The American With Disabilities Act (ADA) celebrated its 20th anniversay at the Capitol on July 26, 2010 with a standing room only event entitled “Dreams Delivered, Dreams Delayed.” The Honorable Lowell P. Weicker, Jr., served as Honorary Chairman. In 1990, then Sen.Weicker was one of the original co-sponsors of this landmark federal legislative initiative to ensure the protection of civil rights to persons with disabilities.
The new law needed advocates to ensure education, outreach and compliance. Among those advocates, was Jan Van Tassel who welcomed the enthusiastic crowd to the event. In her role as Chair of the American With Disabilities Coalition of Connecticut, formed in 1992 to promote compliance with the Americans with Disabilites Act (ADA) in Connecticut, Jan has worked tirelessly for inclusion of all persons with any type of disabilities including mental health disabilities. Ann Steele, former MHAC Public Policy Director was among the Groundbreakers honored at the event as one who advanced to the goals of the ADA.
Stan Kosloski Chair of the Connecticut Disabilities Collaborative identified some challenges ahead in his closing remarks. First, Stan said, to think local. Cities and towns are often not in compliance with the ADA. Every town shouls have an ADA compliance officer and have a transition plan to implement the requirements of the ADA in each municipality. Private businesses should be aware that granfathering will not allow any escape from the responsibility to become ADA compliant today. Stan urged everyone to think about ADA compliance in terms of communication and ideas beyond structural access. We must remember that we still have a long way to go. Employment among non-ADA populations is more than double for ADA the population. Poverty is triple among the ADA population than among the general population and leisure time activities are only enjoyed 45% of the time in ADA population versus 65% of the general population who enjoy leisure activities.
A video entitled “The 20th Anniversary of the Americans with Disabilities Act: Human Rights in Progress” was shown and will be available on the ADA Coalition of Connecticut will be available on CT-N http://www.ctn.state.ct.us/daily_schedule.asp. Congratulations to all who participated in this celebration of life!
New federal regulations have gone into effect this month to resolve a health care disparity in coverage for mental health issues. Before national health care reform, private and public insurance such as Medicaid and Medicare paid less for mental health treatment by requiring higher co-pays and deductibles and less lifetime benefits for treating mental-health disorders and substance abuse compared with standard medical coverage. The Mental Health Association of Connecticut (MHAC) has long advocated for mental health parity. MHAC strongly supported national healthcare reform for the reason that it required mental health parity as established by the Mental Health Parity and Addiction Equity Act of 2008, noted Domenique Thornton, MHAC Policy Director.
Connecticut Health Advocate Kevin Lembo said regulations in the Mental Health Parity and Addiction Equity Act of 2008 make sweeping changes to a previous mental-health parity law of 1996. Here’s what Lembo’s office has to say about it:
For the first time, the federal government has issued regulations that reach for real mental health parity.� Plans are not only prohibited from imposing different financial requirements on mental health access, like co-pays and deductibles, but plans can’t arbitrarily limit the number of mental health visits a consumer can make.� Nor can a plan put greater restrictions on mental health access than on medical/surgical access, like excessive prior authorization requirements, restrictions on access to medications, and types of services, like outpatient or inpatient treatment.
“Every group health plan in Connecticut has an obligation to inform its consumers and provider panels of these new federal regulations,” Lembo said. “The successful implementation of these protections is vital and potentially life-saving.”
Lembo’s office has more information on its website, www.ct.gov/oha.
Anyone with questions for Health Care Advocate Lembo may call 1-866-466-4446.
State Legislative/Budget Update
The housing and homeless line item was preserved with no cuts. Funding was added for 50 new certificates through the Rental Assistance Program (RAP) for supportive housing targeted to frequent users of state funded institutions and services. Service dollars were added to the DMHAS budget as well for this program.
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A New Federal Bill Would Expand Heath Information Technology Funding for Community Behavioral Health
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A new bill to expand federal health information technology payments to previously ineligible community behavioral health providers and organizations.
The Health Information Technology (HIT) for Behavioral Health Services Act of 2010 ensures that behavioral and mental health professionals, psychiatric hospitals, behavioral and mental health treatment facilities, and substance abuse treatment facilities will be eligible for the electronic health record incentive payments established under the American Recovery and Reinvestment Act of 2009. By expanding HIT incentive payments to behavioral health providers, this legislation will provide crucial support for community behavioral health organizations as they seek to implement electronic health records.
Only 2 out of 5 Connecticut’s Congressional Representatives have signed on to this important bill!
They need to hear from you!
