Obsessive-Compulsive Foundation of Greater Boston

"Fairness for Mental Health" read the top editorial in the March 24, 2007 New York Times. After a decade of discouragement and frustration, it looks as if the new Congress may be ready to require insurance coverage for mental illness and substance abuse on the same terms as coverage for physical illness. This "Parity" legislation would be big help to the millions of Americans with mental illness or addiction who now find it hard to pay for treatment. It should also reduce high losses in productivity from depressed or stressed workers.

With parity, if an employer has a health plan, the financial terms and treatment limits would have to be the same as for medical and surgical benefits. Mental patients would not have to pay higher deductibles or co-payments than other patients.

The broad consensus this year behind the bill is due to sustained, effective negotiations by the staffs of the backers, Senator Kennedy of MA, Senator Pete Domenici, R-NM and Rep Patrick Kennedy, D-RI, with employer groups and insurance plans that have fought parity in the past because they thought their costs would go up.

The Senate (S 558) and House versions need to be reconciled and then sent to President Bush for signature. As President Bush has endorsed the idea of mental health parity and both houses of congress appear ready to enact it, a long struggle may be ending. Then insurers and businesses will be on the side of equal treatment for mental health and addiction.

Lawsuit regarding Mentally Ill Prisoners in Segregation: The Disability Law Center (DLC) has sued the Massachusetts Department of Correction DOC) to end the practice of holding prisoners with serious mental illness in segregation, where they are locked in their cell at least 23 hours a day. "We visited prisoners, toured prison units, reviewed the records, and, after an intensive year-long investigation, had our worst fears confirmed," said Stanley Eichner, executive director of the Disability Law Center. "The system is broken. These men are being subjected to intolerable conditions which cause them to gravely harm themselves – to often fatally." The complaint filed in Federal Court in Boston on March 8 alleges that DOC's actions violate the 8th Amendment to the Constitution by subjecting prisoners with serious mental illness to cruel and unusual punishment and that DOC discriminates against the prisoners in violation of the American with Disabilities Act.

As the state's protection and advocacy agency, the DLC has the federal statutory authority to represent the interests of prisoners with mental illness.

Two house bills have been submitted to protect persons with mental illness in emergency rooms. They are:

House bill # 2042 "An act to protect the mentally ill in emergency rooms". It is sponsored by Representative Ruth B. Balser, T: 617-722-2060 or e-mail: Rep.ruthbalser@hou.state.ma.us. This bill would give advocates a greater voice in writing new regulations regarding the treatment of mentally ill persons in emergency rooms.

House bill # 1891 "An act relative to the treatment of mentally ill patients in emergency room facilities". It is sponsored by Representative Peter J. Koutoujian, T: 617-722-2130, e-mail: PeterKoutoujian@hou.state.MA.US. Please call their offices thanking them for sponsoring these ER rights bills. Also, call your own representatives and ask them to support these bills and why. The regulations must be more progressive on restraint and seclusion and forced clothing removal, Bill 2042. Bill 1891 places licensing authority of psychiatric emergency areas in medical hospital emergency rooms under the jurisdiction of the department of mental health, DMH, rather than under the department of public health, DPH, with more lax standards.

Harkin Bill supports Community-Based Services: Washington, D.C. Senator Tom Harkin, D-IA, and Senator Arlen Specter, R-PA, have introduced the Community Choice Act 0f 2007, # S.799. This bill will increase access to community-based services and supports for Americans with disabilities and older Americans. It also provides enhanced federal matching funds to help states develop long-term care infrastructure and grant funds to help states increase their ability to provide these services.

The MA Department of Mental Health, DMH, released in February the last of the 268 patients from hospitals that it identified in 2004 as not needing to be there. The former patients have gone to a variety of housing arrangements across the state. There is concern that DMH does not have enough case managers to provide them with support and oversight services. This is because before this action, DMH only had enough case managers for 10,650 of the 20,400 adults eligible for them.

As promised, Governor Patrick restored $ 384 million for health and human services not previously restored by Governor Romney. Patrick argued the cuts did unacceptable harm to programs for people in need. If this fiscal year tax revenues do not cover the increased cost, Patrick will ask the Legislature to use "rainy day funds".

Governor Patrick has published his Principles for Health and Human Services.
They include:

National, Call to Action:
Whom to call: Your Representative and Senator
When to call: As soon as possible.
The number to call: 877-322-5742
The Message: I am calling to ask you to adequately fund all HUD programs in the FY07 joint funding resolution. HUD programs face severe funding shortfalls if HUD funding is not increased above the FY06 level. Thousands of people will either lose their housing or have no access to housing if HUD programs are left at FY06 levels.

Alert: Sponsors are needed for Mandatory Minimum Reform in the MA Legislature. Senator Cynthia Creem (D-1st Middlesex and Norfolk) has re-introduced a bill to allow persons who are serving a mandatory minimum drug sentence to become eligible for parole after 2/3 of their sentence has been completed. We need to contact legislators and ask them to become co-sponsors of this important legislation.

ACTION: Contact your State Senator and State Representative as soon as possible. It is okay to leave a message. When you call tell the office you are a constituent: Say you request your legislator to become a co-sponsor of Sen. Creem's re-filed 2/3 mandatory minimum reform bill, which is based on S.929 from the last session: 2007-2008 Docket Number SD 00661.

Section 6087 of the Deficit Reduction Act of 2005, which took effect January 1, 2007, now allows states to offer a "Cash and Counseling" option within their regular Medicaid states plans without first obtaining a waiver. The program gives beneficiaries eligible for personal care services, those with disabilities and frail elderly, the option to manage a flexible budget and decide for themselves what mix of goods and services will best meet their needs. Members living in Lincoln, Sudbury and Wayland are asked to contact Mr Thomas Conroy recently elected to the MA house of representatives and ask him to join the Massachusetts Legislative Mental Health Caucus. T: 617-722-2425. To become a member he only needs to notify Representative Kay Khan (617-722-2140) of his interest in joining with approximately 80 of his colleagues who are members. It would mean a great deal to the 20% of his constituents who have mentally ill family members to know that he is interested in learning about the issues related to the needs of their family members. Other topics of interest: National Anti-Stigma Campaign: The National campaign launched in December 2006 is sponsored by the U.S. Department of Health and Human Services. New public service announcements are available for use in your community. For further information contact Stella March, National Coordinator. E-mail: smarch@nami.org. In addition, SAMSHA offers a free kit which offers guidance on how to initiate an Anti-Stigma effort. It can be obtained at: http://mentalhealth.samhsa.gov/publications/allpubs/sma06-4176/.

1. The Massachusetts Legislature voted overwhelmingly to pass landmark Healthcare reform legislation, the first in the nation. It will cover nearly all MA citizens, a significant advance since today there are of the order of 500,000 uninsured residents. All those can afford it will have to join a health plan, those who cannot afford health care insurance will be subsidized. There will undoubtedly be many adjustments as the legislation proceeds. However, MA is to be congratulated for this great and difficult effort.

2. Support Personal Care Attendants (PCA) Quality Home Care Workforce Council Bill, Senate 139/ House 4246. Contact your legislators and ask them to support this bill. The bill which will give PCAs the right to seek a fair wage and benefits through collective bargaining, will improve the PCA program. Bill passage will make it easier to recruit and retain PCAs while consumer control will remain.

3. A grassroots movement to reform CORI (Criminal Offender Record Information) through legislation, action and advocacy is developing. CORI, the laws and practices relating to criminal records in the Commonwealth is a flawed and harmful system. Originally intended to protect the privacy of people with criminal records, expansions have focused on who and what entities are allowed to access. The result: thousands of people in MA are kept from employment, housing, loans, entrance to college, insurance.

4. Please call your state representative and senator and ask them to sign on to the following amendments supported by the MA Mental Health Caucus:

5. In the first NAMI state-by-state report on the nation's mental health care system in 15 years, MA received a C- grade. The report on America's Health Care System for serious Mental Illness confirms what President Bush's New Freedom Commission called "a system in shambles". Research shows that treatment works if you can get it. Today many persons living with the most serious and persistent mental illnesses are not provided with the essential treatment they need. MA forces thousands of mentally ill people to wait for help or do without care because of funding shortages and confusing bureaucracies according to this national report.

