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February 7, 2007SAVE
THE DATES: MHANYS’
MENTAL HEALTH AWARENESS MONTH EVENT –
MHANYS TESTIFIES AT JOINT LEGISLATIVE BUDGET HEARING ON MENTAL HYGIENE: Following is MHANYS testimony. Thank you Assembly member Farrell, Senator Johnson and Committee Chairs Senator Morahan and Assembly member Rivera and other members of the committee. My name is Glenn Liebman and I am the CEO of the Mental Health Association in New York State (MHANYS). The mission of our organization is to advocate for positive transformation of the mental health system and to educate the public about mental health related issues. We have a very strong network made up of over thirty affiliates across New York State that represents 54 of the state’s 62 counties. Many of our affiliates provide community based mental health services in their region of the state. We have long held the belief that you cannot have good health without mental health. Over twenty percent of the nation’s population has a mental illness. Yet, due to stigma, lack of awareness and a system that often provides fragmented care, many people do not seek any services even when they are in desperate need. We must create a system that transcends our existing system of care. We have to incorporate ‘best practices’ into models of care. There have often been barriers in place that make it difficult to take existing research and move it into practice. Our jobs both in and out of government is to work collaboratively to eliminate those barriers and create models of care that are evidenced-based and that fulfill the recovery needs of people with psychiatric disabilities. We are very hopeful that with the Spitzer administration we are moving in a very positive direction. The appointment of Michael Hogan as Commissioner of Mental Health is a very good sign. He has a nationwide reputation for helping to transform systems of care as he did successfully in Ohio. We are very appreciative of the innovative initiatives from the past several years but we are hopeful with Commissioner Hogan that there will be a much more extensive transformation of the mental health system. We are also very hopeful because of all your leadership and support for the passage of Timothy’s Law. This will have a positive impact for millions of New Yorkers and would have never come about with out the leadership of the Legislature. We thank you very much for your help. HOUSING This year’s executive budget is one that we are very supportive of in many ways especially as it relates to housing, which has long been a major priority of our organization. We applaud Governor Spitzer’s commitment to housing and his proposal to add 1,000 new supported housing beds and 1,000 new congregate care beds. MHANYS is a member of several statewide coalitions of organizations, including The Campaign for Mental Health Housing, which calls for 35,000 units of housing over the next ten years. Governor Spitzer’s proposal represents a major step in that direction. We are also pleased to see that this housing is for both congregate care and for supported housing. It is important that recipients of mental health services have options in terms of their housing needs. One of the populations of people who have been identified as possibly needing alternative housing options are adult home residents. Recently, the Office of Mental Health released the results of a case study that found approximately 500 adult home residents were appropriate for more independent housing. In light of this report and the words of many adult home residents who are rallying today in Albany, we join with other members of the Campaign to earmark 500 of the 2000 beds for residents of adult homes. We also strongly advocate for geriatric individuals with mental health needs be included in this priority population. In addition, we are very pleased that there is continued funding for the New York/New York III agreement and new funding and to enhance staffing in Community Residential Programs and Family Based Treatment Programs. There is also $6.3 million in new funding to handle increased rent and utility costs in the third year of a three year increase in stipends for Supported Housing. These
are all significant initiatives that will help enhance the lives
of people with psychiatric disabilities. To
continue to explore ways to insure greater housing for priority
populations including the needs of family members with mental
illness living at home with aging family members and for the geriatric
population. COMMUNITY SERVICES We are appreciative that the administration has called for the continuation of a 2.5% COLA for mental health workers. However, this three year 2.5% COLA will not dramatically improve the ability of community mental health providers to recruit and retain qualified staff. As we said last year when we were fighting for a larger COLA, “this is a good first step but what we need is a quantum leap” We need to keep our work force in place. The most frequently voiced concern by our members is the ability to have funding to keep a quality work force in place in the mental health system. It was true many years ago and it is true that community mental health agencies lose staff because McDonalds pays better than many direct care workers in the mental health system. We have to continue to change that paradigm. In addition, we have to look for alternative ways, including new funding streams, to help fund existing community based mental health programs. These programs frequently provide the most appropriate quality services at minimal expense. They have also been targeted for cuts in recent years. Without these programs in place, many individuals with psychiatric disabilities would end up