Community-centered health homes: The next iteration of quality-based care [KevinMD.com]

Primary Health Care will never have real quality until it takes on ACEs... There is no quality in putting bandages on symptoms whose root cause is childhood trauma... Not for 100% but for many. The medical field continues to ignore the truth... Sometimes I think that is how they want it... Traumatized people means patients to tx symptoms w/drugs and surgeries and other procedures that would never be required if we didn't allow people's minds, bodies, and souls to be beaten, burned and violated in the first place.

No trauma ...few sick people....less doctors needed and fewer drugs and procedures... Means less money for someone

Kind of sad.... Kids must suffer so doctors can feel like super heroes performing procedures that wouldn't be needed in the first place if we actually did our job especially as Pediatricians.... We pride ourselves on prevention but very few are doing much to prevent what harms more children than anything else we see..more damage than asthma, obesity (just another symptom) and on and on

As far as getting Medicare to cover somatic experiencing???? The psychiatry/therapy field is still dominated by the alphabet soup of DSM diagnoses and CBT and drug tx. I have never heard of something like somatic experiencing being covered but then I am in the Midwest. What I believe must happen is we must refuse to accept big pharma's hold on the mind, understand brain difficulties from a trauma such as seeing your mom shoot herself ...I can hardly say this.... In the head ... Would cause any normal human significant distress and trauma and is a NORMAL response to witnessing such a terrible event. Not an unpredictable, genetic brain dysfunction. I would be concerned about the person not affected by such an event and lastly demand that alternative treatments are researched and made available to everyone .....not just some darn drug or talking as BVK says you can only talk so much about this stuff before talking is just more trauma. I hope you can find someone who can do somatic experiencing.....

Hi Samantha and Fellow ACEsConnection Members,

     I have some concerns about the potential for feeling Hopefulness with this DHHS/Medicare Initiative. I trust I can use this ACEsConnection forum, for feedback, lest I endeavor to address my "world view", and appear to go "off the deep end", and expose my Cognitive Distortions, and seem like a ranting madman to readers. A number of my experiences certainly color my "world view". I wish brevity was an option, but I hope readers will indulge me.

 

     One: In 1972, my then girlfriend was doing her Internal Medicine residency at Lincoln Hospital in the Southeast Bronx, in New York City. The House staff/Residency brochure noted: In this "neighborhood", 85% of the Housing is sub-standard and deteriorated; Tuberculosis is 6 times the national average; Venereal Disease/STD's are 4 times the national average; Leading cause of death was Heroin Overdose. There were 100,000 Heroin addicts living in this "neighborhood/community", at that time. My girlfriend wanted to live in the neighborhood, and share a 3 story brownstone house with other physicians and hospital personnel, and some neighborhood youth near the age of majority-but still in high school. My girlfriend's mother [who was also blond haired and blue-eyed but resided in Elizabeth, N.J., and had "good credit"], attempted to secure a mortgage for a suitable building....but was denied a mortgage from every major bank, until she went to the Harlem Savings Bank. (Yes, most Banks were "red-lining" that community!).

 

     Two: During my second term as a VISTA Volunteer, my tasks included ensuring the informed, empowered, participation of low-income and elderly [health care] "Consumers" in the implementation of the National Health Planning and Resources Development Act of 1974, in [Belknap & Merrimack counties of] New Hampshire, which by federal law (Public Law 93-641), required "Consumer Majorities" on all local, sub-area council, certificate-of-need, project review, and state boards. The law defined "Consumer": You could NOT be a "Consumer Representative", if you earned more than 10% of your income from a "health related source", or if you were married to a "Provider", or if you were an "Indirect Provider" (EMT/Paramedic, Dental Hygienist, etc.). During President Reagan's administration, funding for the Consumer Citizen participation component of the act, was cut.

 

Three: During Chiropractic treatment for a back injury, a few years later, I learned the American Chiropractic Association brought a federal "Restraint of Trade" lawsuit against the American Medical Association, in which the Chiropractors ultimately prevailed. (A Family Physician [M.D.] who I initially consulted about the back injury, had told me: "Go see a Chiropractor, and don't tell anyone I told you to!").

 

Four: The Veterans Administration (Roger Pitman, M.D., et al.) began a PTSD study of Non-Military/Non-Veterans, and I participated as a "Research Subject" in that study, ... and after extensive testing, interviews, etc., was advised I met the DSM-3 criteria for [non-combat?] PTSD, but, not being a Veteran, I was not eligible for treatment in the VA system.

 

Five: I worked for an agency from 1989 to 1995, that provided health insurance, as part of its employee benefits package, and ended up seeing an EMDR therapist, and we were able to stop the flashbacks of witnessing my mother's handgun suicide-which I had endured [along with 'numbing' every Mother's Day...] for 28 years. I did not continue in therapy long enough to recognize and address the "traumatic grief"-at that time, but my health insurance did cover the EMDR.

 

Six: I worked for a different agency, from 1998-2001, that not only provided health insurance, but offered a "Medical Savings Account"-which I opted for, along with free Reiki/Energy work sessions offered by one of the members of the Board of Directors-which I also opted for. The Reiki/Energy worker noted a problem, and suggested I avail myself [and I concurred] of Somatic Experiencing therapy-which she knew of a student practitioner [about 60 miles away]-who I could see at "low cost". I subsequently asked my Primary Care Physician Assistant [who had previously been a military nurse in VietNam], if she would write me a prescription for the Somatic Experiencing Therapy-so I could use my Medical Savings Account to cover the therapy costs and/or the mileage. My PCP-Ass't. wrote me a prescription for the Somatic Experiencing therapy. I submitted it to my Health insurer who denied me coverage, so I submitted it for reimbursement from my Medical Savings Account-which I subsequently learned was also administered by my Health Insurer-which subsequently denied that also.

 

Seven: While working for that agency, I also attended "Grand Rounds" continuing education presentations at Dartmouth (Geisel) Medical School. One in particular during 2000, was by an Epidemiologist who had noted that 52% of Detroit Metropolitan Area Schoolchildren met the criteria for PTSD. Similar related stories have appeared in ACEsConnection recently, noting similar findings in Baltimore, Philadelphia, and elsewhere. The similar problems in Rural America, may or may not be noted in the individual state CDC/BRFSS (Behavioral Risk Factor Survey Studies), as not all states are using ACE screening questions in the BRFSS, as yet. In my first VISTA tour, one of my colleagues was a Public Health Nurse working at our almost state-wide OEO Legal Services Health and Nutritional Development component, inspecting migrant camp housing throughout New York State for Lead Paint, and other health hazards. 

 

I don't know what role the National Institute of Health/Complementary and Alternative Medicine plays in this Community Centered Health Homes process, and whether Somatic Experiencing therapy would be covered under my existing Medicare coverage, but that is all I currently have for health insurance, and my state vocational rehabilitation agency no longer pays for EMDR, or any other type of therapy. I thought I might solicit feedback from any readers who might know.

 

While I am concerned about what health services I can avail myself, currently on Medicare, I am also concerned about what the role of Epidemiology and Public Health play in deciding what Preventative and Treatment services are going to be available for my fellow Citizens, and Visitors here on Visas, and their Children, now and in the future. Thank You.