From Payer to Innovator, 25 years of Managed Care, and more with Deb Adler

How Regulatory Barriers Are Harming Patients in Need of Clozapine with Rachel Streiff

In this episode of the Self Disclosed Podcast, host Patrick Gilligan sits down with Rachel Streiff, a passionate advocate for individuals living with serious mental illness and their families. Rachel shares her personal journey into the world of clozapine, an antipsychotic medication used for treatment-resistant schizophrenia, and discusses the significant barriers patients face in accessing this life-saving treatment. Rachel highlights the challenges posed by the FDA's Clozapine REMS (Risk Evaluation and Mitigation Strategy) program, which has created unnecessary hurdles for both patients and healthcare providers. With only about 10% of those indicated for clozapine actually receiving it, Rachel emphasizes the urgent need for change in how this medication is prescribed and monitored. Join us as we explore the stigma surrounding clozapine, the impact of regulatory barriers, and the grassroots movement led by the "Angry Moms" to advocate for better access to mental health care. Rachel also shares her insights on the upcoming FDA committee hearing and how listeners can support the cause. If you're passionate about mental health advocacy and want to learn more about clozapine and the fight for patient rights, this episode is a must-listen! Links Mentioned in the Episode: * Support Rachel's work and sign the petition to end the Clozapine REMS: change.org/endtheclozapinerems [http://change.org/endtheclozapinerems] * Learn more about the Angry Moms movement: theangrymoms.com [http://theangrymoms.com] Don't forget to like, subscribe, and share this episode to help raise awareness about the importance of access to mental health treatment!

CMS Sub-regulatory Guidance on EPSDT with Former CMO of Medicaid Dr. Andrey Ostrovsky and Kellie Hans-Green

In this episode of the Self-Disclosed Podcast, host Patrick Gilligan sits down with two experts in the field of pediatric health: Dr. Andrey Ostrovsky, former Chief Medical Officer of the U.S. Medicaid Department, and Kellie Green, Director of Child and Family Health at CareSource. Together, they dive deep into the newly released sub-regulatory guidance surrounding the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. Join us as we explore the history of EPSDT, its importance in providing comprehensive behavioral health services to children and adolescents, and the implications of the recent guidance for health plans, providers, and families. The discussion highlights the need for individualized approaches to care, particularly for vulnerable populations such as children in foster care and those with special healthcare needs. Discover how this guidance can empower families, improve access to necessary services, and potentially reshape the landscape of pediatric healthcare. We also discuss the role of advocacy, the importance of understanding Medicaid, and how families can navigate the complexities of the system to ensure their children receive the care they deserve. Tune in for an insightful conversation that aims to shed light on the critical issues affecting children's health and the opportunities for improvement in the healthcare system. Key Topics: * Overview of EPSDT and its historical context * The significance of the new EPSDT guidance * Behavioral health services for children and adolescents * Advocacy for families navigating the Medicaid system * The role of value-based care in improving health outcomes Don't forget to like, subscribe, and hit the notification bell for more episodes on important health topics! Timestamps 00:00:00 - Introduction to EPSDT and Peer Support 00:01:33 - Welcome and Episode Overview 00:02:11 - History of EPSDT and Legislative Background 00:05:12 - EPSDT from the Health Plan Perspective 00:05:59 - Inspiration Behind the New Guidance 00:08:12 - Clarifying EPSDT for Behavioral Health 00:09:57 - Impact of New Guidance on Vulnerable Populations 00:11:20 - Higher Standards of Coverage for Children 00:13:27 - Implications of the New Guidance 00:18:08 - State Responses to Sub-Regulatory Guidance 00:20:12 - Opportunities for Improvement in Foster Care 00:22:29 - Empowering Families through EPSDT 00:24:29 - Advocacy and Engagement for Families 00:27:27 - Value-Based Payment Models and EPSDT 00:30:25 - Financial Implications of EPSDT and Prior Auth 00:34:48 - Advocating for Change: Family Perspectives 00:42:09 - Closing Thoughts and Acknowledgments

