June 26,
2009
It has
been a long Legislative session with many alerts
issued due to the terrible budget cuts
proposed. Advocacy works and your efforts have helped to
restore some of those cuts, as well as raise revenue needed
to keep needed services and supports for people with mental
illness. Our work is
not yet done! The NC House and Senate are still
considering budget policies that will harm people with
mental illness. Please take action today.
In this
Issue:
Budget
Update
Mental
Health Medication Access
ACTION:
Keep Access to Mental Health Medications
Budget Update:
House and Senate Conferees began meeting last week but are
still at odds over cuts to health and human services (see
the listing of proposed cuts/restoration at
(www.naminc.org).
House and Senate also cannot agree on tax
revenue packages; The Governor’s office and Senate are
pushing for increases that would total 1.5 billion, while
the House is reluctant to extend revenue increases beyond 1
billion. Without agreement on a revenue package, both the
sources and amounts of new revenue, budget negotiations must
continue based on an assumption of around 900 million being
added back into the budget in new revenue. With around 1.5
billion in stimulus funds, and 900 million in taxes, budget
conferees must still find 2.4 billion in cuts. The Senate
passed an open ended continuing budget resolution that would
keep the state operating at 85% of its current funding; the
House amended the Senate resolution but limited it to July
15. Both CRs stop salary increases, close vacant positions,
and stop state grants which are subject to the proposed
budget reductions, but do allow projects using federal
stimulus dollars to move forward. View the CR here:
http://www.ncleg.net/Sessions/2009/Bills/Senate/HTML/S311v3.html
The House has not passed their final version, calendared for
June 29th. Its unclear if the Senate will concur,
or if the two resolutions will need to go to conference
committee to be passed before the end of the fiscal year on
Tuesday June 30th.
Medication
Access:
One of the significant cuts in the House version of the
Medicaid budget involves 40 million in “savings” to be found
by implementing a preferred drug list in
North Carolina’s Medicaid program.
For a number of years medications for mental illness and for
HIV treatment have been exempt from preferred drug lists,
prior authorization, fail-first programs, and other
strategies that limit access to life changing and life
saving medications. Despite the increasing number and type
of medications to treat mental illnesses that have been
developed in the last two decades, drug treatment for mental
illness remains a highly individualized matter. Mental
health medications are not interchangeable: medications
sometimes have similar impact on symptoms of the mental
illness, but have varied side effects and results for each
individual taking them.
National studies show that many people must change
medications during the course of treatment because they stop
working or the side effects become intolerable.
The
bottom line: there is no nationally accepted evidence-based
medication protocol for mental illnesses. Limiting choices
for individuals with mental illness results in an increase
in use of crisis services, hospitalizations and contact with
law enforcement. States who have implemented preferred drug
lists have repealed their use for individuals with mental
illness. We need to help people find the right treatment and
help them stay with it so they can live healthy. The state
can employ many strategies that will still save money (and
not just in the medication line item) that still allow
choice and flexibility in choosing the medication that is
right for an individual with mental illness.
ACTION:
Tell the NC GA House and Senate Budget Chairs, and
Leadership, that you are opposed to a preferred drug list
for mental health medications in Medicaid.
Please share your story of how these medications have helped
you or those you care about recover from mental illness and
the impact if they were changed or lost. Personal
contacts are best, please use our message below as a
starting point to tell why you want to keep access to
medications.
House
and Senate Leadership
Senate
President Pro Tempore, Marc Basnight
919-733-6854
Marc.Basnight@ncleg.net
Senate
Majority Leader, Tony Rand
919-733-9892 Tony.Rand@ncleg.net
Speaker
of the House, Rep. Joe Hackney
919-733-3451
Joe.Hackney@ncleg.net
House
Majority Leader, Rep. Hugh Holliman
919-715-0873
Hugh.Holliman@ncleg.net
Appropriations
Chairs:
Sen.
Linda Garrou,
919-733-5620
Linda.Garrou@ncleg.net
Sen.
Charles Albertson
919-733-5705
Charlie.Albertson@ncleg.net
Sen. A.B.
Swindell
919-715-3030
AB.Swindell@ncleg.net
Sen.
Charles Dannelly
919-733-5955
Charlie.Dannelley@ncleg.net
Rep.
Henry (Mickey) Michaux
919-715-2528
Mickey.Michaux@ncleg.net
Rep.
Alma Adams
919-733-5902
Alma.Adams@ncleg.net
Rep.
Martha Alexander
919-733-5807
Martha.Alexander@ncleg.net
Rep. Jim
Crawford
919-733-5824
Jim.Crawford@ncleg.net
Rep.
Phillip Haire
919-715-3005
Phillip.Haire@ncleg.net
Rep.
Maggie Jeffus
919-733-5191
Maggie.Jeffus@ncleg.net
Rep. Joe
Tolson
919-715-3024
Joe.Tolson@ncleg.net
Rep.
Douglas Yongue
919-733-5821
Douglas.Yongue@ncleg.net
The
Message:
Mental
health medications are not interchangeable. Effectiveness
and ability to tolerate side effects varies greatly for
individuals with mental illnesses. People with mental
illness need access to a wide range of medication options.
Strategies
like preferred drug lists (PDLs) and prior authorization
have been shown to reduce access and increase the use of
more costly crisis services.
Keep
the mental health medication exemption language in place and
allow the Secretary of DHHS to determine how best to find
“savings” in the Medicaid drug program.
[A
brief fact sheet on “The Truth About Preferred Drug List for
Mental Illness” can be found at
http://www.mha-nc.org/english/index.php/Public-Policy-News/The-Truth-about-Preferred-Drug-Lists-for-Mental-Health-Medications.html
]