Congressman Murphy (CT-5) Press Conference

On Wednesday, April 8th, Congressman Christopher Murphy (CT-5th) held a press conference at Chamberlain Heights in Meriden, Connecticut. Chamberlain Heights is a federal low-income public housing development for families. It is composed of 38 buildings which provide 124 units of housing.

In front of 30 or so individuals, Congressman Murphy announced the introduction of the “Frank Melville Supportive Housing Investment Act of 2009 (H.R. 1675).” In order to gain bipartisan support, Murphy has been partnered up with Republican Congresswoman Judy Biggert (IL-13). This legislation would provide progress in several areas of supportive housing development. More importantly, a national housing statute, or “Section 811,” would recieve the proper reformations. The reformation of section 811 is crucial because it is the only federal housing program that is dedicated to helping extremely low-income people with serious disabilities. It helps these vulnerable citizens live independently in a community environment.

The proposed legislation would make several important changes, including:

• Increased state involvement in the approval of housing projects
• Further incentives for federal housing money to be combined with state and private money in order to spread federal dollars out
• Shifting federal funding away from individual vouchers to construction of new supportive housing units

There were promising remarks from Murphy which reaffirmed his committment to seeing this through. This same bill passed the House of Representatives in 2008, yet due to timing constraints, it has to be reintroduced in order to be considered for this year. During President George W. Bush’s presidency, the Department of Housing and Urban Development was pushed to the side and ignored. Murphy assured the public that he will make it a priority to reach out to the is Department, and furthermore President Obama.

Representatives spoke on the behalf of their own agencies that are in full support of the legislation. Tom Burr, President of Manchester-CT affiliate, spoke about the importance of supportive housing as the father of an adult son with mental illness, but also as a fiscally sound solution for the state taht saves money and lives. Other agencies represented include the Partnership for Strong Communities, The Connecticut Coalition to End Homelessness, and the Meriden Housing Authority.

Murphy acknowledged the Keep the Promise Coalition, and made several remarks applauding their efforts. Murphy stated, “Through all your hard work and dedication over years and years, your efforts are finally getting more recognition…those pins have been on way too long. It’s time they come off.”

Appropriations Committee Proposed Budget

April showers bring May flowers…and in CT the beginning of the month brought with it a proposed budget from the Appropriations Committee. KTP strongly supports the legislature’s efforts to restore funding and eliminate many of the Governor’s proposed cuts in Medicaid, juvenile justice, and other critical health care services.

The Appropriations Committee rejected many of the cuts to Medicaid services proposed by the Governor and include restoring adult dental coverage, retaining a Social Security cost of living adjustement (COLA) for people termed “aged, blind, and disabled,” among several others. The Appropriations budget also proposes to restore $2 million in funding for supportive housing units for families, restores partial funding to implement “Raise the Age” legislation specifically for 16 year-olds, and proposes funding for six more Family Support Centers across the State. It is clear the Appropriations aim was to restore funding or reject cuts that would be devastating to some of the most vulnerable people in CT.

However, we are very concerned about some of the remaining cuts that could negatively impact low-income people with serious mental illnesses. These include the removal of the Medicare part D Wrap Around protection that covers co-pays for people who are dually eligile for Medicare and Medicaid and subjecting them to co-pays up to $15 per month. Although this is less than the Governor’s proposed co-pay ($20 per month), people who are dually eligible usually have the most limited income levels and would be disproportionately affected.

Additional proposed cuts to the social services budget include subjecting mental health related drugs to the state’s PDL (Preferred Drug List) and limiting the medical necessity definition, both of which reduces access to care.

Lastly, there is no investment or strategy to provide access to basic, safe and affordable housing for low-income people with disabilities, which will only assure the need for more high cost services and further reliance on institutional care.

If any of these proposed cuts will affect you or a loved one, please call your legislators. First thank them for rejecting many of the Governor’s proposed cuts to Medicaid services. Then tell them about one or more proposed cuts that would affect you or your loved one and briefly explain. Include explanations of how a cut would be more expensive to the State (eg. need for emergency care, hospitalization, etc.). Urge them to reject harmful cuts or access barriers and remember to thank themfor their time.

