3 out of 5 of the prescribers on the top ten neuroleptic drug prescribers list, work for CWCMH.
(no surprise here)Washington State' public mental health system has a "Regional Support Network" model or “RSN,” which acts as an intermediary between the State and Counties. It is a gate-keeper which distributes mental health funds to Counties, the Counties then contract for mental health services in the community. Densely populated counties, have their own RSN, such as King and Pierce Counties where Seattle and Tacoma are located.
The RSN where we live is in the Greater Columbia Behavioral Health RSN which is a consortium of eleven counties. The region’s main industry is agriculture; with a lot of orchards, vineyards and hopps, crops which demand a lot of manual labor. Part of the Confederated Tribes and Bands of the Yakama Nation's tribal lands comprise roughly a third of the total area of Yakima County. Much of the tribal lands in Yakima County are not at all accessible for any purpose whatsoever; the Nation's land borders the Yakima Training Center, a military training ground.
Map found at Washington State Department of EcologyThe Confederated Tribes and Bands of the Yakama Nation, have been historically excluded from any meaningful participation in how mental health services and public policies affecting them are planned, provided, and/or administered by Yakima County government. As one can imagine, this situation has added insult to injury; to say the very least. For years and years, Yakima County has administered mental health funds which are distributed to the County to contract for mental health services for all of the citizens in Yakima County, including Tribal members.
The GCBH RSN had one of the worst offenders on Washington State's Top Ten Prescribers list compiled at the request of Iowa Republican Senator, Charles Grassley's Investigation into the illegal marketing of psychotropic drugs. The list is comprised of the top ten prescribers for each drug; so there are more than 10 offenders, i.e. prescribers who prescribed neuroleptic, or "antipsychotic" drugs in extraordinarily high volumes. In any case, a psychiatrist who worked in Walla Walla and Benton Counties made the top ten list for four neuroleptic drugs. In 2009 he made the top ten list for both the Managed Care System, and in the fee for service system by writing a total of 1261 prescriptions for Abilify. In 2008 he wrote 2120 prescriptions for neuroleptic drugs, the following year he nearly doubled that amount.
Walla Walla, Walla Walla County and Richland, Benton County Jose Cardell, M.D.
2008 574) $219,374.69 $189,049.13 Geodon
2008 1040 $357,963.10 $308,137.76 Risperdal
2008 1006 $235,977.13 $202,334.52 Seroquel
Totals 2120 $813,314.92 $699,521.41
2009 78 $33,604.94 $0 Abilify MCO
2009 1183 $612,219.58 $432,670.68 Abilify FFS
2009 662 $305,056.18 $218,710.57 Geodon Average $460.81 $330.38
2009 904 $456,102.36 $252,049.20 Risperdal
2009 1214 $383,517.94 $252,300.52 Seroquel
Totals: 4041 $1,756,896.06 $1,155,720.97
Theoretically, if this psychiatrist saw a total of 336 patients regularly once a month in 2009, and every one of them got a prescription every single month that would be a total of 4032 prescriptions---let's further suppose that he had a normal 5 day week with an average of 23 office days a month--he would have needed to see 14-15 patients every single day.
I was not surprised to find the psychiatrist who treated my son when he went to CWCMH on this list:
Philip Rodenberger, M.D. Medical Director, Central Washington Comprehensive Mental Health, CWCMH.
2008 564 $155,700.98 $148,769.89 Risperdal
Nor was I surprised to find him on this list:
via ProPublica Dollars for Docs:
Period 2010 Q1-Q4
Payee PHILIP RODENBERGER
Listed Practitioner Rodenberger, Philip
Location Yakima, Wash.
Period 2009 Q1-Q4
Payee PHILIP D. RODENBERGER, MD
Listed Practitioner RODENBERGER, PHILIP D.
Location YAKIMA, Wash.
Service Healthcare Professional Educational Programs
Number of activities 3
#prescriptions Billed Reimbursed
2009 293 $233,178.95 $213,696.19 KATHLEEN A MACK ARNP - FP Yakima
235 $225,197.86 $190,843.84 ANGELO A BALLASIOTES PHARM Yakima
207 $127,953.72 $97,709.28 MICHELLE R WILLIAMS ARNP - FP Richland
No prescriber in the GCBH RSN made the Zyprexa top ten list. Three of the five prescribers from this RSN who made the list for Risperdal, work at the Yakima community mental health clinic run by Central Washington Comprehensive Mental Health under Medical Director, Philip Rodenberger, M.D.; who was my son's psychiatrist in 2008. The only other prescriber who is on the Risperdal list in the GCBH RSN practices in Benton County.
I want to thank Jim Stevenson from Washington State's Health Care Authority for his prompt response to my request for the data for this post.
Top Ten Fee for Service
Top Ten Managed Care