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Legislative issues

Legislative Report              March 7, 2008 
 

House Bills

HCR043 – Children’s Health – Recognizes the importance of children’s health and supporting public and private outreach efforts to help them get the health coverage they need.

Position:  Monitoring 

HCR056 – Secure Mental Health Facility - This resolution states that the State of Idaho should not use prison facilities for the treatment or confinement of people with mental illness who have not been convicted of a crime or charged with commission of a violent crime.  It also states that a secure facility for treatment of people with serious mental illness should be established under the administration of the Department of Health and Welfare, and should be separate from the secure facility proposed by the Department of Corrections.

      Status: Just printed and will probably be sent to House State Affairs

Position:  Support 
 

H0509 – Prescription Drug Program – Establishes the Idaho Prescription Drug Program within the Dept. of Health and Welfare to provide uninsured and underinsured individuals with prescription drugs at rates similar to those in group health plans.  This program is expected to save people 40-60 % in costs.

      Status:  House Health and Welfare

Position:  Monitoring 

H0517 – Consumer Protection – Provides additional protection to people with disabilities and the elderly under the Idaho Consumer Protection Act.

      Status:  Amended; passed the House 63-4-3 on 2/29; hearing  scheduled in Senate Judiciary for 1:30 pm on 3/5

Position:  Monitoring

Senate Bills

S1340 – Medicaid Fraud – Requires suspected Medicaid provider fraud to be referred to the Medicaid Fraud Control Unit and provides methods for the Dept. of Health and Welfare to investigate and have administrative remedies for provider fraud in other public assistance programs as well.

Position:  Monitoring 

S1386 – Authorization of Medications – Creates a Pharmacy and Therapeutics Committee under the Director of the Department of Health and Welfare, names who will serve on the committee, and says that the committee authorizes a physician to prescribe medication without prior departmental authorization if, in the physician's opinion the medication is medically necessary for a specific patient or if the drug has previously been approved by the department for that patient's medical condition

Position:  Monitoring 
 

S 1426 – Commitment for People with Mental Illness – Amends current law to change the process for committing people with mental illness to outpatient treatment.

      Status:  Passed Senate 33-0-2 on 2/21; Scheduled for a hearing in  House Health & Welfare at 1:30 on 3/10

Position:  Support 
 
 
 

S1452 – DHW Appropriations - This bill is an FY 2008 supplemental appropriation for the Department of Health and Welfare for the Division of Mental Health Services. This bill increases the Children’s Mental Health FY 2008 budget by $320,300 in General Fund monies to pay for attorney fees for the Jeff D. lawsuit. This bill also decreases the Community Mental Health FY 2008 budget by $590,000 in General Funds. The funding will be reappropriated to pay back a Medicare audit in the State Hospital South budget. Finally this FY 2008 supplemental appropriation bill increases the dedicated fund appropriation by $458,600 in the Community Mental Health program to pay for personnel costs.

S1453 – DHW Appropriations - This is an FY 2008 supplemental appropriation for the Psychiatric Hospitalization division within the Department of Health and Welfare. This bill provides additional funding for annualization of expansion costs for additional beds at State Hospital North, funding for an audit payback to Medicare for funding overpaid by the federal government in FY 2006, add funds to the Community Hospitalization program. The Community Hospitalization program is the budget that covers private hospitalization costs of individuals committed to state custody for mental health reasons. The fiscal impact of this bill is a net increase of $3,048,500, $348,500 of which is ongoing funding.

Position:  Monitoring 
 
 

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Where we stand at NAMI Idaho 

Urgent need for secure mental illness facility 
As reported on channel 8 news last night (Nov. 7) a person regarded  
by professionals as still dangerous after being confined in the  
state prison for years, incompetent to stand trial for murder  
because of severe psychosis, has been transferred to State Hospital  
South against recommendation of the staff.  State Hospital South is  
an excellent psychiatric facility but not secure against escape into  
the community or assault against staff or other patients from a  
dangerously violent mentally ill person. 
 
A secure psychiatric treatment facility for dangerously mentally ill  
persons has been the recommendation for years.  With appropriate  
treatment it is possible the psychosis would by now have been  
controlled rendering this patient no longer dangerous.  For example,  
clozapine is the anti-psychotic of last resort that may work when  
all other modern anti-psychotics have failed.  But clozapine is not  
on the formulary of the prison and therefore not likely  
available.  After all, the prison is not primarily a treatment  
facility or set up to manage a drug like clozapine that requires  
close monitoring. 
 
Ideally, such a treatment facility would be directed by a specially  
trained psychiatrist who could in turn train the staff.  The  
facility would be secure against escape, and the perimeter  
controlled.  I am told that a forensic psychiatrist is hard to  
recruit, but as luck would have it such a person is clambering to  
come to Idaho. It is possible that older buildings on the grounds of the State Hospital South or Idaho State Hospital and School (near Boise) could be modified into a secure facility cheaper than building anew. 
 
I personally am disappointed that we have arrived at such a state of  
unplanned for emergency; and wonder how much of this relates to the  
fact that Idaho is one of only four states that have no "not guilty  
by reason of insanity law" and so has allowed for years preferential  
transfer to prison of severely mentally ill people. 
Respectfully submitted, 
Martha Tanner, M.D.                                                                 

Where we stand:

Equal insurance for those with a mental illness

NAMI Idaho has been asking the Legislature for the past 10 years to pass a bill that would give equal insurance coverage to those with a mental illness - the same coverage as any other biological illness receives. Each time it is brought to the legislators, they kill the bill.

It is NAMI Idaho's stand that not providing equal access to care and the same coverage for individuals with brain disorders as is provided for other illnesses is discrimination against a targeted population. Parity laws that are comprehensive, clear, and compelling in ending all forms of insurance discrimination against persons with a severe mental illness should exist in all 50 states. To do otherwise is simply unacceptable.

Formularies for medication through Medicaid

It is NAMI Idaho's stand that people should have access to the medication that provides them with the ability to be the best that they can be.

The 2001 Legislature asked Medicaid to bring back at next year's session, a drug formulary that would list the medications that Medicaid would pay for. With this system, people with a mental illness taking medications not on that list would have two choices: Continue to take their medications, but have to pay for them, or take the medications approved by and paid for by Medicaid. What could result is that people with mental illness would only be able to access older medications or generic medications that do not work on many patients or at the least do not work nearly as well as newer medications. Thus people will not stay as well and the consequences could be more hospitalization. 

Legislators also asked Medicaid to look at a co-pay for medications and services. Most people with a disability, including those with a mental illness, receive an average of $500 per month. Some take as many as six medications, even a $1 co-pay could mean that they not have a decent place to live, or they would not have the food needed to sustain themselves. Or likely they would not be able to afford the co-pay and would discontinue medication and services. Again more hospitalization.

NAMI Idaho believes that the consequences of either of these plans being enacted would again discriminate against those with a severe mental illness and most likely would cost the state more money than if they continue access to the proper medications and not place another burden on people already trying to deal with a serious illness. Money or wellness? Which is more important?

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