The Medicaid Reform Commission has begun two days of hearings at the State Capitol, focusing on mental health and pharmacy issues. A representative of Missouri psychologists tells the Commission that Medicaid reform is an infrastructure issue. John Howell is the Chairman of the Psychological and Behaviorial Health Department at Citizens Memorial Hospital in Bolivar. He says the mental health and health care systems need to be better integrated. As an example, he points to studies that indicate those who undergo heart surgery often suffer depression that if not treated can set back recovery. The Commission is to bring a recommendation to the full Legislature to consider next year.