6. Senator Kennedy needs your help. Over the past 10 years Senator Kennedy has been working to increase the minimum wage from $ 5.15 an hour to $ 7.25 over a 2 year period. He asks you to sign on as a citizen co-sponsor of the Fair Minimum Wage Act and encourage others to do so.

7. Report on a meeting of the MA Legislature Mental Health and Substance Abuse Committee, on the treatment of the Mentally Ill in MA jails and prisons. Co-chairs, Rep Balser and Senator Tolman. The commissioners of the Department of Corrections and House of Corrections, a number of Sheriffs, medical personnel, and the public were invited to give testimony in an effort to create legislation to improve the outcome for mentally ill persons who enter the criminal justice system. The DOC commissioner reported that about 20 % of the inmates had a severe mental illness and 80% had a significant substance abuse problem. In addition many of these persons had severe physical problems as a result of their addiction. Screening of individuals as they enter the system is required but is hampered by lack of previous histories. Also, significant effort is made to assist prisoners when they are discharged. Doctor David Powers giving testimony, noted that the screening was inadequate, there were not enough beds for the severely mentally ill, that persons with mental illness were often given solitary confinement because they could not adhere to prison routines or for minor infractions. They were often victimized by other inmates and the medications dispensed were often not appropriate.. Further, the medical representatives stated that the training of both health care workers and prison staff was inadequate. This has led to several suicides and to worsening of the condition of many mentally ill prisoners. There are attempts to send severely mentally ill inmates to Bridgewater State Hospital but often there were not enough beds. Further, funding cuts also resulted in the loss of trained staff.

Kay Kahn, co-chair of the Mental Health Caucus in the MA legislature is submitting bills for prison reform, including making prison safer for women. She noted that 45,000 persons pass through the system each year, with a very inadequately trained staff. The mental health policies are ok. It is the implementation that needs to be fixed. For example, mentally ill inmates placed in isolation should have a right to counsel. She agrees with the DMH recommendation for the establishment of a jail diversion program for persons with a minor offense; a mental health court with a strong rehabilitation component.

Hal Smith, retired from the NY prison system highlighted the necessity of a continuum of care and access to services. Without them persons tend to keep revolving through the system.

Dr Applebaum and colleagues from U Mass Medical: In their practice they find a wide range of needs in the prison population. They have found it difficult to separate out the consequences of drug addiction from mental illness and thus tend to treat them in a single unit. Many of these inmates would be best treated in community based programs. Many of the inmates are incarcerated for minor offenses like parole violations. They often have co-morbid problems. For example, about 43 % of women have hepatitis B, from use of unclean needles.

The Sheriffs who manage the jails in MA deal with many of the same issues but with fewer resources. They process 70,000 persons each year and have little capability to take care of the 20% with mental health problems. Sheriff Ashe established an Emergency Stabilization Unit for severe cases. It has worked well and the legislature is seeking to set aside funds to establish such units throughout Massachusetts. They endorse mental health courts for minor offenses.

The testimony of many family members of mentally ill jailed persons was very disturbing. Some of their children had committed suicide, the condition of others greatly worsened due to inadequate access to care. The Mental Health Community strongly supports the establishment of mental health courts as an alternative to jail sentences for mentally ill defendants charged with felonies and misdemeanors. It also supports bills which would establish a curriculum for training law enforcement officers in how to respond to emergencies involving persons with mental illness and with cognitive disabilities.

Other topics of interest:
Employment: Leaders in mental health care have long recognized that work is a vital element in recovery. Yet existing organizations dedicated to helping individuals achieve and maintain employment have not been very successful. Well over half adults with a chronic mental illness are not employed. National, state and local mental health organizations are now exploring ways to increase the percentage of persons with jobs. Private and private/partnerships are growing to address this problem through training, engaging businesses, job fairs, etc.

On April 13, 2006 the Metro North Collaborative held a Diversity Job Fair at the Holiday Inn, Woburn, MA. Job Fairs are a good way to explore work opportunities, gain experience and confidence. There were over 25 exhibitors at the Woburn fair with advertised positions ranging from entry level to professional in a range of businesses, including health care, retail, security, the MBTA, and food and insurance industries. For example, the Museum of Fine Arts, Winchester Hospital and Home Depot were exhibitors. Each business has information on employment on their web sites. Employment applications and instructions are available on each companies web site.

Job opening for Administrative Assistant in the NAMI MA office. The position can be tailored to an administrative entry level position up to an assistant director position. Necessary qualifications: computer literate, organizational skills, oral and written communication skills.

An Act to Establish Teen Mental Health Drop-In Centers was filed by Representative Jennifer Flanagan (D-Leominster) on Feb 1, 2006. Thirty-two representatives and senators signed onto the bill as co-sponsors. A hearing will take place in the spring. This bill was initiated by a coalition of youth dedicated to addressing teen health problems as a public policy issue; Teens Leading the Way and STIGMA, Statewide Teens Initiating Greater Mental Health Awareness. The National Mental Health Association has reported that two-thirds of teens in need of mental health services receive no help. The drop-in centers are an effort to bring treatment to teens recognizing that fear of stigma is a factor in their failure to seek help. Under the program 10 Drop-In Centers will be selected in MA through a competitive grant process administered by the Department of Mental Health.

US District Judge Michael Ponsor ruled in January that MA has illegally forced thousands of mentally ill children "to endure unnecessary confinement in residential facilities" because the state did not provide adequate care for them at home violating federal Medicaid law. The Center for Public Representation filed the lawsuit on behalf of eight low-income families over the unavailability of mental health services such as counseling, crisis intervention, and coordination of care. The ruling applies to about 15,000 children statewide with serious mental health problems. The Judge gave the Romney administration and the plaintiffs until the end of February 2006 to negotiate a plan to greatly expand home-based services for children.

Medicaid Update: On February 1 the U.S. House of Representatives approved the FY 06 Reconciliation Bill. The Budget Reconciliation Report allows states the option to force many low-income Medicaid recipients, with and without disabilities, to pay more for their care. Further, the bill exacerbates institutional bias as persons with disabilities living in the community can be charged substantial premiums while exempting those living in institutions. The new provisions are bad public health policy and inconsistent with valuing the lives of persons with disabilities.

On Friday March 10, 2006 the Executive Office Of Health and Human Services, EOHHS, will hold a Public Hearing on the 2007 budget at 10 AM in the Gardner Auditorium, State House, Boston. All disability advocates are welcome. In January, the Justice Department announced a settlement agreement with the city of Royal Oak Michigan. It resolved a lawsuit that alleged zoning discrimination under the Americans with Disabilities Act following a complaint that Royal Oak engaged in discriminatory practices by denying Easter Seals Michigan Inc. a land use permit for the operation of a day program, the "Clubhouse " for adults with psychiatric disabilities. The city denied the permit after opposition from community members many of whom expressed fears about individuals with psychiatric disabilities walking in the neighborhood and the possibility of having an effect on their property values. Under the terms of the consent agreement the Clubhouse will be permitted to open at the contested location, the city will pay monetary damages to the plaintiffs and city personnel will receive training on their obligations under the ADA. Alert: Our elected officials need to hear today that the general public and practicing health care professionals support pending health care reform legislation to expand comprehensive insurance coverage, lower costs, and improve quality. Unfortunately the Mass. business lobby has attacked the fair funding elements of the pending legislation, distorting facts and using scare tactics. Action: Take a few minutes to call your Senator and Senate President Travaglini. The main state house number is 617-722-2000. Your message: My name and where I live. I am committed to supporting health reform that includes comprehensive benefits and fair funding through employer assessment. The funds will allow for an expansion of MassHealth, sliding scale subsidies for middle-income families, and assistance for small businesses.

Health Care Alert: There are 2 steps left to making Massachusetts the first state in the nation to guarantee every resident health and mental health care coverage:

We need your postcard to the Mass legislature telling them that you support the Health Care Constitutional Amendment and request that they bring it up for a vote

May 10, 2006.
The MA budget House 2, proposes expansions in transitional services for adolescents moving to adult programs and in homeless mentally ill services. However, this expansion was funded in part by cuts to the Department of Mental Health base funding.