Senate Democrats: 1-800-842-1420

Senate Republicans: 1-800-842-1421

House Democrats: 1-800-842-1902

House Republicans: 1-800-842-1423

Message: Don’t balance the budget on the backs of people who have low incomes. It will cost people their health and wellbeing and the state more in emergency costs!

*To get more details about the Appropriations budge, please go to http://www.cga.ct.gov/ofa/Documents/OFABudget/2009/Committee/Index.htm or call Cheri or Maura at KTP 1-800-215-3021

Medicaid Cuts:Disasterous Results

I have had the opportunity to analyze several studies on state Medicaid cuts. Virtually all the studies conclude Medicaid cuts are damaging to those who suffer from mental illnesses. Stephen Zuckerman, a senior fellow in the Health Policy Center, Urban Institute, in Washington, D.C., researched and analyzed the effects of the State of Missouri’s 2005 Medicaid cuts. Through the use of administrative data, provider utilization and financial reports, as well as telephone case-study interviews, Zuckerman was able to illustrate the impact of these cuts.

The entire Medical Assistance for Workers with Disabilities (MAWD) program was eliminated in the state of Missouri. It had allowed those who were up to 250% of poverty to qualify for Medicaid. More importantly, it gave citizens an alternative to the Medicaid Spend Down program. Co-payments were increased from a range of $0.50 – $3.00. This type of increase, although seemingly small to some, is extremely wounding to so many. Restrictions on eligibility and services resulted in Emergency Room visits increasing by 167,000 between 2004 and 2006. Of these visits, 30,000 less were Medicaid covered. The number of uninsured visits INCREASED by approximately 85,000. The adverse effects on hospital costs were astounding. In 2004, prior to the implementation of the cuts, there had been a total of $429 million in uncompensated care. In 2006, there was a 38% hike which resulted in a $162 million increase. This came to a total of $591 million in uncompensated care in 2006¹.

Many adults were placed on pharmaceutical companies “Patient Assistance Programs.” This resulted in unnecessary medication changes as well as high administrative costs for Community Health Centers. Having to switch medications, whether to a generic, or to a cheaper, different medication, can have devastating effects on individuals living with mental illnesses. Some patients even had to quit work to remain on Medicaid and to be able to retain access to their medications!

Another study conducted on 10 different states, found on average nearly 50% of all Medicaid patients reported having experienced a medication access problem. States such as Michigan and Georgia were above a 60% response rate of negative experiences! This had to do with certain drugs being eliminated off the Preferred Drug List (PDL)².

This is only skimming the surface of the detrimental effects that cuts to Medicaid and medication access create. From these two studies alone, it is evident that cuts will not save the state money. Rather, cuts will result in substantial increases, particularly in uncompensated care for Emergency Room visits. We cannot let these cuts occur in our state. Connecticut citizens living with mental illnesses should not suffer the same devastating consequences seen in other states.

¹Zuckerman, Stephen. “Missouri’s 2005 Medicaid Cuts: How did They Affect Enrollees and Providers?” Data Watch: Missouri Medicaid.

²”Medicaid Prescription Drug Policies and Pyschopharmacological Treatment Access and Continuity: Findings from 10 States.” American Psychiatric Institute for Research and Education.

Public Hearing Regarding Federal Stimulus Money Distribution

On Friday, March 20th, at the Legislative Office Building (LOB), the Appropriations Committee held a public hearing. Several bills were discussed, although the Keep the Promise Coalition’s main reason for appearing and testifying was due to Bill No. 262, “An Act Concerning a Commission on Federal Stimulus Distribution.” This Commission would provide recommendations not only to the governor, but also to the general assembly about where the federal stimulus money should go. The federal government appropriated $1.3 billion of the federal stimulus package to be used for the Medicaid program over the next two years and made it clear that this was to avoid state’s having to cut Medicaid and essential health care services.

