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

Friday Fax from Albany

Please Join Us! After an extremely successful event last year, MHANYS and Samaritan’s Suicide Prevention Center have once again decided to team up to hold a joint legislative conference. Scheduled for Monday, March 22nd, this event provides MHANYS’ affiliates, Board members and others working in concert with MHANYS on a variety of issues the opportunity to participate in the legislative process.

The conference will include an overview of many of the important issues faced by New York's mental health advocacy community as outlined in MHANYS' Legislative Agenda, a copy of which follows. Participants will begin the day hearing from many of the key players in the development of New York's mental health policy. They will then be provided with time to meet with their own elected representatives to advocate for the advancement of these important issues.

Details regarding the 2004 Legislative Conference appear below. If you are planning to participate, please fill out the registration form that follows. Or, you can let Michael Seereiter, Director of Public Policy know that you’ll be attending by contacting him at mseereiter@mhanys.org or (518) 434-0439 ext. 21.

In addition, if you are planning to attend, please call your Senator and Assemblymember to schedule times to meet with them, starting no earlier than 12 Noon. To find out who your representatives are, go to http://map01.elections.state.ny.us/boe/main.asp.

MHANYS and Samaritans Suicide Prevention Center
2004 Legislative Conference

Date: Monday, March 22, 2004

Location: Room 711-A, Legislative Office Building, Albany, NY

Time: 8:30 – 12:00 Noon, individual meetings afterward

More details, including a schedule, will follow in future editions of the Friday Fax from Albany

Mental Health Association in New York State and
Samaritans Suicide Prevention Center
Legislative Conference

March 22, 2004
Room 711-A
Legislative Office Building

REGISTRATION FORM

Name ____________________________________________________________

Organization ______________________________________________________

Address __________________________________________________________

City ______________________________ State _________ Zip _____________

Phone _____________________________Fax ___________________________

E-Mail___________________________________________________________

Number of Attendees: ____________

Names of Attendees:

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

FAX OR E-MAIL TO:
Michael Seereiter, Director of Public Policy
MHANYS
194 Washington Avenue, Suite 415
Albany, NY 12210
FAX: (518) 427-8676
mseereiter@mhanys.org

Mental Health Association
in New York State, Inc.

2004 Legislative Agenda

Parity: End health insurance discrimination by enacting parity in coverage for mental health and chemical dependency as is provided for other health services

• Enact Timothy’s Law

Plan: New York must establish a planning process that includes all involved stakeholders, in all communities throughout the state, so that the system of mental health care is capable of meeting the ever-changing needs of all children and adults with mental illnesses. The system must:

• Assess existing infrastructure and services, and service needs
• Develop services capable of meeting individualized needs
• Consistently assess the need for existing services through oversight and develop services to address any unmet needs
• Ensure the availability and affordability of safe, quality housing
• Eliminate gaps in services that create barriers to recovery by causing people to unnecessarily ‘fall through the cracks’
• Maintain a workforce appropriately trained and compensated to consistently delivery quality services

Protecting Access: Ensure that individuals living with mental illness have access to the medications and treatment they want and need

• Prescription Drugs in Medicaid
• Electroconvulsive Therapy Patient Protections

Prison and Jail Reform: Prevent individuals with mental illnesses from becoming involved or further involved with the criminal justice system due to inappropriate treatment, and ensure appropriate post-release support

• Medicaid Coverage When Leaving Jails, Prisons & Hospitals
• Eliminate Solitary Confinement for Inmates with Mental Illnesses
• Reform of the “Not Guilty by Reason of Insanity” Defense

In the News:

Torture in 'The Box' - Further confinement of mentally ill inmates is barbaric, and the Legislature must outlaw it. Editorial
Albany Times Union, February 6, 2004

Will someone at the state Capitol please listen to Ray Ortiz. He is, after all, one of the relatively few people who actually knows the horrors of incarceration in The Box firsthand. And this is what he says. "The Box isn't treatment. It's torture."

Mr. Ortiz is very fortunate to have survived the brutal ordeal of serving part of his prison time in what the prison bureaucrats call special housing units. Now he works for the New York Association of Psychiatric Rehabilitation Services, which is fighting to stop the barbaric practice of placing inmates with serious mental illnesses in The Box.

It's such a difficult battle, though, trying to bring some humanity into the state prison system. A bill sponsored by Assemblyman Jeffrion Aubry, D-Queens, chairman of the Corrections Committee, doesn't even have a sponsor in the Senate. Instead the practice of subjecting mentally ill inmates, many of whom shouldn't be in prison at all, to 23 hours a day in confinement continues.

