Fax from Albany
April 25, 2003
Board Members, Affiliate Executive Directors, Interested Parties
Joseph A. Glazer, Esq., President/CEO
(518) 434-0439 ext. 20
York to Pataki: Don’t do Preferred Drug List: MHANYS' campaign
to stop a Preferred Drug List and Prior Authorization in this state was
aided this week by two major new developments. First came the release
of a Zogby Poll showing overwhelming opposition to the idea of placing
medical decisions in the hands of government officials. The second development
was a new study by the Kaiser Family Foundation’s Commission on
Mediciad and the Uninsured, which found that little research has been
done to determine the effects of Preferred Drug Programs and Prior Authorization
on Medicaid recipients. MHANYS used both of these events to issue a press
release Thursday against the Governor’s proposed PDP.
of the press release
Study, Poll Show No Basis or Support For Governor’s
Proposed Prescription Drug Program
governor’s proposed Medicaid prescription drug program lacks public
support and empirical basis, according to a recent poll by Zogby International
and a study issued by the Kaiser Family Foundation’s Commission
on Medicaid and the Uninsured.
A poll recently conducted by Zogby International showed that New Yorkers
overwhelmingly rejected a proposal to give the NYS Department of Health
(DOH) control over which medications individuals on Medicaid can receive.
82% of New Yorkers were opposed to the concept of taking medical decisions
away from doctors and putting them in the hands of government officials.
80% of New Yorkers continued to oppose this idea even after it was made
clear that the limitations would apply only to those on Medicaid. The
poll, which showed similar results regardless of age, race, political
affiliation, religion, and region of the state, has a sampling error of
report issued this week by the Kaiser Commission on Medicaid and the Uninsured
has stated that while many states are rushing to implement Preferred Drug
Programs (PDP), little is known about the effects that these programs
have on Medicaid recipients and providers. The Kaiser report focused on
programs that currently exist in California, Georgia, Oklahoma, Oregon,
and Washington. The report finds that “There appears to be little
monitoring of the effects of prior authorization on beneficiaries and
providers at the state level.” The report goes on to state that
the programs that have the least controversy amongst providers and beneficiaries
are those viewed as having the most credibility by all stakeholders.
is not much of a surprise to me that New Yorkers, who take pride in the
fact that our state has one of the strongest healthcare systems in the
country, overwhelmingly oppose this unproven program,” says Joseph
Glazer, President and CEO of the Mental Health Association in New York
State. “The Preferred Drug Program would risk the well-being of
millions of New Yorkers without any empirical evidence pointing to its
efficacy, which is tantamount to medical experimentation on the poor and
most vulnerable of our citizens.”
to Glazer, a similar plan implemented by Florida has indirectly resulted
in the deaths of two people, one who was living with mental illness and
the other who died as a result of a complication of heart disease.
with mental illness and their families know firsthand how important it
is to have unimpeded access to medications,” said J. David Seay,
Executive Director of the National Alliance for the Mentally Ill of New
York State (NAMI-NYS). “Lack of access to psychiatric medications
can quickly unravel, and destroy, lives. Efforts to control Medicaid costs
by impeding access to medications are bad medicine and social policy."
programs purportedly save money, but as the Kaiser report shows, nobody
has yet looked at the cost to recipients,” says Glazer. “Nobody
wants to ask the difficult questions that go along with these programs,
such as are they resulting in an increase in emergency room visits, institutional
care, or even jail time? Nobody knows, because nobody has bothered to
look at the social costs.”
number of groups, including those representing individuals living with
mental illness, heart conditions, Alzheimer’s Disease, Asthma, Diabetes,
Cerebral Palsy, and other chronic conditions are working together to oppose
the Governor’s proposed PDP. They have sent a letter detailing their
concerns to the NYS Department of Health.
For more information on the Kaiser Family Foundation’s Commission
on Medicaid and the Uninsured report, entitled Prior Authorization
for Medicaid Prescription Drugs in Five States: Lessons for Policy Makers,
go to http://www.kff.org/content/2003/4094/
Advocacy Campaigns Gain Steam, Still Need More: Both of MHANYS’
online advocacy campaigns are showing Legislators that there is strong
public support for our positions. However, as we move into what could
very well be the defining week of the Legislative Session, it is more
important than ever to make sure that you make your voice heard. If you
have not yet sent your legislators an e-mail using our Online Advocacy
system, please take a few moments right now to do so. We cannot pass Timothy’s
Law and prevent the Governor from limiting access to medications without
a strong show of support from you. Please visit the MHANYS online advocacy
system at www.mhanys.org.
