering into the 20th century, right?

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We talk about our rural frontier communities.

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There's not a lot of access, but we still have the onus on us to provide those services.

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So what creative out of the box things are we trying?

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And another thing that I think you touched on that I really liked is that the strengths

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are going to come first now instead of the needs or the deficits.

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We're going to talk about...

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And especially, and when I think about my son and doing those assessments with him,

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he's still present during those first few minutes.

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He kind of gives his report and then maybe he saunters off, but sometimes he stays.

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And when he stays and he hears us talk about needs first, it sets a whole different tone

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versus when he stays and we move right to strengths and the things that he loves and

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he does well and how we love having him in our family.

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And I think that that's how you can tell that they really got that parental input from us,

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right?

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00:16:07,920 --> 00:16:08,920
Yes.

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So I'm very excited about the CANS 3.0.

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I could not agree any more, Alithin.

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And I think so many parents I've engaged with over the years and even sometimes like school,

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social workers, anybody, the amount of parents that didn't know things about it were wild,

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right?

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I know for myself, right?

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If I took my child into the CANS, just like you were saying, we'd get to some questions

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and it was an instant trigger.

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And then we would leave and I would be leaving with my child who was then aggressive, who

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was then trying to hit me in the car, who was then all these things.

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And so to your point, right, having strengths first changes it.

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But I also think it's important that parents know that if there's going to be a question

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that you know is a trigger, you have the right to say, hey, to the provider, I think a couple

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of these questions I need to talk to you about away from my child.

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And that is your right.

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And that's okay.

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Because if you can't have that discussion in front of your kid without it triggering

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them and upsetting them and setting you away with an unsafe kid, that's not beneficial.

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00:17:11,320 --> 00:17:14,880
Or if you have to sit there with your child and not answer them to fidelity, you're not

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helping get a true assessment for your child to help your child either.

275
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And so knowing those rights to get a true CANS is huge.

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So now there's this really cool infographic so parents understand all that too.

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Absolutely.

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So I know as you can hear bigger, better, brighter changes on the horizon for sure.

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00:17:35,920 --> 00:17:43,040
Moving away from the CDA and the CANS tool off to another aspect is have you heard anything

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00:17:43,040 --> 00:17:50,360
about it affecting anyone's copay or does Magellan have any effect on what parents pay

281
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for the service?

282
00:17:51,480 --> 00:17:55,200
I have not heard about any changes regarding that.

283
00:17:55,200 --> 00:17:59,480
It should remain the same as the identified sliding scale.

284
00:17:59,480 --> 00:18:04,560
And just as a reminder, if people haven't noticed, I believe it's always printed on

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the back page.

286
00:18:05,880 --> 00:18:10,880
So if you flip it over and if it is a hardship to pay the copay on the back page, if you

287
00:18:10,880 --> 00:18:18,640
flip it over, there is a notice about being able to say and return it for a lowered cost

288
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or if it's a financial hardship on your family.

289
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And so I think just keeping in mind that that is an option because sometimes times are hard

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or you go through something that maybe you weren't when you were paying your copay.

291
00:18:30,680 --> 00:18:34,840
But the sliding scale copay should remain if you fall in that category.

292
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Okay, perfect.

293
00:18:36,120 --> 00:18:39,240
So a lot of things are going to stay the same.

294
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There's not a big huge effect on families on day one, it sounds like.

295
00:18:45,080 --> 00:18:51,720
So another question I've been hearing a lot is, I think of when I go to the doctor and

296
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my insurance changes and then now all of a sudden I have select health and this provider

297
00:18:57,040 --> 00:19:00,960
doesn't take select health, but they did take UnitedHealthcare or whatever the case may

298
00:19:00,960 --> 00:19:01,960
be.

299
00:19:01,960 --> 00:19:08,580
So now that we're moving and we all have Magellan now, do all of our providers just naturally

300
00:19:08,580 --> 00:19:14,400
accept Magellan because it was optimum, but we didn't make the change ourselves.

301
00:19:14,400 --> 00:19:16,400
It was given to us.

302
00:19:16,400 --> 00:19:18,120
Am I asking this correctly?

303
00:19:18,120 --> 00:19:21,720
Are all providers just naturally going to start accepting it?

304
00:19:21,720 --> 00:19:22,720
Nope.

305
00:19:22,720 --> 00:19:25,600
And that has been a huge question and that's a really good one.

