TELL THE LEGISLATURE NOT TO CUT TAXES AND BEHAVIORAL HEALTH SERVICES

On December 31st, 2014, the current state personal income tax rate will go down from 5% to 3.75% and the corporate rate will go down from 7% to 5.25% unless the Illinois legislature votes to continue the current rates.  These reductions would result in serious cuts to behavioral health services including the following:

  • 140,000 individuals receiving publicly funded mental health services will have reduced access to psychiatry, counseling, ACT, and emergency medications;
  • 35,000 individuals will no longer receive any services;
  • 10,000 people will not receive needed crisis services (resulting in more admissions to the ERs and nursing homes, etc.);
  • 840 beds of the current 3,500 would be reduced for crisis residential treatment, resulting in increased homelessness;
  • 216 individuals would lose rental subsidies for the Permanent Supported Housing program, placing them at risk of losing their housing;
  • Reduction in the Individual Care Grant program, including services serving at least 75 children;
  • Reduction in funding for SMHRF Comparable Services will prevent implementation of a key pilot program;
  • Reduction of services to 880 Williams Class members currently living in the community by the elimination of drop-in centers ACT teams, and other programs.
  • Inability to meet FY15 Consent Decree targets to transition 400 Williams class members and 220 Colbert class members.
  • Inability to meet tenets of these Consent Decrees would result in federal receivership.
  • Reduction of 3,280 civil hospital beds and 320 forensic beds.
  • Reduced staffing by 650 would increase risk of violating CRIPA and other federal laws.

Click here for more details on the budget

The good news is that the Governor has proposed a budget which will continue the current personal and corporate income tax rates beyond December 31st.  However, in order for this budget to become a reality it must be passed by the Illinois House and Senate.  Please contact your state senator and state representative and tell them to vote for a continuation of the current income tax rates.  The legislature is not in session until April 28 so you can call, write or visit your legislators in the home district offices.  Click here to find out the name of your state senator and repreentative and how to contact them.

Hearing held on Congressman Murphy’s controversial mental health bill

A hearing was held on HR3717 on April 3, 2014.  Here is link to the testimony.

On December 12, 2013, Congressman Tim Murphy (R-PA) introduced the “Helping Families in Mental Health Crisis Act of 2013.  This bill (HR 3717)  includes many provisions that have broad support in the mental health community including reauthorization of the Mental Health First Aid Act (S.153/H.R.274), the Garrett Lee Smith Memorial Act (S.116/H.R.2734,  the Children’s Recovery from Trauma Act (S.380), the Excellence in Mental Health Act (S.264/H.R.1263), the Justice and Mental Health Collaboration Act of 2013 (MIOTCRA;S. 162/H.R.401) and the Behavioral Health IT Act (S.1517, S.1685/H.R.2057),.   However, the bill would use Federal funds to encourage states to broaden the use of outpatient commitment.  Outpatient commitment is opposed by many mental health organizations.

Many national organizations have issued statements concerning Representative Murphy’s bill:

Statement of Mental Health America

Statement of the Natiional Coalition for Mental Health Recovery

Statement of the National Disabilities Rights Network

Statement of the American Psychiatric Association

Statement of the National Council 

Statement of the National Alliance on Mental Illness

Statement of Sacred Creations

Statement of Mad in America

Statement of the Autistic Self Advocacy Network

Statement of the Mental Illness Policy organization 

Statement of the Coalition of Citizens with Disabilities of Illinois

APA statement from Jejfrey Lieberman, MD

The Mental Health Summit has not taken a position on this bill.

CMS Responds to Our Concerns-Rescinds Proposal to Limit Access to Psychotropic Medications

Responding to a huge outpouring of concerns and complaints from the mental health advocacy community across the country and also to pressure from Congress, the Center for Medicare and Medicaid Services (CMS) reversed its decision to limit access to psychotropic medications.  Virtually every mental health organization in Illinois and across the country communicated to CMS  and to Congress our opposition to this proposal which would have allowed Medicare Part D providers to restrict access to medications for the treatment of serious mental illnesses.  Bravo to everyone who joined in the effort to stop this bad policy from taking effect.

