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To read NAMI PA, Main Line's proposals for health care reform that will meet the needs of individuals with severe mental illness, scroll down to see the related file at the bottom of this page.

Advocacy Alert: 28 June 2009

For more information, read NAMI's principles for health care reform.
 
To read NAMI PA, Main Line's proposals for health care reform that will meet the needs of individuals with severe mental illness, see the link at the bottom of this page.

Advocacy Alert: 27 June 2009
WE NEED TO CONTINUE TO OPPOSE STATE BUDGET CUTS FOR MENTAL HEALTH SERVICES!  Your advocacy efforts have made a positive impact on the state budget process. SB850 failed to be passed by the House Appropriations Committee on June 8th, 2009. Consequently, there is no state budget.

Now, the Governor has submitted a revised proposal which increases his earlier recommendation of 3 million in proposed cuts for Mental Health services. The new proposal is for 14 million in cuts for Mental Health services.

These proposed cuts will be devastating to the mental health community. Please renew your calls and emails to your legislators.

We need you to continue your efforts by email or phone. Please ask family members, friends, neighbors and acquaintances to make calls and to send email messages as well.  It is critical that our elected officials support our request for restoration of these critical funds.  Click here to find telephone contact information for your legislators.

The focus of our efforts needs to include letters and calls to the Governor. The Governor's proposed budget makes cuts to community mental health services.

Remember these points in your contacts:

• Mental Health and Disability Services are essential services.
• Cutting services will not save money.
• Cuts will shift the cost to families, jails and counties.

Resources to help you:

• General Talking Points
• Specific Talking Points

Advocacy Alert: 24 June 2009
Help Improve Re-entry Support for People with Serious Mental Illness

Act Now!
Access to medical care, through Medicaid, and income supports through Social Security, are life-saving for people with mental illness. Tell your House member to co-sponsor the Recidivism Reduction Act, and help ensure that people with mental illnesses can get well and avoid involvement in the criminal justice system. Take action now using NAMI's Legislative Action Center!

When people with mental illness are incarcerated, often for very minor crimes, they lose access to Medicaid and Social Security benefits which they had previous received. Even when benefits could be restored upon release, frequently administrative delays slow down the process. Reapplying for benefits is time-consuming and complex, and many jails and prisons do not assist in planning prior to release. Without access to medication and income immediately on release, people with mental illnesses are less likely to get and stay well, and are at increased risk of getting re-entangled with the criminal justice system.

A new bill is being introduced in the U.S. House of Representatives to help ensure that people re-entering the community can have ready access to the benefits they need to survive. The Recidivism Reduction Act, HR 2829, provides an incentive to state Medicaid systems to suspend, rather than terminate Medicaid benefits during incarceration - making it easier for the benefits to be restored on release. The bill also requires the Social Security Administration (SSA) to provide a provisional benefit for some SSI recipients immediately upon release from jail; SSA would then complete a review of the individual's eligibility and stop payments in the rare case that the person is no longer eligible.

Learn More

Read background information on the Recidivism Reduction Act.

Read a draft of the Recidivism Reduction Act.

View a chart of the changes to Medicaid and Social Security proposed by the Recidivism Reduction Act.

Advocacy Alert: 15 June 2009
Act Now to Prevent the Incarceration of People with Mental Illness 

Act Now!
Last week, the House Appropriations committee approved the FY 2010 budget for Commerce, Justice and Science programs, which includes $12 million for the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) and $100 million in funding for the Second Chance Act. MIOTCRA grants support communities working on programs that are proven to help break the cycle of incarceration. The Second Chance Act supports re-entry programs to help people get the services and support they need to successfully reintegrate into society. Let your Representatives in the House know that people with mental illness should not be in jail.   Write a letter today telling them to support funding for MIOTCRA and the Second Chance Act as part of the 2010 Commerce, Justice and Science Appropriations Bill. The full House is expected to vote on the bill this week.

The criminalization of people with mental illness is a growing problem that devastates many members of our community. A study released this month in the journal Psychiatric Services shows that the prevalence of people with serious mental illness in jails is increasing. The study, which was presented June 1st at a Senate briefing featuring NAMI National board member Fred Frese, found that overall, 16% of jail inmates have a serious mental illness. Even more alarming, 31% of female jail inmates have a serious mental illness.   These numbers suggest that up to 2 million jail bookings every year involve an individual with serious mental illness.  

Learn More

Visit the Criminal Justice/Mental Health Consensus Project Web site to learn more about the study.

