March 8, 2006

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

MHANYS LEGISLATIVE CONFERENCE: On Monday, March 13th, people from all over New York State who are interested in shaping New York’s public policies, as they effect people living with mental illness, will gather in Albany for MHANYS Legislative Conference. Starting at 9:00, attendees will be afforded the opportunity to participate in the legislative process, get the opportunity hear from the state’s top mental health policy makers, and meet with their elected representatives. The event will take place in “The Well” of the Legislative Office Building in Albany. A light breakfast will be served. Directions follow below.

Issues discussed and supported will include all issues on MHANYS’ 2006 Legislative Agenda:

Timothy’s Law

Issue: Health insurance policies continue to discriminate against those living with mental health and addiction needs by limiting coverage and charging significantly higher co-payments to access such treatment and services. Inadequate treatment for mental health and addiction disorders costs the US economy hundreds of billions of dollars each year. Coverage and co-payments for mental health and addiction services should be the same as it is for other health services.

Action: Pass Timothy’s Law - A.2912 (Tonko) / S.6735 (Duane)

Housing

Issue: The lack of available and affordable housing for people with mental health needs is prevalent in urban, suburban and rural communities throughout New York State. Many New Yorkers could transition to much less restrictive and less expensive alternatives if such options were made available. The priority populations for transition include homeless individuals and those in homeless shelters, those who currently live in adult homes in deplorable conditions, individuals with psychiatric disabilities living at home with aging parents, and individuals transitioning from the criminal justice system. Additional capacity in existing housing models, and development of new housing models, are necessary especially for these identified priority populations. The recently enacted NY/NY III agreement, which will provide housing options for thousands of homeless New York City residents, many with mental health needs, is an excellent step toward addressing the housing need for this population of people.

Action: 1) Provide additional resources for the development of alternative housing options for people with mental health needs and for assistance to help people with mental illness afford housing; 2) Replicate the NY/NY III agreement, statewide, to address the needs of those with psychiatric disabilities.

Civil Confinement of Sexual Offenders

Issue: While the state should take steps to prevent sexual offenses from taking place and treat those who offend so that they will not offend again, efforts to place such offendersinto psychiatric centers after their release from the criminal justice system isa misuse of thestate’s mental health system. Such proposals would create huge safety risks for existing psychiatric center patients, sap desperately needed resources from mental health treatment and services in future years, and further stigmatize those attempting to recover from mental illness.

Action: Ensure the public’s safety from sexual offenders by adopting the recommendations of the professionals in sex offender management – sex offender treatment providers – 1) to provide treatment to all offenders, 2) establish prevention programs and 3) provide intense supervision for most likely to re-offend. Such programs should be the responsibility of a separate state agency, other than the Office of Mental Health. This would avoid any safety risks associated with co-mingling, ensure that resources are not diverted from programs and services for people with mental illness, and prevent further stigmatization of people with psychiatric disabilities.

Budget

Issue:
$10M Increase for Community-Based Providers: Over the past decade, community mental health providers have seen little-to-no funding increases, and have even weathered multiple funding cuts, placing them in a position where they are unable to cover increasing operating expenses related to property, personnel, insurance, and energy costs. Without additional resources to accommodate these increased costs, mental health programs will be unable to meet the existing need and maintain the quality of programs provided by a dedicated workforce.

Geriatric Mental Health Act: Enacted into law in 2005, funding must now be provided to develop pilot programs designed to address the increasing mental health needs of the aging population of New Yorkers.

Action:
$10M Increase for Community-Based Providers: While the 2.5% Cost of Living Adjustment provided in the Governor’s budget proposal is greatly appreciated, a $10M increase in funding is necessary to prevent community mental health providers from further scaling programs back or closing programs altogether.

Geriatric Mental Health Act: Annualized $5M for pilot programs

Access to Services and Treatment

Issue: Ensuring that individuals living with mental illness have access to services and treatments is an essential component of achieving recovery from mental illness. While well-intentioned, many government proposals and actions effectively restrict access to the services and treatments that allow individuals living with mental health needs to remain healthy and stable, especially with regard to medications.