In the meantime, Congress is considering legislation to prohibit CMS from going forward with such a rule.  

Below are links to information about the  CMS change of heart:

Partnership applauds CMS

Obama drops Medicare Proposal

National Council press release

NAMI press release

New York Times article–March 11, 2014

SAVE ACCESS TO MENTAL HEALTH TREATMENT–TELL CONGRESS YOU CARE

The Centers for Medicare and Medicaid Services (CMS) wants to significantly limit access to antidepressant and immunosupressant medication for people subscribing to Medicare Part D. Read today’s post to learn why you should be concerned, and what you can do to support the mental health community by raising our voices in Washington.

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would remove antidepressants and immunosupressants from the protected class status under Medicare Part D and is considering removing antipsychotics from the same status the following year. If CMS adopts its proposal, it would reduce patient access to and the availability of mental health treatment.

Since it went into effect in 2006, Medicare Part D’s protected class structure ensures patients with mental health conditions have access to all or substantially all of the most appropriate medications, protecting them from “fail-first”1 experiences or other appeals processes. In many cases, delays caused by these processes can result in inadequate treatment and potentially tragic outcomes.

We need to ensure that all mental health patients have access to all the medications that they need. It is clear that CMS’ rule will signal a step in the wrong direction and the consequences will be detrimental. According to the World Health Organization, depression is currently the leading cause of disability worldwide. By 2030, it will be the leading global burden of disease.2 In the United States alone, the total direct and indirect cost associated with depression exceeds $83 billion annually.3

Ultimately if CMS’ rule is approved, there will be severe human, economic and societal consequences for not only mental health patients, but for all Americans. We must take action now.

Here’s How You Can Take Action Today

Now, more than ever, the mental health community of patients, families, friends and others need to join together to tell CMS and the Administration how big of a mistake implementing this rule will be for all Americans. Below you’ll find several ways in which you can make your voice heard during CMS’ open comment period, ending March 7, to protect antidepressants, immunosupressants and antipsychotics within Medicare Part D. The clock is ticking!

  1. Make Your Voice Heard by writing to your Member of Congress. Use the sample email letter to inform your member of Congress that the implementation of this proposed rule is a big mistake. Be sure to share any personal experiences and how this rule will impact you or a loved one.
  2. Share your personal stories: The Care For Your Mind blog is interested in your personal stories to help share the extent of the issue and how it will impact you or a loved one. While this rule is expected to decrease patient costs for medications, members of the mental health community understand the treatment for our conditions is far from one size fits all. Below are a few questions that may help you shape and share your story:

a. What will happen if you lose access to your medications?
b. Have you had a negative experience with “fail-first” experiences?
c. How will the new rule impact you, your parents, other family members or friends?

We encourage you to submit your personal story here for publication on our website. And in the meantime, join our conversation online by contributing to this blog below. Your voice counts and the time to speak up is now!

Share this information with others: Knowledge is power. The more people know about the proposed rule’s real life consequences, the more we can make our voices heard. Share this post and relevant information with your friends and family, on your social media accounts, through email and word of mouth offline.Together, we can send a powerful message and help ensure that patients have access to the medications they need and deserve.

Here is an action link.

Here is a recent article on this topic

Fixing Illinois’ Fiscal Crisis a Top Priority for Mental Health Advocates

Several years ago, faced with a fiscal crisis, Illinois enacted a “temporary” income tax increase.  That income tax increase will expire (“sunset”) on December 31, 2014 unless the Illinois legislature passes and the Governor signs, legislation to extend it.  If the tax increase is not extended (or some other substantial source of revenue identified) Illinois will be facing a $4 to $5 billion hole in its budget.  While there is certainly some waste in the state’s budget, it is not possible to identify $4-5 billion in cuts which will not result in dramatic reductions in mental health services and all other human services as well as in state funding for schools and other vital government programs.

