Testimony before the Council of the District of Columbia Committee on Health
Budget Oversight Hearing
Submitted by Divya Moolchandani
McClendon Center’s Board of Directors

To the DC Council,
My name is Divya Moolchandani and I am a Board of Director for DC’s McClendon Center, as well as a healthcare consultant primarily serving the Centers for Medicare and Medicaid Services. The McClendon Center helps more than 4,500 DC men and women who come to the Center for primary care needs and psychosocial services, including counseling, community support, housing assistance, art and movement therapy groups, and counseling for those with both mental health and substance use disorders. All of our clients are diagnosed with severe mental illness, and many represent our most disenfranchised community members. Nearly 91% of our clients are African American, ages range from 19 to 96 (33% are 55 or older), and 28% are homeless or staying in shelters. Depressive disorders comprise the #1 diagnosis (39%) followed by schizophrenia and schizoaffective disorders (25%), and bipolar disorders (17%). All of our clients are working toward recovery, independence, and personal success.
I come to you with direct asks. DC’s Department of Behavioral Health (DBH) is planning to cut about $20 million from its budget by imposing service caps on community support and assertive community treatment. Based on our own agency’s data, service caps will not be able to generate the proposed savings, which means that additional services will need to be cut to save the projected amount. I have identified DBH’s proposed changes to save money below, and respectfully request that you reject the service caps to community support and assertive community treatment. As a healthcare professional, I assure you the downstream implications of these service caps and any associated reduction in other services is tremendous. By cutting this significant amount designated for community support, the District’s disenfranchised residents, and our clients, will subsequently lose housing, Medicaid eligibility, job opportunities, and access to food and other services.
— DBH seeks to impose additional medical necessity criteria for all services, which the Council should NOT approve. While it is important that our clients get services for which they qualify, imposing additional, restrictive medical necessity criteria will be counter-productive and create unnecessary cost burden by putting paperwork over patient care. Medical necessity authorizations will cost the District’s providers and staff in submitting, approving, and appealing authorizations. As evidenced by private sector health plans and Medicare, burdensome medical necessity criteria costs more dollars and creates little-to-no cost savings, while disrupting the continuity of care for patients, who are District residents in this case.
— DBH is sacrificing an estimated $1 million by not filling 8 vacant positions, and the Council should instead consider other positions to eliminate in addition to not filling these 8 positions. The community will be sacrificing far more than that by having to lay off enough staff system wide, to eliminate services to members of our community that need it the most. The goal for this is ask to avoid having the provider system lay off any staff who are providing direct services since these services are vital to thousands of disadvantaged individuals.
I respect the Council because all of you felt a call to serve a greater purpose, as I did with the McClendon Center and its clients, and I implore you to listen to my ask. During our time in quarantine, many have struggled with mental health challenges, and the need for community engagement and social interaction to combat isolation. Our clients essentially live in this mental state every day, and The McClendon Center provides the haven that disenfranchised District residents need to help address these mental needs. These service caps and any additional service cuts will be another consequence in a long chain of inequalities that have left people in those predominantly African American communities more vulnerable due to chronic condition and lack of consistent access to care.
My job today, as a Board member, is to represent the voice of the Center’s clients and staff, so that they achieve their highest degree of mental health recovery and independence. Your job, as a Council member, is to represent the voices of the community, so all can have equal access to the foundational support they need to try to live happy, healthy, lives. We both have an obligation and moral directive to do our jobs. The $20 million budget cut from service caps on community support and assertive community treatment, coupled with adding medical necessity requirements, will harm our community, especially those that need the most help. Reject these cuts.

 

 

Testimony before the Council of the District of Columbia Committee on Health

Budget Oversight Hearing
Submitted by Caitlin Gritt
Vice Chair, McClendon Center’s Board of Directors

June 10, 2020

Committee Chair Gray and other distinguished Council members of the Committee on Health:

Thank you for the opportunity to submit testimony regarding the proposed FY 2021 Budget for the Department of Behavioral Health (“DBH”). My name is Caitlin Gritt. I have been a resident of the District of Columbia for over a decade, and I serve on the Board of Directors of McClendon Center, a nonprofit, 501(c)(3) charitable organization. For 40 years, McClendon Center has provided critical programs and services to DC’s most vulnerable residents — those diagnosed with severe mental illness — empowering them to live more independently and improve their quality of life. Our organization is certified as both a Core Services Agency and a provider of Rehabilitation/Day Services. Last year, we served 4,500 people. 91% of our clients are African-American. 28% of them are homeless or staying in shelters. One-third of them are 55 years of age or older.