Medicare Part D: Of particular concern are the difficulties individuals on both Medicaid and Medicare (dual eligibles) are facing attempting to get the medications they need to remain healthy and stable under the new Medicare Prescription Drug Benefit (Medicare Part D).

Preferred Drug Program: In addition, the Governor’s budget proposal calls for elimination of safeguards that allow the doctor to make the final decision about which medications a patient gets, and the consideration of cost in determining which drugs become ‘preferred’ (which would certainly impact the rather expensive mental health drugs) under Medicaid’s Preferred Drug Program.

Action:
Medicare Part D: 1) Provide permanent “wrap around” Medicaid coverage for dual eligibles unable to get their medications from their Medicare Part D plan; 2) Cover co-payments for those dual eligibles unable to afford the now-mandatory co-payments required by Medicare Part D

Preferred Drug Program: 1) Reject the Governor’s proposal to eliminate the “physician prevailing” language from Medicaid’s Preferred Drug Program; 2) Reject the Governor’s proposal that would allow cost to be used as a consideration of which drugs are deemed “preferred.”

Transition Issues

Issue: Individuals with serious psychiatric disabilities have difficulty transitioning from school to the adult mental health system, and must have a strength-based, individual-centered assessment that identifies choices regarding education and employment. There must be greater emphasis on post-school outcomes including an emphasis on research-based practices.

Action: 1) Provide an additional $500,000 for case managers who will help with the transition of young adults from high school to the adult mental health system; 2) Allocate $500,000 for supported employment programs to help make this transition more successful, and; 3) Allocate $500,000 for demonstration projects that will fund 2 drop-in centers for individuals 18-25 with psychiatric disabilities.

 

Directions

From the North: Take Interstate 87 (Northway) to Interstate 90 (East), proceed east to Interstate 787 (South) and take the Empire Plaza exit.

From the South: Take New York State Thruway (Interstate 87) to Exit 23 - straight through Toll Booth to Interstate 787 (North). Take Empire Plaza exit.

From the East: Take Interstate 90 and cross Hudson River. Take exit to Interstate 787 (South). Take Empire Plaza exit.

From the West: Take the New York State Thruway (Interstate 90) to Exit 24, proceed on Interstate 90 (East) to Interstate 787 (South). Take Empire Plaza Exit.

The Legislative Office Building is located on the corner of Swan and State streets, across State Street from the NYS Capitol (not specifically marked on the map above). Access to the Legislative Office Building is from two locations. First is from the underground Concourse that runs the length of the Empire State Plaza, from the Capitol to the Museum/Libraray/Archives, which brings you into the Legislative Office Building on the 1st floor. Second is from State street, which brings you into the Legislative Office Building on the 3rd floor. “The Well”, where MHANYS’ Legislative Conference will take place, is the open area on the first floor of the Legislative Office Building.

Download a map of selected visitor parking areas in and around the Empire State Plaza.

IN THE NEWS:

New York Puts Mental Patients in Homes Illegally, Groups Say. By Richard Perez-Pena
The New York Times, March 8, 2006

New York State regularly sends patients from mental hospitals to nursing homes, where it illegally houses hundreds of them without the care they need and often under conditions that approach imprisonment, according to legal groups designated by the state to represent the disabled.

Those groups said they would file a lawsuit today in Federal District Court in Brooklyn, accusing New York State of violating several federal laws and claiming that many of the mentally ill patients who have been moved from state psychiatric hospitals into the nursing homes should instead be back in their own neighborhoods, living independently but with government help.

The groups say that they have talked with the Pataki administration for years, seeking to end the practice, but that the problem has worsened. They say more than 1,000 former psychiatric patients could now be in nursing homes in New York and New Jersey. They charge that 500 to 600 are in two New Jersey homes alone, nearly twice as many as in 2002 when the practice first came to light.