306
00:19:25,600 --> 00:19:28,120
So there's two parts to this.

307
00:19:28,120 --> 00:19:33,100
Many providers have opted to sign a contract to transition to Magellan.

308
00:19:33,100 --> 00:19:35,400
Now that doesn't mean all of them have.

309
00:19:35,400 --> 00:19:37,640
And that could be for various reasons.

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00:19:37,640 --> 00:19:44,880
Maybe they need to up their licensures and maybe their licensures need to be renewed

311
00:19:44,880 --> 00:19:46,840
first before they could sign their contract.

312
00:19:46,840 --> 00:19:48,920
That's something we heard from some providers.

313
00:19:48,920 --> 00:19:51,800
And so that could cause a delay, things of that nature.

314
00:19:51,800 --> 00:19:56,280
Or maybe they opted to not renew their Medicaid eligibility at all.

315
00:19:56,280 --> 00:19:58,360
And so then there might be a gap.

316
00:19:58,360 --> 00:20:00,880
If that happens, now we do know lots to be clear.

317
00:20:00,880 --> 00:20:05,520
We do know that the majority, at least last I heard, had renewed their contracts or had

318
00:20:05,520 --> 00:20:07,940
signed onto a contract with Magellan.

319
00:20:07,940 --> 00:20:11,320
So I do not foresee there being a huge gap.

320
00:20:11,320 --> 00:20:13,240
Now that doesn't mean there's not a gap.

321
00:20:13,240 --> 00:20:18,840
If there is a gap for those that fall into that, if your provider did not, Optum has

322
00:20:18,840 --> 00:20:23,500
extended a 90-day grace period, which I think is phenomenal, right?

323
00:20:23,500 --> 00:20:28,000
Because that gives you a comfort to know that for the next 90 days, I don't need to panic.

324
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I can still go see my provider for medication management, for counseling, for whatever it

325
00:20:33,720 --> 00:20:39,320
may be that I was receiving while I search for WANDOTs now in my network.

326
00:20:39,320 --> 00:20:43,320
I think additionally, what's important to note to help you so that it doesn't need to

327
00:20:43,320 --> 00:20:44,560
feel like it's on you.

328
00:20:44,560 --> 00:20:49,720
You don't need to be calling around and just randomly trying to feel like you are overwhelmed

329
00:20:49,720 --> 00:20:53,480
trying to find your child a new provider to take over everything.

330
00:20:53,480 --> 00:20:58,400
That hotline you used to call for Optum, the number that was on the yes side or that was

331
00:20:58,400 --> 00:21:03,440
on the Optum line that you may have had saved, that is the same number that you would now

332
00:21:03,440 --> 00:21:04,820
call for Magellan.

333
00:21:04,820 --> 00:21:08,000
It seamlessly transitioned over as of yesterday.

334
00:21:08,000 --> 00:21:12,840
So I think that's really important to note is that that number that was previously Optum's

335
00:21:12,840 --> 00:21:14,880
is now Magellan's.

336
00:21:14,880 --> 00:21:17,680
You can find that on the Magellan site or on the yes site.

337
00:21:17,680 --> 00:21:21,720
In addition, you should have also received packages in your mail from Magellan for your

338
00:21:21,720 --> 00:21:23,640
children during this transition.

339
00:21:23,640 --> 00:21:25,240
So that would be there as well.

340
00:21:25,240 --> 00:21:30,680
I will say that I did just get that package in the mail last night, actually.

341
00:21:30,680 --> 00:21:38,040
I've been looking for it and I think it was really important to me to see the list of

342
00:21:38,040 --> 00:21:43,960
things that were going to stay the same and what they were and how it was very much a

343
00:21:43,960 --> 00:21:45,720
release of tension in my shoulders.

344
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Like, okay, we got this.

345
00:21:47,320 --> 00:21:54,040
It's still very much the same and there are basically protections in place to help us

346
00:21:54,040 --> 00:22:00,200
navigate through this if our provider does choose to go a different direction.

347
00:22:00,200 --> 00:22:01,800
Where can we go now?

348
00:22:01,800 --> 00:22:04,120
And I think that that was really important.

349
00:22:04,120 --> 00:22:09,640
Again, this is just harkening back to the ending of the public health emergency.