homeless, in emergency rooms or in jails and prisons. This is devastating for the individual and costly to the taxpayers. We look forward to working with all of you to increase funding for community based mental health services and recognizing that this should be a priority in mental health. Recommendation: CHILDREN’S SERVICES The members of our organization run many children mental health programs. The percentage of children with mental health need is at a staggering 20%. As with the adult system of care, there must be greater recognition of the needs of children in the mental health system. We are pleased that Governor Spitzer has continued the commitment to funding Home and Community Based Waiver Slots for 180 new slots for this year. This program has proven itself as a very effective and efficient way in which to address mental health needs in children. We are also very pleased to see that the Achieving the Promise Program which funds Child and Family Clinic Plus programs, continues to be funded as part of the Governor’s proposal. This program was designed to help create over 400,000 new mental health assessments in schools and bring about early detection of mental illness in children. With the increased identification of mental health needs come increased capacity issues. Part of the ‘promise’ of this program should be to insure that there are appropriate community placements and additional school personnel trained to work with this population of students. Recommendation: PRISON MENTAL HEALTH SERVICES We applaud Governor Spitzer for proceeding with targeted investments to expand and enhance services to prisoners with mental illness which features the development of specialized residential mental health programs. One of the major efforts of the mental health community has been to eliminate the use of 23-hour solitary confinement in Special Housing Units (SHUs) for prisoners with psychiatric disabilities—an effort that was vetoed by Governor Pataki last year. There is $2 million in this year’s budget for an expansion of mental health services (this annualizes to $9 million) in prisons, combined with Capital funding to create alternatives to Special Housing Units for prisoners with psychiatric disabilities. This is an important acknowledgement of the need to improve upon the mental health services within the correctional system---a system that has seen a seemingly endless increase in the number of people with psychiatric disabilities in recent years. This practice must end and this funding to create residential programs in prisons will be a significant positive step. FACILTY CLOSURES We know that there are no proposed facility closures in this year’s budget. However, we are pleased to see the language from the Executive regarding the ‘right sizing’ of the current institutional service system. MHANYS and other mental health advocates believe that inpatient mental health services can be delivered in a more efficient manner, which will allow for full reinvestment of saved resources in community-based mental health care aimed at preventing people from needing inpatient services. As part of the transformation of the mental health system, we must work with all stakeholders to develop a plan for better serving people with severe mental health needs without causing undue harm in the process. Recommendation: CO-OCCURRING DISORDERS We support Governor Spitzer’s proposal to fund $4 million in demonstration projects for co-occurring disorders. Well over 50% of people with a mental illness also have a co-occurring addiction disorder. It jumps to over 80% for the forensics population. Unfortunately, the way the system currently operates is that there are parallel systems of care for both mental health services and addiction disorders. Instead, there should be integrated treatment for mental health and addiction disorders. We have to incentivize providers to create a better system of care through funding evidence based best practices including integrated treatment services for people with co-occurring disorders. This funding should help support creation of demonstration projects that can be identified as best practices for integrated treatment. In addition, we should utilize this funding to encourage core competencies for practitioners in the field. SEXUAL OFFENDERS This year’s proposed budget calls for $19.2 million ($46 million annualized) to house sex offenders in the state’s inpatient mental health system. MHANYS has long maintained that housing sexual offenders in psychiatric facilities is not an appropriate placement for several reasons including the safety of individuals already in the psychiatric centers, the stigma of equating people with psychiatric disabilities with sexual offenders and the cost of such a program to the mental health system estimated at $200,000 per person per year. Recommendation: MEDICATIONS Having been very involved with efforts to make the transition from Medicaid to Medicare as smooth as possible for dual-eligible individuals under the Medicare Modernization Act, MHANYS is very pleased that Governor Spitzer’s budget continues the Medicaid wrap-around benefit provided to dual eligible individuals needing atypical antipsychotics and anti-depressant medications. However, given the complex medical conditions of many individuals, we believe this safety net coverage should be available for all dual eligible individuals. With regard to the Medicaid Preferred Drug Program, we are pleased that Governor Spitzer recognizes the necessity of providing an individuals’ doctor with the final determination as to which medication is most appropriate for that patient. However, we are concerned about this proposal to remove anti-depressants from the list of medications carved out