Familycare Update

Below is an email I am sending to clients who currently have Familycare Insurance and are concerned with their reported closure. I hope that it can help people feel they can advocate and also be up to date regarding what is occuring:

. As you might of heard they are currently reporting they will close as of January 1st unless they obtain equal funding to the other CCOs that provide the exact same services. I will post a link to more information below but clearly I do not have all of the answers regarding the politics of what is going on. What I do know is that they are informing providers that they are shutting their doors January 1st unless a miracle occurs and the Oregon Health Authority (OHA) continues to negotiate and they come to an agreement by that date. 

Many of you might be wondering where does that leave you (and us)?  Honestly where that leaves us is that I will no longer be able to be your counselor as it stands currently. Healthshare (the only other CCO..they provide the mental health coverage through your county no matter if you choose providence/moda/Kaiser or CareOregon) refuses to contract with Individual providers, like myself. They only contract with large organizations likes Western Psychological Services, Cascadia and Lifeworks. These agencies already have long wait lists.

OHA has not contacted providers and because of that I have no idea if they have a plan in place or what exactly would occur within the next two weeks….the only other option I can think of is that they might leave people on Open Card until they figure it out. Again this is not a solution…Open card is OHA direct which means the same phone # you call to renew your insurance, that as of right now typically has multiple hour hold times and no way for me to obtain authorization for services…as it is most doctors and providers can take open card (myself included) but because of their lack of staffing and structures in place it is an extreme challenge and best to be completely avoided.   OHA has been quoted in the press stating that Healthshare can accommodate the 100,000 people who currently are on Familycare though I get roughly 10-15 calls a week from people currently on Healthshare not able to enroll in services.

I am not writing this to scare you…I am working as hard as I can to obtain information for you and will make sure to keep you updated.  I am also working to alert media, contact representatives and even organizing with other medical providers (from all areas of medical treatment) to try to appeal to Governor Kate Brown to force OHA to work with Familycare and to do the fair and equitable thing…treat the CCOs as equals and give them equal pay for each consumer.

I am far from an expert in politics and even more so in the state budgeting or what is going on “behind” the scenes. I am going to share some links below and talking points that I have vetted and can be a starting place IF you would like to follow up with representatives.  Again the purpose of the letter is to let you know what I am doing and to be transparent in my quest to advocate for your care.  The information listed below is just things I have found helpful in these regards and are starting places if you would like to reach out…I know that I can feel overwhelmed at contacting representatives so please look at these as just guidelines.You also have the option to not follow up at all I just know many have reached out asking what to do so I thought I would share.

Do reach out to me if you have any questions but again all that I know as of right now is listed above. I will follow up if I do learn anything more, especially in regards to transition of services or hopefully at an agreement being made.

Sincerely,

Lacy

 

 

Information regarding this conflict:

https://www.thelundreport.org/content/familycare-threatens-close-after-report-supports-states-cco-rates

http://portlandtribune.com/pt/9-news/368266-250011-state-sought-to-plant-negative-stories-about-nonprofit

https://www.thelundreport.org/content/familycare-says-it-will-close-its-doors

 

Here is the email I wrote to both the director of OHA and Kate brown:

Email Pat Allen, Director of OHA:

OHA.DirectorsOffice@state.or.us

Mr. Allen,

As a mental health professional, I am deeply concerned and disturbed that FamilyCare is being forced to close due to OHA's refusal to provide equitable reimbursement. I do not accept the findings of the recent CCO rate investigation that FamilyCare's reimbursement rates of $377.57 versus HealthShare’s $409.75 are actuarially sound. A $32.18 per-member difference is undoubtedly biased.

FamilyCare's closure creates an immediate mental health care crisis for 120,000 of Oregon's most vulnerable citizens. There is very little overlap in mental health providers between FamilyCare and HealthShare. Most of us who are contracted with FamilyCare to provide mental health services are not contracted with HealthShare, leaving our clients without care in a matter of days. We do not accept OHA's assertion that HealthShare can serve our clients; mental health clinicians at agencies contracted with HealthShare already have caseloads of 80-120 clients and wait lists.

Please consider how this will specifically impact clients with severe mental health concerns who have built strong relationships and treatment plans with their FamilyCare providers. Give FamilyCare the same rates as HeathShare: $409.75.

