Daily Briefing – October 8, 2019

“Debut coincides with World Mental Health Day on Oct 10th San Francisco – The California Peer-Run Warm Line officially opened today, offering free non-emergency emotional support and referrals to anyone in the state via telephone or instant messaging. This service is made possible because of a state budget allocation of $10.8 million over three years, championed by Governor Newsom, State Senator Scott Wiener (D-San Francisco) and Assembly Budget Committee Chair Phil Ting (D-San Francisco). “When addressing issues surrounding health, the conversation must also include emotional wellness. This new state resource builds on our current mental health system by serving a population that is not in crisis but still in need of support,” said Ting.”

“Half of millennials and 75% of Gen Z have left a job due to mental health reasons, according to a study conducted by Mind Share Partners, SAP, and Qualtrics published in Harvard Business Review. The study, which looked at mental health challenges and stigmas in the US workplace, polled 1,500 respondents ages 16 and older working full-time. That’s significantly higher than the overall percentage of respondents who have left a job for mental health reasons — 20%, according to the study. This indicates a “generational shift in awareness,” wrote the authors of the report, Kelly Greenwood, Vivek Bapat, and Mike Maughan. That shift is no surprise, considering that millennials have also become known as “the therapy generation.” They’re cognizant about their mental health and helping to destigmatize therapy, Peggy Drexler wrote in an essay for The Wall Street Journal. Millennials, she said, see therapy as a form of self-improvement — and they also suffer from a desire to be perfect, leading them to seek help when they feel they haven’t met their expectations.”

“The California Department of Health Care Services (“DHCS”) recently revised its Medi-Cal telehealth policy to allow providers increased flexibility in their use of telehealth as a modality for delivering medically necessary services to their patients. The policy is retroactively effective as of July 1, 2019, and fee-for-service providers must submit claims for services provided via telehealth according to the new policy. Updates to the telehealth policy include the following: Reimbursable Modalities: Providers now decide what modality (either live video or store-and-forward technology), they want to use to deliver eligible services to a Medi-Cal enrollee as long as (i) the service is covered by Medi-Cal and meets all other Medi-Cal guidelines and policies, (ii) can be properly provided via telehealth and (iii) meets the procedural and definition components of the appropriate CPT or HCPCS code. Telehealth from Home: An “originating site” now includes the home and there is no requirement that a provider be with the patient at the time of the telehealth interaction. E-Consults: Providers may now engage in e-consults, defined to mean “asynchronous health record consultation services that provide an assessment and management service in which the patient’s treating health care practitioner (attending or primary) requests the opinion and/or treatment advice of another health care practitioner (consultant) with specific specialty expertise to assist in the diagnosis and/or management of the patient’s health care needs without patient face-to-face contact with the consultant. E-consults between health care providers are designed to offer coordinated multidisciplinary case reviews, advisory opinions and recommendations of care. E-consults are permissible only between health care providers.” Provider Requirements: The Policy now includes specific requirements for providers to be eligible to receive reimbursement for telehealth provided services. Specifically, providers must meet all of the following criteria: (i) Provider must be licensed in CA, (ii) enrolled as a Medi-Cal rendering provider or non-physician medical practitioner and (iii) affiliated with an enrolled Medi-Cal provider group. The enrolled Medi-Cal provider group for which the health care provider renders services via telehealth must meet all Medi-Cal program enrollment requirements and must be located in California or a border community.”

“Mental health awareness has reached an inflection point. Singers, actors, and athletes are increasingly coming out about their challenges. Michael Phelps has been outspoken about his struggles with depression. Lady Gaga told the press what it’s like to live with PTSD. Prince Harry added his voice to the group when he spoke about his battle with anxiety. Dwayne “The Rock” Johnson, talking about how he copes with depression, said, “One of the most important things you can realize is that you’re not alone.” While these kinds of stories help to break down stigma, they are, unfortunately, not enough to make people feel safe talking about mental health at work. Despite the fact that over 200 million workdays are lost due to mental health conditions each year ($16.8 billion in employee productivity), mental health remains a taboo subject. In fact, almost 60% of employees have never spoken to anyone at work about their mental health status. To figure out why, Mind Share Partners, SAP, and Qualtrics conducted a study on the prevalence of mental health challenges and stigma in U.S. workplaces. It looked at the full spectrum, from 100% mentally healthy to chronic and severe impairment. In previous studies, mental health has often been measured through either diagnosable conditions or general stress levels. But these two metrics do not fully capture the breadth of mental health experiences that lie between them, such as undiagnosed conditions, episodic challenges, and symptoms that do not meet a clinical threshold.”

“As a result of the growth of the physician assistant (PA) profession, certified PAs may be an innovative and practical resource to expand the mental health workforce capacity and address unmet needs within mental health services, according to research presented at Psych Congress 2019, held October 3 to 6 in San Diego, California. Researchers from the National Commission on Certification of Physician Assistants conducted a web-based survey of PAs to describe the contributions to the mental health field from certified PAs across practice areas. The survey included mental health diseases and disorders as well as knowledge and skill statements that PAs rated from 0 (never) to 5 (daily). Data analysis identified the top 10 psychiatric diseases and disorders seen by PAs. The same diseases and disorders were analyzed from PAs who practice across 5 primary care practice areas: emergency medicine, family medicine, general internal medicine, hospital medicine, and pediatrics.”