Insight Matters
Winter, 2004

Advocacy Works!
by Mark R. Munetz, M.D., President

How wonderful it is to report that on February 5, 2004 the Ohio House passed a mental health parity bill, House Bill 225 by a vote of 52-40. This bill, sponsored by OPA's hero, Representative Lynn Olman will require health insurance plans to end the discriminatory practice of limited health coverage for mental disorders. This bill would not have passed the House without the incredible work of advocates like NAMI Ohio and the Ohio Psychiatric Association. The bill itself is a compromise, covering only serious mental disorders and excluding substance abuse disorders. Furthermore, the bill now needs to pass the Ohio Senate and be signed by the Governor. The Governor recently repeated his request for a moratorium on health insurance mandates. So our advocacy efforts must continue as strongly as ever. Thanks to all of you who wrote or emailed your representatives. Keep up this important fight.

Our January Council meeting was memorable. Following the (natural) high many of us felt after our grand celebration of Phil Workman's retirement the evening before, we got down to work with our new Executive Director, Janet Shaw. Janet comes to OPA after more than 20 years at the Ohio State Medical Association. Janet brings great energy and vision to OPA and we are extremely fortunate to have lured her away. It was evident to all of us at Council that Janet has hit the ground running and will help OPA continue to grow as the premier District Branch of the OPA.

In my report to Council I asked for input on two important issues. And with OPA Council, when you ask, you receive. First I told the group that I have been invited to the March meeting of the APA Board of Trustees meeting. I will be given a few minutes to speak to the Board to share major concerns of our District Branch. I asked for Council's thoughts about what I should say. Consensus was reached that major issues to address include the importance of APA sharing non-dues revenues with District Branches like OPA and help us address the problems of membership recruitment and retention; that we express our belief that universal health care coverage should be a right not a privilege; and it was also suggested I share some of the discussion and complex policy questions raised by the recent release of Risperdal Consta, which in fact was the second issue I asked Council to discuss.

Risperdal Consta issue addressed
The short version of the Risperdal Consta issue is simple. A new, long acting injectable formulation of risperidone has been approved by the FDA and is now on the market. The longer version is quite complex. There is great interest in this medication because it is the first long acting new generation antipsychotic medication. While it is on the Medicaid formula, it is classified as a medical benefit and not a pharmacy benefit, which essentially has kept it from being used in the public mental health system in Ohio. Council had extensive discussions on this issue. It included thoughtful considerations of the real advantages of this new tool, the controversies around the purported advantages of new generation antipsychotics and of depot medications, the complex issues of "regular" and "community" Medicaid, the role of Medicare and perhaps most complex OPA's relationships with the pharmaceutical groups and our partners in advocacy, especially NAMI Ohio. As a group, we decided to slow down enough, to take the time to reach a thoughtful position. I will be working with the OPA leadership to craft such a position, which will culminate quickly in letters to the Ohio Department of Jobs and Family Services and to the manufacturer. While our specific positions are not finalized, it is safe to say that there is consensus among OPA Council members that a physician and his/her patient should be able to prescribe that medication they deem most appropriate for that patients care; and that we are disappointed with the high cost of Risperdal Consta.

The complexity of the Risperdal Consta story underscores how funding of mental health care in our country is disjointed and at times even bizarre. While space here precludes my giving you the whole story we will post my full version, from my personal perspective on the OPA website. Ms. Shaw and I want to see our membership have more reason to visit the website. I hope I have stimulated your interest enough to take a look at my version of the Risperdal Consta story. Take a look at www.ohiopsych.org. And send any feedback to me at mmunetz@neoucom.edu or opapresident@ohiopsych.org

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