350
00:22:09,640 --> 00:22:15,280
We don't want individuals to realize that they're no longer covered when they get to

351
00:22:15,280 --> 00:22:21,300
their doctor's office or when they get to the Walgreens to pick up their medications

352
00:22:21,300 --> 00:22:22,300
all of a sudden.

353
00:22:22,300 --> 00:22:25,580
It's like, oh, you don't have coverage anymore.

354
00:22:25,580 --> 00:22:31,480
Remember always to reach out to your doctors to update that information with the Department

355
00:22:31,480 --> 00:22:35,920
of Health and Welfare so that we can get these packets mailed to you so that you can get

356
00:22:35,920 --> 00:22:37,960
this information.

357
00:22:37,960 --> 00:22:42,920
Just a little public service announcement, a constant reminder.

358
00:22:42,920 --> 00:22:48,240
I want to shift gears again and ask, and I know that you'll be a good person to ask as

359
00:22:48,240 --> 00:22:55,440
an individual who does live in a more rural area and not the great state of ADA.

360
00:22:55,440 --> 00:23:01,960
So with Magellan coming in, does it mean there are going to be any different services provided

361
00:23:01,960 --> 00:23:04,860
in Idaho that weren't previously?

362
00:23:04,860 --> 00:23:09,140
And I'm mostly asking about those rural and frontier areas.

363
00:23:09,140 --> 00:23:12,400
Is there a plan for more access there?

364
00:23:12,400 --> 00:23:17,240
So in my conversations with Magellan, that is something that we have continually worked

365
00:23:17,240 --> 00:23:18,440
to remind them.

366
00:23:18,440 --> 00:23:24,600
And that is something that they have continually been aware of and providing.

367
00:23:24,600 --> 00:23:28,120
I do think it will take time.

368
00:23:28,120 --> 00:23:32,840
I think we do know that they took over on July 1, but that doesn't mean that July 1

369
00:23:32,840 --> 00:23:35,680
everything is going to be readily available in every area.

370
00:23:35,680 --> 00:23:39,440
I think some of it might take time to build up, but I will say that I have hope that it

371
00:23:39,440 --> 00:23:41,920
will happen.

372
00:23:41,920 --> 00:23:46,840
I believe one of the things that they are saying that they are really, really working

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00:23:46,840 --> 00:23:52,800
on doing is making sure that certain intensive services like intensive care coordination

374
00:23:52,800 --> 00:23:58,320
or wraparound are readily connected and available for children with those intensive needs right

375
00:23:58,320 --> 00:23:59,320
away.

376
00:23:59,320 --> 00:24:00,720
The second that is identified.

377
00:24:00,720 --> 00:24:06,600
So if we're looking at a child who's showing up in emergency rooms or Christ youth crisis

378
00:24:06,600 --> 00:24:14,040
centers or they're having a provider fill out referrals for intensive residential or

379
00:24:14,040 --> 00:24:18,720
psychiatric residential facilities, those kinds of levels of care, their goal is to

380
00:24:18,720 --> 00:24:23,840
immediately if they already don't have an intensive care coordinator or wraparound coordinator,

381
00:24:23,840 --> 00:24:26,280
that they will immediately be referred for one.

382
00:24:26,280 --> 00:24:30,920
And so I think it might take time to build up if that built up is not already in place.

383
00:24:30,920 --> 00:24:34,400
I think that will be determined over the next several weeks or month.

384
00:24:34,400 --> 00:24:39,920
But the fact that that will be an immediate referral is something that hasn't quite happened.

385
00:24:39,920 --> 00:24:44,800
And I would believe that that is something that has demonstrated an intense need, especially

386
00:24:44,800 --> 00:24:49,040
in the last several years as we're seeing a youth behavioral health crisis, not just

387
00:24:49,040 --> 00:24:53,600
statewide but nationwide, it has demonstrated a need for something like that in place.

388
00:24:53,600 --> 00:24:59,960
And so I know myself, I have really advocated to say that that has been needed in urban

389
00:24:59,960 --> 00:25:05,560
areas and so that is immensely needed in rural areas because in rural areas myself, it's

390
00:25:05,560 --> 00:25:08,880
been in my child's plan for years and we've never seen it.

391
00:25:08,880 --> 00:25:14,160
And so you can tell us it's needed, but you're going to have to really build that trust with

392
00:25:14,160 --> 00:25:18,000
families because just to have it in their plan and they never seen it, you're going

393
00:25:18,000 --> 00:25:21,200
to have to really build that trust so that they know it's there.