Visit the House Appropriations Committee Web site to read a summary of the Commerce, Justice and Science Appropriations Bill.

Read more about the briefing on the prevalence study hosted by the Senate Judiciary Committee.

Advocacy Alert: 27 May 2009
Please take action to oppose impending budget cuts that threaten to drastically reduce needed behavioral health services.  The PA State Senate has passed a budget bill (SB 850) that would slash the community mental health and state hospital budgets. Specifically, the budget makes the following cuts:

A reduction to the community mental health budget of almost $10M will result in cutting off community services to over 4,000 individuals. The BHSI reduction will eliminate services to 2,761 individuals with mental illness and 7,500 individuals in need of substance abuse treatment. Without BHSI funding, persons in need of behavioral health treatment who do not qualify for Medical Assistance will lose a critical lifeline to services.

Some of the Reasons for Opposing These Cuts

1) Budget Cuts Increase Costs for Care
Cutting funding for behavioral health services does not mean that the persons in need will just go away. When they are denied services that support their recovery, they are likely to utilize other services that are more costly and less effective, such as corrections, homeless shelters, and emergency rooms.

2) Counties Will Bear Burden of Cuts
SB 850 avoids a state tax increase. Since the need and costs will remain, county government will be forced to raise taxes to fill the gap.

3) Rainy Day Fund
The nationwide economic slowdown has resulted in a serious revenue shortfall in Pennsylvania. There is a Rainy Day Fund of $750 million and the Governor proposed to use $375 million of the fund to fill some of the shortfall. The Senate eliminated that money from their budget and is opposed to using any of the Rainy Day Fund. It is not just raining, it is pouring in Pennsylvania so any final budget must include a portion of the Rainy Day Fund for essential government services.

4) Essential Government Services
Behavioral health services are essential state services. In a very difficult economic environment elected officials must make tough decisions and eliminate or significantly reduce funding for non-essential programs. We contend that the state's responsibility to provide a safety net for vulnerable populations certainly includes the provision of mental health and substance abuse services.

The Governor and our legislators need to hear from us to know that we strongly oppose these cuts. The phone number for the Governor is 717-787-2500.  You can click on this link (http://www.visi.com/juan/congress/) to find out who your representative and senator are and obtain phone numbers and other contact information.  Or to send an e-mail message drafted by NAMI PA (which you can edit), click on this link (http://www.namipa.org/legislativealertformletter.html).  If you are interested in participating in a visit to your state senator or representative, please reply to this e-mail or call 267-251-6240.
 
(This message has been excerpted and revised from an Action Alert distributed by NAMI PA.)

Advocacy Alert: 20 May 2009
Support a Bill To Prevent Suicides And Improve Treatment for Veterans  A bill has been introduced in Congress to require mental health screening for members of the Armed Forces who are deployed for combat.  The Post-Deployment Health Assessment Act of 2009, which is sponsored by Senator Max Baucus (D-MT) and Senator Mike Johanns (R-NE) in the Senate and by Representatives Dennis Rehberg (R-MT.) and Mike Thompson (D-CA) in the House, would require mental health screenings for active duty members of the armed forces prior to deployment, and following deployment at regularly scheduled intervals.  The bill also would require sharing of information for purposes of ensuring continuity of care after individuals leave active duty military status.
 
Act Now!
Please contact Congress today to urge their support of this very important legislation, using NAMI's Legislative Action Center.  Together we can make a difference in the lives of veterans struggling with mental illness.

Advocacy Alert: 10 April 2009
Advocacy Needed for $100 Million Increase in Services Funding!  One month after the release of Grading the States 2009, the report continues to have an impact on policy debates at the federal and state level.  NAMI's landmark report documents the decline of public mental health systems in states across the nation and enormous lack of progress in providing evidence-based, cost-effective, recovery-oriented, services for adults living with serious mental illnesses.  

Now you have a chance to help improve the quality of state mental health services. This past week Senator Debbie Stabenow (D-MI) initiated an effort to secure an additional $100 million for the Mental Health Block Grant program for FY 2010.  The program, which provides grants to states to support mental health services, was funded at $428 million for FY 2009 and has not been increased in a decade. It has lost nearly 55% of its purchasing power since 2001.  While the program is only a small piece of overall public mental health funding, it is a critical resource in underserved areas and is, in many states, the only source of funding for services for uninsured adults with serious mental illness.

Act Now!
Contact your Senators today and tell them to support Senator Stabenow's effort to increase the Mental Health Block Grant by $100 million for FY 2010.  Urge them to sign on to her letter to the Appropriations Committee before May 1st. View the Senator's "Dear Colleague" letter announcing her effort.

