SIGN UP FOR THE MENTAL HEALTH UPDATE TODAY.

MENTAL HEALTH UPDATE - INDEX

March 3, 2006

SAVE THE DATE: MHANYS' LEGISLATIVE DAY MARCH 13, 2006

$10 MILLION CAMPAIGN CONTINUES: On Tuesday, MHANYS joined NYAPRS and several other organizations in meeting with members of the Legislature to urge support for a $10 million increase for community mental health programs in this year’s budget. This week brings with it financial forecasts for the state’s revenues that include a surplus above and beyond the projections released in recent months. In these meetings, we made the case for a $10 million emergency appropriation given the cuts that community mental health providers have faced in recent years. Our situation is understood by the Legislature, but any commitments have yet to come.

Therefore, we are urging everyone to join in a Statewide Call-In on Tuesday March 7th. The flyer follows below.

Campaign for a $10 Million Rate Adjustment
for Community Recovery and
Rehabilitation Services

CALL LEGISLATIVE LEADERS NEXT TUESDAY!
MARCH 7, 2006

The Senate and Assembly are moving quickly to finalize their budget priorities and begin negotiating with each other and the Governor to reach a final state budget agreement.

NEXT WEEK IS THE BEST TIME TO REMIND THEM HOW IMPORTANT GRANT-FUNDED COMMUNITY RECOVERY AND REHABILITATION SERVICES FOR ADULTS & CHILDREN ARE…AND THE TERRIBLE CRISIS STATE THEY FACE!

We need to speak out loud for services for children and their families, for employment and education services, advocacy, outreach, multicultural and transportation services and for clubhouse and self help programs.

With virtually no funding increases over the past decade and in an environment of steadily rising costs, our programs are in dire distress with high staff turnover and growing declines in program capacity, staffing, services, and hours of operation.

While we support the Governor’s proposed 2.5% 3 year COLA, it will not provide enough financial relief in enough time to make a measurable enough difference for most of these long under-financed and overextended community recovery programs.

We desperately need greater relief NOW, in the form of a ‘front loaded’ emergency fund to keep afloat our very special programs!

On March 7 , Call Our Legislative Leaders and Your Legislator!

• Call Senate Leader Joseph Bruno and YOUR Senator at (518) 455-2800
• Call Assembly Leader Sheldon Silver & YOUR Assembly representative at (518) 455-4100

and leave the following message:

“I’m a registered voter from (your locality) calling to urge you to support a $10 million emergency fund that is necessary to preserve critically overextended local community mental health recovery and rehabilitation services for adults and children.”

 

MHASC MEETS TO STRATEGIZE ABOUT SHU LEGISLATION: Also this week, MHANYS participated in the Mental Health Alternatives to Solitary Confinement (MHASC) face-to-face meeting in New York City, held to make sure the legislation aimed at eliminating use of solitary confinement in prisons for inmates with mental health needs (A.3926 / S.2207). MHANYS and other members of MHASC firmly believe that alternative housing and treatment options must be made available for inmates living with mental illness.

MHASC will hold a Legislative Advocacy Day to push for passage of these bills on March 28th in Albany. Buses will be running from New York City for anyone who may be interested in attending. Please contact Emily Benedetto (212) 780-1400 ext. 7723 or ebenedetto@communityaccess.orgto reserve your seat on the bus. (Light breakfast and lunch will be served.)

 

ORGANIZATIONS CONVENE TO CALL FOR PERMANENT MEDICAID WRAP AROUND FOR DUAL ELIGIBLES UNDER MEDICARE PART D: MHANYS joined with several other organizations representing individuals with various types of disabilities and AARP on Thursday to call for a permanent Medicaid wrap around for dual eligible individuals now getting their medications through a Medicare Part D plan. The Governor’s budget proposal would provide such a wrap around for dual eligibles denied medications under a Medicare Par D plan until July 1st. However, after July 1st, only certain medications, including some mental health medications, would continue to be covered under such a wrap around.

Following is the press release issued yesterday.