From Payer to Innovator, 25 years of Managed Care, and more with Deb Adler

In this episode of the Self-Disclosed Podcast, I sat down with Deb Adler, CEO of Navigator Healthcare, to explore the complexities of the healthcare system, particularly in the realm of substance use disorder. With over 25 years of experience across health plans and providers, Deb shares her journey from working in a state-operated psychiatric hospital, to leading Network Strategy at the nations largest payers, to today where she runs her own start up in the substance use disorder space. Join us as we discuss: * The evolution of managed care and its impact on behavioral health * The challenges and opportunities in transitioning from fee-for-service to value-based care * Insights into the barriers faced by providers and payers in implementing new care models * The importance of health literacy and member engagement in improving outcomes * Deb's vision for a more accessible and effective mental health landscape Whether you're a healthcare professional, a provider, or someone interested in the future of mental health services, this conversation offers valuable insights into the ongoing challenges and innovations in the field. Subscribe to the Self-Disclosed Podcast for more engaging discussions on mental health and healthcare innovation! Timestamps 00:00:00 - Eliminating Waste in Healthcare 00:05:30 - The Evolution of Managed Care 00:10:01 - Effectiveness of Managed Care 00:15:10 - Barriers to Value-Based Care 00:20:01 - Payer Mindset and Risk Aversion 00:25:00 - Navigating Innovation in Health Plans 00:30:00 - Advice for New Providers 00:35:00 - Understanding Payer Pain Points 00:40:00 - Unexpected Challenges in Starting Navigator 00:45:00 - The Decision for a Nationwide Approach 00:47:00 - Improving Health Literacy in Mental Health

Transforming Youth Mental Health with the Be Calm Model with Dr. Desiree Murray

In this episode of the Self-Disclosed Podcast, host Patrick Gilligan sits down with Dr. Desiree Murray, a clinical psychologist and prevention scientist at the University of North Carolina, Chapel Hill. Dr. Murray shares her journey into youth development research and discusses her innovative Be Calm model—a mindfulness-based social-emotional learning program designed for adolescents in school settings. Join us as we explore: * The challenges of implementing effective interventions for youth and adolescents. * Dr. Murray's early research experiences and the pivotal moments that shaped her focus on emotional regulation. * Insights into the importance of mindfulness in supporting youth development. * The four pillars of the Be Calm model and how it integrates mindfulness with social-emotional learning. * Strategies for engaging educators and students in meaningful ways. * The impact of school culture on student engagement and well-being. For more information about the Be Calm model, visit https://www.becalmprogram.com/ [https://www.becalmprogram.com/]. Timestamps 00:00:00 - Introduction to the Podcast and Guest 00:01:49 - Dr. Murray's Journey into Research 00:02:59 - Foundational Lessons in Research 00:04:49 - Longstanding Interest in Youth Development 00:05:55 - Early Observations in Adolescent Challenges 00:08:57 - The Role of Emotion Dysregulation 00:10:54 - Exploring Mindfulness as an Intervention 00:12:20 - Development of the Be Calm Program 00:15:58 - Challenges of Integrating CBT and Mindfulness 00:18:47 - Overview of the Be Calm Model 00:19:38 - Pillars of the Be Calm Model 00:26:00 - Building Teacher Capacity and Engagement 00:27:17 - Addressing Teacher Concerns and Resistance 00:32:24 - The Importance of Adult Influence on Youth 00:33:20 - Engaging Students in the Be Calm Model 00:35:30 - Results and Findings from Be Calm Studies 00:42:00 - Future Directions and Goals for Be Calm 00:45:48 - Conclusion and Final Thoughts 00:46:23 - Dr. Murray's Vision for Youth Mental Health

From Asylums to Modern Interventions: The Evolution of Peer Support with Nicole Lederman, LCSW

In this podcast episode, host Patrick Gilligan sits down with Nicole Lederman, an LCSW and the head of clinical operations at Somethings, to delve into the world of peer support. They discuss the history of peer support, recent research in the field, and the current landscape of peer support interventions. From the origins of peer support in the 18th century to its integration with clinical care today, they explore the effectiveness and potential of peer support in mental health treatment. Key Points Covered: * History of Peer Support: From the 18th century to modern-day applications * Research Backing Peer Support: Studies demonstrating successful outcomes * Examples of Peer Support Today: Organizations and programs making a difference * Challenges and Opportunities: Addressing gaps in accreditation, reimbursement, and research * Future of Peer Support: The role of peer support in addressing workforce shortages and improving patient outcomes Join Patrick and Nicole as they uncover the power of peer support in mental health care and discuss the exciting developments shaping the future of this field. Subscribe to the podcast to stay updated on the latest episodes! Timestamps 00:00:00 - Introduction to Peer Support 00:02:01 - History of Peer Support 00:12:01 - Research Backing Peer Support 00:15:01 - Examples of Peer Support Programs 00:17:55 - Importance of Peer Support for Teens 00:19:12 - Integration of Peer Support with Clinical Care 00:22:55 - Leveraging Peers for Progress 00:25:07 - Challenges Faced by Peer Support 00:29:16 - Future Outlook and Opportunities for Peer Support