of the Preferred Drug Program. Carving out these medications would likely reduce access that helps people with psychiatric needs remain healthy and stable and would instead cause them to rely on more expensive and intensive forms of care. In addition, such a policy would be inconsistent with the continued Medicaid wrap-around the Governor recommends, which includes coverage for anti-depressant medications. Recommendation: GERIATRIC MENTAL HEALTH ACT Enacted in 2005 and funded for the first time in 2006, there is no additional funding in this year’s budget for Geriatric Mental Health. Recognizing the mental health needs of the elderly population is significant and there should be additional funding for more demonstration projects for the geriatric population Recommendation: SUICIDE PREVENTION We were pleased to see funding in last year’s population that accompanied the NYS Suicide Prevention Plan that recognizes the significance of this issue. While the Governor’s budget calls for continuing funding at last year’s level, there is no new funding in this year’s budget to expand the excellent work aimed at preventing tragedies related to suicide. Recommendation:
The issue of youth in transition is a very important priority to the membership of the Mental Health Association. There are many adolescents with a psychiatric diagnosis who either drop out of school or graduate from school without any transition plan in place for their future. There are also adolescents aging out of the foster care system and juvenile justice system that also have a mental health diagnosis and with no transition plan in place as well. As a result, many adolescents with a diagnosis end up hospitalized, homeless, or end up in jails and prisons. Some of these people even end up as victims of homicides or suicides. Recommendation: 100
HOUR CAMPAIGN TO ‘BOOT THE SHU’: We need your support to make this happen. We are asking you to commit yourself to making the noise that will bring Albany’s attention to this issue.
ASK
FOR FUNDING FOR GERIATRIC MENTAL HEALTH:
Overall Governor Spitzer’s 2007-8 budget for mental health is very good. However, the Governor neglected to include additional funding for geriatric mental health services despite acknowledging the growth of the older adult population and the need for more services. In response, we are taking a two-pronged strategy: We know that Governor Spitzer is supportive of community based health and mental health services for all New Yorkers, including older adults. And funding for geriatric mental health services is critical to keeping older adults with mental disorders in the community. So, we are urging that the Governor include $3 million for geriatric mental health services in his Executive Budget Amendments. In case geriatric mental health is not included in Spitzer's amendments, we are also asking the Legislature to include $3 million for geriatric mental health services. In order to maintain the momentum created by the passage of the Geriatric Mental Health Act and funding for the Act's demonstration programs, we ask that you please:
Senator
Martin J. Golden Senator
Thomas P. Morahan Assemblyman
Peter Rivera Assemblyman
Steven Englebright
IN THE NEWS: Kids'
Suicides Rise, CDC Report Finds CHICAGO -- New government figures show a surprising increase in youth suicides after a decade of decline, and some mental health experts think a drop in use of antidepressant drugs may be to blame. The suicide rate climbed 18 percent from 2003 to 2004 for Americans under age 20, from 1,737 deaths to 1,985. Most suicides occurred in older teens, according to the data -- the most current to date from the federal Centers for Disease Control and Prevention. By contrast, the suicide rate among 15- to 19-year-olds fell in previous years, from about 11 per 100,000 in 1990 to 7.3 per 100,000 in 2003. Suicides were the only cause of death that increased for children through age 19 from 2003-04, according to a CDC report released Monday. "This is very disturbing news," said Dr. David Fassler, a University of Vermont psychiatry professor. He noted that the increase coincided with regulatory action by the U.S. Food and Drug Administration that led to a black box warning on prescription packages cautioning that antidepressants could cause suicidal behavior in children. Fassler testified at FDA hearings on antidepressants during 2003 and 2004 and urged caution about implementing black box warnings. The agency ordered the warnings in October 2004 and they began to appear on drug labels about six months later. Psychologist David Shern, president of Mental Health America, called the new data "a disturbing reversal of progress." Other research has linked certain antidepressants with decreasing suicide rates, Shern said, adding, "We must therefore wonder if the FDA's actions and the subsequent decrease in access to these antidepressants in fact have caused an increase in youth suicide." The advocacy group receives funding from makers of antidepressants, government agencies and private donations. The suicide data are in a report on vital statistics published in February's Pediatrics. Antidepressant use among children decreased during the same time period. Data from Verispan show 3 million antidepressant prescriptions were written for kids through age 12 in 2004, down 6.8 percent from 2003. Among 13- to 19-year-olds, the number dropped less than 1 percent to 8.11 million in 2004. Steeper declines in both age groups occurred in 2005, according to the prescription tracking firm. The suicide data are preliminary and don't show whether suicides might have been concentrated in one region or among one gender or ethnic group, said the CDC's Dr. Alexander Crosby. "It's something that we want to look a