GOVERNOR PLANS TO ELIMINATE MEDICAID Rx SAFETY NET

Broad Coalition Rails Against Proposal & Urges Lawmakers to Continue Rx Coverage for New York's Most Vulnerable

Governor Pataki's budget proposal to eliminate 'wrap around' drug coverage for many New Yorkers who rely on both Medicare and Medicaid for their prescription drugs ran into serious opposition today. An unprecedented coalition of New York's leading organizations for the elderly, people with disabilities, HIV/AIDS community and individuals with psychiatric disabilities joined forces, calling on legislative leaders to reject the proposal that serves to deny drug coverage to hundreds of thousands of New Yorkers.

In his Executive Budget, the Governor calls for dropping Medicaid 'wrap around' drug coverage, starting July 1, 2006, for New Yorkers who are eligible for both Medicaid and Medicare (dual eligibles), except for certain drugs used to treat mental illness, HIV/AIDS and organ transplants. The 'wrap around' coverage currently pays for drugs not covered by Medicare Part D.

There are over 600,000 dual eligibles in New York who are largely the frail elderly, disabled and poor who have extensive health care needs, often times taking multiple drugs that may not be covered by one single Medicare Part D plan. Eliminating the 'wrap around' would deny drug coverage to those who need it most.

'High drug costs are already forcing people to cut their pills, take less and sometimes not even be able to fill their prescriptions at all,' said Lois Aronstein, AARP New York State Director. 'Eliminating 'wrap around' coverage is a harsh move that will deny drugs to our state's most vulnerable populations : we urge the Legislature to reject the Governor's proposal.'

'Embrace the wraparound and provide the permanent protection that vulnerable poor and disabled people need and deserve in New York,' said Ann Hardiman, Executive Director, NYS Association of Community Residential Agencies

'New York has always thrown a lifeline to those unable to survive without our health care safety net. People with disabilities have been able to count on it,' said Susan M. Dooha, Executive Director, Center for Independence of the Disabled, NY. 'Now the Governor proposes to tug that lifeline away. We can't allow that. The legislature must act.'

'The people covered by both Medicaid and Medicare are our most vulnerable citizens. It is difficult to understand how this group of people, so well served by Medicaid for so long, now may not be able to receive the medications they need simply because Medicare has begun to cover prescription drugs,' said Susan Constantino, President & CEO of Cerebral Palsy Associations of New York State.

'For people with HIV/AIDS, the Governor's proposed wrap for antiretrovirals (ARVs) is grossly insufficient,' said Ronald Johnson, Associate Executive Director of Gay Men's Health Crisis. 'Many of the individuals who come through our doors take upwards of 20 medications a day - medications that must be carefully combined with their ARVs. No single Part D plan covers all their drugs. Without the Medicaid wrap, low-income HIV positive New Yorkers are at risk.'

'For individuals receiving both Medicaid and Medicare, this is not a time-limited situation, and will not disappear once Part D implementation problems have been ironed out. For most dual eligibles, no single plan will cover all prescribed drugs on a formulary basis; and there is no reason to believe that the difficulties in accessing medication will be temporary,' said Margarey Ames, Executive Director, InterAgency Council of Mental Retardation and Developmental Disabilities Agencies.

'Medicaid 'wrap around' drug coverage is, literally, a lifeline for some of our most vulnerable citizens,' said Richard J. Mollot, Esq., Executive Director, Long Term Care Community Coalition. 'We urge every Senator and Assemblyperson to reject this mean-spirited, unconscionable proposal which would put many families and individuals at risk.'

'As advocates for individuals with psychiatric disabilities, we have concerns about early implementation of Medicare Part D. Only through wrap-around coverage, will we be able to insure that these individuals are receiving appropriate mental health medications and access to side effect medications,' said Glenn Liebman, CEO of Mental Health Association in NYS, Inc.

'We implore the Legislature and the Governor to make the Medicaid wraparound permanent and ensure comprehensive prescription drug coverage for our most vulnerable citizens with disabilities, many of whom are medically frail with extreme and multiple needs,' said Marc Brandt, Executive Director, NYSARC, Inc.

'Ensuring that medication regimes continue is not only the humane thing to do, it will save the state money by keeping the most vulnerable New Yorkers out of the hospital,' said Robert M. Hayes, President of the Medicare Rights Center, a consumer service group which provides a Medicare counseling hotline for New Yorkers.

