Tuesday, March 5, 2013

LB 556: Testimony from the director of the NFF opposing school based telehealth services


My name is Brenda Vosik.  I am the director of Nebraska Family Forum, a grassroots organization of 495 citizens statewide who are concerned about education, child welfare, and parental rights issues in Nebraska.  I am representing this group’s concerns with LB 556.

I originally planned to discuss our serious issues with the mandatory mental health screening requirements in Sections 4 and 7, as well as the added mandatory physical at grade 9.  However, it does appear that Senator McGill has recognized that these issues are problematic and she plans to amend the bill accordingly.  As long as she is willing to put an opt in clause in the bill, our concerns about the mandatory screening are alleviated. 

I do want to emphasize though, that the option needs to be an opt in, not an opt out.  Let me clarify the difference because it’s very important:  An opt out situation means the screening will be done unless the parent proactively tells the doctor that they are declining it.  This would require every Nebraska parent to know that this screening is being done and to know that they have an option to decline.  Unfortunately, my guess would be that most parents would have no idea what was happening until it was over and the results of the screening were placed in their child’s permanent medical record.  What we need is an opt in.  In this case, the doctor can tell the parent that a mental health screening is available as part of the physical and that the cost is covered as preventative care.  The parent would have an opportunity to ask questions about what the screening entails, consider the interests of their child, and then choose how they would like to proceed with no repercussions for their choice.

 “No repercussions” is another important point.  We would like to see that verbiage included in the bill so if a parent makes the decision that their child will not have the mental health screening, or if the parent agrees to the screening but decides not to pursue recommended treatment, there can be no future repercussions such as accusations of neglect.  This would be a very important component of the bill, especially in this state where children are removed from their homes at three times the national rate.  If there is any possibility that this will turn into another gateway law for DHHS to punish and break up families, we need to close that gateway with clear verbiage in the bill.

And speaking of clarity—even though I’ve read this bill numerous times, there are still many aspects that are very confusing.  Sen. McGill and her staff have referred to a mental health crisis in our state.  Maybe that’s true, maybe not.  But if there is indeed a crisis, it’s not a crisis due to lack of screening or due to lack of telehealth services in the schools.  Rather it’s a lack of providers and affordability.  This bill does not address those issues at all. On the contrary, this bill will dump a bunch of newly screened kids with questionable diagnoses into the pool of families clamoring for services.  This can only detract attention and services from the children who are suffering from truly serious mental health issues.

The reason I mention questionable diagnoses is because many of the mental health screening tools on the market are created and financed by big pharmaceutical companies.  Pfizer alone has seven mental health screening tools.  I think we can all agree that the pharmaceutical industry definitely has a financial stake in getting mental health diagnoses on our children.  This renders the screening results questionable at best and harmful at worst.  I am providing an article on the dangers of mental health screening from the Journal of American Physicians and Surgeons.  I ask you to please take the time to read this article.  It’s very important for each of you to be informed on the pros and cons of these screening tools.  I am also providing you with information on the most widely used screening tool, Teen Screen, which is now known to misidentify mental health issues related to suicide risk 83% of the time.  A congressional investigation of the financial ties behind Teen Screen has been initiated, which may be what put a halt to this program at the end of 2012.

Finally, we don’t think mental health services belong in the schools at all.  It is not the schools’ job and the logistics of how these services would even work remain unanswered.  Where in the world will a school find an environment that is confidential and sound proof for an uninterrupted therapy session?  As a mom of four boys, I can assure you that nurses’ offices are not that environment.  Another question is where all those providers are going to come from.  Have hundreds of therapists agreed to participate in providing on-line therapy services in a school setting?  The physicians I’ve spoken to have not had a positive response to this idea:  One of them said, “I wouldn’t touch this with a 10-foot pole.”  Another said, “This is a HIPAA violation waiting to happen.”

There are just too many unknowns in this bill and unknowns are dangerous when it comes to our kids.  I appreciate that Sen. McGill intends to amend her bill to address those unknowns and I look forward to seeing those changes confirmed in writing.  On behalf of the Nebraska Family Forum, I urge you to vote against bringing LB 556 out of committee until all concerns are clarified and addressed.

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