There was a solid turnout in terms of the number of Legislators that were present during the hearing. Initially, there were around sixteen present, and as time went on, the number rose to as many as twenty-three. This made the hearing all the more beneficial in several ways. First, more legislators were exposed to testimony and in turn heard testimony from NAMI-CT and Keep the Promise Coalition members. Secondly, there were productive Q & A’s between legislators and testifiers, which further educated the committee about where we, as an advocacy coalition, are coming from. There were also several testifiers who rely on Medicaid for prescription drug coverage, which gave the legislators a personal view as to how important this state-funded assistance is to helping keep people with serious mental illnesses engaged in recovery, and in turn, more integrated in the community and less reliant on high cost institutional and acute levels of care.

It is important to point out that already the state is saving $159 million a year due to the implementation of Medicaid Pard D. This does not include the extra $28 million subsidy for state retirees. This brings the grand total of savings to $187 million! Despite these savings, the Governor has recommended restricting access to medications and service cuts under Medicaid in her budget. There are serious implications to the implementation of these cuts. Many people with severe and persistent illnesses will have to choose between paying for medication or for food. There are studies that have documented this as being the case.

It is critical that KTP, NAMI-CT, people with mental illnesses and their family members make it clear that they need not and cannot be forgotten, despite this state and federal budgetary crisis. The $1.3 billion in federal stimulus dollars must be used towards its original, intended purpose — preserving and protecting Medicaid and essential health care services. Low-income people with mental illness who so greatly depend on Medicaid assistance must not lose access to these vital services.

Raise The Age Rally on March 4th

On Wednesday, March 4th, a rally and juvenile justice public hearing took place inside the Legislative Office Building in Downtown Hartford. It was organized by the Connecticut Juvenile Justice Alliance (CJJA). At least 60 people gathered in the middle of the first floor lobby. Everyone’s presence was well recognized. Coordinators went to each attending individual, handing them a bright orange t-shirt to wear as well as a button promoting Raise the Age. Many individuals arrived well before the 11:45 AM scheduled hearing, and took the time to visit their legislator’s offices, leaving notes and/or speaking to aides to help reinforce the message: Raise the Age must be put into place now! Not later! The Governors proposal to postpone it until 2012 must be voted against and struck down!

The public hearing was electrifying and full of energy. I offered to remain standing behind the podium, as well as dozens of others, giving the hearing a more unified feel. Looking around the room, all you could see were crowds of bright orange t-shirts. Individuals of various racial and ethnic backgrounds sat or stood side by side, all coming together for this same vital initiative. Four legislators attended and spoke at the hearing. These legislators, in the order of which they spoke, included: Rep. Toni Walker (93rd-New Haven), Rep. Gary Holder-Winfield (94th-New Haven), Rep. Chris Lyddy (106th-Newtown) and Rep. Minnie Gonzalez (3rd-Hartford). Each legislator expressed his or her deep and endearing commitment for the need to strike down this proposed postponement. There were oftentimes pauses due to numerous applause’s. Every few minutes I would also hear audience members saying, “Yes,” “That’s right,” and more often than not, “Mmmhmm.”

There were two individuals who testified at the hearing, one of whom had gone through the prison system since he was nearly 20 years of age. The other was a mother of a son who for the last several weeks, has been incarcerated at Manson awaiting trial as an adult. The former inmate, now 28, had just been released a few weeks ago. In the beginning, he had made it absolutely clear that the reasons for his incarceration were strictly non-violent and only drug related. His passion for this cause was personal. A point that he stressed time and time again was the need for juvenile offenders not to be incarcerated in adult prisons, but instead to be rehabilitated with the support of counselors, and access to education. He himself discussed the fact that earning his high school diploma, and learning how to write essays, has given him a renowned sense of optimism about his future. The words he spoke were powerful, with the use of eye contact, hand gestures, and body language making it all the more engaging for me as an audience member.

The second individual, a mother, came across as if her son being taken away from her had eaten her up inside. I can only imagine that telling her story must have taken at the very least, a moderate load off her shoulders. All of us can attest to the fact of how much better we as human beings feel when we are able to share something that has been bothering us, or that we feel passionate about. Instead of staying at home, and feeling sorry for son and herself, she has gone above and beyond, giving up her own sense of privacy in order to work for a justified cause. There was no doubt that this was a loving and caring mother, who would do absolutely anything to make sure that her son is properly taken care of and helped.