The advocates message: we appreciate the expansion money but we do not support expansion by cutting the base of an already underfunded agency. Thus, we request:

Other topics of Interest:
"Measuring the Promise: A Compendium of Recovery Measures"; authors, Campbell-Orde, Chamberlain, Carpenter and Leff was published through the Evaluation Center at Human Services Research Institute. It addresses the continuing need for measurements for recovery. The compendium is available as a free download in electronic format or for $50.00 in print. (http://tecathsri.org/search_products.asp?query=PN-55).

A new report "Improving the Quality of Health Care for Mental and Substance-Use Conditions" by the Institute of Medicine cites the "quality chasm" between care that is known to be effective for mental illness and substance abuse and the care that is actually delivered. According to the report, major depression and substance use disorders together are the leading cause of death and disability among American women and the second highest cause, after heart disease, among men. This report, also notes that millions of those who need treatment for mental illness and substance abuse do not receive it, and that most of the care that is available fails to follow guidelines for evidence-based practices. This report, part of the Quality Chasm Series is available at (http://www.iom.edu).

The Center for Psychiatric Rehabilitation announces four workshops to be held May 8-11, 2006 at the Boston University Corporate Education Center in Tyngsboro, MA. May 8th: Engaging and Supporting Transition Age Youth on a Path to Productive Lives; May 9th: Photovoice: An innovative tool for Mental Health Program Development; May 10th, Beyond the Myths of Job Retention: How to Support People for Job Success. Full workshop descriptions and registration information are available on line at: (http://www.bu.edu/cpr/workshops/index.html)

Legislation and Public Policy
January 2, 2006

The new Massachusetts report, "Action Costs Less, The Health Care Amendment Standards and Options for Reform" by Dr Kenneth Thorpe, former Deputy Assistant Secretary for Health Policy concludes that comprehensive health care reform could save MA $30 to $105 billion over the next 10 years. Dr Thorpe's analysis presented to Massachusetts legislators provides a context for the ongoing health care reform discussion. To request a copy contact Michael Carr at mcarr@healthcareformass.org or call 617.868.1280.

Action Alert: Please contact your state representative and state senator about H.4476 and S.2282 which address Mental Health in Health Care Reform Legislation. Thank them for tackling this important public policy initiative for MA. However, the Governor has proposed eliminating the specialized care that acutely ill patients receive under MassHealth and move everyone into managed care organizations (MCO). Today about 300,000 severely ill children, adolescents and adults are served by this statewide system. Request that they support efforts to ensure continuity of care for this very vulnerable population and oppose the Governor's effort. It is vital that this population continues to have access to the most comprehensive level of care. For email and fax information for your legislators go to (http://www.mass.gov/legis/citytown.htm) or write them at: The State House, Boston MA 02133.

NAMI (National Alliance for the Mentally Ill, www.nami.org) Crisis Intervention Teams (CIT) Technical Assistance Resource Center (TARC) has been established. It will be a repository of information about CIT, pre-booking diversion initiatives and a catalyst for the development of CIT programs across the country.

Bonnie Sultan is the Coordinator of the NAMI CIT TARC e-mail: (BonnieS@NAMI.org). NAMI is partnering Council on StateGovernments and Police Research Forum to develop a country wide data base to be managed by CSG which will be available to the community by late spring 2006.

Other topics of interest: Metro Boston Behavioral Health Resource Center, consumer run, is established. The goal is to help people with behavioral health needs and their families through information, referral, education and advocacy. The Resource Center is located on the fifth floor of the Solomon Carter Fuller Building on the Boston Medical Center Campus at 85 East Newton Street, Boston MA 02118. Web site: (www.bostonresourcecenter.org), e-mail: (info@bostonresourcecenter.org). Persons interested in volunteering for this effort should call 617-305-9976.

Might OCD respond to antibiotics in children and adolescents? Evidence has been building since the late 1980s that the streptococcus bacterium might cause, or contribute to certain cases of obsessive compulsive disorder (OCD).

Isobel Heyman M.D., PHD., a consulting child and adolescent psychiatrist at the Institute of Psychiatry in London, and co-workers drew blood from 50 children and adolescents with DSM-IV defined OCD, 100 children and adolescents with other conditions (stroke, metabolic movement disorders, or encephalitis) and 40 healthy children and adolescents. They then determined whether antibodies in the blood samples reacted with a specific antigen, delipidated human basal ganglia, as the basal ganglia has been implicated in OCD. They found anti-basal ganglia antibodies in 42 percent of subjects with OCD, but only in 2 to 10 percent of the control groups. Heyman and her group suggest that "central nervous system autoimmunity may have a role in a significant subgroup of cases of OCD".

Psychiatric News December 2, 2005; volume 40, number 23 or for complete article click on (http://pn.psychiatryonline.org/cgi/content/full/40/23/42-b?etoc).

January 3 at 7:00 pm a discussion "Consumers and Social Security Benefits" will take place at the Robbins Library, Arlington MA. It is hosted by the NAMI Cambridge Middlesex Affiliate.

Legislation and Public Policy
27 November 2005

The Massachusetts Executive Office of Health and Human Services (EOHHS) held a public hearing on the 2007 budget at the State House Gardner Auditorium on November 4, 2005. It was the first opportunity for the new Secretary of EOHHS , Mr. Murphy, to hear from the public the need for increased resources for persons with disabilities due to mental illness. Mr. Murphy has made clear his interest in contracting out many of the services supporting mentally ill persons. The testimony made clear that it is important to set standards to ensure that the care of the mentally ill is not compromised in any new contractual arrangement.
The MA House and Senate approved an important health care reform package in November. There have been federal pressures for the state to implement a plan to expand health insurance by Jan 15, 2006. According to the US Census 11 percent of MA residents or 748,000 persons are uninsured. The law will put a mandate on businesses and residents to purchase health insurance or face financial penalties. Please call your legislators and tell them you support Health Access and Affordability Act H 2777, S 738. To identify your legislators: http://www.wheredoivotema.com/bal/myelectioninfo.php or call the state house at 617-722-2000. This bill will improve the lives of persons without health insurance in your community and will help small businesses cover their workers.
The mental health community gave testimony on October 12 in support of two related bills. SB437, "Act Relative to Medicaid Prior Authorization" introduced by Senator Walsh. The testimony argued that mental health treatments that have been recognized as effective by FDA and/or NIMH must be available. Restricting access to persons with acute mental illness would lead to more costly inpatient treatments. SB432 an "Act Relative to Prior Authorization of Prescription Medications" was introduced by Senator Tolman. The intent of this bill is to establish a transparent process for the prior authorization of prescription drugs for Mass Health recipients.
Congress is still debating how to pay for Hurricane Katrina and recommending huge cuts in human service programs to pay for the relief costs. Call you Senators and Congressmen at the U.S. Capitol toll-free 1-800-426-8073. The Message: cutting Medicaid at a time when low income Americans and victims of hurricane Katrina need the programs is unnecessary and reckless. Low-income Americans with disabilities receive critical services and supports. It is fiscally irresponsible to make poor and vulnerable Americans pay for the hurricane relief costs. ADAPT, the nations largest grassroots disability rights organization went to Washington in September to deliver the message: "Don't target low-income people with disabilities" We all need to add our voice to their plea.
H 3899, "An Act Relative to Genetic Testing" has been passed by the Massachusetts House and Senate. This is an important bill for persons with mental illness and their families as more relationships are being discovered between genetics and mental illness. Please thank your legislators who made this victory possible. These include: Speaker DiMasi, Senate President Travaglini, Sponsors Jay Kaufman and Harriette Chandler, Public Health Senate Chair and co-sponsor, Susan Fargo. Efforts will continue to ensure that the bill is signed into law by the Governor.
The Massachusetts Senate passed its comprehensive health reform bill by a 38-0 Vote. A conference committee made up of house and senate members has been established to hammer out a compromise. Amendments to the Senate bill were passed to include restoration of dental care and eyeglasses for adults in MassHealth and restoration of coverage to 7000 adult legal immigrants.

