October 19, 2005

NAMI’s Statehouse Spotlight is a biweekly electronic public policy news resource containing recaps of recent media coverage and useful grassroots tools gathered from across the country.  NAMI leaders and advocates are encouraged to use this information to energize their thinking as they plan future advocacy efforts.

News from the States

To follow up on any of the items featured in this publication, please contact Steven Buck, director of state policy at sbuck@nami.org

New Jersey Mental Health Practices Panned and Praised

Despite missing a court-imposed deadline, New Jersey has finally addressed the illegal warehousing of dozens of children with mental illness in youth jails. The steps were taken in response to a 2003 federal settlement that required the overhaul of the state’s child welfare system. A follow-up report on the state’s emphasis in meeting the terms of the settlement is expected to be critical of the state for acting so slowly. (The Staff-Ledger, October 7, 2005)

New Jersey’s acting Governor Codey signed an executive order creating an 11-member council tasked with breaking down social stigmas that prevent people with mental illness from recovering. Codey has spotlighted mental health issues as one of his leading policy objectives. (Asbury Park Press, October 8, 2005)

Medicaid in Massachusetts Facing Federal Pressures

The federal government has threatened to reduce federal payments to the state of Massachusetts Medicaid program by nearly $400 million, if the state fails to address the number of uninsured within the state. The state must submit a plan by January 15, 2006, and must have any revisions in place by July 1, 2006. Governor Romney, a possible candidate for President in 2008, and legislative leaders have introduced plans to address the concerns, but to date there has been little movement towards a bi-partisan resolution. (Boston Globe, October 4, 2005)

2005 Medicaid Actions To Date

Despite predictions to the contrary, state Medicaid programs in 2005 have not suffered the dire cuts predicted earlier in the year. With the exception of Tennessee and Missouri, few states enacted the drastic cuts feared. In review, 19 states took action to increase reimbursement rates, 19 states expanded eligibility criteria, and 29 states expanded optional benefits. (Health Policy Tracking Service, October 5, 2005)

Medicaid Cuts Loom in Kentucky

Facing significant budget pressures, Medicaid officials in Kentucky have proposed program changes that would limit the number of prescription drugs available to participants, increase patient obligations for non-emergency trips to emergency rooms, and increase co-payments for many health services. Medicaid officials also acknowledged that other cuts could be pending. Medicaid in Kentucky serves 700,000 state residents. (The Courier-Journal, October 15, 2005)

Healthier Lifestyles a Current Trend in Medicaid Policy

Georgia, Florida, Iowa and Michigan are pursuing Medicaid policy initiatives that reward recipients who make healthy lifestyle choices, with incentives that might include lower co-payments, provide for cheaper prescription drugs, better vision benefits, or even gift certificates to local retailers. Legislators are using the incentives to address smoking, obesity, and lack of exercise that many suggest are increasing Medicaid cost pressures. (Stateline.org, October 4, 2005)

NAMI Advocacy Tools & Resources

NAMI West Virginia, a NAMI Campaign for the Mind of America state, has recently completed a report card on legislation from the 2005 state legislative session. The report card is intended to remind state officials that NAMI and its Campaign partners are paying close attention to how legislators address the state’s significant mental health treatment needs. To review a copy of the report card, click here.

Washington Quick Glance

Congress Begins Work on Budget "Reconciliation" Measure -- Cuts to Medicaid Under Consideration

This week, key committees in the House and Senate are expected to begin work on budget legislation that is expected to include proposals to trim future Medicaid spending by at least $10 billion over the next 5 years, and possibly even more, especially in the House, where pressure is building on Republican leaders for additional budget cuts to offset emergency hurricane response.

Among the Medicaid proposals under consideration are proposed changes to the scope and definition of targeted case management (TCM) and rehabilitation services recommended by the Bush Administration. These changes would make it much more difficult for states to use their Medicaid programs to finance intensive case management and assertive community treatment (ACT) programs -- especially through public agencies such as community mental health centers and county mental health departments. NAMI strongly opposes this proposal. It is likely that some form of the Bush Administration's proposal on TCM and the Rehabilitation Option could end up in the separate House and Senate bills moving forward later this week. In addition, the House bill is likely to include a separate proposal -- supported by the National Governors Association-- to allow states to increase co-payments on most Medicaid recipients.

As details on the Medicaid proposals in both the House and Senate packages emerge, NAMI will be sending out additional information, as well as an advocacy alert.

Campaign for the Mind of AmericaNAMI Statehouse Spotlight is an electronic newsletter provided free of charge as a public service. With more than 1,100 state and local affiliates, NAMI is the nation's largest grassroots organization dedicated to improving the lives of people with severe mental illnesses. Contributions to support our work can be made online at www.nami.org/donate.

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