Sincerely,

Lacy Cooper LPC

Address and contract information

 

FamilyCare Advocate scripts for consumers:

People to reach out to via email:
· — Chair of Oregon Health Care Committee Representative Mitch Greenback, Rep.MitchGreenlick@Oregonlegislature.gov� 503-297-2416
· -- Rep Robe Nosse, Vice Chair of Health Committee, rep.robnosse@oregonlegislature.gov (503) 986-1442
· -- Patrick Allen Director of OHA: OHA.DirectorsOffice@state.or.us

>>>EMAIL SCRIPT<<<
NAME OF RECIPIENT,
As a recipient of OHP FamilyCare services, I am deeply concerned and disturbed that FamilyCare is being forced to close due to OHA's refusal to provide equitable reimbursement.

FamilyCare's closure creates an immediate health care crisis for me, personally, as one of the 120,000 FamilyCare clients affected. As of January 1, unless you take action, I will no longer have access to my current provider through OHP. Starting over with a new provider is not an option for me. Even if it were, I have no confidence that HealthShare will be able to provide timely services for 120,000 of us when its system is already overburdened.

Please consider how FamilyCare closing will specifically impact clients like me who have built strong relationships and treatment plans with their FamilyCare providers. Please do what you can to give FamilyCare the same rates as HealthShare and support me and those like me.
Sincerely,
YOUR NAME
YOUR ADDRESS/CONTACT INFO

 

Call Governor Kate Brown;
· — Governor Kate Brown 503-378-4582, call and leave a VM
>>>>VOICEMAIL SCRIPT<<<<
“My name is ______, my zipcode is______ and my phone number is_________. As a recipient of OHP FamilyCare services, I am deeply concerned and disturbed that FamilyCare is being forced to close due to the Oregon Health Authority's refusal to provide equitable reimbursement. In a matter of days, I will be without essential care since my FamilyCare provider is not contracted with HealthShare. Contrary to OHA's assurances, there is simply no way that HealthShare can serve me, since clinicians who are contracted with HealthShare are already overburdened and have wait lists. Please get involved and force Patrick Allen and the OHA to provide fair rates to FamilyCare.”

Feeling guilty about taking time for yourself?

I hear it from my clients everyday, and I even catch myself thinking it from time to time.  "There are so many things that I should do that I just don't feel right taking time for myself."  Sound familiar?

Our everyday hustle and bustle keeps many people so busy that we continue to put off things that we enjoy in order to make time for chores.  We get so caught up thinking about what we should do that many of us forget about what we want to do.  And when we do steal a minute to enjoy our coffee, or an hour for a leisurely walk, or a weekend getaway, we are left feeling ashamed of or guilty about our "wasted time."  We spend so much time and energy working that we forget to live.  No wonder so many people feel unhappy with life!

I had someone ask me what to do to feel more happy.  When I asked how much time she spent doing things that made her feel happy, she realized that she hadn't spent any time at all.  "It's not really that simple, is it?"  Of course it's that simple!  If we do nothing that makes us happy, then we will not feel happy.  This means that in order to feel happy, we need to spend time doing things that make us happy. 

I know it is difficult to justify spending an afternoon watching a favorite movie or curling up with a book when your in-box is overflowing at work, there are errands to run, and there are partners, children, parents, and pets clamoring for your time and energy. And the more you have on your to-do list, the more you need that time for yourself.  I like to think of it as charging our batteries.  Our cell phones and laptops stop working if we don't give them time to charge. The same thing goes for us!  We need nutritious food, good sleep, and time enjoying life to charge our batteries.  If we go too long without any one of these things, we quickly run out of steam.

I would like to challenge each of us to carve out time for ourselves every day, even if it is a only a five-minute pause to smell the fresh air and enjoy your surroundings.  Taking care of yourself is a top priority, and there can be no better way to spend time than spending it enjoying life.  Your loved ones will appreciate the new, fully-charged you. 

Single & Happy...possible?

Yesterday was Valentine's Day and for many people this day is full of stress and despair! 

Are you are single and feel that this day is just yet another slap in the face?!  Tired of turning on the TV and see jewerly commercial after jewerly commercial with a perfectly executed cheesy proposal or reading your friend's facebook updates and seeing picture after picture of flowers delivered to them, or check-ins to their "super romantic vday dinner".  It can be overwhelming, humiliating and downright painful! 