Amendment # 102 introduced by Senator Tolman also passed. Under this amendment, all behavioral health managed care organizations contracted to administer behavioral health services by the Executive Office of Health and Human Services shall be required to obtain the approval of the commissioner of the department of mental health for all behavioral health benefits. This amendment gives DMH its proper role as the state's mental health authority over public behavioral health care management.

In response to the President's Freedom Commission Report on the state of Mental Health Care in the US, many efforts are underway to foster the reform of Mental Health Systems in the US. A new federal grant program supported by the American Psychiatric Association aims to spur a nationwide reorganization of state mental health services. In October SAMHSA awarded $92.5 million to seven states: CT, Ohio, OK, WA, MD, NM, and Texas. For details click on: http://pn.psychiatryonline.org/cgi/content/full/40/21/8?etoc.

Also of Interest:

ABC-TV Documentary , Shadow Voices: Finding Hope in Mental Illness aired December 4, 2005. The program enters the daily lives of persons living with mental illness in many areas of the country. Former First Lady Rosalynn Carter, mental health professionals, clergy and family members are interviewed. They explore new perspectives on ways the community can contribute to the recovery and rehabilitation process.

Consumer Guide is available to assist people with disabilities in navigating Medicare Part D drug coverage. The authors, Crowley and Williams note that the Guide should be a useful tool for persons with disabilities, their families and others who may assist them in enrolling in a Medicare drug plan. Free copies can be obtained in PDF and HTML formats at http://hpi.georgetown.edu/rxchanges.html.

You are invited to a conference on Spirituality and Healing in Medicine. The conference will highlight the importance of the integration of Mind/Body Practices and Prayer. It will take place December 10-11, 2005. The course directors are leaders in the field of Spirituality and Health. Register on-line, visit the Harvard CME website by clicking on the link: Spirituality and Healing Conference (http://cme.hms.harvard.edu/index.asp?SECTION=CLASSES&ID=00251464&SO=N). There is an excellent SAMHSA resource on-line on mental health issues, where you can also order material to be mailed free of charge. It is: http://store.mentalhealth.org/publications/ordering.aspx.

Legislation and Public Policy
27 August 2005

The Edinburgh Center, with headquarters in Lexington, provides training and support for Department of Mental Health clients in the west suburban area. It has worked with police departments in surrounding towns to prevent the arrest of persons suffering from mental illness and directing them to treatment. It has been awarded a grant from the Clipper Ship Foundation to support the development of a Jail Diversion Program in partnership with the Watertown and Waltham police departments.

FY 2006 Federal Funding Bill , HR 3010, for Mental Illness Research and Services:

On July 14, the Senate Appropriations Committee passed spending legislation for the U.S. Department of Health and Human Services, HHS. It includes the 2006 budget for the Department of Mental Health, NIMH, and the Substance Abuse and Mental Health Services Administration, SAMHSA. The Senate version of the bill includes $1.46 billion for basic scientific and clinical research at NIMH.

The SAMSA allocations are level funded in 2006 except forMental Health Transformation Grants, increased to $26 million to assist states in planning for systems change to implement the 2003 President's New Freedom Mental Health Commission Report.

Direct Support Professionals Fairness and Security Act of 2005, H.R. 1264 .

Introduced by Representative Lee Terry (R-NE) and Lois Capps (D-CA), HR 1264 is an attempt to increase the wages and training of direct support professionals. Direct support professionals are key for persons with severe disabilities to be able to live in the community, yet there is a more than 75 percent annual turnover rate due to low wages and difficult working conditions. Contact your congressional representative and ask them to Co-Sponsor HR 1264.

Medicaid Alert: Rehabilitation Services at Risk . The Bush Administration has delivered draft legislation to Congress that aims to reduce Medicaid spending in connection with reconciliation instructions to save billions in Medicaid spending over five years. Specifically it would place additional restrictions and limitations on comprehensive services under Medicaid. It is imperative that your Congressional lawmakers recognize the value of rehabilitative services to individuals with mental disabilities.

In response to the president's New Freedom Commission report of 2003 , on the poor state of the mental health enterprise in the US, SAMSA has released action steps to transform the infrastructure to ensure that people with mental illness have an opportunity to recover. Six federal cabinet level departments; Health and Human Services, Education, Housing and Urban Development, Justice, Labor, Veterans Affairs and the Social Security Administration are engaged in a collaborative effort with federal funds realigned to ensure the success of the program. Specific steps in the mental health action agenda entitled "Federal Action Agenda for Mental Health" can be found at: http://www.samhsa.gov/Federalactionagenda/NFC_preface.aspx.

Health Care Reform : Health Care for All and several other organizations are working to develop legislation to change health insurance laws and close gaps in affordable good quality coverage. 100,000 signatures are needed before October 3 to get this legislation on the state ballot in the fall of 2006. If you wish to help please call Deborah Blumer at 508-879-0658

Additional Information :

Medicare Drug Coverage website : http://www.medicarerights.org/101.html .

It contains what you need to know about the new Medicare Prescription Drug Benefit.

World Suicide Prevention Day September 10, 2005. The "Stop A Suicide Today" Campaign is sponsored by the World Health Organization. The campaign website: www.StopASuicide.org .

Making Sense of it All : Consumer Providers "Theories about Factors Facilitating and Impeding Recovery from Psychiatric Disabilities" was published in the summer 2005 issue of the Psychiatric Rehabilitation Journal. It is a qualitative study examining the accounts of fifteen adults on how they recovered from serious psychiatric disability. This article may be obtained at: http://www.bu.edu/prj/summer2005/mancini-etal.html.

Legislation and Public Policy
3 August 2005

Action Alert : Please request that your representative contact Chairman DeLeo (617-722-2990) and ask him to report favorably on police curriculum bill (S-1352). Also ask your representative to vote in favor of the bill. This bill would create a commission to study and make recommendations on a curriculum for training law enforcement officers in how to respond to emergencies involving persons with mental illness and with cognitive disabilities. The bill has been passed by the Senate and now needs a positive vote by the House before it can be sent to the Governor's desk for approval.

SAMSA is applauded for its Elimination of Barriers Initiative, a pilot effort between SAMSA and mental health authorities in eight states including Massachusetts. SAMSA, Substance Abuse and Mental Health Administration is a part of the US Department of Health and Human Services.

SAMSA Voice Awards: For the first time ever, on July 20 in Los Angeles, the federal government honored TV and radio writers and producers who created positive, accurate, and dignified portrayals of people with mental health problems. The writers and producers of The Aviator, ER, Monk and Scrubs were selected for their positive portrayals of people with mental health problems. In addition Brooke Shields, Maurice Benard and the Spanish language television network, Univision, were honored for their activities on behalf of mental health awareness.

Please call or e-mail your members of the US Congress and urge them to vote against the Health Care Choice Act, H.R.2355 and S.1015. You can reach them through the capital switchboard: 202-225-3121. This bill would allow insurance companies to avoid vital consumer protections by selling individual health insurance across state lines. Under this bill, insurance companies would only have to follow the laws of one state, the state with the fewest consumer protections, but could sell policies to consumers in all 50 states.

Good news for MA citizens: The MA legislators overrode Governor Romney's veto on the $500,000 DMH rental subsidy in line item 7004-9033 and restored $20 million for a salary reserve for human service workers.

Americans With Disabilities Act was passed July 26, 1990. During its 15^th year celebration, Dean Crossley of the University of Pittsburgh School of Law noted that the law, intended to bring equal rights for the disabled has driven many positive changes enabling persons with mental or physical disabilities to live independently. Much remains to be done. The law has been least successful in helping disabled persons join the job market, with 70 % of persons of working age with significant disabilities unemployed.

Legislation and Public Policy
29 May 2005

The President's budget for 2006 jeopardizes the well-being and even lives of persons with disabilities. There are significant cuts in medicaid, housing, employment and education documented by Curt Decker, Chair of the Consortium for Citizens with Disabilities. The House and Senate members are working to reduce these cuts. Please let your federal legislators know you oppose these cuts which target our most vulnerable citizens.