Advocacy Alert: 27 February 2009
Tell the Senate to Support FY 2009 Budget  As explained in the NAMI E-News below, funding for mental illness research and services and relevant HUD programs will be significantly increased if the Senate passes the 2009 Omnibus Appropriations bill (HR 1105) by March 6.  Please call your Senators today to urge them to support this bill.

Senator Robert Casey 202-224-6324 or 215-405-9660
Senator Arlen Specter 202-224-4254 or 215-597-7200

Expanded Legislative Advocacy Efforts
NAMI PA Main Line works with NAMI National, NAMI PA, and cooperating Southeast Pennsylvania NAMI affiliates to expand our advocacy efforts.  We meet with U. S. Congressmen, Senators and with state legislators to establish relationships, provide them with accurate information regarding mental illness, and lobby on behalf of important mental health issues.  If you would like to participate in this advocacy effort  please contact Ingrid Waldron at mainline@nami.org or 267.251.6240. 

Advocacy Alert:  10 February 2009
Senate Clears Economic Stimulus Package; Action Needed to Ensure Strong Final Bill.  By a vote of 61-37, the Senate today gave final approval to a $838 billion economic recovery and stimulus package, setting up what is expected to be a very short process of reconciling it with a separate competing House-passed proposal.  President Obama is now aggressively working to ensure that the differences between the two bills are worked out quickly, perhaps by the end of this week.

Action Required
Advocates are urged to contact their Senators and House member and urge them to press Speaker Pelosi and Majority Leader Reid to ensure that the final economic recovery and stimulus package (known as the American Recovery and Reinvestment Plan) contains critical protections for state level safety net programs serving adults with children living with mental illness.  It is important that the final package also ensure that appropriate investments are made in health care research and technology that will improve quality and create jobs.

NAMI is urging the following as part of effort to reconcile the House and Senate bills:

• $87 billion in additional federal Medicaid matching funds (known as FMAP), over the next 27 months,
• A 3-month extension of the current legislative moratoria on Medicaid regulations (including those that would restrict case management and rehabilitation services),
• The full $10 billion in funding for medical research at the National Institutes of Health (NIH), including the National Institute of Mental Health (NIMH), as recommended in the Senate bill,
• Restoration of the full $2.5 billion for retrofitting and upgrading supportive housing developments for people with disabilities and elderly under the HUD 811 & 202 programs,
• Protections included in the Senate bill to ensure that the $1.1 billion investment in Comparative Effectiveness Research (CER) is focused on improving quality and clinical outcomes, and not simply government promotion of less expensive therapies,
• Full funding ($20 billion) for Health Information Technology (HIT) and development of electronic medical records and inclusion of community-based mental health providers as eligible for grants and incentive payments, and
• Restoration of $5.8 billion for HHS-wide wellness and prevention that was cut from the original Senate bill. 
  
  Click here to send a letter to your Senators and House member.  In addition, all House and Senate offices can be reached by calling 202-224-3121.
  
  Click here to view additional details on the changes made to the Senate bill as part of a Substitute Amendment developed by Senators Ben Nelson (D-NE) and Susan Collins (R-ME)
  
  Click here to view NAMI's letter of support for the House version of the American Recovery and Reinvestment Plan

Advocacy Alert   - January 13, 2009 
Support Children's Health Insurance!   Later this week the House is set to vote on legislation reauthorizing the State Children's Health Insurance Program (SCHIP).  The bill (HR 2) is nearly identical to separate bills that were vetoed by President Bush in 2007 and 2008.  The plan is for the House to pass the bill this week and for the Senate to follow as early as next week. The bill will be delivered to President-Elect Obama after he is inaugurated on January 20.
 
Act Now!
Contact Congress, and tell them to vote in favor of renewal of the SCHIP program.  The bill would renew the program for 4.5 years and add an additional 4 million low-income children to the program. 

Remind your members of Congress that the bill is nearly identical to previous versions of SCHIP legislation from the 110th Congress.  The bill would also allow states to add legal immigrant children to their SCHIP programs.  Finally, the bill contains a provision ensuring that all private sector SCHIP plans comply with the Paul Wellstone & Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 - the new federal parity law.

Contact Congress today using NAMI's Legislative Action Center!

All House and Senate offices can be reached by calling 1-800-828-0498.

Click here for additional information on the new SCHIP reauthorization bill.