Its easy to try to brush it off your shoulder and say "its just a day" and while some people are able to actually do that for some trying to shake it off is like trying to shake off a swarm of bees when you are covered in honey. 

 So what is one to do?

1. Accept where you are at.

Yup you are single. Sometimes this is intentional and sometimes it is just crappy luck.  We all desire a   partner to share our thoughts/day/leftovers with though in this moment its just not happening.  Your life has not ended, focus on the positives of being single: you control what to watch on tv, you don't have to worry about anothers feelings or their dinner choices: you can focus on YOU.

2. Be Selfish.

So I am going to let you in on a little couple's therapy "secret"....while some couples do need help communicating with each other, especially about stressful subjects (sex, money, kids, etc) MOST couple's problems get better NOT because of learning different magical skills together...nope...they get better when each person actually steps back and figures out where they are coming from, figures out their motivations, their "hang ups", their insecurities...the more secure/healthy each partner is the stronger/more fulfiling the relationship as a whole will be. 

So use this time to become the best person you can!  Use this time to explore your dreams, your passions, your insecurities, how you deal with money/negative people/talking about uncomfortable things.  Do you want kids? What do you want to accomplish before you do? Are you interested in a religion? Or in a religion you might no longer be 100% dedicated to? Do you have any subjects that cause you a lot of stress or anger?


THIS IS YOUR TIME...FOR YOU!  Use this time to become the person you want to be.

3. Create a plan.

The easiest way to do this is get a piece of paper, flip it so it is landscape (so it is longer then it is tall) and at the right edge write create a column down it listing where you would like to be in one year.  Maybe you want to be in school, maybe you want to move to another city,you want to be your own boss, whatever it is write it down! Want to feel secure? Want to be able to stand up for yourself? Be happy? What does that look like for you? Your happiness is going to look different then mine so be descriptive.   How will you know you have reached your goal if you don't know what it actually looks like?

When you have that all done start to work backwards (so work towards the left side of your paper) and make make a line for every 3 months (if my math is right you should have a total of 4 more columns)....and fill those sections in working backwards...so at 9/6/3 months you should be at least enrolled in school, or have your funding set up.  You have found a hobby you enjoy and are actually doing it, enroll in a money management course to learn how to budget, etc. 

When you get to the left side of the paper this will lead you to today. The day after Valentine's day....

What are you going to do TODAY that will help you get to that place in one year? 

Use this unhappy energy you have to motivate you to CHANGE.  To IMPROVE. To GROW. 

Hang your piece of paper up somewhere you will see it daily.  Mark stuff off as you accomplish it and I bet next Valentines day, romantic partner or not, you will have a different feeling about the day....pride! Security! Happiness!

If you ever get stuck, need some help creating this chart give us a call or email.  Don't lose your motivation.

 

 

Grief

In our society death is something to be feared and avoided at all cost. It is not something we talk about freely and the given “standard” to deal with it is to cry a bit and then move on..but what if it isn’t that easy? Grief can take years to fully process and can surprise us when it hits. It is not something that can be dealt with and forgot about, it is something that does not follow a set standard for everyone or every situation. There is no right way or wrong way to grieve, even avoiding it for a bit until you have the skills/capacity to deal with it is okay but it is not something you can put off forever. It will manifest somehow in you life eventually.

A close friend of mine had started running and had a goal of eventually completing a 5k yet no matter how much training she did she could not run longer than 20 minutes. She hit a roadblock, she would call saying her legs were fine just mentally she could not do it. After a week of this and trying to figure out what the issue was she realized it was due to grief…her dad had died a couple of years ago and instead of dealing with her grief she had gotten 2 jobs, started grad school and did as much as possible to avoid it. Though with running she had 30 whole minutes to herself daily, to think and feel, no one demanding her to think about various problems and because of this her grief kept popping up and she finally decided she was strong enough to process and deal with the loss of her father. It took another couple of weeks and a support group but she was able to run again for long periods of time and could even relax a bit without feeling a nagging deep inside herself.