394
00:25:21,200 --> 00:25:27,560
And I know I have really, really expressed that to their new CEO, their medical team,

395
00:25:27,560 --> 00:25:32,600
and I just have faith that they have really heard us in that and that they're really going

396
00:25:32,600 --> 00:25:37,220
to push for that because everything I've seen shows that that is something they're prioritizing.

397
00:25:37,220 --> 00:25:45,700
They are working to also have a crisis response team and they're trained to actually also

398
00:25:45,700 --> 00:25:48,900
support youth, which is something we've never had before.

399
00:25:48,900 --> 00:25:53,680
Now their mobile crisis teams, they're starting out with only three for the entire state.

400
00:25:53,680 --> 00:25:57,260
So I don't want to give everybody false hope that they're going to be very responsive to

401
00:25:57,260 --> 00:26:01,060
everybody right away, but I do want to tell you that they are trained for youth.

402
00:26:01,060 --> 00:26:04,920
So if they are able to respond to your youth, I do want you to know that they are trained

403
00:26:04,920 --> 00:26:08,960
for youth and I think that that in itself is a huge starting point.

404
00:26:08,960 --> 00:26:13,960
And over the course of the year, they will be 24 seven and that also is huge, not just

405
00:26:13,960 --> 00:26:15,460
nine to five business days.

406
00:26:15,460 --> 00:26:21,140
So I think we're working in the right direction and Idaho is a very large state that is very

407
00:26:21,140 --> 00:26:22,360
spread out.

408
00:26:22,360 --> 00:26:26,200
And so we're starting out small and we're working to get to where we want.

409
00:26:26,200 --> 00:26:31,240
I think that that's huge, especially like you were mentioning a mental health crisis

410
00:26:31,240 --> 00:26:36,680
isn't always going to happen at 3 p.m. on Tuesday and sometimes the emergency room isn't

411
00:26:36,680 --> 00:26:38,340
the best place.

412
00:26:38,340 --> 00:26:44,740
So the fact that there's a lot of steps being taken is just huge and I hope that Idaho families

413
00:26:44,740 --> 00:26:47,540
see hope in this.

414
00:26:47,540 --> 00:26:52,200
Another thing that I wanted to ask that I think a lot of that I feel and maybe I'm just

415
00:26:52,200 --> 00:26:57,320
putting words into parents' mouths, but I don't think it's really quite known yet is

416
00:26:57,320 --> 00:27:04,760
that Magellan is now going to be overseeing inpatient and outpatient care and what benefit

417
00:27:04,760 --> 00:27:08,080
is that going to have or what does that mean for our families?

418
00:27:08,080 --> 00:27:12,060
This is another big, looming question to your point.

419
00:27:12,060 --> 00:27:18,760
I will tell you from my perspective, this is the most exciting thing about this contract

420
00:27:18,760 --> 00:27:21,920
and I think a lot of people don't understand that, but this is why.

421
00:27:21,920 --> 00:27:25,000
So most states do this already.

422
00:27:25,000 --> 00:27:29,720
Most states, when they have a behavioral health contract awardee, they manage inpatient and

423
00:27:29,720 --> 00:27:36,200
outpatient and the reason being, so previously Optum was in charge of all outpatient care

424
00:27:36,200 --> 00:27:39,520
and outpatient should be your first line of defense, right?

425
00:27:39,520 --> 00:27:42,360
You want to think of it like early intervention.

426
00:27:42,360 --> 00:27:44,840
We know that early intervention is best practice.

427
00:27:44,840 --> 00:27:46,840
We get in there while children are young.

428
00:27:46,840 --> 00:27:51,240
We really provide them with those critical skills to help get their language developed,

429
00:27:51,240 --> 00:27:55,880
all these things that foreseeing delays young because we know that that is best practice

430
00:27:55,880 --> 00:28:00,880
and that can help bolster them and get that in there while their brain is still malleable.

431
00:28:00,880 --> 00:28:05,100
So if we do that, we know what this shows.

432
00:28:05,100 --> 00:28:07,980
So the same thing with behavioral health care.

433
00:28:07,980 --> 00:28:11,520
If we can do it in their home and community, it shows that it's best, right?

434
00:28:11,520 --> 00:28:13,560
The goal is to not institutionalize.