Proposals for Health-Care Reform
from our December 27, 2008 Community Discussion
Reported by Ingrid Waldron, President, NAMI PA, Main Line

Roughly 5% of the US population has a serious mental illness, and the consequences of untreated or inadequately treated mental illness extend well beyond these individuals to create major problems for their families, as well as large public expenses, e.g. when these individuals are hospitalized or incarcerated.  Therefore, planning for health-care reform must take into account the needs of individuals with severe mental illness.

• Major problems which many individuals with severe mental illness experience include:
  lack of access to needed health care due to lack of insurance or unavailability of appropriate providers who accept their insurance,
• long waiting lists for some needed services,
• inadequate quality of some services,
• inability to afford prescriptions, especially given the low income of many disabled individuals,
• difficulty navigating the complex system of health care and other resources needed by people with severe mental illness.

The following paragraphs provide our proposals concerning the type of health-care reform we feel is needed to address these problems.  We are happy to note that our proposals are in line with many components of the President-Elect's Health-Care Plan. 

1a. For individuals with severe mental illness, provide integrated services, including care for physical illness, mental illness and substance abuse available at a single location, with a case manager to help these individuals access all needed health care and other services.  Insurers should reimburse for multiple treatments in one clinic visit in order to minimize transportation and organizational difficulties, which are common for individuals with severe mental illness.

1b. Medicaid, Medicare, and other types for health insurance should cover all needed types of treatments, e.g. case management, Assertive Community Treatment, and rehabilitation services that help an individual to manage a chronic illness such as a severe mental illness.

1c. Coordinate federal, state, county and privately funded services into a coherent system which can be easily navigated to obtain needed services.

Note: Integrated comprehensive services have been shown to save money by reducing rates of hospitalization and incarceration.

2a. Change Medicare and Medicaid reimbursement rates to encourage health-care providers to incorporate all appropriate services (e.g. behavioral health screenings for pediatric checkups and screening for depression and substance use in pregnant and perinatal women). 

2b. Adjust reimbursement rates to encourage medical students to become primary care providers and enter needed specialties such as child psychiatry. 

2c. Increase Medicaid and Medicare reimbursement rates, so more providers will accept Medicaid and Medicare patients.

3.  Encourage use of evidence-based best practices for prevention and treatment of mental and physical health problems through reimbursement rates and requirements for continuing education in best practices in psychiatry for primary care providers who often provide psychiatric care.

4.  Phase out the 24-month waiting period between the first month of Social Security disability coverage and the beginning of Medicare coverage to ensure access to needed medical care for disabled individuals (many of whom do not have access to Medicaid, COBRA or other alternatives).

5a. Offer a new public health insurance program with sliding scale fees for people who do not qualify for Medicaid and/or Medicare and who do not have access to employment-based insurance and/or cannot afford this insurance.  This plan should include coverage of mental health services and prescriptions. 

5b. All health insurance plans, especially all publicly funded programs (including State Children's Health Insurance Programs (SCHIP)), should be required to include coverage of mental health services.

6a. Everyone should have access to a prescription plan.  All prescription plans should include coverage for a wide range of medications, since different individuals need different medications in order to control chronic conditions such as severe mental illness, and specific medications needed often are not included in a restrictive formulary. 

6b. Reform Medicare Part D, which currently leaves many people with medication bills of thousands of dollars; this is not affordable for many disabled individuals, who often have very low incomes.  Eliminate the doughnut hole.  Include a provision for Medicare officials to negotiate lower drug prices.  Streamline the design of this benefit so it is not so hard to figure out the best plan. 

In conclusion, we very much appreciate the opportunity to provide input at this early stage in the planning of health-care reform.  We encourage readers of this report to submit their own observations and proposals at the http://change.gov/agenda/health_care_agenda/ website.

ACTION ALERT:   Reminder: Discussion this Saturday, 27 December,  at 2 p.m.
Topic:     How should the health care system be reformed to best help individuals with serious mental illness and their families?
Purpose: To inform ourselves and to provide input to the Obama-Biden Transition Project
As we wrote earlier, several members of NAMI PA, Main Line are hosting one of the Health Care Community Discussions sponsored by the Obama-Biden Transition Project.   Our discussion will focus on suggestions for how health care reform can best help individuals with serious mental illness and their families.  The report on our discussion is also supposed to include "particularly poignant stories about healthcare from participants that can be used to help emphasize the need for health care reform in our country".  You can learn more about the Health Care Community Discussions by viewing the Participant Guide at http://change.gov/participantguide.

Related Files

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