Department of Correctional Services Commissioner Glenn Goord defends the use of The Box on the grounds that it's intended to change inmates' behavior. Perhaps it does, in a constructive sense, in certain cases. But the evidence suggests that confinement in The Box further damages mentally ill inmates, who are much more likely to be locked up there than other inmates.

A report by the Correctional Association of New York, an organization specifically authorized by state law to visit prisons and interview inmates and employees, found last year that when inmates in The Box try to hurt or kill themselves, as they do with alarming frequency, the prison system punishes them with even longer stays.

There are any number of injustices and inequities awaiting action, or, in many cases, perhaps, inaction by the Legislature this year. Few, if indeed any, would be as great an assertion of fundamental human rights as a ban on the incarceration of inmates with serious mental illnesses in The Box.

Surely there's a senator who shares that view, isn't there? Someone will co-sponsor Mr. Aubry's bill, right?

That would leave the next move up to Sen. Michael Nozzolio, R-Seneca Falls, chairman of the Crime and Correction Committee. Or Sen. Joseph Bruno, R-Brunswick, the majority leader. We'll look forward to hearing from them

State May Close Psychiatric Centers
The Associated Press, February 7, 2004

ALBANY, N.Y. -- Despite nearly two years spent in a state psychiatric center during the 1980s, Susan Sleasman graduated from college last year, and has a job, an apartment and a boyfriend — successes she attributes to the community based mental health services she received.

"I believe recovery happens in the community," said the 36-year-old policy associate for a children's advocacy group.

Still, about once a year, when flashbacks from childhood abuse or depression overwhelm her, Sleasman spends a few weeks getting needed support at a clinic or psychiatric unit of a hospital.

"I still struggle to this day," she said, adding there probably will always be a need for the big psychiatric centers.

Now, however, the question both the state and advocates are asking is: "How many hospitals are needed?" Gov. George Pataki has proposed a new bipartisan commission to determine how many of the state's 26 aging psychiatric hospitals should remain open, a politically thorny issue involving patient care, jobs and a weakened state budget.

Pataki's legislative proposals would reinvest savings in community-based services, half directly in state programs.

The state Office of Mental Health estimates 630,000 New Yorkers annually get $4.8 billion of publicly funded care, including Medicaid. About one-third is spent on the less than 10 percent who are served by psychiatric centers.

In his 2004-05 budget, Pataki proposed shutting the Middletown Psychiatric Center, noting the patient population has fallen from more than 3,600 to 115. Inpatients would be transferred to nearby centers in 2005. Almost 370 workers would be reassigned, transferred or laid off.

Hospital workers, backed by state lawmakers from the Hudson Valley, held protest rallies last month.

"As a nurse for 29 years, I've seen firsthand what a tough affliction mental illness is to manage, and we shouldn't make it harder," Assemblywoman Aileen Gunther said in a statement.

The Pataki administration predicts annual savings of almost $7 million from closing Middletown, which then would be plowed back into community-based programs in the area. Closure would also mean avoiding capital expenses of $27 million.

With advances in medications and outpatient treatment, New York went from having 93,000 inpatients at 20 adult psychiatric centers in the 1950s to less than 5,300 in 26 centers today.

"There is no longer a need to continue operating this many facilities," Pataki said.

Pataki's proposal last year to close mental hospitals in Middletown, Elmira and Syracuse was blocked by a judge after unions sued, saying formal one-year notification was required before making "significant service reductions" in the state psychiatric system.

Elmira and Syracuse were not specifically targeted this time. If the administration tries to close centers, the Civil Service Employees Association will probably go back to court, spokesman Stephen Madarasz said. The union has 5,000 to 6,000 members at the hospitals, mostly therapy aides and clerical staff.

"What happens in many communities is an awful lot of the services, even community-based services, tend to revolve around the psychiatric centers," Madarasz said. "You can't just create a void and expect those services will be delivered."

State officials will ensure patients have access to services, said Kevin Quinn, spokesman for Pataki's Budget Division.

The proposed state Commission for the Closure of State Psychiatric Centers is made up of eight voting members — two chosen by the Senate, two by the Assembly and four by the governor — who have authority to recommend hospital closings through 2010.

The OMH commissioner would carry out recommendations unless the Legislature passed resolutions rejecting them. The 26 centers have more than 15,000 employees.

The proposed $2 billion OMH budget, including aid to counties, would add about 1,300 beds in the next fiscal year to the 26,700 now in community residences, according to budget documents.