The groups charge that the nursing homes do little more than medicate the mentally ill residents and do not adequately provide the services that the state is legally required to offer — treatment by psychiatrists and social workers, and training in everyday skills like shopping and cooking. The mentally ill residents, who have not been declared a threat to themselves or others, are generally not allowed to leave the nursing homes and in many cases are even restricted to their floors most of the day, the groups say.

"The state is warehousing people in nursing homes who don't need nursing home care, and not providing the services that they do need," said Cliff Zucker, executive director of Disability Advocates Inc., one of the groups filing the suit. Those who are sent out of state, he said, are isolated from family and other sources of support.

Jill Daniels, a spokeswoman for the state's Office of Mental Health, which runs the psychiatric hospitals, said the patients were being properly discharged to nursing homes, and that the state was following federal guidelines about doing so. She said they were all screened and deemed in need of nursing home care. And she said the residents were receiving proper "clinical treatment."

The suit does not accuse the nursing homes of wrongdoing, but it draws a disturbing picture of life there for the patients, arguing that the homes are simply not equipped to handle them. It says that one plaintiff, Bradley W. — the suit does not use full names to protect patients' privacy — was discharged last year from Rockland Psychiatric Center in Orangeburg, N.Y., to a nursing home in New Jersey, "and is required to wear an electronic wristband on his wrist that would signal an alarm if he tried to leave."

Edwin T. "is permitted to leave the floor and go outside only at designated times to smoke and to play basketball," it says, and Lisa H. is not allowed to go to her church. "Carlos S. sees the psychiatrist once per month, for medication purposes only."

Under Gov. George E. Pataki, the state has cut the population of its psychiatric hospitals by more than half, to about 4,000, in part to save money. Throughout that effort, people who work with the mentally ill have complained that for many of those patients, the state did not provide the right alternatives to hospitalization.

The state has placed thousands of people in large adult homes where, The New York Times reported in 2002, many were merely warehoused, neglected and even abused.

Patients and lawyers and other professionals working on their behalf contend that the ideal setting for many people released from mental hospitals is "community-based housing" — either small group residences or individual apartments — paid for by the state, with an array of support services and a high degree of independence. But for years, the Pataki administration discharged people from hospitals much faster than it added community housing.

In the last three years, the state committed itself to increasing this housing by several thousand units, but the demand still far exceeds the supply.

For the last decade, the state has also sent large numbers of people from mental hospitals to nursing homes, and it has been accused of doing so as a way to save money.

The state, for instance, pays the entire cost of community housing for the mentally ill, but when those people are instead placed in nursing homes, the costs are paid by Medicaid, and thus split among the federal government, the state and local governments.

Roger A. Bearden, a lawyer for Disability Advocates, said, "In discharge papers, the clinical reason given time and time again for sending them to the nursing homes is 'medication management,' which is and can be performed in the community."

Disability Advocates is one of several nonprofit legal groups named by the state, under a federal grant program, to represent people with disabilities. Another group with that same state designation, New York Lawyers for the Public Interest, is helping represent the plaintiffs in the suit. One of the plaintiffs in the case is Sidney Hirschfeld, director of one of four Mental Hygiene Legal Service offices that are part of the state court system, created by state law to do similar work for the mentally ill.

The suit accuses New York State of violating the Americans With Disabilities Act, a 1990 federal law, by unnecessarily segregating mental patients from the population at large and preventing them from taking advantage of other government services.

When The Times reported in 2002 that New York had placed hundreds of former psychiatric patients in nursing homes in New Jersey, Gov. James E. McGreevey, the New Jersey governor then and other New Jersey officials protested the practice and said they were unaware that the practice was so common. They dropped the matter the next year, saying that they had found nothing inappropriate about the practice, and had concluded that it did not cost New Jersey any money.

The suit focuses primarily on the two large New Jersey homes, Andover Subacute and Rehabilitation Center II, in Sussex County, and Lincoln Park Care Center, in Morris County, but it also names nine others in Queens, mostly on the Rockaway Peninsula.