Mental Health Association in New York State, Inc.
(Publication Archives)

Friday Fax from Albany

Mr. 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.

Stone, who has been Commissioner of OMH since 1995, is expected to depart for the DC area shortly.

From 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."

SAMHSA 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.”

The 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 Weiner.

We 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:
Following 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.

Press Release

For Release: May 29, 2003

Advocates Continue to Oppose PDL for New York State --
Call 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 recipients…”

“The 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, Inc. (MHANYS).

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.”

“These 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 costs.”

In the News:

Mental 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.

The 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.

"We 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.

But 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.

The 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.

The alliance released a study Tuesday claiming that increased health insurance costs resulting from mandates are leading to New Yorkers losing their health-care coverage.

Timothy's 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.

The Assembly, which passed a similar bill last year, is expected to approve the bill soon, Tonko said.

Sen. Thomas Libous, chairman of the Senate's mental health committee, plans to introduce the bill in the Senate today, his spokesman Bijoy Datta said.

Excerpts from Albany Times Union Letters to the Editor regarding Timothy’s Law

Parity 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 expanded ones.

PAUL F. MACIELAK
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.

In Pennsylvania, the impact of its 1999 law was approximately 0.43 percent of the total monthly health care premium

In 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."

RUDY NYDEGGER, Ph.D.
President New York State Psychological Association
Schenectady

Tonko 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.

In 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.

Timothy's Law would require that health insurance providers treat mental and physical illnesses equally.

For employers, these treatments are cost-effective with PriceWaterhouseCoopers estimating the expense at $1.26 per employee per month.

JOHN J. McENENY
Member of Assembly
Albany

Until next time, we remain,
Working to ensure available and accessible mental health services for all New Yorkers