Senate Majority Leader Joseph Bruno, a Rensselaer County Republican, has said the commission proposal makes sense but Democrats in the Assembly are resistant.

"The Assembly has historically denied attempts to close facilities and last year fought the governor's efforts to undercut the current law that assures that communities have a role to play in these major decisions," said Eileen Larrabee, spokeswoman for Assembly Speaker Sheldon Silver, a Manhattan Democrat.

Mental health advocates say a nonpartisan commission that accurately assesses statewide mental health needs is a good idea.

They also back community reinvestment of all savings from hospital closings.

"It's getting it beyond the issues about jobs and economic considerations and politics," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.

Joseph Glazer, president of the Mental Health Association of New York State, said he wants to see a comprehensive plan for mental health care, similar to the state system for the mentally retarded and disabled. He said probably 2,500 outpatients use Middletown and their care must be not be jeopardized. He also said New York's history in the decades-long move to de-institutionalize patients is poor.

"Nearly 80,000 people left psychiatric hospitals before the first dollar was spent," Glazer said. "That's how we wound up in the situation we're in with a terribly underfunded state psychiatric and mental health system. The community system is better, but it's nowhere near sufficient."

Statistically, one in five people will have serious mental health needs sometime in their lives, he said.

Pataki's plan is bad medicine for indigent, elderly. By Peter M. Rivera and Joan L. Millman
Times Herald Record, February 10, 2004

As it if it is not bad enough that we have more than 3 million fellow New Yorkers without any type of health insurance, now New York is about to make the poor that do have health insurance beg for their medication.

For the last two years, Governor Pataki has proposed the creation of a preferred drug list and prior authorization process for those on Medicaid. Riddled with consumer safety concerns and more questions than answers, the governor's proposal is a cost-containment strategy that puts patients in harm's way. Unfortunately, the newspapers that have covered this issue across the state have failed to list the human costs of such a proposal.

The plan would create a list of medications that will be available to Medicaid recipients. The state, under the direction of a committee appointed by the governor, would decide which medications will be available. Their decisions will be based on cost, not on the quality of the medication available or the outcome for the patient.

The proposed systems will be managed by a non-physician bureaucracy that will be set up to second-guess doctors and will limit access to appropriate medicines. Without adequate patient protections, this policy proposal cannot be allowed to take shape.

Its impact on women and racial minorities is of great concern due to the fact that more than 60 percent of Medicaid recipients are women and a large number are African-Americans and Hispanics.

It is our opinion that this attack, on the poorest of our fellow citizens, must be stopped because it is the right thing to do. This decision is based not only on a philosophy that we must protect the most vulnerable amongst us, but it is a practical derivative of scientific information that clearly indicates that there are differences in medications and outcomes based on the gender and ethnicity of the patient.

It has been documented that for every dollar spent on drugs in the United States, $1.50 is spent on adverse outcomes of inappropriate therapy. Therapeutic failures cost the healthcare system more than $177 billion annually.

Will poverty-stricken women suffering from cancer and on Medicaid be given the best medicine available to save their lives, or will a generic with a lower rate of success in stopping the disease be prescribed? Will indigent children, inflicted with asthma, have access to modern medications that neutralize asthma triggers or will those children only have access to medications that will expose them to higher and more frequent doses of older medications with side-effects for their developing bodies? What will be the ultimate outcome for the patient and our society of a proposal that restricts the best medication available for a disease?

Ninety-two percent of Americans over the age of 65 live independently. This has been achieved by advances in medicine and access to new medications that improve the quality of life. The governor's plan tampers with this outcome in a way that can increase the number of elderly needing nursing home care.

This plan also attempts to micro-manage the lives of millions of New Yorkers who depend on Medicaid. Will it lead to the next level of government-making decisions that will place limits on which medical procedures, tests and technology is also available to poor patients in order to save the state money?

The governor's proposal also fails to adequately address the issues driving the increasing costs of health coverage for our most needy: booming aging and indigent populations in New York. Today, nearly 6,000 Americans turn 65 every day. In just 10 years, that number will grow to nearly 10,000 a day. Many of these older Americans are poor and qualify for Medicaid. New York is a long way from addressing this imminent danger to its fiscal stability.

Our constitutional system of government was established to limit the power of government. This proposal is antithetical to such a notion. Justice will not be served if New York implements a preferred drug list and prior authorization process.

Assemblyman Peter M. Rivera, is chairman of the New York State Assembly Puerto Rican/Hispanic Task Force. Assemblywoman Joan L. Millman, is chairwoman of the New York State Assembly Legislative Task Force on Women's Issues.

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