No matter how much we want to avoid it these things pop up and so I thought we could share some tips/insights that might be helpful to deal with grief. Please note that no one follows the same path to heal from loss, there is no wrong way or right way to feel. If you lose someone of importance in your life the grieving process can takes years and it can evolve, and giving yourself some slack and room to experience it can help not only you deal with the loss but also help continue you on your path of emotional maturity and strength.  It is okay to feel anger, sadness, frustration and even happiness towards the person who died.  You might also feel regret and or guilt and if so some of the process to process your grief will to be to accept what took place and to forgive yourself as well.

We recommend finding a grief support group. If you have never been to a group before we would like to clear some things up: you are not required to talk..honestly. It is okay to sit and listen. Confidentiality within group members is required and respected. The reason why a group could be helpful is that it helps people realize that they are not alone, that is it okay to feel mad, sad, hurt, abandoned, etc, etc, etc. It can also help you figure out what exactly you are feelings…so many times (especially in our society) we are not taught how to articulate what we are feeling so hearing someone else describe themselves might help you realize “me too!” or “exactly”. Groups also offer hope. Many times there are members at different stages of grief and because of that you can see that even though it is super hard right now there is a light at the end of the tunnel, that peace can be achieved and sometimes that can give enough strength to continue on the journey that is grief.

Some local groups are:

Q-Center

Grief Watch has a list of both infant loss support groups and partner loss

The Dougy Center is a great place for groups helping children and teens deal with death.

Also ask your insurance providers if they provide a support group (for example Kaiser has many that are low cost) and if you are religious your local church might also provide supports. Do not be afraid to try a variety of different groups. Some are very structured, some are focused on the social factor than a set “to do” list, some incorporate art/spirituality/meditation/food/etc, even the different people who make up the group can play a significant factor on if you feel comfortable, supported and connected. Group therapy can also lower the cost of getting services which is also a benefit. Currently LINKtherapy does not offer a therapy group for grief but can provide individual therapy if you do not feel that currently a group therapy session is a good fit for you. A lot of people will attend one type of therapy for a bit and then switch to the other as needed to help them heal and process their loss. Give us a call or email for more information or to schedule a session.

 

Do-It-Yourself Happiness

Its Summer!  There is Less Rain! You can now do things outside and absorb some of that amazing Vitamin D and use those natural “healers” to depression and months of perpetual grey.   While some fun things do cost money there are MANY activities in Portland you can do to help turn that frown upside down on the cheap:

  1. Go to a local dog park, even if you don’t have a dog!  Their funny antics, the ability to pet them and enjoy the outdoors can help you lower your stress, get some of the benefits of pet ownership without the cost (or time commitment) of actually having a dog.
  2. Write someone a thank-you note.  This is a low cost way to show your appreciation to a loved one.  It can also help you focus on what you have, instead of what you don’t.  It is an instant positive shift of focus.
  3. Try something new!  It can be ANYTHING.  Check out free classes from some local businesses, from home brewing, cheese making, glass blowing, borrow a friends guitar, etc.  Many times the class is low cost and not only can help you learn a new skill but also help you meet people who share your interests!
  4. Go enjoy some Oregon Strawberries.  If you aren’t local you might not realize that the strawberry season in Oregon only lasts for a month and these delicious, packed with good nutrients, mouthwatering morsels will make anyone smile.  We recommend Hood Strawberries as the very best.
  5. Head to a local park and play some Frisbee Golf!  You only need one frisbee to start and if you take some friends it will help you slow down, de-stress and get some endorphins pumping in your body!
  6. De-clutter your personal space and donate everything you don’t need anymore.  It will help you feel more centered, less distracted and helping others is always a great feeling!
  7. Get your library card and check out a new book.  It is a very low cost way to ‘escape’ your everyday life for a bit even if you don’t have the funds or time for a vacation this summer.
  8. Turn off your computer, your phone, your ipod, etc and just spend a set amount of time without electronics stressing you out.   If you can’t devote a whole day try just doing this for lunch one day a week.
  9. Set some goals and start working towards them.  If you are in hard place right now then working towards something you ultimately want can help you focus on the big picture and not feel “stuck”.
  10. Find your “Summer 2011” song.  Find something that screams summer to you.  The journey to finding this song is part of the fun and also once you find this song it will be helpful this upcoming winter to replay so you can remember that no matter how much rain, grayness, etc, it will end and help bring up all the fun you had!

