Nancy Moran

TO: Senator [massmail]
Senate Finance Committee

RE:
HB1452
Mental Hygiene Administration - Study of the Maryland Public Mental Health System
Hearing Wednesday, April 7, 2004
FAVORABLE WITH AMENDMENTS

Mental Illness affects over 2% of the population. That makes the Public Mental Health System a considerable cost center. (handout to follow)

Yet there is an absence of Quality Assurance or Quality Control in the Mental Hygiene Administration. (letter from the Department of Health & Human Services to follow - take note of the last sentence) To wit:

• There is not an entity in the Department of Health and Mental Hygiene devoted to or offering quality assurance with regard to mental health services to either uninsured individuals or individuals enrolled in health plans.
• The Hospital Unit of the Office of Health Care Quality within the Department of Health and Mental Hygiene is not specialized in mental health care.
• There is not an entity in the Department of Health and Mental Hygiene solely addressing the quality assurance needs of the Mental Hygiene Administration.

The Public Mental Health System is primarily a teaching vehicle. Most if not all of the "professionals" seen by patients is by interns, residents and others who have not completed their training. Supervision is lax. This leads to overdiagnosis, overutilization and additional patient-days. (two pages of my complaint to the Department of Justice to follow)

Defensive medicine. Falsification of medical records. Dependence on gossip, hearsay and innuendo. (abridged for the sake of brevity)

• The head of the outpatient clinic at UMMS (Doris Balis) put in the record that I had multiple hospitalizations and a long history of non-compliance despite the facts that neither statement was true according to her own clinic's records which had been maintained for three years.
• The (false) statement about non-compliance put me on the "state hospital list" and assigned me a medical student obviously an Affirmative Action candidate. In retaliation for my comment that she "sucked up" to superiors, the medical student entered in the record that I had "trouble with analogies".
• Resident Melanie Coffman, from a distance of 30 feet and in the presence of other patients, asked me if I was still getting messages from the TV. Broadcasting at the time was the Maury Povich show: "Teenage Lesbians with Multiple Lovers", the sole and only "entertainment" on the inpatient ward during mornings. I answered sarcastically, "Yes, I am getting messages from the TV." Resident Coffman then went to the attending physician and it is in the medical record that I was (psychotically) receiving messages from the TV. Maury Povich was not mentioned. Coffman strongly advocated transfer to the State hospital system during the clinical review panel.
• Diane Ossip, in an emergency evaluation petition initiated by Doris Balis, listed every drug I had been on for a two year period but did not list my then current drug regimen, known to Doris Balis.
• Resident Joseph Mullen, after a 5 minute interview in the hall, went into an Involuntary Commitment hearing confusing the Department of Public Safety with the Department of Defense. Further, although it was known by Doris Balis and Sharon Lerner, LCSW-C that I had had dealings with the Rite Aid Corporation, Joseph Mullen ascribed my claims in that regard to psychosis. The Administrative Law Judge held Mullen's position as definitive.
• Attending physician Angela Udebuiwa swore under oath at the Involuntary Commitment hearing that she had examined me that morning while, in fact, there never was any eye contact and there was never a word spoken between us.
• Resident Jenifer Deniece Oldham, after a clinical review panel led by Doris Balis, consistently told me I belonged in the State hospital system. I was an inpatient for 56 days. Oldham not only told me Udebuiwa would be controlling my medications in the State system but she falsified the Discharge Summary to indicate I suffered from headaches and she added a person in her report (DeGuzman - a longer story) who was not present at the clinical review panel. The Discharge Summary that went to the State hospital system was different from the one in the permanent medical record.

Funding sources. Maryland Health Partners was approached even before Blue Cross and Blue Shield. A "patient-day" is billed at $800 with $100 or $125 added for "professional services". My stay as an inpatient at University of Maryland thus costed on the order of $50,000. My stay at the State Hospital System costed approximately $25,000.

Outpatient. I qualified for a $2 copay. I was billed (see letter to follow) in excess of $400 per month (two visits social worker, two visits resident).

Pharmaceuticals. "Professionals" in the University of Maryland System earn "Continuing Education Units (CEU)" for their participation in seminars and presentations of pharmaceutical representatives. In fact, drug companies provide the only pharmacology they know.

In the mental health arena, the most popular drugs are Zyprexa, Seroquel and Risperdal. Risperdal is proprietary with the University of Maryland to the detriment of the others.

My current doctor made a quick substitution for Seroquel, which was costing $188 per month even after the dose was cut in half. My costs went to $20.48 and $98.80 for three months. I was right to ask for a man over 50 in place of a female in her 20s.

Risperdal costs $350 per month and I have a strong allergy to it. It is manufactured by Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, makers of Tylenol.

Zyprexa was given to me free and it was two months of hell. The resident (Ivana Iacopovich) didn't know the difference. I have had a number of phone calls with the Eli Lilly Corporation since. (letter to follow)

Let the attachments to follow explain more.

LIST OF ATTACHMENTS

• Profiles of Schizophrenia and Bipolar Disorder
• Letter from HHS: "... our office does not have the authority to investigate complaints involving the quality of mental health care that you received."
• Cover sheet and Table of Contents: U.S. Department of Justice
• DHMH, Herbert Spenser: UMMS Billing
• Bipolar Realities: Comparative Drugs, Comparative Costs
• (Disregarded) Prescribing High Doses of Neuroleptics and Benzodiazepams for Punitive and Retaliatory Reasons
• Letter to Eli Lilly Corporation regarding Zyprexa
• Commentary to the FDA about Neurontin