435
00:28:13,560 --> 00:28:16,840
So home and community services, if we can really bulk them up, really build them up

436
00:28:16,840 --> 00:28:21,880
and do all these things, we can try to prevent any institutionalization.

437
00:28:21,880 --> 00:28:23,700
Now we know that's always possible.

438
00:28:23,700 --> 00:28:26,040
Sometimes somebody does need that level of care.

439
00:28:26,040 --> 00:28:30,500
Can't always prevent it, but we'll do the best we can if we can build up those services.

440
00:28:30,500 --> 00:28:37,680
So when you have separate, when there's a big separation between inpatient and outpatient,

441
00:28:37,680 --> 00:28:43,220
there is no onus on the person who provides the outpatient care to bolster and provide

442
00:28:43,220 --> 00:28:44,220
all those services.

443
00:28:44,220 --> 00:28:48,960
Because if they don't and somebody who continues to get need those services and they're not

444
00:28:48,960 --> 00:28:53,160
getting them in the outpatient, well, the onus isn't on them to provide it.

445
00:28:53,160 --> 00:28:57,280
Because if they don't, all right, well, we'll just kick the can down the road because the

446
00:28:57,280 --> 00:29:02,320
onus falls on now a different division, a different agency to provide that really high

447
00:29:02,320 --> 00:29:08,440
level expensive care of institutionalization of 20, $30,000 a month when the individual

448
00:29:08,440 --> 00:29:09,880
is now in need of that.

449
00:29:09,880 --> 00:29:16,000
So now that individual is at risk of institutionalization, which is not where we wanted them to be,

450
00:29:16,000 --> 00:29:19,480
but they didn't get that earlier intervention that could have helped prevent that.

451
00:29:19,480 --> 00:29:23,800
All those tools, all those skills, now they're at the level of institutionalization because

452
00:29:23,800 --> 00:29:28,180
they didn't get that other service or services likely.

453
00:29:28,180 --> 00:29:32,400
So now they need this highest level, highest cost, highest risk.

454
00:29:32,400 --> 00:29:33,400
And here they are.

455
00:29:33,400 --> 00:29:34,580
And now it's harder to reintegrate.

456
00:29:34,580 --> 00:29:36,920
It's harder to all these things.

457
00:29:36,920 --> 00:29:38,580
It's a trickle down effect.

458
00:29:38,580 --> 00:29:40,720
And like we just said, it's extremely costly.

459
00:29:40,720 --> 00:29:44,080
Another reason nobody wants that on top of that, right?

460
00:29:44,080 --> 00:29:48,920
At least nobody from that standpoint, no agency wants to fund it, nor do we want our children

461
00:29:48,920 --> 00:29:50,600
there unless we have to.

462
00:29:50,600 --> 00:29:56,920
So if it's all under the same umbrella, the onus is on them to provide those earlier services,

463
00:29:56,920 --> 00:30:00,520
to help keep in the home, to help support the family, to help support the child and

464
00:30:00,520 --> 00:30:06,680
youth because then they can save themselves money also by not having to spend 20, 30 plus

465
00:30:06,680 --> 00:30:09,960
a month, 30,000 a month to send a child away.

466
00:30:09,960 --> 00:30:11,280
They can help keep them in the home.

467
00:30:11,280 --> 00:30:13,040
They can help support the family.

468
00:30:13,040 --> 00:30:18,660
They can help keep people together and provide the necessary services to really support somebody.

469
00:30:18,660 --> 00:30:22,800
And then when we have those outliers who truly, really do need that intervention despite it

470
00:30:22,800 --> 00:30:25,040
all, it makes sense to support it.

471
00:30:25,040 --> 00:30:27,280
But we'll still try to keep everybody together because guess what?

472
00:30:27,280 --> 00:30:28,920
The onus is on them the whole time.

473
00:30:28,920 --> 00:30:33,800
So it's essentially just to check the checker, right?

474
00:30:33,800 --> 00:30:36,520
So don't forget, either way, you're paying for it.

475
00:30:36,520 --> 00:30:40,960
So it behooves you to start early and be more supportive.

476
00:30:40,960 --> 00:30:46,040
So it's just another way to benefit families in the end and for the kids.

477
00:30:46,040 --> 00:30:52,840
And family blame may still happen, but in my experience, family blame is less likely

478
00:30:52,840 --> 00:30:57,880
to happen when you have the same players involved in that family circumstance the whole time

479
00:30:57,880 --> 00:31:00,440
because they see this family really is trying.