We applaud the NAMI Western MA Coalition to save Section 8. They obtained over 4000 signatures on postcards pointing out the impact and presented them to Gov. Romney and their legislators.

Bill HR 1588 was introduced by Rep Lane Evans (D-Ill) to improve PTSD services for soldiers. The bill is titled "Comprehensive Assistance for Veterans Exposed to Traumatic Stressors Act of 2005". It would eliminate gaps in the DOD and VA health care systems and extend the time combat veterans are entitled to services from 2 to 5 years.

Many states are establishing Mental Health Courts as an alternative to jail sentences for the mentally ill. These Mental Health Courts accept mentally ill defendants who are charged with felonies and misdemeanors and offer an alternative approach to sentencing offenders.

On May 10th "FRONTLINE" aired the documentary "The New Asylums". Fewer than 55,000 Americans currently receive treatment in psychiatric hospitals. Meanwhile nearly ten times that number, 500,000 mentally ill men and women are serving time in US jails and prisons. Frontline went deep inside Ohio's state prison system to explore this complex and growing issue of mentally ill prisoners.

On May 23, 2005, the MA Senate approved the amendment sponsored by Senators Joyce, Fargo, O'Leary and Barrios to increase funding for the Alternative Housing Voucher Program by $700,000.Please call your Senators and thank them for supporting this legislation. It included: MA Affordable Housing Trust Fund, Floor Amendment # 306, MA Rental Voucher Program # 303, Alternative Housing Voucher Program #304, Public Housing #302, Disposition of State Surplus Land #586.

Action Alert: Contact your Representative and Senator and ask them to co-sponsor the budget amendment sponsored by Senator Cynthia Creem to set up two separate funds in the commonwealth to be known as the State Mental Health Facilities Disposition Fund and the State Mental Retardation Facilities Disposition Fund. The budget amendment reuses state property to create housing for the mentally disabled. It does not interfere with amendments designed to override 548. The proceeds from the sale of state hospitals established to serve the mentally disabled must be converted to community resources for the mentally ill and the developmentally disadvantaged. This is prudent and just as well as good economic policy.

Please call your State Senators and thank them for their support of the budget released on May 17. It fully funds PACT (Program for Aggressive Community Treatment) and includes $3 million for adolescents aging into the adult mental health system, increases the funding for substance abuse services by $833,000 over the House budget and much more.

Call your Representative (617-722-2000) and urge her/him to maintain the Senate Budget funding and include in the Conference Committee important language that is in the Senate Budget, Line 4000-0300 that requires EOHHS (Executive Office of Health and Human Services) to "develop written policies, directives, interagency agreements or other instruments providing the commissioner of mental health with oversight and authority over the expenditure of Medicaid funds for the procurement, contracting, or administration of behavioral health care services".

Other Items of Interest:

Support Groups for Spouses and Partners of People with Bi-Polar Disorder (Manic-Depressive Illness) seeking new members. When: Each group meets two Thursday evenings per month from 7:00-9:00 PM. Where: Newton-Wellesley Hospital. Contact: Chuck Weinstein, 781-643-7750 or e-mail: groupfacilitator@aol.com, sponsored by MGH Department of Psychiatry

The Mental Health Legal Advisors Committee is sponsoring a workshop "Maximizing Legal Advocacy on behalf of Children with Mental Illness and Learning Disabilities" Friday June 3, 2005, 10 Winter Place, Boston. To attend: contact Kate Dulit at MHLAC T: 617-338-2345 X 30 or E-mail: kdulit@mhlac.org

Managed Care Hotline: T: 1-888-266-2555. The managed care hot line is housed at Mental Health Legal Advisors Committee and is co-sponsored by SEIU Local 509 and the Advocates for Quality Care. It provides legal advice to people who are having trouble with insurance, get mental health services cut off, or are not satisfied with mental health services received.

1 May 2005

Alert: Call today and ask your Congressional Representative to remove Medicaid cuts from the House 2006 Budget Resolution. Call 1-800-828-0498 to be connected to your Representative. Ask friends and other family members to call as well. The message: I am your constituent and a supporter of the Medicaid program. Please vote for the motion to instruct Budget Resolution Conferees to agree with the Senate and strike cuts to Medicaid. Medicaid funding support is critical to people with disabilities.

NAMI is concerned about the decision of United Way to cut funding for the mentally disabled in a national restructuring. This decision comes at a time when federal and state funding is being reduced. We all need to work to change the decision of this good private organization.

Urgent: Call your state Representative now (617-722-2000) and ask that they support Representive Kay Khan's budget amendment # 898 to increase funding to Community Mental Health line 5046-0000. This amendment would create an outside budget section to use funds from the sale of former Dept of Mental Health and Dept of Mental Retardation facililties to fund affordable supportive housing for DMH and DMR clients.

Representative Khan is also currently sponsoring an "Act Relative to Hospital Surplus Land Use". This act mandates that the sale of any closed state property must create housing for the disabled. These state hospitals were established to serve the disabled. It is sound economic policy to use proceeds from the sale of these properties to create cost-effective community-based services.

Action Needed on Supplemental Security Income, SSI. The SSI program was established to assure that the Nation's aged, blind and disabled people would not have to subsist below the poverty level. Like Medicaid, SSI is in jeopardy in the 2006 budget conference negotiations. Please urge your Senators and Representatives to tell their leaders to stick with the Senate budget bill which has no cuts and reject House cuts in order to protect key programs for people with disabilities like SSI and Medicaid.

Conference on the Olmstead Challenge: Altering Accepted Practices, Legislative Initiatives. May 10, 2005, 9:15 A.M.-3:30 P.M. at the Hilton Boston Logan Airport, 85 Terminal Rd. The 2005-2007 legislative session will be an opportunity for the disability community to develop a strategy to implement the Supreme Court's Olmstead decision mandating that services to people with disabilities be provided in the most integrated, least restrictive setting. To attend call the Disability Law Center, 617-723-8455 or e-mail: DPC_MA@yahoo.com.

29 March 2005

LEGISLATION AND PUBLIC POLICY ISSUES
Section 8 Housing Voucher Program cut 4.1 Percent for 2005. The US Department of Housing and Urban Development (HUD) recently notified Public Housing Authorities (PHAs) that each PHAs funds for Housing Choice Vouchers will be reduced 4.1 percent because the appropriations bill did not include funds to operate the program at the 2004 level.

There is concern about the President's budget for 2006 which includes a $3.0 billion cut in HUD programs. It includes deep cuts in programs that serve the lowest income families and individuals with disabililties. We must let our federal legislators know the importance of access to safe, affordable housing for persons with disabilities.

Campaign for Mental Health Reform: This national coalition has condemned President Bush's Proposed 2006 Budget for undermining already overburdened services that are crucial to people with mental illnesses. "At a time when the Administration should be offering bold proposals to address major problems in public mental health systems, it has instead proposed tens of billions of dollars in cuts to Medicaid, the largest public funder of mental health services and slashed discretionary spending on mental health."

Governor Romney has released his 2006 budget of $23.2 billion which includes $619.8 million for the Department of Mental Health. DMH Commisioner Childs has said that this budget would not allow the department to expand services as it must pay for the transfer of patients now in acute care hospitals to community based settings. Lawmakers have asked the department to provide them with a more comprehensive plan addressing early intervention services, screening children for behavioral problems, and the housing shortage for mentally ill persons.

Give your Support for a Bipartisan Commision on the Future of Medicaid. A bipartisan coalition led by Gordon Smith (R-OR), Jeff Bingaman (D-NM), Representative Heather Wilson (R-NM) and Donna Christensen have introduced legislation (S 338 and HR 985) to create a bipartisan commission on the future of the Medicaid program. The commission would evaluate Medicaid programs and recommend improvements before funding cuts or changes to the program are made. ACTION: Please call your federal legislators and ask them to support this legislation for establishment of the commission as Medicaid is the dominant source of funding for treatment and support services for children and adults in this country living with mental illness.

