Heard in the Halls June 2009 #4

NAMI North Carolina's Heard in the Halls Budget goes to House Floor containing devastating cuts to mental health services June 2009 Number 4  Quick Links NAMI NC   NAMI National   North Carolina General Assembly     Welcome back to NAMI NC Heard in the Halls.  I hope to bring you direct information on what is happening in the general assembly regarding issues that touch you and your family members.    Deby Dihoff Executive Director National Alliance on Mental Illness NC The Cuts Just Keep Coming...  This week we saw some action in the House, with the Finance Committee at long last addressing revenue enhancements that would ultimately reduce the total volume of cuts to the Health and Human Services Budget by about $800 M.   We applaud the actions taken by the Finance Committee because the enhancements are more progressive than we had expected.  Please thank your legislators!  This budget cannot be balanced on cuts alone; we must look at taxes.  The changes would mean that tax breaks and loopholes for businesses and corporations would end, and there would be an expansion of sales tax to cover warranties, home repairs, and on line purchases.  Also, there is a l/4 percent increase in the overal sales tax.  The cigarette tax increase did not go through as proposed.   Please thank your legislators for this progressive movement on taxes, but also add that the revenue enhancements are simply not relieving enough of the cuts to mental health services.    While all that was happening, I was upstairs in the full House Appropriations seeing the latest rounds of cuts.  These  cuts would later be ammended by the increase in revenues by Finance.  That was all made public at yesterday's HHS subcommittee of appropriations meeting.  They passed the ammended SB 202 restoring some of the previously cut items. But the good news- the room was jammed with people wearing t-shirts saying No Budget Cuts to Mental Health!  I have never seen the room so full of supporters.  But it was passed, so it is onto the floor of the House today.      So how did things work out for the people in NC affected by mental illness?  Remember, we went into the session with a clear disadvantage:  Health and Human Services was making up 50% of the cut, while they constitute  only 23% of the total budget.  Overall, we did not fare that well in mental health.  Massive restorations were made to Smart Start, child care subsidies, and other items, and community support and group homes were not restored by even a penny.  Here are the figures:   Restored:   Division of Mental Health Stated Funded Services -  cut $50M; restored $50M In Home Personal Care Services                                cut $49 M, restored $34M Personal Care in Adult Care Homes                           cut $l0M, restored $8M Eliminates PT/OT/ST                                                 cut $l5M, restored $l5M Adult Optical                                                            fully restored (3.2M) Dental Coverage                                                        cut $l5M, restored $l5M Orthotics, ER co-pay, CCNS, Providers fees - fully restored   Other:   Provider rate cuts - moved back from 5.5% the first year and 6% the second year to 3.06% in the first year and 3.56% in the second year.   What else:   The big news is really what didn't get restored or addressed in any way.  And that is the cuts to Community Support and Level 3 and 4 Group home- these touch thousands of individuals, and it is not known how they will transition out of these.  To what, and where? - sensible questions given our system capacity issues.  33,000 people will no longer receive community support which includes training and case management services.   Nor did they change or restore the open access to medications for those with severe mental illnesses.    It is clear that advocacy has worked to restore provider rates, PT, OT, Speech, personal care.  Let's get going and ask that the following be addressed!  Eliminate cut to community Support by $59 M in year one, $116 M in year two (no replacement for this service is proposed  Keep the waiver for drugs for those with severe mental illness to not be subject to a preferred drug list to save $40 M year one, $50 M year two Eliminate the cuts to Level III and IV Group Homes What Can you Do?  Thank your legislators for their revenue enhancements, but make it clear we must not cut Community Support and LEvel III and IV group homes without substituting other services. Ask that they continue the "carve out" for psychiatric medications making them not subject to a preferred drug list A suggested replacement package for the Community Support is as follows: Immediately move to adopt a medicaid billable peer support definition Add a targeted case management definition Review caseloads of community support to determine who might benefit from either peer support or case management Appoint a transition committee including family members and consumers to work out the details.      4.  Mobilize your affiliate members; organize a letter to the editor What can I do? Listening to the news I learned that the budget is being debated on the floor of the House, and it is continuing through today and probably tomorrow as well.   So- there is a chance to influence your Representatives:  call, email, visit.   Attend the Together NC rally at 5:30 on Monday the l5th of June - show a groundswell of support   Talk to both your Senators and Representatives as the conferee process is next- where they try to resolve the differences   Talking points These cuts are a pipeline to prison, poverty, and patient deaths It will take people and programs decades to recover People will be harmed, and some will die These cuts bring with them hidden costs- when the local services aren't there for people, they all to often land in an emergency room (more expensive), jail or an institution (more expensive) Some good news:  Just this morning I had a call from the Governor's Office - Ann Bryan, who spoke at our annual conference.  She wanted input to share wtih the Governor and leadership about the impact of these proposed cuts.  I shared with her the replacement ideas for community support and residential services.   Those living with mental illnesses are taking too big a share of the cuts  Take Action  Make a Difference.  Do it Today   Deby Dihoff, MA, Executive Director