2014 is an election year for the Governor, most of the Illinois Senate seats and all of the seats in the Illinois House.  Mental health advocates are urged to communicate to all legislators and all legislative candidates in the upcoming primary our support for legislation extending the current state income tax rates.   

One of the problems with the Illinois income tax is that the Illinois Constitution prohibits progressive taxation of any kind.  Thus, millionaires pay the same income tax rate as those making very minimal amounts.  This makes it difficult to raise revenue or even maintain our current tax rates without harming some of our most vulnerable citizens.  The Mental Health Summit supports efforts to place on the Fall Election Ballot an amendment to the Illinois Constitution which would permit the legislature to enact a progressive tax system.  Mental health advocates are urged to communicate to all candidates their support for placing this amendment on the Fall ballot so that all voters can consider this important issue.  Resolutions which would accomplish are pending in both the Senate and the House.  Please urge all Senate candidates to support Senate Joint Resolution  Constitutional Amendment 40 (Harmon).  Please urge all House candidates to support House Joint Resolution Constitutional Amendment 33 (Jakobsson).

Click here for information about the budget crisis.

Click here for a recent article about the crisis.

Increasing Access to Psychotropic Medications

The Mental Health Summit is working with other groups to remove obstacles preventing persons with serious mental illnesses from obtaining the medications they need to treat their illnesses.  Last year the Illinois legislature passed a law limiting Medicaid recipients to four prescription medications each month.  Any person needing more than four medications must obtain permission (“prior authorization”) from the Illinois Department of Healthcare and Family Services.  Unfortunately that process is excessively burdensome and many patients simply give up.  There is substantial evidence that this type of restriction harms persons with mental illnesses and actually costs Illinois taxpayers more money paying for the costs of increased hospitalizations and other negative outcomes.  Fortunately, there are several bills pending in the legislature which are designed to fix all or part of this serious problem.  The Summit urges mental health advocates and others to support the following bills.  Specifically, please ask your state senator and state representative to sign on as co-sponsors of these bills:

House Bill 2469 (Chapa Lavia) removes some psychotropic medications from the 4-drug restriction

House Bill 3671 (Flowers) would eliminate the 4-drug restriction entirely

House Bill 3688 (Harris) removes some generic psychotropic medications from the 4-drug restriction.

Senate Bill 2611 (Hastings) removes some psychotropic medications from the 4-drug restriction

The Summit is also working with other health care groups to make the prior authorization process more user friendly for physicians.  Two bills have been introduced with the goal of having a uniform and easy to use prior authorization process which would work no matter which insurance company or other third-party payer was involved.  The precise language of these bills is still being worked on.  The Summit urges advocates to watch this space for an update when these bills are ready for consideration by the legislature.  The bills in question are:

House Bill 3638 (Representative Fine)

Senate Bill 2585 (Senator Kotowski)

Medicaid Expansion Approved–Governor Issues Signing Statement Critical of IMD Expansion

On July 22, 2013, Governor Quinn signed Senate Bill 26 into law as Public Act 98-0104.  Mental health advocates are thrilled that this law will implement the Affordable Care Act in Illinois by expanding Medicaid to 138% of the poverty level.  This expansion will result in the largest increase in mental health funding in the state since the enactment of Medicaid decades ago.

Unfortunately, the Governor did not heed our call to issue an amendatory veto of SB26.  The Summit and other advocates sought this veto to remove the last minute addition of provisions greatly expanding the services to be provided by the 24 so-called “IMD” nursing homes. The Summit, however, was hearten by thesigning statement which accompanies the Governor’s approval of this bill.  The Governor expressed his concerns about the addition of the new law governing nursing homes for people with mental illnesses (now to be called Specialized Mental Health Rehabilitation Facilities) and promised to take steps to insure that the new law does not undermine Illinois’ commitment to re-balance the mental health system in Illinois away from an excessive reliance on out-dated institutions.  The Summit stands ready to work with the Quinn Administration to implement this commitment.