IN THE NEWS:

At What Cost? - Implications of civil confinement too important to ignore. Editorial by Angelia Mack, Syracuse University student
Syracuse Post-Standard, March 3, 2006

There is little debate from the right or the left when it comes to having sex offenders on the street. The controversy becomes evident when we ask the question, what should we do with sex offenders who still pose a threat to society after they have served their prison sentence?

As The Post-Standard reported on Feb. 5, Gov. Pataki has proposed a civil confinement center, with a price tag of $130 million, to replace the existing minimum-security prison in Pharsalia, Chenango County.

A hundred questions need to be answered, as The Post-Standard reported, but not only from the residents of Chenango County and their concerns about the safety of such a facility in their community, but by the residents of New York, and the country at large.

This is not as cut and dried as it might seem to the casual eye that certainly wants to keep dangerous sexual predators away from our children. We are not just talking about keeping the worst sex offenders off the street; we are talking about assessment concerns, funding for long-term treatment, recidivism, and like it or not, civil rights.

The assessment of "threat" seems contingent; if these convicted felons have been serving a 20-year sentence, then the assessment of their danger to the public would be based on psychological evaluations.

Many sexual offenders do not fall under the diagnosis of psychological disorders, and the threat of perceiving or equating sexual offenders with mental disorders is very concerning to the field of psychiatry.

Pataki has been using his authority to confine the most dangerous sexual offenders who had served their prison terms and were about to be released into society.

Nearly 40 sex offenders have been confined to psychiatric institutions in New York using existing mental health laws. The concerns of this action lie in the connection made between mental health and sexual perpetrators, and that because of limited space, there are waiting lists for patients who require mental health treatment, of which dangerous sex offenders are currently using about 40 beds.

As a mother, woman and concerned citizen, I am certainly not advocating for violent sex offenders to walk the street, but I suggest that Gov. Pataki and the citizens of this state consider what this may mean in the larger scheme of things.

Civil confinement could easily cross the line to become a second prison term for sexual predators with a hefty price tag, about $200,000 per bed annually, and questions about effective rehabilitation for these so-called "mental abnormalities," under which the sexual offenders will be confined, seem undefined.

Research has shown that one out of four sexual offenders in prison have a violent juvenile record. This could be a good indicator for intensive intervention strategies to be implemented long before horrible offenses take place.

Angelia Mack, of Auburn, is a student at Syracuse University.

Stealth Jail Terms For Sex Offenders. By Niall Stanage
New York Observer, March 6, 2006

No one ever lost an election by being too hard on sex offenders. The public thirst for the severe punishment of molesters and pedophiles is both understandable and unquenchable.

That reality, however, brings obvious dangers. It suggests, at a minimum, that justice may not best be served by leaving the fate of the most abhorred category of criminals in the hands of politicians.

A controversy that is roiling Albany points to the same conclusion.

The furor centers on the practice variously referred to as civil containment, civil confinement or civil commitment. Whatever the preferred term, the meaning is the same: authorities use powers more typically deployed in relation to the mentally ill to lock up sex offenders after they have served their sentences.

The people in question serve the indefinite extra time in secure mental hospitals or, sometimes, in purpose-built facilities. Sixteen states have civil commitment on their books, and the principles underpinning the measure have been upheld, with some qualifications, by the U.S. Supreme Court.

New York does not yet have a civil-commitment statute for sex offenders, much to Governor George Pataki's frustration. Every year since 1998, he has introduced a bill that includes such a provision. Usually, it has been passed in the Republican-controlled State Senate, only to die in the Democratic-controlled Assembly.

Late last year, Mr. Pataki decided that he would no longer bother waiting for the Legislature to act. He set events in motion that led to 39 men being placed in mental institutions at the conclusion of their prison terms.

To nobody's great surprise, legal challenges to the men's confinement were mounted. The challenges were duly upheld by the courts' which was also no surprise, since judges do not look kindly upon attempts by politicians to circumvent their authority.

The most charitable interpretation of Mr. Pataki's move is that it was an attempt to shock the State Legislature out of its torpor. In this, he seems to have succeeded.