little bit closer into," Crosby said. "It's probably too early to say" if declining use of antidepressants had anything to do with it, he said, The CDC is expected to issue a more thorough report on the data in a month or two. The data are concerning, but it's too soon to know if they're anything more than a statistical blip, said Dr. John March, a Duke University psychiatry professor. He led landmark National Institute of Mental Health research linking antidepressant use with an increased risk for suicidal behavior, but also showing that getting psychotherapy at the same time canceled out that risk. Some mental health experts believe suicide prevention programs and effective use of treatment including drugs and therapy contributed to the decline in suicides that occurred in the 1990s. Funding cuts for school-based suicide prevention programs might have contributed to the apparent rise noted in the new CDC report, said Emory University psychologist Nadine Kaslow. But the rise might not indicate a nationwide trend and needs to be investigated, she said. "It's definitely concerning" but will need to be followed to see whether increases occurred in subsequent years, Kaslow said. Beware
of Criticism of Child Mental Health Screening It was sad, but not unexpected, to read the poorly informed criticisms of New York's Child and Family Clinic-Plus Program ("Better Ways to Help Children with Problems"). Despite the assertions of a small minority of nonNew York residents who clearly harbor their own views on mental health, the Clinic-Plus Program is widely considered to be an exceptional, enlightened mental health program that takes into account many years of research and serous thought. Mental health screening is only one of the core components of Clinic-Plus, but is singled out for criticism. Screening is valuable when a condition is hard for parents to recognize and / or when children keep their troubling thoughts to themselves. This is what justifies screening adolescents for suicide risk. Roughly 85 percent of teens who have thought about suicide, and approximately 50 percent of those who have made a suicide attempt, have not disclosed their thoughts or activities to either friends or family members. However, when asked in well-designed screening questionnaires, they readily disclose this information. There are other problems, including certain types of learning difficulties, anxiety, and concentration problems that are frequently dismissed as laziness, poor motivation and other failures, but which, in fact, follow from disorders that, without treatment, result in time lost from the fullness of these children's lives. Mental health screening programs for children and teens have been endorsed by the American Academy of Child Psychiatry and the American Academy of Pediatrics, and are recommended by the New Freedom Commission on Mental Health. Screening is considered valuable and effective by these groups for the reasons that drive most public health initiatives - a wish by people in public service to improve the community's health and well-being. Those who attempt to downplay the risks and reality of suicide and unidentified mental illness do the public a disservice at many levels: They foster the stigma that deters those who need help from seeking it out, and they underestimate the benefits of the treatments that are available. Criticism by adherents of certain groups of a program that is based on decades of research, primarily funded by governments and foundations, and that would put New York in the lead in addressing the problem of unidentified and untreated mental disorders in childhood is, at best, predictable and, at worst, dangerous. David Shaffer is Irving Philips Professor of Child Psychiatry and professor of psychiatry and pediatrics and director of the Division of Child and Adolescent Psychiatry at Columbia University Medical Center. Timothy's
Law is a Victory for Everyone in New York I hear people today bemoaning the fact that presidential candidates are all saying things that are either outright lies or direct contradictions of what they have said in the recent past. Surprised? I hear people today complaining that the media is saying things that are blatantly false or known to be inaccurate. Amazed? I hear people today saying that there are so many issues to protest that there is no way to address them all and that there is no way and nowhere to effectively be heard. Confused? Dazed? Feel helpless? Politics are not about truth but rather about the public perception of what may be true; politics are about power. Think of politicians as weather vanes; as soon as the wind changes, 95 percent of politicians must automatically change their angle, too. The media is not about truth but about ratings. Just as often as not, when you are asked to contribute to a media event you will not recognize what you said when you see the finished presentation. Your part will be incomplete and/or twisted around to reinforce some other point of view. This has to happen to you to believe it. The way to effective citizenship is through education, which this administration and others have been so devoted to hamstringing. They have good reason to do so: their own survival. We can all learn and be strengthened by the story of Timothy's Law, a great modern-day victory for justice. For years, a specialized group of people have concentrated their efforts to change what they believed to be an egregious injustice, the fact that health insurance companies in New York state did not offer mental health coverage on a par with physical health coverage. If you wanted it, you had to pay a lot more. One of Gov. Pataki's last official acts was to sign a bill called Timothy's Law, which now obliges insurance