Click on to the National Council URL below to take action now by typing in your zip code and address to get your correct congress person.
http://capwiz.com/thenationalcouncil/utr/2/?a=14935431&i=96032809&c=
Today finding health insurance just got easier!! The U.S. Department of Health and Human Services launched HealthCare.gov. This easy to use website helps you understand many of the options now available. This new insurance will benefit individuals and families who have gone without health insurance for at least six (6). The website includes an insurance finder that makes it easy for you to find the type of program that might be right for you. From this website HealthCare.gov will allow you to request and receive updates in the future as the new health care law rolls out. I expect that the federal government will continue to keep the process of obtaining insurance as open and accessible as possible and I think this is a great step forward. HealthCare.gov is one step to making it possible for everyone in these United States should have the ability to access affordable, quality health care. Best wishes for a happy and safe 4th of July!.
The national MHA
Washington DC conference could not have come at a better time. June 10, 2010 was a full day at Congressional DC offices for Mental Health Association Policy Advocate, Domenique Thornton. The Senate
is expected to vote, starting today, on the bill to restore Unemployment
Insurance, provide more aid to states to help with rising Medicaid costs, and
provide jobs for low-income youth and parents. The vote is expected to be very
close and a yes vote on H.R. 4213 will save jobs and protect needed services. A NO vote threatens to halt the fragile recovery and will hurt people who need it the most.
Domenique met with Senator Dodd’s liaison for health care who informed her that Senator Dodd is supporting the bill to enhance Medicaid payments to the states. Federal aid continues to be vital to Connecticut’s economic recovery. Senator Lieberman needs to hear from you. Senatorial aides cautioned that Sen. Lieberman is taking a taking a more neutral position. Please contact your Senators now and inform them that their YES vote on the JOBS Bill will not only help continue unemployment insurance but help with Medicaid costs for those who have not yet found jobs. Thanks for your support.
Call Now!!
Senator Chris Dodd -
(202) 224-2823
Senator Joe Lieberman - (202) 224-4041
This week, Domenique Thornton, MHAC policy advocate, heads to Washington DC to attend the national Mental Health America conference and lobby Connecticut’s congressional delegation to extend fiscal relief to our cash strapped state. If Congress does nothing to extend the increased federal match instituted last year under the Recovery Act, many public programs could be cut. Next year Connecticut is facing a $3.9 Billion budget shortfall. The budget shortfall would be even greater if the previously included $365.6 million anticipated from the federal government is not received. If that additional revenue does not come through, the state will be well over $4 billion in the hole. Most states did the same as well by including anticipated federal revenue to balance their budgets. Now, that funding is in jeopardy. At least 34 states - two-thirds - will have to cut jobs and services if the enhanced federal match fails to be legislated. Please call your Senators today to ask them to support the enhanced Federal Medical Assistance Program (FMAP) in H.R. 4213, the American Jobs and Closing Tax Loopholes Bill now pending in congress.
Call your US Senators today and tell them to support FMAP in the Jobs Bill!
Senator Chris Dodd - (202) 224-2823
Senator Joe Lieberman - (202) 224-4041
May is Mental Health Month, and on May 18, bloggers will come together to educate the public about mental health, decrease stigma about mental illness, and discuss strategies for making lasting lifestyle and behavior changes that promote overall health and wellness. Today is a good time to tell your federal representatives to extend the increase in Medicaid funding FMAP. The 2009 American Recovery and Reinvestment Act (ARRA) includes only a temporary increase in federal Medicaid matching funds otherwise known as FMAP lasting until December 2010. There is pending legislation, however, that would extend this funding to all the states for another six months. Every state needs more money in these tough economic times. This is federal money that would be available to states in order to avoid devasting cuts to services for persons with disabilities. Every state has two United States Senators and every citizen has a congressperson that represents their district. Call the Congressional switchboard at 202 224-3121and ask to speak with your representatives. Ask them to support the efforst to extend an increase in Medicaid funding through July of 2011. Unless the extension is granted, states will be forced to make deep cuts in Medicaid coverage. Thanks for your support.
Members of the MHAC Waterbury Independence Center personally visited their legislators today and left them letters of concern. They told legislators that they would not be able to afford increased co-payments on Medicaid and Medicare. Such an increase in co-payments could jeopardize their access to important psychiatric medications and increase the likelihood of costly hospitalization. Members also asked their legislators to reject Senate Bill 424 consolidating five large departments because persons with serious mental illnesses need specialized care not found in any other department. It has not been shown that such a consolidation would even save money.
Senate Bill 140 An Act Concerning Transitioning Youth written to ensure that young people aging out of the custody of the Department of Children and Families (DCF) to the adult system have the essential elements of their relevant treatment plans in place before they leave DCF has passed favorably out of the Committee on Insurance. The state of the law today is that when young people reach age 18, DCF no longer considers it has an obligation to maintain treatment services. This leaves young adults, many with severe and persistant mental illness and most frequently with trauma histories, in a most untenable position without the necessary services to ensure their success. We know that early intervention can have a huge impact on recovery. We must make sure that all the necessary components are in place. We look forward to its passage on the floor of the house.
