December 14, 2005
The next issue of the NAMI Statehouse Spotlight will publish on Wednesday, January 4, 2006. Best wishes for a joyous holiday season from the NAMI State Policy team.
News from the States
To follow up on any of the items featured in this publication, please contact Steven Buck, director of state policy at firstname.lastname@example.org
Codey Draws Public Attention to Treatment of Mental Illness
One year after meeting with patients at the Greystone Psychiatric Hospital, New Jersey Governor Richard Codey returned to the hospital to celebrate the progress made in the past year. During the visit, Codey stayed overnight and joined patients in eating pizza and singing holiday songs. Codey, who as a state senator went undercover at Marlboro State Psychiatric Hospital to expose shoddy conditions and poor hiring practices, has been a champion for people living with mental illness. (Newsday.com, December 1, 2005)
Revenue Initiatives Proposed to Enhance Mental Health Services
The Aurora, Colorado, city council is contemplating the creation of a special tax district to provide additional services for people with mental illness. If created, the district would raise an additional $10 million annually through a new 0.25% sales tax. The ability of cities to fund mental health services by using city sales taxes was authorized through the passage of SB 059 during the 2005 legislative session. (TheDenverChannel.com, December 6, 2005)
In a related development, Chuck Huckleberry, a county administrator in Pima County, Arizona, has proposed a bond issue for $54 million to build new psychiatric facilities. Huckleberry cites growing mental health and substance abuse pressures for the move and has asked for the bond package to appear on the May 16 ballot along with a regional transportation plan. A decision on whether or not the bond initiative is to be considered will be announced on January 10, 2006. (Arizona Daily Star, December 6, 2005)
Georgia Tightens Medicaid Application Rules
Georgia's Medicaid program now requires specific proof of income documentation prior to allowing applicants to join the state’s Medicaid rolls. Current rules require the applicant to self-declare income during the application process; the stated income is later verified through Department of Labor and Social Security databases. Under the new provisions, applicants must present a W-2 form, pay stub, or copy of his or her most recent tax return. People eligible for Medicaid due to age or disability have been required to provide front-end verification previously. (Atlanta Journal-Constitution, December 3, 2005)
Bredesen Proposes Modest TennCare Expansion
Within months of ordering devastating cuts to the state’s Medicaid program, Tennessee Governor Phil Bredesen has unveiled a plan to add back a modest number of “medically needy” constituents to the state rolls. The “medically needy” category requires recipients to document high medical bills and lack of alternative health insurance to qualify for the program. Other requirements include being a single parent or disabled. The plan currently awaits action by federal regulators. (The Tennessean, December 3, 2005)
Medicaid Reform Plans Developing for Oklahoma
An Oklahoma legislative task force is preparing to unveil a reform plan for the state's Medicaid program. Based upon principles of patient empowerment and patient-driven care, the task force has used waiver applications from Florida and South Carolina as examples. The panel is expected to publish its recommendations prior to the start of the 2006 legislative session which begins in February. (The Journal Record, December 1, 2005)
CMS Decision Prompts Cuts for 5,000 in North Carolina
The Center for Medicare and Medicaid Services (CMS) recently rejected a plan that allowed the North Carolina Division of Mental Health to provide assistance to constituents with mental disabilities in developing daily living skills. The services in the state had cost $80 million annually and the federal government had been shouldering a majority of the expense. In response to the cuts, the state is contemplating moving the affected recipients to other programs. (The News and Observer, December 10, 2005)
NAMI Advocacy Tools & Resources
The long anticipated Medicaid reform proposal for Florida is closer to enactment. With many state legislators from other states focused on the pilot proposed for Florida, the NAMI State Policy Team suggests that advocates review the following two documents to obtain a better understanding of the pilot and its implication on Medicaid recipients in counties designated as pilot sites.
To review a recent report published by the Kaiser Family Foundation, click here.
A bill summary of the enacting legislation prepared by the Florida Council of Community Mental Health Centers is available here.
Washington Quick Glance
In a transition plan issued December 1, the Centers for Medicare and Medicaid Services (CMS) announced the development of a "Point of Sale Protection" for beneficiaries who are concurrently eligible for both Medicare and Medicaid (dual eligibles) who go to pharmacies before they have been auto-enrolled in a Medicare Part D plan. This will ensure that full dual-eligible individuals experience no gap in coverage when Part D commences on January 1, 2006.
A beneficiary who presents at a pharmacy counter with evidence of both Medicaid and Medicare eligibility, but without current enrollment in a Part D plan, will still be able to leave the pharmacy with his or her prescriptions. CMS has contracted with Wellpoint, a national Prescription Drug Plan (PDP), and Z-Tech to immediately follow-up to validate the beneficiary's eligibility and facilitate his or her enrollment in a Part D plan.
The CMS announcement of this new policy can be viewed by clicking here.
Click here to read about CMS Clarification of the Formulary Oversight Process.
NAMI Statehouse Spotlight is an electronic newsletter provided free of charge as a public service. With more than 1,100 state and local affiliates, NAMI is the nation's largest grassroots organization dedicated to improving the lives of people with severe mental illnesses. Contributions to support our work can be made online at www.nami.org/donate.
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