Action Alert: We encourage you to send a letter to your senators and house representatives urging them to reject the Bush Administrations deep cuts in the HUD FY2006 budget for the Section 811 program. The requested 50 % reduction in a key housing resource for people with severe mental illness and their families would completely eliminate funding for production of new units of supportive housing. This reduction in the Section 811 program would mean that 70% of the remaining funds would be consumed by renewing or keeping in place housing funded under the program in previous years. Moreover, the elimination of the capital advance/project-based side of the 811 program would end the 30 year commitment from the federal government to production of new units of supportive housing for people with severe disabilities.

The Kaiser Family Foundation has released new guides that offer a basic introduction to the Medicare and Medicaids programs. They provide answers to such questions as: How do people with disabilities apply for coverage under Medicare or Medicaid? Can a person with a disability who has Medicare and/or Medicaid be employed and still keep their coverage? The guides are available at: http://www.kff.org/medicare/med020705pkg.cfm.

The House and Senate are responding to the Administration's cuts in the Medicaid Program in the FY 2006 Budget. Members of the Senate listened to their constiuents and voted to reject the cuts. The cuts could be revived when the House and Senate work on a compromise budget in April. Please contact your Congressman and let her/him know you oppose the Presidents reductions in the 2006 Medicaid Program. Medicaid is the largest source of funding for the public health system in every state. The burden of deficit reduction should not fall hardest on the most vulnerable and disabled, including children and adults with severe mental illness.

Ask your Congressman and Senators to sign on as co-sponsors of the Child Healthcare Crisis Relief Act H.R. 1106 and S. 537 and request that the bill be passed this session. It is estimated that the United States needs at least 33,000 qualified Child and Adolescent psychiatrists, there are now only about 7,000. The Act would address the shortage by providing loan repayment and scholarship assistance to students and provide grants to graduate schools for mental health programs, for internships and field placements in child mental health services and grants to help train paraprofessionals.

State Hospital Property in MA: Representative Kay Khan is sponsoring an Act Relative to Hospital Surplus Land Use. This act mandates that any state hospital or state property that closes and is sold must provide a 25% set aside for housing for the mentally ill. The resources must be used to provide cost-effective community-based services that are replacing the hospitals. With 14,000 mentally disabled persons waiting for Department of Mental Health services this act is good economically and is also just. We urge you to inform your MA legislators about this effort.

31 January 2005

Legislation and Public Policy
ALERT: Oppose H.R. 181, the Parental Consent Act of 2004. This bill sponsored by Representative Ron Paul of Texas would prohibit the use of federal funds for mental health screening. Our nation cannot afford to continue to fail our youth with mental disorders who need treatment. The tragic consequences of our failure to identify youth through early assessment and treatment are all too familiar. 90% of the 3000 youths who die each year from suicide, have a diagnosable and treatable mental illness according to the US Surgeon General's report of 1999. Anti-psychiatry groups have a campaign of misinformation, false claims targeting our federal legislators. We ask you to call or write your representatives and tell them you oppose H.R. 181, you can tell your story. Reach them by calling the capital switchboard at 202-224-3121 or look them up in their local offices, listed in the blue pages of your local telephone directory.

Mental Health Caucus: Please call your representative or senator and ask them to join the Massachusetts Legislative Mental Health Caucus. If they are already members thank them. If they are not please ask them to join by calling Representative Kay Khan (617-722-2140) or Representative Peterson (617-722-2637). The Caucus, currently made up of 60 legislators, is dedicated to improving the care and treatment of Commonwealth residents with mental illness. It works with the Department of Mental Health and other government organizations to improve the delivery of mental health services to our citizens.

Healthcare for all our citizens: Dr. William Beardslee, Dept of Psychiatry and Marylou Sudders, president and CEO of MA Society for the prevention of Cruelty to Children have written an important piece for the Boston Globe arguing for Universal Mental Healthcare. The passage of the Parity Law in MA in 2000 made a difference in adding mental health coverage to insurance policies in MA. Advances in neuroscience have shown that mental illness is just as biological and medical in nature as a physical illness. Only with universal comprehensive health care can the true goals of parity be achieved.

ADVOCATES BUDGET BRIEFINGS: The briefings will take place Feb 15 and 16 from 4:00 to 7:00 PM. The briefings are designed to provide advocates with knowledge needed to influence the budget making process in the house and senate. Make reservations by e-mailing Jen Douglas by Feb 11 at: jendouglas_mhsc@hotmail.com.

Massachusetts Legislature Session 2005-2007.
Issues of interest.
MEDICAID FUNDING: The Bush administration is working to disallow intergovernmental transfers that MA depends on to obtain $600 million in federal Medicaid funding. A ruling is expected by the end of the month. Public Counsel Services: The state's highest court ruled in July 2004 that some defendents have been deprived of their rights because funding was not adequate for attorneys to represent the poor. Remedies in 2005 may range from substantial increases in pay to bar advocates to a complete overhaul of the legal aid system.

The National Council on Disability which advises Congress and the President reported that legislation is needed to restore the original intent of the 1990 Americans with Disabilities Act. It cited Supreme Court decisions which have reduced the status of disabled people "to that of second-class citizens". The council proposed an ADA Restoration Act, asking Congress to introduce legislation to bar discrimination against anyone "on the basis of disability"

New Medicare Law and Drug Costs: The Kaiser Family Foundation has just released a report based on a model of the Actuarial Research Corporation. Low-income persons with Medicare who sign up the the Part D drug plans, an estimated 8.7 million are projected to pay 83 percent less for prescription drugs in 2006. Those who enroll in the drug plan but do not receive low income subsidies are projected to pay 28 percent less.

We welcome the launch of the RX Access Card. The new plan, established by the pharmaceutical industry provides low-income and uninsured Americans access to prescription drugs at a 25-40% discount.

A Health Access and Affordability Act was filed in December 2004 by Senator Richard Moore (D-Uxbridge) and Rep. Deborah Blumer (D-Framingham). The bill seeks to extend both state-funded and employer-provided health insurance to a significant portion of the state's 460,000 uninsured. It expands Mass Health coverage, provides government subsidies to individuals and small businesses to help pay for insurance. A broad coalition of health care professionals, hospitals, labor unions and businesses endorse this proposal.

Governor Mitt Romney's recent healthcare proposals could hurt hundreds of thousands of individuals in MA affected by mental illness. His healthcare reform would offer stripped down versions of health coverage, which would mean excluding many mental health services. This is in marked contrast to the Mental Health Parity Law passed unanimously by the legislature in 2000.

Of General Interest:
Mental Health and Wellness Seminars: The topics cover common challenges and practical solutions. These seminars are sponsored by the Mood and Anxiety Disorders Institute at MA General Hospital. They take place Thursday Evenings from March 17th through May 5th, 2005 in the O'Keeffe Auditorium, 55 Fruit Street, Boston. Registration: 6:30 PM, Seminar 7:00-8:00 PM, Questions and Answers: 8:00-8:30 PM. The seminars are for people who are affected by any major psychiatric illness (including anxiety disorders, mood disorders, and schizophrenia), and their family, friends and caregivers. They are given to help participants become more knowledgeable consumers of mental health services, and more effective advocates for their own and their loved ones mental health care. The seminars are FREE, but space is limited, to register telephone: 617-724-8318 or e-mail: info@moodandanxiety.org.

The Boston University Center for Psychiatric Rehabilitation Spring Workshops will take place April 11-14, 2005 on the BU Campus. They include: "How to incorporate recovery values into evidence-based practice" and "The many faces of resilience".

A Forum on Understanding Teen Depression and Suicide will take place Wednesday, February 2, 2005 , 7:30 PM at the Concord Carlisle Regional High School Auditorium. It is sponsored by the Alliance for Teen Safety. All are welcome.

Suicide Prevention Coalition of Massachusetts will hold the 6th Annual Statehouse Event, Taking Action Preventing Suicide, on Monday, February 7, 2005 from 10:00 AM to 12 Noon. All are welcome.