Speaker Donovan commenced the informational forum called by the Legisaltive Committee on Insurance along with State Comptroller Nancy Wyman and Healthcare Advocate Kevin Lembo. The Committee learned that healthcare accounted for fully one third of the state budget or $7 Billion. Both Wyman and Lembo said that Connecticut was well positioned to take advantage of all of the reforms at the national level because they CT had the foresight to pass the Connecticut State Sustinet Bill last year over the Governor’s veto.
The Patient Protection and Affordable Care Act (PPACA) is huge and will not be fully implemented until 2014. However, because of Connecticut’s foresight to pass the Sustinet Connecticut state legislation, there will be immediate advantages such as subsidies to bring people not now covered under Medicaid up to 133% of the federal poverty level. Early deliverable items are the high risk pool dollars, reinsurance for early retirees, grants for independent state offices of health insurance and mental health parity implemented to a greater extent. The Connecticut plan called Sustinet may be licensed as and insurer or as an exchange. But, this policy decisions have yet to be been made by lawmakers who will receive a report from the Sustinet Board by mid summer. State legislation may still be required to be draw down on all available federal funding.
Rep. Fontana asked “How much could Connecticut be eligible for in competitive federal grants?” Because Connecticut is ahead of federal government on such issues as rate review and the higher standard for revocation of insurance, Connecticut could apply for demonstration grants. At the primary care level, Rep. Ritter was interested in medical home model and the work force development. How will insurance exchanges work? asked Sen. Prague. The role of the exchanges is to provide insurance for those for whom obtaining insurance is currently difficult for individuals or businesses. Private market will still be there but the exchange will also compete or may also be part of the exchange. Sen. Harp was interested in the high risk pool for persons who have run out of COBRA and cannot obtain insurance because of preexisting conditions. There are discussions whether or not Connecticut should have its own high risk pool as it currently does or go in with the federal high risk pool. With so many variables possible including a maximum rate for the high risk pool and with the federal legislation, the committee and health advocates agree that the Sustinet legislation must be monitored closely as the federal plan unfolds.
Young Adults with serious mental illness often age out of Department of Children and Families at age 18 without the necessary completed treatment plan in place to support the transition to adult services at the Department of Mental Health and Addiction Services. We thank the Appropriations Committee today for successfully passing a raised Senate Bill 140 An Act Concerning Youth Transitioning Between the Department of Children and Families and theDepartment of Mental Health and Addiction Services. We particularly thank Representative Toni Walker who championed the bill out of committee as she stressed that this bill gives the force of law to an understanding that the two departments now have. The passage of this bill will ensure that the essential components of the treatment plan have been identified and are in place before a young adult can move out into the world. MHAC supports passage of the final bill in the legislature.
MHAC policy advocate, Domenique Thornton, joins consumers, agency heads and other disability advocates today to inform the Committee on Government Administration and Elections that merging the five agencies of DSS, DCF, DPH, DDS and DMHAS will not result in savings but will negatively impact the quality of services provided to vulnerable people. The super agency will need one more layer of bureaucracy at the commissioner level head to serve as an agency head. However, the needs of the specialized populations served by the super-department will have less expertise and scrutiny. DMHAS chief Pat Rehmer expressed concerns that the 90,000 persons with with severe and chronic mental health disabilities and substance abuse disorders need “expertise and clinical sensitivity to the individuals served by the agencies.” Thornton agreed that “A case manager from DMHAS is not interchangeable with a case manager from DDS, DCF or DSS.” because their missions are separate and distinct having different needs.
Domenique Thornton spoke before the Appropiations Committee last week to tell them why cuts to Medicaid and elimination of supplemental services under Medicare Part D were so egregious and will hurt Connecticut’s most needy and vulnerable populations.
Medicaid recipients have already been subject to serious cuts under last year’s budget. But this plan, further cuts would be made to Medicaid and medication access. Ironically, this will happen at a time when the state is receiving $66 million in new federal money to prevent any further cuts. Last year, Connecticut’s low-income older adults and children and adults with disabilities “shared the pain” and paid their share of cuts including:
· Co-pays for people on Medicare and Medicaid receiving drug coverage through Medicare Part D. This subjects them to co-pays up to $15 per month.
· Restrictions on psychiatric medications for people receiving drug coverage through Medicaid or SAGA.
Thornton continued that these cuts, which are already causing significant harm, in addition to the Governor’s mid-term budget adjustment proposals, contain among other proposals:
Thornton also reminded the committee that when Connecticut cuts gross expenditures, Connecticut loses federal matching money. Rep. Toni Walker a member of this committee asked why the Deficit Mitigation Plan came so close upon the heels of the Budget Adjustment. Thornton concluded that each plan contained cuts upon cuts. The impact of these cuts must be analyzed individually so that the full impact of all the cuts cannot be appreciated. The Deficit Mitigation Plan includes $140.5 Million in gross expenditure reductions that will result in a loss of $58.6 Million in federal revenue. At a time when the legislature has prioritized the maximization of federal revenue as a matter of highest public policy, neither plan makes any sense except it will be clear that the poor and vulnerable will have less and pay more for it.