The proposed FY 2021 Budget contemplates a staggering ~$21 million reduction in DBH’s funding for community-based support services and assertive community treatment. Such a draconian cutback has severe ramifications for the budgets of mental health agencies across the District and the DC residents who we serve together. Without this crucial funding, some city mental health providers may not remain financially viable, and the predictable consequence will be a shortchanging of the clients who rely on them. Without this essential support, our DC neighbors are susceptible to losing their Medicaid eligibility, their healthcare, their housing, and their access to services that help address inequities in Social Determinants of Health, such as food insecurity and lack of employment opportunities.

In the midst of a global pandemic and record unemployment — when marginalized individuals require more care, not less — and during a time of civil unrest due to ongoing racial injustice, DC’s Budget should prioritize the health of its residents by promoting access to services, rather than putting them at greater risk of illness and/or death.

I volunteered to join McClendon Center’s Board of Directors because I care deeply about the wellbeing of my neighbors and the health of my community. On behalf of those we serve — many of whom cannot speak for themselves — I am asking for your assistance in eliminating the proposed DBH budget cut, so that McClendon Center and other agencies throughout the city can serve as many residents as possible, helping them to live safer, healthier, more independent lives.

Thank you for your time, your consideration, and your service to our city.

 

 

Testimony before the Council of the District of Columbia
Committee on Health, Budget Oversight Hearing
Submitted by David A. Harris
Member, McClendon Center Board of Directors

Founder, Song Dog Spirits LLC

June 10, 2020

Committee Chair Gray and other distinguished members of the Committee on Health:

Thank you for this opportunity to submit written testimony regarding the proposed FY 2021 Budget for the Department of Behavioral Health (“DBH”). I have been a proud District resident for almost three decades, and I serve on the Board of Directors of McClendon Center, which as you know is a nonprofit 501(c)(3) organization providing essential behavioral health services and support to marginalized residents in the District of Columbia. I am proud that our amazing agency staff was able to serve and support more than 4,000 District residents last year, the vast majority being African American.

This is precisely the wrong time to cut more than $20 million from DBH funds available for community support and treatment. This action will jeopardize the health and well-being of some of the District’s most marginalized citizens, while threatening the financial health of the providers of these vital behavioral health services.

The era of a global pandemic is exactly the wrong time to balance the city’s budget on the backs of the city’s most vulnerable residents. This is not just a matter of helping support the behavioral health of the District’s long-term residents in dire need of those services; such a budgetary change can also jeopardize their housing, their Medicaid eligibility and essential healthcare as well.

If there has been any silver lining to recent horrifying events, it’s seeing people come together across ethnic, generational and religious lines to recognize and fight racial injustice and support African Americans. The District of Columbia cannot and should not choose to further disenfranchise its own African American citizens right now – against this backdrop – by denying them access to the support they desperately need and deserve.

I am appealing to your sense of justice and respectfully asking you and the Council to ensure that these cuts do not transpire, and that we protect and – if anything – we add to the funds allocated to helping our most vulnerable neighbors.

Thank you very much for this opportunity to share my testimony, and for your good work and continued service to our city.

As we are settling into new ways of doing things we are also finding new ways to serve our clients. Due to the hard work of Aisha Shabazz, McClendon Center’s Day Program Manager, we have started a “Virtual Day Program”.  It took a great deal of effort and organizing for Aisha and her staff but they have created something wonderful. Human connection is so important to our clients and having a dedicated place to go every day and interact with others was important to so many of them. Offering that connection on Zoom can now help to bridge the gap of loneliness. Even more amazing, we have expanded our reach – now serving not only many current MCC clients but now 20 other DC residents. And we see that number growing as we expand the program. Aisha gives a more detailed explanation of how she, her staff, and the clients are benefiting:

Most of our day program clients depend very heavily on the day program.  For many of them it is the only place that they have friends and participate in meaningful activities.  When we realized that the day program would have to close temporarily due to COVID-19, we were very worried about how it would affect the clients.