480
00:31:00,440 --> 00:31:01,720
We're working with them the whole time.

481
00:31:01,720 --> 00:31:06,480
We're working with them to provide the services versus this family is getting passed around

482
00:31:06,480 --> 00:31:10,440
this whole time from this agency to this agency to this agency.

483
00:31:10,440 --> 00:31:12,560
And then the family often gets blamed.

484
00:31:12,560 --> 00:31:16,480
But if they're all engaged the whole time, they know that that family is trying.

485
00:31:16,480 --> 00:31:19,760
Oh, I mean, the change is going to be good.

486
00:31:19,760 --> 00:31:24,000
I think if you take away nothing from that question, the change is going to be good and

487
00:31:24,000 --> 00:31:26,400
it's going to be helpful.

488
00:31:26,400 --> 00:31:32,500
I think the last question I have is parents are going to have questions.

489
00:31:32,500 --> 00:31:38,040
We're going to want to learn more, maybe even potentially express concerns that we might

490
00:31:38,040 --> 00:31:39,040
have.

491
00:31:39,040 --> 00:31:45,960
Do you know of any upcoming opportunities where parents can share their voice?

492
00:31:45,960 --> 00:31:51,480
So at this exact moment, just because at the very beginning of their launch, they haven't

493
00:31:51,480 --> 00:31:53,600
put forth their next listening sessions.

494
00:31:53,600 --> 00:31:54,600
Okay.

495
00:31:54,600 --> 00:31:58,600
However, Magellan has made it very clear that they do want public engagement.

496
00:31:58,600 --> 00:32:03,000
They want to continue hosting engagement and family listening sessions.

497
00:32:03,000 --> 00:32:08,600
So I would be more than happy to share those with you as soon as I see the next engagement

498
00:32:08,600 --> 00:32:09,600
opportunities.

499
00:32:09,600 --> 00:32:17,720
They do have publicly on their website, Magellan of Idaho under the, which section is it?

500
00:32:17,720 --> 00:32:20,920
The Magellan of Idaho, it's the member section.

501
00:32:20,920 --> 00:32:27,480
They do have on there the ways that you can provide feedback, ask questions, file a complaint

502
00:32:27,480 --> 00:32:29,080
or a concern.

503
00:32:29,080 --> 00:32:33,360
And I just want to highly encourage people that if you have questions, put them in there.

504
00:32:33,360 --> 00:32:36,360
They're really responsive.

505
00:32:36,360 --> 00:32:42,680
I mean, I engage with their staff all the time and I get prompt responses at all hours.

506
00:32:42,680 --> 00:32:44,880
I think they're amazing.

507
00:32:44,880 --> 00:32:50,360
Additionally, because we're talking about kids who fall under the yes system of care,

508
00:32:50,360 --> 00:32:56,400
under the yes website, you can find a spot to file complaints or concerns.

509
00:32:56,400 --> 00:33:01,120
And I really want to emphasize that also because I think when the word complaints gets used,

510
00:33:01,120 --> 00:33:03,160
people are like, oh no, I don't want to file a complaint.

511
00:33:03,160 --> 00:33:05,160
I don't want to be that person.

512
00:33:05,160 --> 00:33:09,600
But the reason I really want to emphasize that one is because the yes system of care

513
00:33:09,600 --> 00:33:15,720
is a result of an ongoing lawsuit from the Jeff D. Sublimen agreement.

514
00:33:15,720 --> 00:33:20,000
Anything that is filed through there has to be looked into and it is sent over to the

515
00:33:20,000 --> 00:33:21,660
due process work group.

516
00:33:21,660 --> 00:33:25,540
And so those things are actually, something happens to it.

517
00:33:25,540 --> 00:33:29,240
It's not like they're just sent into a black hole and you have a voice in there, right?

518
00:33:29,240 --> 00:33:32,240
You can check a box that says, I don't want to be contacted.

519
00:33:32,240 --> 00:33:33,240
I want to be anonymous.

520
00:33:33,240 --> 00:33:38,640
I don't want, or I do, or, and you can have an advocate file on your behalf.

521
00:33:38,640 --> 00:33:41,880
I file for families all the time who don't want their name in there.