You can read and learn more about the CT Juvenile Justice Alliance by visiting: http://www.raisetheagect.org

Please take the time time to email, call, or visit your legislators. Tell them your stance and why you feel the way you do. To find whom your legislator is, as well as how to get in contact with him or her, visit: http://www.cga.ct.gov/

State Budget Hearing on Social Services and Children’s Systems

The much anticipated Department of Social Services and Department of Children’s and Families Budget Hearing was held on Wednesday, February 18th. The immense amount of prepartation kept everyone at the Keep the Promise Coalition (KTP) and NAMI-CT occupied and on their toes. Through phone calls to those who are connected to KTP and NAMI-CT, we were able to find several individuals to testify and share their experience. A few of the main issues that were addressed in people’s included: Medicaid Spend Down, the Governor’s proposed cuts to Medicaid, issues with access to medications, as well as their experiences dealing with the DSS and DCF. The Governor is proposing major cuts to critical health care services, such as restricting access to psychiatric medications and eliminating the Medicare Part D state wraparound for co-pays and non-formulary drugs. These decisions will disproportionately hit those with the least resources.

On February 11th, staff members of NAMI-CT and KTP facilitated a testimony workshop, which not only helped prepare testifiers with prearing their written testimonies, but also with what to expect. Alicia Woodsby, Public Policy Director at NAMI-CT, gave an overall description of the environment in which people would be giving their testimony. In addition, we had our own “Mock Budget Hearing,” in which staff took on the role as legislators, watching and listening to each individual’s testimony.

Having had class all day on Wednesday, I was not able to get to the Legislative Office Building (LOB) until later in the night. I was able to arrive just in time to watch NAMI-CT Executive Director Kate Mattias provide her testimony to the Committee. Sitting at the desk, typed testimony in front of her, Kate went on to speak for the full three minutes that is allotted for every testifier.

Kate’s testimony appeared to grab the attention of the legislative panel. I was anxious as I watched and listened at the same time, with thoughts streaming through my mind, ‘I hope this testimony is going to register in these legislators brains! I hope they understand how critical these issues are to those who live with and are affected by mental illnesses!’

Later this same week, Friday, February 20th, I will attend the public hearing relevant to the budget of The Department of Mental Health and Addiction Services (DMHAS). I will, with no doubt describe how this hearing went in my next entry.

Protect Services for People with Mental Illnesses at Upcoming Budget Hearings

By all accounts, the Governor’s budget is expected to include massive draconian cuts to programs and services — many serving the state’s most poor and vulnerable populations. Like the impact of September 11th and the Iraq war, the state’s current economic crisis, with rising foreclosures and layoffs, increases the demand for mental health services. Cutting these services will compound that crisis by forcing individuals to use emergency rooms and expensive hospital services. Now is the time to assure adequate access to community care and reduce our reliance on institutions by investing in proven solutions.

The Governor will reveal her proposed budget on Wednesday, February 4^th at the Capitol Building in Hartford. This will be followed by a series of budget hearings allowing the public to provide feedback to the Legislature on the potential impact of the Governor’s recommendations. Keep the Promise Coalition will be organizing members of the Coalition and the broader mental health community to testify at these hearings and to come out to heighten the visibility of our issues. On Friday, February 13^th, the hearing will address budget related concerns about programs and services provided by the Department of Social Services and Department of Children and Families. The following Friday, February 20^th, will be the budget hearing for the Department of Mental Health and Addiction Services (DMHAS).

Keep the Promise Coalition will send out information to all members of our action alert email list detailing proposed budget cuts and any changes to community based mental health services, housing options for people with mental illnesses, or to healthcare programs and medication access. We will also provide talking points and data relevant to our main message, “Community Solutions, Not Institutions”. We hope that you will join our effort to stop short-sighted policy decisions, such as cuts to vital community based programs and housing, which will increase long-term costs and the reliance on more costly and inappropriate settings like prisons and nursing homes. Please contact us with any questions by email or phone with the information listed on our website at www.ctkeepthepromise.org