Mental Health Week: Children's Mental Health Week is nearing. What
are you doing to help raise awareness to the importance of this issue?
See the Children's Mental Health Toolkit online. Make
things happen in your home town.
May 4th - 10th is Children's Mental Health Week.
Hutchings closing seen as inevitable; Mental health advocates admit
it's likely, want savings used for programs
Syracuse Post Standard, April 21, 2003
Central New York's politicians are solidly against Gov. George Pataki's
plan to close Hutchings Psychiatric Center, some mental health advocates
say it may not be a bad idea and concede closing or downsizing it is probably
those advocates also emphasize that the state must "reinvest"
the savings from closing Hutchings into other mental health services for
Central New York.
Tindall, a consumer of mental health services, says she'd have no problem
with the Syracuse facility closing - with that condition.
it can be guaranteed the money (savings) is reinvested in our community,
then I'm all for it," Tindall, 54, of Syracuse, said on the steps
of the state Capitol last week after she and about two dozen other Central
New Yorkers participated in a rally supporting "reinvestment."
who said she has not used services at Hutchings, isn't alone. Two powerful
advocacy groups for the mentally ill - the New York Association of Psychiatric
Rehabilitation Services, or NYAPRS, and the Mental Health Association
in New York State - are not opposed to closing Hutchings and several other
psychiatric centers around the state.
the chairman of the state Senate's Mental Health and Developmental Disabilities
Committee called the downsizing and possible closing of Upstate psychiatric
all argue the savings from any closings should be reinvested in the community,
and NYAPRS says patients in a hospital that closes should have the chance
to remain in their community "with an appropriate array of 'step
down' community housing, services and supports."
plan calls for shutting Hutchings by July and transferring inpatients
and staff to Utica's Mohawk Valley Psychiatric Center.
Pataki administration says the closing of three Upstate centers - Hutchings,
Elmira and Middletown - would save the state $18.2 million a year in the
midst of a fiscal crisis. Closing Hutchings is expected to save $6.6 million.
even Republican allies of Pataki say his plan is ill-advised.
trying to preserve the psychiatric centers and come back with a reasonable
plan that downsizes facilities over time," said Sen. Thomas Libous,
R-Binghamton, the mental health committee chairman. "Ultimately,
there is going to be downsizing. But the way it's proposed by the Division
of the Budget is unacceptable." Libous suggested parts of Hutchings
could eventually be converted into transitional housing units, with the
psychiatric center becoming apartment-type living units.
would keep people employed; you keep up the facility," Libous said.
"There are all types of options. The problem with (Pataki's budget)
proposal is they give us no options."
Assembly counterpart wasn't as convinced of the inevitability of downsizing.
"We haven't had the right type of planning for the state of New York
so we can make the intelligent decisions - how many beds do we need, and
if we do close beds, how do we properly close them?" said Assemblyman
Peter Rivera, D-Bronx. He said he wants a council for long-term mental
not ready to answer what the rock-bottom number of (psychiatric hospital)
beds should be," said Rivera, the new chairman of the Assembly Mental
I know that, I can't say we're ready to close."
4,200 New Yorkers remain in psychiatric institutions, down from about
90,000 in the 1950s.
Rivera and Libous do agree on "reinvestment."
law requiring savings from institutional downsizings to be invested in
local communities expired in 2001, and Libous last week introduced a bill
to match one proposed earlier by Rivera to reinstate the law.
vetoed a similar bill last year.
the Pataki administration says the $11.5 billion deficit the state has
to close in the current fiscal year, which began April 1, makes the new
reinvestment bill ill-advised.
current fiscal crisis precludes new reinvestment funds for fiscal year
2003-04," state mental health Commissioner James Stone told lawmakers
during hearings on Pataki's $90.8 billion budget proposal earlier this
year. "Instead, savings would be used to preserve the existing system"
and to pay for cost-of-living increases for community mental health workers
and an increase in the fee the state pays for certain Medicaid mental
spokesman Roger Klingman noted last week Pataki has proposed creating
600 supported mental health housing beds, although that project wouldn't
begin until 2004-05.
said New York's psychiatric hospital infrastructure is excessive.