companies to provide mental health coverage with the same co-pays as physical coverage, with only a tiny increase in premiums across the board. The law was named for Timothy O'Clair, a 12-year-old boy who committed suicide in 2001 soon after being put into foster care (the only way he could become eligible for Medicaid services). The passage has been the cause for elation throughout the disability advocacy world and here at Action Toward Independence. Ordinary people have never had more ability to organize, to share information and communicate rapidly. But we are dazzled by it, too, and this mesmerization has led to a recent national dissipation of focus and contributed to the present administration's ability to foster a regression in human rights unparalleled in our history. It's the old principle of divide and conquer. Meantime, our economic system has been surreptitiously breaking up the family unit so as to be able to sell each individual his own car, house, toaster, lawyer and Christmas tree. And gun. That's the glory of capitalism, not "democracy," and that's what we are so dedicated to spreading all over the world today, for oppressed peoples' "own good," where we are being grossly misrepresented. I hear people saying "What can I do?" Read about and remember the O'Clair family's determination in memory of their son and never give up. Whatever makes you most angry, calm yourself and take up the tools to change it. Whomever you hear voicing the same protest, align yourself and join forces with them. Whatever entity or person you see as responsible for changing that which is aggravating you, pound on their door until they open it and listen to you. That's how and why Timothy's Law came to exist and to protect us all. The American way is to make our country what we want it to be. There is no magic bullet, and freedom will wither if it's not used and championed and kept alive. We've seen that happen right here over the last six years. Regroup! Concentrate! Organize! Focus! Follow through on one thing at a time! Only our own shortsightedness and hesitancy prevent us from achieving success in righting the wrongs and injustices that are perpetrated against us. Gilles Malkine is the director of services at Action Toward Independence in Monticello. Handle
New Law with Care Thank you, on behalf of the Board of Directors and Board Advocacy Committee of the Mental Health Association of the Southern Tier, to the Press & Sun-Bulletin for the excellent coverage on the issue of mental health care, parity, and more specifically Timothy's Law. The articles you provided over the years thoroughly represented all views. We are thankful that our legislators recognized the need for accessible mental health care that is at least equal to physical health care. The most recent article on this topic noted the difficulty insurers have with implementing this new law. I would like to ask all insurers to treat this with the utmost priority as if it were your 12-year-old who needed the care. Marita
Florini APRN, BC Mental
Health Advocates Like Budget Plan Mental health advocates are generally pleased with Gov. Eliot Spitzer’s proposed Executive Budget but are expressing some concern regarding civil confinement and a change to Medicaid drug coverage. Advocates are excited about proposed funding increases for housing, children’s services and the expansion of prison mental health services. However, one Medicaid provision and a proposal concerning sexual offenders are causing some unease. The budget announcement came a week after a large rally for mental health causes, convincing advocates that their requests did not fall on deaf ears. Allocations of $6 million this year and $12.1 million annually to create a thousand more supported housing beds has mental health advocates singing the governor’s praises. An additional $200 million intended to create a thousand new congregate care beds also elicited a positive reaction. Congregate care beds cost comparably more than supported housing due to the difference in housing models. Congregate care beds focus “80 or 90 or 100 beds” in a single unit according to Antonia Lasicki, executive director of the Association for Community Living, while supported housing is “individual apartments rented on the open market.” Congregate care units usually require remodeling or constructing an entire building. Each consumer receives his or her own room similar to a studio apartment along with communal services such as a kitchen, and constant medical supervision. Consumers of supported housing receive an on-call supervisor to aid with rent, medication and other patient needs. “We’re overwhelmingly enthusiastic,” Glenn Liebman, CEO of the Mental Health Association of New York State, said of the budget proposal, “especially around housing. This has long been a major priority to our organization as well as to most mental health advocacy groups I’m familiar with.” Some advocates feel that the recent rally led to the favorable budget proposals, but Steve Coe, executive director of the New York State Campaign for Mental Health Housing, said that during the organization’s 12 years of advocacy, he has seen a change in attitudes from the Office of Mental Health. He said this change, paired with the work of individuals on the governor’s transition team, played an important role in budget proposals for supportive housing money. Though the proposed appropriation of supportive housing units is considered a victory in the mental health community, a proposal to allot spending for increased in-patient beds at state psychiatric facilities for sexual offenders has mental health advocates apprehensive. Liebman is concerned that it is stigmatizing to commingle sexual offenders and mentally ill individuals