Some form of civil-commitment law looks inevitable this year, since both the Senate and the Assembly have drawn up bills on the issue.

There are significant differences between the proposals; in short, the Assembly's plan is less draconian. Nevertheless, attempts to hammer out a compromise are ongoing and, at the time of writing, appear likely to succeed.

Civil commitment is therefore poised to become law after little public discussion. The question of whether it's a good thing to give the state the power to detain people indefinitely, with only anemic safeguards against abuse, surely deserves more debate.

Commitment involves prolonging the incarceration of people not because of criminal acts, but on the mere suspicion that they might commit such acts in the future. It seems like a classic example of the first step on a slippery slope.

Civil commitment is also rationalized on the basis that sex offenders, alone among all types of criminals, can never be rehabilitated.

In fact, the evidence on that topic is mixed. Senate Majority Leader Joseph Bruno, a strong supporter of civil commitment, issued a statement in January that included the claim that 'almost half of the people who commit sexually violent offenses' end up back behind bars after their release.

But a survey in the state of Washington found that felony-level sex offenders had a recidivism rate of only 2.7 percent, which was lower than the rate for drug offenders and other comparable criminals.

Perhaps the single worst element of the civil-commitment practice is its basic dishonesty. In most states where it's on the statute books, it has been used as a way for the authorities to extend criminal sentences without openly stating that they are doing so.

The practice was first introduced in 1990 in Washington State. By 2004, almost 3,500 sex offenders had been held under the laws nationwide. A nonpartisan Web site, Stateline.org, noted last month that Massachusetts has placed 306 people in civil confinement since 1998. Four have been released.

Maybe sex offenders need to be locked up for a longer time than is currently the case. There are valid arguments to be made for moving in that direction. But if that is our objective, then we, as a society, should be debating longer criminal sentences. We should not be dodging that discussion by hiding behind genteel terms like 'civil commitment.'

The disingenuousness of the terminology has concrete effects. It creates victims in the form of people already housed in institutions for the mentally ill, as well as taking its toll on the workers who treat them. New York's threadbare commitment to the mentally ill will be stretched to the breaking point by the demands of people who should either be in prison or under close supervision on the outside.

The urge to protect the weakest members of our communities from the depredations of sexual offenders is natural and powerful. But its sheer potency can lead us down dangerous trails in the search for safety and justice.

 

Medicaid and SPMI Enrollment.
Crain's Health Pulse, February 24, 2006

Medicaid plans are concerned about Gov. George Pataki's proposal to mandate enrollment for about 100,000 people with serious and persistent mental illness, a population known as SPMIs.

The proposal calls for covering the SPMIs' medical benefits under managed care, while keeping behavioral health and pharmacy services in the fee for-service Medicaid program.

SPMIs have such debilitating conditions as schizophrenia, depression or bipolar disorder; many have dual mental health and addiction diagnoses. It is a complex group that the health plans say they lack experience caring for.

Plans and providers also dislike the way medical benefits would be carved out from drug and mental health coverage, saying that such a separation raises clinical and administrative issues. For example, which plan would providers bill if an SPMI were hospitalized for diabetes?

The plans want an existing law amended to require that before SPMIs are moved to managed care, the commissioners of health and mental health convene a group to study SPMIs' special needs, recommend strategies for care management and report the findings to the Legislature.

Mental-health gains. Editorial
The Journal News, February 27, 2006

The stigma against those with mental-health or emotional problems thrives even, or especially, in the realm of government funding. So it is rare that advocates for mentally ill people, the latter's families and patients themselves have something to cheer.

Contained though in the governor's 2006 budget proposal are increases to children's mental-health services in New York state and an expansion of newly recognized geriatric ones. The largess of George Pataki may stem from his eye on offices outside state borders and a need to enhance his record on social issues — especially given his administration's disastrous oversight of adult homes for the mentally ill.

Whatever the impetus, the Editorial Board and others who have lobbied for mental-health reforms will take the extended wallet and try to open it a bit wider. Now it's up the Legislature to go the governor at least one better, expanding funding and passing meaningful legislation this session.