During the first weeks of the Quarantine, Day Program staff stayed connected to the clients by calling them several times a week to check on their wellbeing (did they have enough food and medication, offering solutions to symptom management and keeping them company).  Although the clients appreciated these calls, after a while all they wanted to know was “when will we be able to come back?” It was very frustrating and actually heartbreaking not to have an answer.

One day a staff member called 6 clients at the same time.  This call lasted for about an hour.  Not only did they miss coming to the day program, they also really missed each other!  Friends are such an essential part of life. The Department of Behavioral Health (DBH) authorized Virtual Day Services at the end of April.  On Monday, May 4^th the McClendon Center offered it’s first Virtual Day Programming through Zoom. We do our best to create programing that is very similar to what clients receive at the ACTUAL Day Program. We are currently offering Virtual Day Programming at 4 different sites (a Community Residence Facility (CRF), 2 transitional houses and a group home) through Zoom Meetings. Some of the groups offered are: Art Therapy (we ship art supplies to the sites), Movement/Dance Therapy, Educational Games, Recovery Based Groups and Mental Health Awareness.   Groups are offered at 9:00, 10:00 and 11:00. The clients participate in 3 groups daily and then receive lunch, which is delivered by our lunch provider, Catholic Charities.   We also offer groups twice a week through Google Duo for our clients that live independently. So far on average we have been providing Day Services to 20 clients a day. We are planning on adding more sites and expanding our Google Duo groups.This has been challenging at times, because it requires a lot of “technology juggling,” but the feedback from CRF directors, House Managers and clients has been overwhelmingly positive.  The clients report loving seeing their group facilitators and are enjoying groups.  The House managers report that it has been easier to get the clients to “social distance” by remaining in the house, because they aren’t leaving out of boredom. This has been a HUGE team effort that has been very much worth it.

We also want to give an update on our Art of Transformation. Originally we had hoped to move it to November. However, that seems unrealistic given all the uncertainty. We have always put client and staff safety at the top of our list – and we need to keep our friends, family, and supporters safe too. We will have a celebration in person, we just aren’t sure when. We will keep you up to date on planning. We are also working on ways to stay connected in the meantime – so stay tuned for that!

-Dennis

Small changes in our routines are designed to ensure client and staff safety. For some of our clients taking public transit is beyond their ability. For some, getting to appointments has always required McClendon Center coordinate transportation. Staff continue to pick these clients up and drive them to the clinic for their medications and care.

Always with safety in mind, both staff and client are provided masks and gloves. Staggering appointment times also helps to keep patients safe by ensuring an empty waiting room. The clinic and the office are regularly wiped down with medical grade cleaners throughout the day. It is just the new normal for us.

Sadly, we have had a handful of our clients test positive for Covid 19. Their care is being closely monitored and we advocate on their behalf whenever necessary. It would be easy to get overlooked in the fast paced response by all the various agencies that are involved. McClendon Center tries to stay one step ahead whenever possible. We know you agree –  it is what our clients deserve.

Thank you for your continued interest for the people we serve and the tireless staff providing that care. It is even more meaningful knowing we have your support.
-Dennis

PS – Did you know the new CARES (Coronavirus Aid, Relief, and Economic Security) Act allows taxpayers to take a charitable deduction of up to $300 ($600 for married couples) for those who take the standard deduction?

For those who do itemize their deductions, the new law allows for cash contributions to qualified charities such as McClendon Center to be deducted up to 100% of your adjusted gross income for the 2020 calendar year.

McClendon Center’s Patient Discharge Coordination (PDC) program, a collaboration with AmeriHealth Caritas DC, was featured in the DC Hospital Association Quality Showcase publication. PDC was launched in 2015, with the goal of reducing hospital readmissions and improving HEDIS* measures by seamlessly transitioning and reintegrating individuals from psychiatric hospitalization back into the community. Since its inception, PDC has reduced hospital admissions from 17% to 9% — a 47% readmission reduction.

Read the full article HERE. Click on PDC for more information about this program.

*Healthcare Effectiveness Data and Information Set (HEDIS) measures six “domains of care”: effectiveness, access/availability, experience, utilization, health plan descriptive information, and collected measures through electronic clinical data systems.