23-November, 2004

Legislation and Public Policy
Negotiations are underway in the US Senate and House of Representatives to finalize the 2005 budget before going on recess. Of great concern to the mental health community are proposed changes to the Section 8 rental voucher program under the Department of Housing and Urban Development (HUD). These could include adoption of the Bush Administration plan to convert Section 8 to a Block Grant program. It would discourage local housing authorities from providing rental assistance to very low income households, including mentally ill persons on Supplemental Security Income (SSI). This would threaten the housing of several members of Elm Brook Place, for example.

Please call, write or e-mail Senator Kennedy and Senator Kerry and your Representatives. Urge them to support the senate version of the FY 2005 VA-HUD appropriations bill. It provides funding to renew current Section 8 vouchers. Ask them to reject the $1.6 billion cut in the program and reject the Administration's "Flexible Voucher" proposal.

Good news: Congress appropriated $10 million for youth suicide prevention initiatives as part of the Garret Lee Smith Memorial Act, signed into law on October 21, 2004. The act authorized $82 million over three years to states, Indian tribes, colleges and universities for the development of youth suicide prevention and intervention programs.

Please call Governor Romney and Senator Kennedy and thank them for their efforts to stop a planned cut in the FY2005 of $583 million in the Medicaid budget for MA.

This large cut will lead to despair for many and will impact hundreds of thousands of families across the Commonwealth. A cut of this magnitude will have grave consequences for our most vulnerable citizens.

Healing, Health and Human Services Legislator Briefing
December 7, 2004, 10:30 a. m. to noon.
Advocate organizations and individuals are invited to attend this event for the newly-elected legislature. The Massachusetts Human Services Coalition (MHSC) and the Public Policy Institute (PPI) have teamed up to provide this opportunity for you to meet with legislators and discuss your priorities for 2006.

Good News: The US House of Representatives unanimously passed S.1194 the "Mentally Ill Offender Treatment and Crime Reduction Act of 2004". S. 1194 authorizes grants to states and local communities to foster local collaborations to more effectively respond to non-violent offenders with mental illnesses. Once the house and senate versions are negotiated, it will be sent to President Bush for signature. Please thank your representatives and senators for their support of this bill.

Legislation and Public Policy
Save the Date: The DMH Commissioner, Elizabeth Childs, invites you to celebrate Mental Illness Awarness Week, October 3-9, at 10 a.m. on September 30, 2004 in the Great Hall of the MA State House. This will also be the Kick-Off for the "Eliminate the Barriers Initiative". DMH was selected by SAMSA (Substance Abuse and Mental Health Services Administration) to conduct a public education effort to raise awareness about the consequences of stigma and to change public attitudes about mental illness.

Urge your congressional representatives to support the "Second Chance Act of 2004 (HR 4676). This legislation is a bipartisan effort by Reps. Portman (R-Ohio), Davis (D-Ill), Jones (D-Ohio) and Souder (R-Ind). This legislation calls for renewing and expanding a grant program to help local communities develop integrated services for former inmates. Nearly half a million people are released from jails or prisons each year in the US. When they return to their communities they face discrimination in jobs, housing, student aid and child custody which prevents their successful reintegration into the community. If the bill becomes law, it "will serve as an entry point in turning the nation's approach away from excessive retribution and punishments and towards rehabilitation and redemption".

MASS Medical Security Trust Fund: In 1999 state legislators set up a Health Care Security Trust Fund to invest hundreds of millions of dollars from the state's settlement with tobacco companies. The trust fund would finance public health programs and anti-smoking efforts. However, once the fiscal crisis developed and tax revenues decreased lawmakers used the funds revenues to prop up state spending. There are currently two vacancies on the trust fund board. Remind your legislatures of what the fund is for and ask them to propose strong candidates for the two vacancies on the trust fund board. Appointments to the board must be approved by the treasurer, attorney general and the governor.

Call Governor Romney or his administrative staff and ask him to Fund the Disability Housing Bond Bill, T: 617-725-4005. For the Bill to be implemented it must be funded. The Romney administration is operating under a self imposed spending cap for capital projects. In order to adequately fund programs under this bill the Governor needs to increase the Department of Housing and Community Development's (DHCD) share of the annual cap from $123 million to $165 million in the 2005 budget.

Call your Congressional representative and ask that they sign the discharge petition, H Res. 748, for the National Housing Trust Fund legislation H.R. 1102. The purpose of the discharge petition is to move H.R. 1102 out of the financial services committee where it was stuck. If the discharge petition is signed by 218 House members, 214 members have already signed, it will go directly to the house floor for a vote. If passed by Congress much needed funds would be available to states for the development of housing for low income families.

HUD has recently has proposed significant changes in the way in which FMRs (Fair Market Rent areas) are defined. If implemented it will severely disrupt local operations of the Housing Choice Voucher program and other federal housing programs because they deeply cut allowed payment standards for some areas while raising them drastically in others. Many communities in MASS would experience voucher rent reductions from 30% to 50%. Members of the MASS Congressional Delegation have asked the HUD Secretary to revise and delay implementation of the proposed new FMRs in Massachusetts which is scheduled to go into effect 1 October 2004. Many housing advocacy organizations including CHAPA ( Citizens' Housing and Planning Association) are making great effort to revise the new FMR distributions to reflect the reality of housing costs in MASS.

Have you been denied service by your HMO? Effective January 1, 2001, MA consumers who receive health coverage from a MA carrier, insurer or HMO are entitled to new protections covering internal grievances, medical necessity, continuity of care and independent external reviews. You may call the Office of Patient Protection within the Department of Public Health. T: 1-800-436-7757

Legislation and Public Policy
On August 10 Governor Romney signed H.4911, An Act Relative to Low Income Housing Tax Credits. The disability housing bond bill language is included in H.4911. It provides $ 200 million for the following programs: Facilities Consolidation Fund ($100 M), Housing Innovations Fund ($ 50 M), Home Modification Loan Program ($ 25 M), New Community-Based Housing Program ($ 25 M).

Now we must work to ensure that these programs receive adequate funding in the capital budget under the Department of Housing and Community Development’s (DHCD) bond cap. We need to convince Governor Romney to increase the DHCD’s annual share of the spending cap for capital expenditures from $ 123 million to $ 165 million in FY 2005.

You can help by calling Governor Romney: 617-725-4005, Secretary of Administration and finance, Eric Kriss: 617-727-2040 and the Secretary of Commonwealth Development, Douglas Foy: 617-573-1380 and ask them to increase the DHCD bond cap.

A Boston Globe editorial of 10 August 2004 states that if President Bush wants to end homelessness, he should protect federal rent subsidies. Poor people pay 30 percent of their income in rent with a Section 8 voucher and the federal government pays the rest. Unfortunately, Bush’s 2005 budget proposal is $ 1.6 billion below the amount needed to maintain the current level of assistance. If this proposal goes through more than 8,000 people in the Massachusetts voucher program could face eviction. This represents 44% of the state’s vouchers.

Alphonso Jackson, the secretary of housing and urban development, representing the Bush administration counters (August 6, 2004 New York Times) that the Section 8 voucher program is broken. "It consumes too much of the HUD budget" and does not give housing authorities enough flexibility to optimize their support to low income families.

Fair Market Rents (FMR’s): On August 6, the U.S. Department of Housing and Urban Development released the FY 2005 Fair Market Rents for existing housing. See the Federal Register (Vol. 69, No 151, page 48040). There are significant changes since last year. For example, Massachusetts has now only 8 Metropolitan Statistical Areas rather than 11 and only 2 Non-metropolitan Counties rather than 8. The impact on FMR’s will be great in some cases. Comments on the new FMRs are due by 7 September. Respond to Cindy Rowe: crowe@chapa.org.

MassHealth Defense-Free Health Care Pool Hearing. The Division of Health Care Finance and Policy has proposed new regulations for the Free Health Care Pool. Individuals and organizations are encouraged to submit testimony at a public hearing on August 24 2004 at 10:00 a.m. at 2 Boylston Boston. You may send written comments to Division of Health Care Finance and Policy, 2 Boylston St, Boston MA 02116. An Uncompensated Care Pool was created by the state to reimburse providers for free or partially free medical care for uninsured or underinsured persons who need care. In July 2004, new regulations were proposed that would restrict the services that hospitals get reimbursed for and remove important patient protections. For more information call: 617-350-7279, web: http://www.hcfama.org.