Welcome and congratulations to Edwin Norse, new member of the MHAC Board of Directors for submitting testimony in favor of Senate Bill 405 An Act Concerning the Developement of Cost Effective Suuportive Housing for Frequent Users of Costly State Services. Friday, the legislature’s committee on Public Health considered a bill that would propose to develop new housing for frequent users of high cost hospitals, inpatient services, nursing homes, or prisons when supportive housing could diminish such uses. His testimony has been featured on the Partnership for Strong Communities Website at http://www.ctpartnershiphousing.com/index.php?option=com_content&task=view&id=1432&Itemid=40
As the State of Connecticut considers closing Cedarcrest hospital and other institutional settings, all the savings from closure of these institutions should be used to support people in recovery in the community where they can develop full and productive lives with cost effective community services.
MHAC’s Domenique Thornton and Board member Steve Madonick witnessed a standing room only packed meetibng last night at the first P & T Committee to consider what mental health medications would be included in the state’s Preferred Drug List (PDL). The PDL will determine which antidepressants, SSRI and antipsychotics will be available for use on any state funded health program. Thornton spoke to committee chair, Dr. Carl Sherter, moments before the meeting started to ensure that correspondence from MHAC President Philip Wyzik was given consideration. Public participation is not required and MHAC was not among those selected to speak at the hearing. Speakers emphasized the importance of establishing the widest array of medication selection because one size does not fit all in the area of psychotropic medications. Consumer committee member, Stella Cretella also advised against substituting generics for brand name antipsychotics for the treatment of schizophenia. The chairman assured all present that the committee’s intent was to assure that all medications in this class were available as well as save the state some dollars.
The Human Services Committee agreed today to endorse a bill that would open the Pharmaceutical and Therapeutics (P &T) Committee to public participation. For many years, Connecticut has wisely exempted mental health medications from the restrictions of a preferred drug list. Last year, in the tough economic climate, this exemption was lost. Now, mental health medications will be deliberated by the P & T Committee before accepted for inclusion for use in any state funded health care program. MHAC lobbyist, Domenique Thornton testified Tuesday that more public participation was needed to ensure the widest selection for inclusion on the state’s Preferred Drug List (PDL). She noted that many advocates including MHAC President Phil Wyzik with 25 years of community mental health experience and Dr. Steve Madonick head of Children’s Services at the Institute of Living and MHAC Board Member were denied the opportunity to speak at tonight’s P & T Committee that will consider which mental health medications will be included for the first time. Thornton thanked members of the committee as they left the hearing room for passing this bill unanimously on a bipartisan basis.
Domenique Thornton, MHAC public policy advocate spoke at the Legislature on March 2, 2010 in favor of increasing public participation in meetings of the Pharmaceutical and Therapeutics (P & T) Committee. The P & T Committee determines what medications will be available for persons under state funded programs. Connecticut has wisely exempted mental health medications for many years. Today, legislators are looking to cut costs by restricting access to medications which are the most effective method of treating mental health disorders. Thornton noted study after study has shown that restricting access to effective medications will increase more expensive modalities of care such as doctor visits and hospitalization. Requiring Prior Authorization (PA) is also not a good remedy. Recovery setbacks, mental health relapse, poor outcomes and life problems of the sickest and poorest residents in the state are ignored when they are required to “fail first” before they can receive an effective medication not on the preferred list. Therefore, the state should ensure that the most robust array of medications are available through increased public participation. Thornton also suggested appropriate utilization management clinical edits to identify high users of pharmacy benefit and by linking the DSS database on claims with DMHAS information on hospitalizations, employment, substance use, the current level of care and system-wide admissions and discharges. The departments must share and compare two sets of data from prescription drug medications and patient outcomes to get the results everyone hopes to see.
Last week, I was delighted to be accompanied by Dick Schreiber, Edwin Norse and Amelia Saunders to testify before the Human Services Committee in opposition to Medicaid cuts and the merger of the CODHI with DSS. The entire committee received a long list of published resources substantiating that restrictive Medicaid drug policies always cost more in more expensive services and never save money. I was especially dismayed and shocked to learn that DSS Commissioner told the committee he planned to mitigate the DSS deficit with $66 million of additional payments expected from the federal government even though HHS Secretary Kathleen Sebelius stated that these additional funds are specifically intended to “continue to provide critical health care and to maintain Medicaid and other budget priorities in these difficult economic times.”