because less than seven percent of individuals with mental disorders are sexual offenders, he pointed out. Coe said this seems indicative of a problem in the legal system and says, “[The proposal] sends a wrong message to the public about what mental health care is about. “If the type of punishment is not adequate something out of whack,” Coe said. If the proposal is passed, $19.2 million in the first year and $46 million annually will be used to hire employees to support sexual offenders placed in mental health facilities. Concerns other than housing that were voiced at the rally made it into the budget as well. The 2.5 percent cost of living adjustment for community-based programs was proposed to be continued for a second year, and money was proposed to bolster children’s services. A proposed $1.2 million this year and $4.7 million annually would expand the Home and Community Based Waivers program which the Mental Health Association claims “has proven extremely successful in meeting the needs of children with psychiatric disabilities.” Five-hundred-thousand dollars has been set aside for OMH for the care of young adults transitioning to the adult service system and $7.7 million has been proposed for improvements to the children’s magnetic resonance imaging suite at the Nathan Kline Research Institute, which the budget proposal briefing describes as holding a “leadership role in cutting edge research in children’s mental health.” Also, an initial $2 million and $9 million annually would go to expanding state prison mental health services if the budget is passed. Harvey Rosenthal, executive director of New York State Association for Psychiatric Rehabilitation Services, is excited about this possibility. He has speculated that Spitzer “is planning something major,” and said “that can only be good for everyone involved.” He is also excited about the prospect of state psychiatric hospitals being included in efforts to “rightsize” hospitals statewide. Mental health advocates are disappointed that anti-depressants will no longer be covered under the Preferred Drug Program and fear that access to the medications will be limited. Money has also been proposed to continue or expand funding for Project Caring, a service for women with mental illness; supported employment slots for people with mental illness; comprehensive psychiatric emergency programs; trend factor increases for residential treatment facilities; school mental health services; maintenance of beds in OMH facilities and facility building preservation. Timothy's
Law Gets Shaky Start Late last year, state lawmakers finally got around to fixing an unconscionable loophole that failed to provide insurance coverage for so many people being treated for mental illness. The tortured process this legislation went through is highly instructive. It shows how long delays by state lawmakers can cause confusion, and add to the headaches of doing business in New York. For years, the state Assembly passed the measure called “Timothy’s Law,” named for 12-year-old Timothy O’Clair of Schenectady, who hanged himself after his parents went through a desperate search for care. Under the law, mental illness treatments will be covered by insurance as physical ailments are. It brings parity to a system that was in dire need of it. More than 35 other states require insurance carriers to provide mental health coverage. New York lawmakers were right to get the law on the books here as well. But, for years, the state Senate and Assembly couldn’t agree on similar versions of the bill, so the matter lingered. Two years ago, the Senate did pass what it deemed a compromise bill that allowed companies with 50 or fewer employees to opt out of the parity coverage. But the action was taken so late in the session that there wasn’t enough time to deal with the significant differences between the houses in a conference committee. Last year, the two legislative houses reached an agreement in principle at the end of the regular session in June, but didn’t have time to actually vote on it. Lawmakers did strike an accord on protections for companies with fewer than 50 employees by having the state absorb any increases in premiums. Not enough time left for big changes The Senate approved the bill at a special session in September. But the Assembly didn’t come back to approve the legislation until mid-December, and then-Gov. George Pataki didn’t sign it until Dec. 22. Technically, that left the insurance industry 10 days to deal with a massive change, one that would come as Gov. Eliot Spitzer was taking over and initiating changes to many state agencies, including the Insurance Department. Insurance industry representatives told the Gannett News Service in Albany they are doing their best to comply with the new law, citing the need to revamp computer systems and educate staff about the new law. The state’s superintendent of insurance also still has to devise the specifics of the system to deal with the state’s cost of additional premiums for small businesses. It didn’t have to be this way. The changes are complicated enough. It’s another example — voting reform being another striking one — where the state lawmakers took literally years to reach an agreement on a significant matter, then left little time for people on the receiving end to deal with the ramifications. The lawmakers were right to approve the coverage, and they should get credit for that. But the next time they talk about how they will “eventually get around” to passing something without any sense of urgency, without any recognition that late-year decisions can come with avoidable consequences, they should remember how this law is being implemented. |
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