522
00:33:41,880 --> 00:33:46,480
You have a lot of options, but if it has to do with anything in the yes system of care,

523
00:33:46,480 --> 00:33:51,320
I cannot emphasize enough using that site because that means it has to be looked into

524
00:33:51,320 --> 00:33:55,960
because if it's happening to you, if it's happening to somebody else, and then we can

525
00:33:55,960 --> 00:33:59,080
do something about it and we can improve it for everybody.

526
00:33:59,080 --> 00:34:00,080
Absolutely.

527
00:34:00,080 --> 00:34:06,400
And I will make sure that those websites that you just mentioned are linked in the description

528
00:34:06,400 --> 00:34:10,880
box so people have easier access to them.

529
00:34:10,880 --> 00:34:15,600
If when you make that comment, something weighing heavy on their noggin automatically goes,

530
00:34:15,600 --> 00:34:16,600
yep, that's me.

531
00:34:16,600 --> 00:34:17,960
I want to make my voice heard.

532
00:34:17,960 --> 00:34:20,240
We'll make sure that you have access to that.

533
00:34:20,240 --> 00:34:23,680
But I just want to say, Brittany, you are amazing.

534
00:34:23,680 --> 00:34:25,920
You are instrumental.

535
00:34:25,920 --> 00:34:31,480
You are making the stuff and the things happen and keeping the wheels moving.

536
00:34:31,480 --> 00:34:38,680
And we are beyond appreciative of the work that you do and the time that you've spent

537
00:34:38,680 --> 00:34:41,440
even just here with us today.

538
00:34:41,440 --> 00:34:49,720
But if I had one more question or last request, it would be, do you have any parting thoughts

539
00:34:49,720 --> 00:34:52,800
or any advice for families?

540
00:34:52,800 --> 00:34:59,760
My last parting comment to any families is just don't be afraid to advocate for your

541
00:34:59,760 --> 00:35:00,760
child.

542
00:35:00,760 --> 00:35:05,760
If something doesn't feel right, just say something or ask somebody about it.

543
00:35:05,760 --> 00:35:06,760
Don't be afraid.

544
00:35:06,760 --> 00:35:08,760
It definitely takes a village.

545
00:35:08,760 --> 00:35:15,840
And I think the biggest thing I would leave you with is that the Yes system of care is

546
00:35:15,840 --> 00:35:18,160
built around the child and family team.

547
00:35:18,160 --> 00:35:22,480
The child and your voice are central and the most important part.

548
00:35:22,480 --> 00:35:27,040
And just never forget that your voice and your child's voice are the center of it all.

549
00:35:27,040 --> 00:35:28,920
And so remind yourself that.

550
00:35:28,920 --> 00:35:30,400
You heard it, families.

551
00:35:30,400 --> 00:35:35,920
Well, I just want to say another, again, big huge thank you to you, Brittany, and your

552
00:35:35,920 --> 00:35:37,080
time.

553
00:35:37,080 --> 00:35:41,560
And if anyone out there is listening in on this and says, hey, you know, I love everything

554
00:35:41,560 --> 00:35:46,320
Brittany said, and I want to get involved, please do not hesitate to reach out.

555
00:35:46,320 --> 00:35:49,360
And I can absolutely get you connected.

556
00:35:49,360 --> 00:35:51,520
The more voices, the better.

557
00:35:51,520 --> 00:35:54,320
But again, Brittany, thank you so much for your time.

558
00:35:54,320 --> 00:35:55,320
Absolutely.

559
00:35:55,320 --> 00:36:02,840
Thank you so much, Allison.

560
00:36:02,840 --> 00:36:07,760
Thank you so much, everyone out there for listening in and know that if you are in Idaho

561
00:36:07,760 --> 00:36:15,080
or planning on moving to Idaho and have questions on systems or services for children with disabilities,

562
00:36:15,080 --> 00:36:19,280
please consider reaching out to us on our website at I pull Idaho.

563
00:36:19,280 --> 00:36:23,920
That's I P U L Idaho dot org.

564
00:36:23,920 --> 00:36:29,280
Or by calling us at 208-342-5884.

565
00:36:29,280 --> 00:36:31,320
Be sure to tune in next time.

566
00:36:31,320 --> 00:36:34,320
Until then, this has been unlimited parenting.

567
00:36:34,320 --> 00:36:35,320
Thanks for listening.

568
00:36:35,320 --> 00:36:58,780
God bless.