How's the Big Picture Look Regarding NC's Budget? 

Here's how things stand for mental health:

1. People using MH services funded by state dollars will have to start paying a Medicaid-type copay
2. Eliminates 7 advocacy positions (56 left; ll% reduction) at state hospitals
3. Reduces Community Services funds by $20 M.  Management funds reduced by 2%, another 7M (8% reduction)
4. Reduces by $25M Community Services Funds to LMEs through a swap with their fund balance money.  For those entering into waiver environments, this is a considerable handicap as they will be at risk for spending past the "capped" amount of medicaid through that program
5. Includes a tax ("assessment" of up to 5.5% on willing Medicaid healthcare providers (will include CABHAS, CAP-MR, and Hospitals) ($60M)
6. Generic substitution for Off Patent Drugs Savings of $7M starting in 2012-13
7. Modify Pharmacy Services - Cut of #10M first year, $14 M second year (eliminate automatic refills, dispensing fees, better manage rebates)
8. Waiver expansion - Cuts of $10M and $52M through projected savings
9. Cuts of $90M through Community Care of NC (CCNC) savings through improved health management
10. Cuts of $l6M and $22M (first and second years of biennium) whereby the Secretary can reduce or eliminate coverage for hearing aids, dental or optical care, chiropractic, podiatry services, prosthesis, physical therapy, and nursing care
11. Eliminates automatic inflationary increases to medicaid providers ($62M, $130M)
12. Reduce provider rates by 2% - $46M
13. Eliminates funding and positions for the NC Care Line ($380,000)



These are just the items from the Division of MH and DMA sections- there are other important cuts in Education, Public Safety, Vocational Rehabilitation that obviously also impact on those living with mental illness

This version spends $l.4 Billion less than the Governor proposed, and does not include the $75M trust fund that would have helped fund much needed housing for people with mental illness.  HHS's share of the increased cuts is $460M 

And What's the Good News?

• Say Thank you to Representative Dollar and Burr for their work in appropriations in getting language back in that will waive mental health drugs from being subject to a prior authorization.  That's just a barrier to getting the important medications people need to mange their own health
• Program Integrity Act (Senator Mansfield) will ensure that pharmacists may not substitute different drug products without consent from the patient
• SB 334 would expand inpatient psychiatric beds throughout NC by $l0M (50 beds)  Thank you Senator Nesbitt!
• HB 659 Capital Procedure/Severe Mental Disability sailed through the Judiciary Committee last week with unanimous support.  This would remove the death penalty for those who had a severe mental illness during the commission of a capital crime.  Say thank you to Representatives Stevens and Glazier!!

The National Picture

Federal Block Grant Changes and Opportunity for Input

The Substance Abuse and Mental Health Services Administration (SAMHSA) has proposed new regulations for federal Mental Health and Substance Abuse Block Grants that may affect how states allocate block grant dollars, including funding for NAMI organizations. You can comment on the proposed regulations by emailing Summer King at SAMHSA by June 9, 2011.

The proposed regulations encompass broad changes, including additional target populations, a focus on recovery services and outcomes, required needs assessments, biennial reporting periods, and more. These changes may represent both opportunities and challenges for NAMI. To learn more, visit SAMHSA's block grant site and view a presentation on proposed changes and the revised draft planning section and mental health reporting section.

NAMI will be hosting a Webinar on SAMHSA's proposed block grant changes.Save the Date: May 26th--3:30 to 5:00PM EDT

 Ask Congress to Sign-On to Parity Letter

More than two years after passage of federal insurance parity, the full intent--and hope--of parity has not been realized. You can help! Call your U.S. Senators and Representative today and ask them to sign-on by April 29th to a "Dear Colleague" letter that requests federal agencies to clarify key areas in federal parity rules that insurance plans are using to discriminate against mental health and addiction services. Read more.

Advocates are strongly encouraged to contact their House member and Senators and urge their Senator to please sign on to the Franken parity letter and their Representative to sign on to the Tonko-Sullivan parity letter.  The letters will be open for signatures through the end of April, 2011. All House and Senate offices can be reached by calling (202) 224-3121

What can you do? 

1. Call your legislators - or write to them.  Do it today!  Tell them you do not support these further cuts to mental health-through provider rate cuts, moving too quickly on the waiver, and the cuts to Community Services
2. Tell them that they can balance the budget by continuing the Sales Tax enacted to solve just these problems - it will create over $lB for NC's budget!
3. Tell them your personal story about dealing with the complexities of these illnesses, and how so many more "rules" on managing care may be difficult and result in poorer care ultimate.
4. Take action as above on the federal Medicaid Block Grant threats

Stay Tuned.  Your Advocacy is so important.  Stay informed and talk with your legislators