Heard in the Halls is an email service of NAMI North Carolina to provide updates on state legislative and policy issues. Heard in the Halls is produced for community advocates at least monthly and more frequently during sessions of the General Assembly. To be added to the Heard in the Halls list send a message to heard@naminc.org with just "subscribe" (no quotes) in the subject header. Because of the variety of e-mail servers, Heard in the Halls is sent in plain text and as a formatted attachment. Previous issues of Heard in the Halls can be viewed a www.naminc.org

5-19-03

(http://www.naminc.org/RTR/RTRhome.htm )

NAMI North Carolina, in association with experts from UNC School of Social Work, Duke Psychiatry, and the UNC Shep Center, has completed a review of the Local Business Plans submitted by programs identified as being in the first phase of reform efforts.

North Carolina is in the midst of a comprehensive effort to reform its public MH/DD/SA system. While there are many reasons for this reform, central to it are a number of principles that form the vision for a better service system. Among these principles are a personal recovery focus; consumer/family involvement and choice; community collaboration, integration and involvement; clinical, administrative, and fiscal accountability; and identification and provision of best practice services to those populations most in need (i.e. "target populations").

The initial mechanism through which reform is operationalized is in the development and implementation of Local Business Plans. Local Business Plans were to be developed through a community-based inclusive and interactive strategic planning process collaborative led by the Area Programs/Local Management Entities. The plans detail how communities will meet state expectations around the goals and vision of reform.

The review concludes that while the plans make a good first step, important policy and operational changes must be made at the state and local level for reform to be successful. It is hoped that leaders at the state and local level will use the observations and recommendations contained in this review to move forward to the next level of implementing meaningful reform of the MH/DD/SA system.

The review can be found at: http://www.naminc.org/RTR/RTRhome.htm

Below is an important alert from NAMI. Please respond! Passage of the Collins amendment is critical to help the budget situation in North Carolina and to help save MH/DD/SA services:

NAMI E-News                May 16, 2003              Vol. 03-25
_____________________________________________________________

SENATE BACKS ADDITIONAL FEDERAL FUNDS FOR MEDICAID AND FISCAL ASSISTANCE FOR THE STATES
PLEASE CONTACT YOUR REPRESENTATIVE IMMEDIATELY
AND URGE THE HOUSE TO FOLLOW SUIT!

In response to the growing budget crises faced by the states, the Senate voted 95-3 in favor of a plan to provide $20 billion in federal aid, including
additional federal matching funds for Medicaid (the largest and most important source of funding for public sector mental illness treatment and support programs).  The Senate's action came as part of an amendment authored by Senator Susan Collins (R-ME) to pending tax cut legislation (S 1054).  Last night, the Senate finished its work on the tax cut legislation (S 1054), setting up a confrontation with the House, which did not include fiscal relief in its tax cut package.

ACTION REQUESTED
NAMI advocates are requested to contact their House members and urge them to support inclusion of the Collins Amendment in the final tax bill that will be sent to President Bush later this spring. 

* Remind them of the importance of Medicaid for children and adults with severe mental illnesses and their families.  As noted above Medicaid is the largest source of funding for state and local public sector mental health services - covering prescription medications and supportive services such as case management, rehabilitation and outpatient treatment.

* Make it clear that cuts to Medicaid at the state level are devastating to
access to treatment and services, with limits being imposed on open access to medications and critical supportive services.  Additional information about the current threats to Medicaid at the state level is available at:
http://www.nami.org/states/statesincrisis.html

* Urge your House member to contact House Speaker Dennis Hastert (R-IL) to include state fiscal relief and an increase in the federal share of Medicaid in the final tax bill.  Note - if your House member is a Republican, urge them to join Representatives Peter King (R-NY) and Ray LaHood (R-IL) in signing their letter to Speaker Hastert in favor state fiscal relief.

All members of Congress can be reached by calling the Capitol Switchboard toll free at 1-800-839-5276 or at 202-224-3121 or by going to the policy page of the NAMI web site at www.nami.org/policy.htm and click on "Write to Congress." North Carolina House members are:

Rep. Bob Ethridge        Rep. Walter Jones, Jr.
Rep. David Price           Rep. Richard Burr
Rep. Howard Coble      Rep. Mike McIntrye
Rep. Robin Hayes         Rep. Sue Myrick
Rep. Brad Miller           Rep. Charles Taylor
Rep. Melvin Watt

Background on the Collins Amendment
The $20 billion state fiscal relief amendment passed by the Senate includes two parts:
1) $10 billion in increased federal Medicaid matching funds (also known as
FMAP) for the states.  Most states would see their match rate (which varies 50% to 80% depending on a state's relative wealth) increase by about 1.5% through the end of FY 2004 to cope with growing costs in Medicaid,
2) $10 billion in revenue sharing from the federal government through the end of FY 2003 and all of FY 2004.  These funds would be split with 60% going to the states and 40% to localities.  States and localities would have substantial discretion in how to spend these funds although they would be encouraged to use these funds to cope with the growing costs of federal mandates related to education, homeland security and Medicaid. Funds would be allocated by population, with every state guaranteed at least $50 million.

The overwhelming bipartisan majority in the Senate that supported the Collins Amendment demonstrates the strong support that fiscal relief for cash strapped states has in Congress.  It is also a clear demonstration of the growing concerns related to the impact that budget cuts in health and human service programs are having on vulnerable populations such as children and adults with severe mental illnesses.