Fax from Albany
May 30, 2003
Board Members, Affiliate Executive Directors, Interested Parties
Joseph A. Glazer, Esq., President/CEO
(518) 434-0439 ext. 20
Stone Goes to Washington: Earlier this week, the Substance Abuse and
Mental Health Services Administration (SAMHSA) announced that NYS OMH
Commissioner James L. Stone was appointed deputy administrator of SAMHSA.
who has been Commissioner of OMH since 1995, is expected to depart for
the DC area shortly.
the SAMHSA press release -- “James Stone will further our vision
of a healthier U.S. by addressing the mental illnesses and substance abuse
that disable millions of Americans,” Health and Human Services (HHS)
Secretary Tommy G. Thompson said. "Those who suffer from mental illness
or substance abuse deserve to be treated with the same compassion and
medical attention as those who suffer physical ailments. James Stone's
stellar record in New York shows we have the right man for the job."
Administrator Charles G. Curie said, “I am truly excited to have
James Stone on SAMHSA’s executive team. His proven leadership and
extensive experience in strategic planning for mental health services,
his ability to encourage collaboration among advocacy groups, provider
groups and government agencies, his experience in addressing co-occurring
substance abuse and mental disorders, and his management expertise will
propel SAMHSA into a new era of responsiveness and efficiency.”
rumor mill is already grinding. Immediately mentioned to replace Stone
as Commissioner is Executive Deputy Commissioner Sharon Carpinello and
Senior Deputy Commissioner Linda Rosenberg. Outside of the agency, names
being mentioned include Erie County Mental Health Commissioner Michael
congratulate Commissioner Stone and wish him well, and look forward to
working with him in his new capacity with SAMHSA.
MHANYS Press Release on Preferred Drug List:
is the text of a MHANYS’ press release in opposition to the implementation
of a PDL on the grounds that such a program would restrict access to medications.
The press release points to the fact that both the Supreme Court’s
latest decision regarding the Maine PDL program and the Kaiser Family
Foundation report point to the fact that information regarding PDLs remains
unknown. Both go on to state that such a program must be thoroughly studied
to determine the cost effectiveness and, more importantly, the effects
on individuals’ ability to access the medications they need.
Release: May 29, 2003
Continue to Oppose PDL for New York State --
for a Comprehensive Study
Groups say both Supreme Court Decision and Kaiser Family Foundation
prove that not enough is known about restricted medication access in Medicaid
A recent Kaiser Commission on the Uninsured study and the Supreme Court’s
ruling in Pharmaceutical Research and Manufacturers of America (PhRMA)
v. Walsh (Concannon) both have raised concern amongst advocates that
little, if anything, is known about the effects a Preferred Drug Program
would have on Medicaid populations. In the wake of this, advocates are
calling for a study analyzing the effects of a PDP on the poor, elderly,
chronically ill and disabled residents served by public health programs
to meet their many healthcare needs.
A week ago, the Supreme Court issued their much publicized decision in
the case of PhRMA v. Walsh (Concannon). While allowing the Maine
Rx program to remain in place, the court did not rule on the legality
of the practice of medication restriction under Medicaid. In the opinion
Justice Stephens stated that, “The Court did, however, express concern
that the prior authorization might affect the quality of care for Medicaid
recent report of the Kaiser Foundation, along with the Supreme Court decision,
reaffirms what advocates have been saying – the potential for harm
from a Preferred Drug Program in Medicaid may greatly outweigh the benefits,
if any. No state has proven cross-system savings, but in the state of
Florida, the PDP has already cost two lives,” said Joseph A. Glazer,
Esq., President/CEO of the Mental Health Association in New York State,
By allowing the implementation of the Maine Rx Program, the Supreme Court
indicated that evidence of impact was required before the court could
decide the issue. Indeed, Justice Stephens opinion specifically stated
that PhRMA had the right to once again pursue its pre-emption challenge
if there was evidence that the program harmed Medicaid recipients.
A report by the Kaiser Commission on Medicaid and the Uninsured, released
in late April, had findings similar to the Supreme Court’s recent
decision. The report stated that while many states have been quick to
put in place PDPs, restricting patient access in an effort to save costs,
no actual study has occurred of the existing programs and their impact
on beneficiaries, providers, or state budgets. The report argued that
states are jumping on a bandwagon without knowing fully the effects of
their actions, both short-term and long-term.
These two reports have led advocates in New York to call for a study of
existing PDPs before such a program is implemented in New York. "The
Alzheimer's Association continues to be greatly concerned that public
policy decisions regarding the costs of pharmaceutical treatments are
being made in the absence of independent, meaningful data,” said
Marvin LeRoy, President and CEO of the Coalition of New York State Alzheimer’s
Associations. “While saving money for taxpayers is surely an element
of the public official's charge, it is incumbent upon them to ensure that
cost savings on one hand doesn't simply lead to cost expansion on the
other. Failure to measure all decisions within this context is especially
troubling when one is considering how best to care for our most vulnerable
members of society ... the disabled and frail elderly."