More children's services: Included in the 2006-'07 budget for the state Office of Mental Health and its proposed increase of $70 million is money for expanding and reshaping community-based children's services. The office's health commissioner, Sharon Carpinello, calls it the "single-largest investment in new children's mental-health service in this state's history.''

Under a $62 million umbrella effort with the lofty name of "The Achieving the Promise for New York's Children and Families'' initiative, $33 million will be targeted at local mental-health clinics to actively pursue early intervention in children's lives. Nearly 400,000 children are to be screened for emotional disturbance each year, including a doubling of admissions to clinic treatment and 22,400 children receiving in-home treatment services. Other home and community-based programs will be expanded, and technology grants will be given to five rural counties to add "rural telepsychiatry'' to increase psychiatric consultations in hard-to reach areas.

While more children at risk of costly and isolating institutional placements will be able to stay in their homes and school districts while receiving services, the actual number of additional slots for such programs would be only 450, at a total cost of $21.5 million.

The tasks before the Legislature includes finding money to boost that number and makes shifts within the budget to leverage dollars for even more programs.

It also must weigh the impact of proposed Medicaid reform at both the federal and state levels — read "cutbacks in benefits'' — on all mental-health programs in New York and the unintentional domino effect they can have systemically, including on children's services.

Legislatively, the best effort that lawmakers can make on behalf of mentally ill adults and children would be to pass Timothy's Law. Named after a 12-year-old upstate youth who committed suicide in 2001 after his family's mental-health benefits were exhausted, it is a bill to establish insurance parity — which about two-thirds of others states already have. Under Timothy's Law, the practice of limited and therefore discriminatory insurance coverage for mental-health and substance-abuse services would be stopped.

The Democratic-controlled Assembly has passed it before; to its shame, the Republican-run Senate has not.

Help for the elderly: Last summer, Pataki signed into law the Geriatric Mental Health Act, making New York the first state to not just recognize the growing mental-health challenges of older adults but to do something about them. It does two things

• Created an Interagency Geriatric Mental Health Planning Council to build bridges between several state departments and other agencies to focus on the unique, and historically unaddressed, mental-health needs of New York's elderly, whose numbers are expected to grow rapidly.
  
• Target some money toward funding a grants programs for demonstration projects to show the innovative ways mental-health care could be delivered to the aged in their communities. Pataki included $2 million for the grants in his 2006-'07 budget plan. Advocates, happy with the law's passage, nevertheless were looking for $5 million for projects to identify needs, improve treatment, make services more accessible and affordable, engage minorities, assist family caregivers, identify alternative living arrangements and expand the work force.

It's a sensible investment, one that can be solidified if the Legislature committed an additional $3 million to fund demonstration projects that do get up and running into the 2007-'08 budget year. Far more than a one-year, one-shot, feel-good hit is needed.

 

Catholics to lobby leaders. By Rob Cullivan
Catholic Courier, March 1, 2006

Catholics from the Diocese of Rochester will join hundreds from around New York state to buttonhole legislators in Albany on Tuesday, March 14, for the New York State Catholic Conference's annual Public Policy Day.

The conference represents the state's bishops on matters of public policy, and has a wide-ranging agenda to advance this year, according to Dennis Poust, spokesman.

Catholics will lobby their legislators on issues that include education tax credits for parents of nonpublic-school students; promotion of adult and umbilical-cord stem-cell research and opposition to embryonic research and human cloning; passage of Timothy's Law to provide parity in health insurance for mental-health and substance-abuse treatment; increased access to health care for the poor and uninsured; and continued reform of the Rockefeller Drug Laws.

During the Rochester Diocese's annual Public Policy Weekend Feb. 11-12, parishioners were asked to sign petitions urging legislators to promote adult stem-cell research and prohibit embryonic stem-cell research. Ethically acceptable stem-cell research is this year's parish-based public-policy advocacy goal, and the petitions will be delivered to state legislators March 14, according to the diocese.

Poust added that the hottest issue at the moment is education tax credits, the subject of a Valentine's Day rally that drew thousands to Albany (see related story on page A6). The rally featured appearances by Gov. George Pataki and New York Cardinal Edward Egan. Pataki has included in his proposed budget a plan to provide tax credits to parents of nonpublic-school students in underperforming public-school districts. Public-school districts are considered to be underperforming when they fail to meet student-achievement standards set by the federal government, Poust said.