Gender: Not always simple

What is the first question people ask when a new baby is born?  Is it a boy or girl? But what happens when that baby doesn’t fit nicely into the boy or girl package?  Although it is impossible to know exactly how many people fall outside of the male or female “norms,” an estimated 1% – 5% of people identify as transgender.  An even larger percentage of the population falls outside of stereotypical gender roles.

Many people believe that a person’s sex (or their genitalia) determines their gender.  Although frequently a person’s sex and gender are the same, this is not always the case!  Sometimes your body does not match your mind, and you often start to realize this at a very young age.  Typically kids begin to identify as male or female between 2 and 4 years old.  But sometimes a child who has a male body self-identifies as a girl, or a girl-bodied child feels more like a boy.  Too often these children are told that they are wrong and they are forced to conform to society’s norms.  Without support, these kids can have a very rough road ahead, often filled with depression, self-hatred, and thoughts of suicide.

For adults who grew up forced to hide their true identity, the processing of “coming out” can be very difficult and frightening.  Many fear rejection from friends and family, as well as retaliation at work or school.  Often this process can feel very lonely unless they are able to find a support system that understands what they are experiencing and encourages their decision to come out.  If you are in the process of coming out or transitioning you may feel overwhelmed.  Try to surround yourself with people who love and care about you.  If you are already in the process of transitioning or have lived as your true gender for a while, it can still be difficult to be a member of a group so often discriminated against.  Here are some possible places to find support:

  • Understanding friends and family members
  • Local support groups
  • Online chat groups and forums
  • Local non-profit organizations (see our resources page)
  • PFLAG organization
  • A counselor

For more information about the gender spectrum, please visit Gender Spectrum.org

If you identify as transgender, or don’t feel like you fit into your assigned gender and would like more information about counseling with us just email or call. Also check out Q-Center for some awesome support groups.

Poor Communication: The Deadly Relationship Killer

Relationships are hard. Take the people involved, their baggage, their insecurities, a culture that indicates that it should be a piece of cake and what you get is a mix that makes it challenging to talk about difficult subjects with your partner. If you can’t effectively talk to your partner or resolve conflict it can seem as if the one person who should always be in your corner isn’t there to support or appreciate you.

Here are some tips I have found help to help you get past some of the barriers to hopefully start towards the pathway of open & clear communication:

1. Take time outs. If one of you is upset, needs time to process or calm down have a set code word either one of you can say at anytime to take a break. This is not something to create or talk about in the heat of the moment. Instead when there is no arguments or negative emotions talk about what a time out would look like for both of you. I suggest you choose a short (two syllables max) word that you both can easily remember, if it is humorous even better! You can also set a time limit for the time out or not, whatever you and your partner agree upon before actually using this method. Once a partner engages the word all communication stops and each person takes a breather. This is not something to use to just “skip” the conversation. Part of the agreement to allow time outs is that you must pick the conversation back up. It might seem ineffective to “stop” communication to actually improve it but this can not only prevent you from saying something hurtful in the heat of the moment but also give you (or your partner) time to actually think through and fully understand the situation. People react with either fight or flight in tense situations and time outs can help de-escalate the situation so you both can actually work on the problem not just “survive” the moment.

2. If something is bothering you instead of complaining ask for what you want! I blame society for instilling this idea that the perfect partner will be able to read your mind and just know what to do. Sorry to burst your bubble but it is NEVER going to happen and playing the “you should just know” game or retreating and acting passive-aggressive is not going to help fix the problem. SIt down with your partner and don’t focus on what is going wrong instead focus on the solution and how they can be apart of it! Have concrete examples and ideals. You can’t read minds and either can your partner! For example if you are feeling under-appreciated, instead of complaining ask your partner to give you positive feedback at least once a day, and provide examples of what positive feed back looks like to you. Be concrete. Provide Clear Examples and make sure to follow #3 when they do it….

3.Give feedback and praise. If you see any sort of improvement praise, praise, praise. It can be difficult trying new things. It can be hard to open up and be honest, especially if there has been pain and mistakes along the way. Giving encouragement and in a way guidance can foster a positive environment for growth for not only your partner but also yourself. The one mistake I see with this tip is backhanded praising/insults…so if you asked for a compliment daily when your partner says “that was a good dinner you cooked” make sure to say “thank you that means a lot” instead of “thank you too bad I also had to do the dishes”…this only can hurt your partner and does nothing to create a positive place in your relationship. It takes time to grow and learn and it is unfair of us to expect our partners to become perfect overnight.