York's adult, inpatient psychiatric system, with 17 facilities, is the
largest in the nation by far," said Klingman, noting California has
just four psychiatric hospitals.
of those (New York) psychiatric centers have space that is not being fully
used. Others require structural improvements and updates that will cost
millions of dollars."
the sense is the budget state lawmakers plan to adopt this week - when
they return from their Easter/Passover break - will preserve Hutchings,
Middletown and Elmira psychiatric centers.
worker unions have already obtained a court order blocking further administration
moves toward closure.
is not in on budget negotiations, and there is widespread anticipation
at the Capitol that he will veto any additions or changes legislators
make to the budget he proposed Jan. 29.
Is Up. So Why Are Mental Health Benefits Down?
York Times, April 20, 2003
anxious or depressed? The continuing uncertainties of war, terrorism and
the weak economy have left many people longing for stability and looking
for ways to cope. But just when some people could arguably gain the most
by spending a little time on a therapist's couch, their mental health
benefits are at risk.
a survey this month by the Pew Research Center for the People and the
Press in Washington, about a third of the people questioned said they
felt depressed by the war with Iraq. Russ Newman, executive director for
professional practice at the American Psychological Association, said
the war was affecting the vast majority of the group's patients, based
on a survey conducted last month, but that it was "just the latest
the years, the stress people feel just continues to increase," he
share of employers offering mental health benefits, however, dropped to
76 percent last year from 84 percent in 1998, according to the 2002 benefits
survey of the Society for Human Resource Management. Because health care
costs are estimated to rise 15 percent this year, "employers are
looking for areas where they can cut costs," said Jennifer Schramm,
manager of workplace trends and forecasting for the human resources group,
"and mental health is one of the areas that's easier to cut."
are less likely to protest because of the stigma around it," she
if they don't cut benefits outright, some employers are increasing co-payments
and deductibles, said Patrick Leary, a group health care consultant at
Watson Wyatt Worldwide, a human resources consulting firm based in Washington.
Others are reducing out-of-network coverage, he said. That is significant
because many psychologists and specialists do not participate in large
health care networks.
reducing mental health coverage, employers may be hurting themselves.
In a study released in February by Mercer Human Resource Consulting and
Marsh Inc., an insurance broker, 70 percent of 723 employers reported
that stress or depression had increased in cost or frequency as a disability
condition during 2001. That was a higher figure than for any other health
problem, including cancer, lower-back pain or repetitive trauma like carpal
tunnel syndrome. "Many industries have been cutting back on staff
because of the economy, but the work still has to be done," said
George Faulkner, a principal at Mercer. "That exacerbates the stress."
1996, Congress took the first step toward elevating mental health coverage
to a par with medical and surgical care. It passed legislation that prevented
private plans from setting lower annual or lifetime caps for mental health
care than for other types of coverage. But that law allowed companies
to require much higher deductibles and co-payments for mental health treatment
than for other kinds of care.
bill introduced this past winter in the House and the Senate would close
those loopholes. But it's no panacea; like the original bill, it would
apply only to employers who already offer mental health coverage, and
then only to those with 50 or more employees. There has also been talk
of restricting the disorders covered by the bill — excluding, for
example, post-traumatic stress syndrome, anorexia and autism.
course, the bill could backfire, even with the restrictions. "I've
certainly heard of employers who've said they'd drop their mental health
coverage if the legislation goes through," said Ruth Donahue, a health
care consultant in the Chicago office of the Segal Company, a benefits
consulting firm based in New York.
that employers found ways to circumvent the original 1996 legislation
by requiring higher co-payments and deductibles, Ms. Donahue said, "if
they put real teeth into this new parity legislation, it will be interesting
to see what kind of creative ways employers find to get around it again."
for an already anxious public, that may be just one more thing to worry
disorder - Letter to the Editor
Schenectady Gazette, April 24, 2003
Carl Strock should do the readers of the Gazette a favor and hie himself
out of his armchair and get better informed about the topics he writes
his April 10 column, "Of dogs, disorders and parity," he does
an outstanding job of laying out all the outdated arguments for mental
health discrimination. Mr. Strock is apparently unaware of the modern
tools that insurance companies use nowadays to help prevent just the sort
of chicanery he is so afraid of.
Strock's fear of mental health parity is so unfounded that it borders
on paranoia. Fortunately for Mr. Strock, there is treatment available
- if he is insured.
next time, we remain,
Working to ensure available and accessible mental health services for
all New Yorkers