“Persons 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 of the Mentally
Ill of New York State (NAMI-NYS). “Lack of access to medications
can quickly unravel, and destroy, lives. Efforts to control Medicaid costs
by impeding access to medications are bad medicine and bad policy.”
programs reportedly save money, but as the Supreme Court and the Kaiser
report show, nobody has yet looked at the costs to recipients,”
says Glazer. “We haven’t answered the difficult questions--
are there increases in emergency room visits, institutional care, or jail
time? Nobody knows, because nobody has bothered to look at the social
coverage cost inflated, supporters say. By Shirin Parsavand
Schenectady Daily Gazette, May 29, 2003
ALBANY - Supporters of a bill to require health insurance plans to provide
the same level of coverage for mental health services as for other services
said Wednesday the health insurance industry is inflating the bill's cost.
Assembly sponsor of what's being called Timothy's Law, Assemblyman Paul
Tonko, D-Amsterdam, and other supporters said it will increase insurance
costs by less than 1 percent.
They cited a May 2002 study by PriceWaterhouseCoopers that estimated the
cost of mental health and substance abuse parity legislation in New York.
The study estimated the bill would increase monthly insurance costs by
$1.26 per person, or less than 1 percent.
need to get away from the old debate about numbers, dollars, pennies.
We're talking about pennies," said Joseph Glazer of the Mental Health
Association in New York State.
groups representing employers and health insurers said they think the
study the Timothy's Law supporters cited failed to take into account some
factors affecting New York that would drive the cost higher.
Employer Alliance for Quality Health Care, a business coalition lobbying
against health-care mandates, wants the state to perform a cost-benefit
analysis of any new health insurance mandate.
alliance released a study Tuesday claiming that increased health insurance
costs resulting from mandates are leading to New Yorkers losing their
Law is named after Timothy O'Clair, a Rotterdam boy who committed suicide
two years ago at the age of 12, after suffering from severe depression.
His parents, Tom and Donna O'Clair, had trouble getting him ongoing treatment
because of the limit on the number of psychiatric visits allowed under
their health plan.
Assembly, which passed a similar bill last year, is expected to approve
the bill soon, Tonko said.
Thomas Libous, chairman of the Senate's mental health committee, plans
to introduce the bill in the Senate today, his spokesman Bijoy Datta said.
from Albany Times Union Letters to the Editor regarding Timothy’s
law would push more off insurance
First published: Monday, May 26, 2003
. . More than three million New Yorkers have no health insurance at all
and for those people, even a "small amount" makes health care
that much more unaffordable. The No. 1 reason people go without insurance
or become uninsured is because the cost of coverage is too high. If the
mental health advocates' campaign is successful, even more New Yorkers
will be priced out of coverage, leaving them with no benefits rather than
President & CEO New York Health Plan Assn. Albany
Studies show mental health parity is an affordable option
First published: Monday, May 26, 2003
. . Actual experience supports the position that mental health parity
is affordable. Consider the following data from PriceWaterhouseCoopers,
about states where mental health insurance parity is now law:
In Maryland (where mental health parity was passed in 1995), Rhode Island
(1995) and Minnesota (1995), insurance parity resulted in cost increases
of less than one percent.
Pennsylvania, the impact of its 1999 law was approximately 0.43 percent
of the total monthly health care premium
Vermont, the estimated impact of the law on its 1998 rates was 0 percent
A PriceWaterhouseCoopers report, prepared for New York state just one
year ago, is probably the most current and accurate reflection of modern
day medicine and mental health treatments. "Our estimate for New
York indicates the cost of mental health parity is 1.7 percent, with a
net insurance effect of 0.7 percent."
President New York State Psychological Association
bill battles health insurance injustice for mental illness
First published: Tuesday, May 27, 2003
. . Assemblyman Paul Tonko's bill named for Timothy O'Clair of Schenectady,
would enable private sector employers to retain trained, valuable and
experienced workers and avoid the costs of recruiting and training.
New York state alone, the private sector loses hundreds of millions of
dollars each year in direct and indirect costs resulting from untreated
and under treated mental illnesses and chemical dependence.
Law would require that health insurance providers treat mental and physical
employers, these treatments are cost-effective with PriceWaterhouseCoopers
estimating the expense at $1.26 per employee per month.
Member of Assembly
next time, we remain,
Working to ensure available and accessible mental health services for
all New Yorkers