It is difficult to hear couple’s come in for therapy and state that one, or both, have been unhappy for years. Poor communication can make small things become big, hurtful subjects it also can prevent a couple from creating healthy conflict resolutions. Poor communication is one of the top reasons Couple’s come into therapy and if you and your partner are having problems feel free to email us or call. We also recommend you check out these books:

10 lessons to transform your Marriage

A Couple’s Guide to Communication

When Anger Scares You: How to Overcome Your fear of Conflict

Abuse Survivors

If you were abused as a child, you are not alone! An estimated 20% of adults in America experienced abuse as a child.  Being abused affects everyone in different ways, but many survivors of abuse experience some similar things.  Some of the most common reactions to abuse are:

  • Not believing it happened (denial)
  • Denying that it affected you (minimizing)
  • Trouble trusting people
  • Feeling unsafe
  • Feeling worthless
  • Feeling damaged or like something is wrong with you
  • Having a hard time establishing healthy relationships
  • Difficulties with emotions – can be too intense or you numb yourself to them
  • Feeling disconnected or tuning out of life (dissociation)
  • Drug, alcohol or other addictive behaviors
  • Thoughts of suicide

This list may be overwhelming, but it may also be comforting.  Many survivors of abuse don’t realize that some of the struggles they are experiencing now may be related to being abused.  The good news is that the worst part is over – you lived through the abuse!  The best news is that you can get better.  Being a survivor of childhood abuse does not mean you are sentenced to a life of pain and suffering.  You can create a happy, fulfilling life for yourself!

The most important first step in recovering from a painful past is to build a support system to help you through this journey.  This can be a close friend, a family member, your partner, whoever and whatever feels supportive to you.  Sometimes this is the hardest step for people, especially when they feel like they have no one to turn to or they keep trying to build relationships that always fall apart.  Sometimes a great place to start building support is through counseling with a supportive therapist.

Another very important part of healing is to take care of yourself!  I often hear survivors talk about how difficult this can be, or that they don’t even know how to take care of themselves.  Start by doing something you enjoy every day, whether you spend 5 minutes or 5 hours.  Below is a small list of things some people find relaxing and pleasant.  Remember, choose what you enjoy!

  • Play your favorite song
  • Light a scented candle
  • Go to the gym
  • Take a walk
  • Call a friend
  • Watch a good movie
  • Play a game
  • Take a warm bath
  • Play with an animal
  • Go to the beach
  • Volunteer
  • Buy yourself a toy or gadget
  • Engage in your religion
  • Read a book or magazine
  • Go fishing
  • Sit in the sun
  • Ride a bike
  • Go to the museum
  • Breathe deeply
  • Write in a journal
  • Have a daydream
  • Kiss someone special

If you are ready to see a counselor to begin healing from you abuse, please feel free to contact LINKtherapy.

If you feel ready to see a counselor but are not sure if we are the right fit, please visit the following links to search for a counselor in your area:

PSU Health Resource Fair 2011

The Portland State Queer Resource Center hosted this exciting themed health event, “Love Yourself”.  LINKtherapy was excited to share with students that they had an option to receive counseling!  Currently Portland State’s Counseling center has over a month wait so many students were excited that another option was available.  We shared some ‘Fair Fighting Rules’ with participants…just incase they didn’t receive the valentine’s gift they wanted.  Ha!  We also were able to talk OHSU & National College of Natural Medicine about some projects they have going on in the community.  If you know anyone who is HIV positive or has AIDS please have them contact Partnership Project for some great services, both medical and natural supports.  The National College of Natural Medicine also provides alternative health care services for great prices!  It was a very fun event and we were glad we were invited.  Thanks Portland State!

Communi-T @ Portland QCenter

LinkTherapy was lucky to combine the opening of our counseling center with an amazing event. The Q-Center decided to sponsor a trans-resource fair, with the focus on queer friendly medical professionals. The event was really well attended and a great learning opportunity for everyone involved! We met a lot of great people who really were excited to hear about LINK & other professionals whom were a lot of fun. Everyone was so positive and it was a great way to start the company. We can’t wait for other fun events with the Q-Center in the future.