According to the conference, Pataki's proposal would enable parents to receive credits for such expenses as tutoring, summer instruction and other supplementary instruction, as well as tuition at religious or independent schools. Pataki has announced that he would include in his executive budget a $500-per-child education tax credit for parents of children in underperforming school districts.

Sister Patricia Carroll, assistant superintendent for government services and administration in the Rochester Diocese's Department of Catholic Schools, attended the Feb. 14 rally and said that supporters of education credits were urged to speak with their legislators before March 31, when the budget is due.

Poust stressed that although the education tax-credit proposal is a hot issue, the church considers other issues just as important.

"The breadth of our agenda is wide, and we can't promote this issue at the expense of others," he said. "It's critical that we protect human life and, at the same time, promote the real potential of adult stem cells and umbilical-cord blood cells. We must speak out on behalf of the voiceless in terms of increasing access to health care and getting people the mental-health and substance-abuse treatment they need."

On that note, representatives from around the Rochester Diocese said they plan to talk with their state legislators about a range of issues.

Marv Mich, director of social policy and research for Rochester's Catholic Family Center, said his agency plans to press for reform of the Rockefeller Drug Laws -- which mandate lengthy prison sentences for possession of illicit drugs, and which the Catholic conference has criticized for unduly punishing low-level first-time nonviolent offenders. Mich noted that among those traveling with him to Albany will be representatives of Freedom House, which is part of Restart, CFC's program to treat men with chemical addictions.

Kathy Dubel, justice-and-peace director for Catholic Charities of Chemung/Schuyler/Tioga counties, said about 15 parishioners, Catholic-school students and her agency's staff members will go to Albany. She noted her delegation will deliver petitions calling for ethical stem-cell research; promote education tax credits; and call for parity in mental-health insurance. According to information from the Catholic conference, the bishops are calling for passage of Timothy's Law (A.6498), which addresses various barriers that discourage individuals from seeking treatment for mental illness and substance abuse.

The Sisters of St. Joseph's Justice and Peace Committee will send to Albany a delegation of two or three people, according to Sister Anne Urquhart, pastoral associate at Rochester's St. Andrew Church. She noted that the sisters will present petitions calling for ethical stem-cell research and post cards calling for education tax credits.

Bishop Matthew H. Clark is slated to receive from the New York State Council of Catholic Charities Directors the Bishop Frank Mugavero Award for "outstanding contributions to the work of Catholic Charities." The bishop will receive the award at a reception March 13 in Albany.

Jack Balinsky, Catholic Charities director for the Rochester Diocese, called Bishop Clark "the leader who has inspired the decentralization and expansion of Catholic Charities in the Diocese of Rochester."

"The bishop has viewed Catholic Charities as the leaven to call parishes and the diocesan community to service and advocacy," Balinsky said.

 

Plan for Sex Offenders Debated. By Rick Karlin
Albany Times Union, March 2, 2006

ALBANY -- The number of violent sex predators who might be released under "intensive parole supervision," rather than held in a state center emerged Wednesday as a potential sticking point in Gov. George Pataki's plans to confine predators after they get out of prison.

"You don't have civil confinement if you're letting someone out on the street," Sen. Dale Volker, R-Depew, said during a joint conference committee meeting at which the issue appeared to divide along party lines Assembly Democrats and Senate Republicans.

Volker was referring to a prediction by Assemblyman Joseph Lentol, D-Brooklyn, that as in other states, some 99 percent of sex predators would remain confined after completing prison sentences. Volker expressed doubts that so many offenders would end up in confinement.

"I think the really bad cases ... are going to be civilly confined," he said.

Under Pataki's plan, which has met with broad conceptual approval in the Senate and Assembly, prison inmates deemed to be persistent sex predators would be kept in confinement after prison.

He has proposed to convert a minimum security prison in Pharsalia, Chenango County, into a 500-bed confinement center, and use some smaller facilities across the state.

The Democratic Assembly has proposed a larger role for mental health workers in diagnosing and overseeing offenders, while the Senate Republicans, along with Pataki, want corrections workers to take the lead.