Social Security Ticket to Work Program: SSI and SSDI beneficiaries with mental illness continue to be frustrated in their efforts to use the 1999 Ticket to Work and Work Incentives Improvement Act (TWWIIA) to leave the disability rolls and enter the workforce. Individual citizens are addressing the inequities in SSA's disability programs. You can learn more about the "Ticket" program and these issues at: http://www.ssa.gov/work/ticket/ticket_info.html.

Federal Senate Bill S-545 and # 8211, the Small Business Health Fairness Act of 2003 should be opposed. Please contact Senator Kennedy at http://kennedy.senate.gov/contact.html and Senator Kerry at http://kerry.senate.gov/text/contact/email.html. If this bill passes it will weaken state mental illness parity laws. As envisioned by this bill Association Health Plans would be exempt from all state insurance laws, including state parity laws, minimum coverage standards for mental illness treatment and other consumer protections.

Section 8 Housing Voucher Legislation: MA Rep Barney Frank has introduced legislation to amend the FY04 VA/HUD Appropriations Act to re-emphasize that Congress intended for Section 8 Housing Vouchers to be funded based on actual costs. HUD has been reimbursing Housing Authorities at August 2003 costs which was not the intent of congress. Rep Frank is seeking cosponsors for this legislation. Contact your congressional delegates to inform them of the bill and ask if they would cosponsor it.

40B legislation. Chapter 40B legislation was enacted to encourage cities and towns to develop affordable housing. It states that until a there is 10% affordable housing in a city or town, developers may bypass some of the zoning restrictions if they guarantee a certain percentage of the development units will be affordable. A Joint Committee on Housing and Urban Development released 40B reform legislation, H 4240, in the Fall to address legitimate local concerns while keeping the law intact. Ask your representative to support this compromise 40B legislation prepared by Chairman Honan and his committee and oppose any amendments to further weaken 40B. The bill will be voted on by the full House very soon.

Action on MassHealth/CommonHealth insurance program for working adults with disabilities. Please call your Senator and ask him or her to sign on to Sen. Chandler’s amendment to protect individuals eligible for CommonHealth from asset tests and enrollment caps in the Senate’s FY 2005 budget recommendation.

Legislative Action: Budget Update: FY 2005 House 1. Good News! The advocacy efforts of mental health organizations, mentally ill persons and NAMI paid off :

There are problem areas: The DMH 5011-0100 Operations Account is under funded which will result in reductions in important staff and program support positions. There is also concern that as patients in hospitals are released there will not be enough resources set aside to support them in the community. There was no mention in the budget of a set aside of a portion of the proceeds from the sale of the Medfield State Hospital Property for housing for the mentally ill.

Actions Needed: Ask your legislators to support the following amendments filed by Representative Scaccia:

Walk for the Mind of America
You are invited to WALK for the Mind of America, a statewide effort to increase awareness of MA legislatures and the public about the state of Mental Health Care and Services in MA and fight Stigma. The WALK will take place rain or shine on Saturday May 22, 2004 starting at 11 am in Artisani Park along Soldier's Field Rd. If you cannot walk you could assist in one of the booths or help guide the walkers. You could also raise money for OCFGB. About 45 % of the money collected by walkers and their supporters, donors can be given back to OCFGB if you sign up in the NAMI Central Middlesex red tent and identify yourself on the pledge sheet as NAMI Central MIddlesex-OCFGB. For further information call Janet at NAMI-MA, T; 781-938-4048 or visit www.NAMImass.org.

The campaign for the Mind of America was launched 28 April 2004
The National Alliance for the Mentally Ill together with national and state partners launched a campaign for the Mind of America at the MA State House on 28 April 2004. Speakers included Mike Fitzpatrick, National Executive Director, NAMI, MA representative Peter Koutoujian, Chair, Health Care Committee, representatives of the American College of Emergency Physicians, National Association of County and City Health Officials, Child Welfare League, Mass Chapter of the National Association of Social Workers, Judge Maurice Richardson, Director of the Diversion Resource Center, U Mass Medical School, The Samaritans of Boston, and the Mass Teachers Federation. A report was released entitled "The State of the Mental Health System in Massachusett, which describes the mental health crisis in Massachusetts. Nationwide, untreated mental illness costs more than $100 billion annually from lost productivity and diverted resources. The campaign will work to underscore the unintended costs and consequences to the community of lack of access to treatment and services for those living with mental illness in the Commonwealth. For copies of the report call 781-938-4048 or visit the web site: www.NAMImass.org.

Senators Pete Domenici (R-N.M.) and Edward Kennedy (D-Mass) have co-sponsored and given priority to the passage of the " Senator Paul Wellstone Mental Health Equitable Treatment Act (S 486/HR 953) which would expand the parity mandate to provide full parity. A companion bill, House (HR 953) was introduced by Reps. Jim Ramstad (R-Minn.) and Patrick Kennedy (D-R.I.). Please let these senators and representatives that you support this legislation and appreciate their efforts.

The bills would require group health plans that provide mental health benefits to do so without limits different from limits on medical and surgical benefits. If parity becomes law, health plans could not impose arbitrary time limits on treatment or require patients to pay more out-of-pocket expenses for their mental health benefits. Businesses that employ 50 or fewer persons would be exempted. More than 45 medical societies have contacted every member of Congress in support of this legislation; nondiscriminatory coverage for mental illness. This demonstrates that parity is not just a psychiatric issue but is important to all medical practice.

The U.S. Senate has enacted the "Mentally Ill Offender and Crime Reduction Act of 2003 (S 1994), a bill that authorizes $ 100 million in federal grants that states or local communities can use to reduce involvement of people with mental illness in the criminal justice system. To move forward the related House bill HR 2387, entitled "Mentally Ill Offender Treatment and Crime Reduction Act of 2003 needs more co-sponsors. Current sponsors include Congressman Strickland (D. Ohio), Rep. Spencer Bachus (R-AL) and Rep. William Delahunt (D-MA).

Please call/fax or email your congressman and ask him/her to co-sponsor HR2387 and ask Congressman Hyde and Congress Conyers to report this bill favorably for a vote. This important bill will: Create jail diversion programs, Provide treatment for incarcerated adults and juveniles with serious emotional disturbances, Fund cross-training of criminal justice, law enforcement, court and mental health personnel and Provide mental health services for these persons on reentry into the community.

Governor Romney’s 2005 budget, House 1, was released January 31, 2004. This 23 billion dollar budget request, contains a $523 million increase for Health and Human Services. There are, however, significant cuts in the Department of Transitional Assistance and the Department of Mental Health which will decrease support for persons with disabilities. The Governor’s budget recommends $ 588 million for DMH which is $7 million less than the maintenance budget requested by DMH for 2005. Please contact your senators and representatives and ask for the restoration of three budget cuts in FY2005 (House1). 1. DMH, Department of Mental Health, Adult Continuing Care Inpatient (5095-0015). The inpatient account was cut $4.6 million anticipating the closure of 160 adult inpatient beds. Section 381 proposes that DMH move $5 million to the adult community account but this will cover only 1/3 of the cost of beds and services for this population. 2. DMH Supported Research Funds (5046-0000) Cut $2 million. This research is crucial to finding better and more cost effective treatment for chronic mental illness. This work generates over $2 million in federal matching funds. and treats about 750 consumers each year. 3. Cut Mental Health Training and Consultation Services for Child/Adolescents (5042-5000) by $983,992. This cut would eliminate funding for mental health training and consultation services to over 600 schools impacting more than 310, 000 children and adolescents in MA.

A NAMI MA panel including Phil Hadley, Toby Fisher, Sid Gelb and Rita Sagalyn gave testimony opposing these cuts before the joint session of the Senate and House Ways and Means Committees at the State House Gardner Auditorium on February 27, 2004. Your legislators need to hear from you now.

Copyright © 2000-2010 All rights reserved

Copyright © 2000-2010
All rights reserved