CONSUMER ADVOCACY PARTNERSHIP’S CONSUMER BUDGET FORUM

On March 13th, 172 consumers from around the state attended The Consumer Advocacy Partnership’s Consumer Budget Forum: Response to the Proposed FY ’04 Budget in the State House Annex. In attendance to listen to 30 mental health consumers talk about affordable and supportive housing, non-interchangeability of psychiatric medications, medication co-payments, Partnership for Children, and Redirection II/community supports were Senator Peter A. Inverso (R14), Assemblyman Reed Gusciora (D15), Assemblyman Joseph Pennacchio (R26), Doug McGruther, Medicaid, Reginald Lewis, Special Assistant for External Affairs in DHS, Julie Calawan, Director Partnership for Children, Jon Poag of DMHS, and Kevin Ryan of the Governor’s Office.

MEDICAID: THE FEDERAL ISSUES

President Bush’s plan would force many states to cut back a vital and effective health insurance program at the very moment our citizens need it the most – Medicaid.

Background:

• Medicaid is the largest program providing medical and health related services to America’s poorest and neediest people.

• Medicaid (Title XIX of the Social Security Act) became law in 1965, as a jointly funded cooperative venture between the Federal and State Governments to assist states in the provision of adequate medical care to eligible needy persons.

• The total Federal outlays for Medicaid have no set limit (cap). Rather, the Federal government must match whatever the individual state decides to provide, within the law, for those who are eligible.

• Medicaid requires that in order to receive Federal matching funds, certain mandatory benefits— including hospital, physician services and early and periodic screening diagnosis and treatment (EPSDT) services — must be offered to the categorically needy population in the state – Medicaid Mandatory Population.

• States may also receive Federal funding if they elect to provide an optional benefits package for the Medicaid Mandatory Population which may include clinic services, prescription drugs, psychiatric rehabilitation and case management.

• The people that individual states have opted to serve, Optional Eligibility Population, include many people with mental illness and other disabilities whose income is above the qualification level for federal disability benefits (SSI).

• During the 1990’s, the Clinton administration and the states tapped their unexpected budget surpluses to make Medicaid more widely available. They eased eligibility requirements and were more aggressive about enrolling people. As a result, 47 million people receive Medicaid today, up from 40 million in 1998.

• Without Medicaid, a high number of Americans without health coverage today – some 42 million – would likely be a few million higher.

• New Jersey Medicaid provides health care needs to more than 900,000 people (Approximately 600,000 are Medicaid Mandatory Population, and approximately 300,000 are Optional Eligibility Population)

• In N.J., the Division of Medical Assistance and Health Services (DMAHS) administers the Medicaid program.

The Bush Administration would effectively eliminate the Medicaid entitlement.

The 10 year proposal would provide to participating states, additional federal Medicaid dollars in the short term — $3 billion in new money for fiscal year 2004, part of an additional $13 billion over the next 7 years. The states would be required to pay back all of the $13 billion in the three years that follow the initial seven.

In addition, states accepting the up front money would have to sign off on a major shift in the program’s overall financing scheme:

• Under the proposal, states would receive federal funding for all Medicaid services through a block grant, a fixed sum each year. Washington would stop providing the bulk of Medicaid financing as matching funds, which rise as states enroll people. The fixed sum, based on a formula, could easily underestimate the true need for services. States would be locked into this option for 10 years.

• Individuals would lose their present federal entitlement to receive services in “sufficient amount, duration and scope” to treat their conditions.

• States would have the flexibility to cut benefits, alter eligibility criteria, and increase co-payments for Optional Eligibility Groups.

• Optional services needed by beneficiaries in the Medicaid Mandatory Population may also be at risk

• How might this specifically affect the thousands of low income children and adult mental health consumers in New Jersey?

• Most community mental health services for adults are provided under the optional benefits package that could be cut under the proposal.

• Mandatory benefits could be cut for consumers who, because of their income, are in the Optional Eligibility Group

• It is unclear whether children covered in Optional Eligibility Group would retain their rights under the program’s mandate for EPSDT (Early Periodic Screening Diagnosis and Treatment.). EPSDT is used in the identification of both physical and mental illness for eligible children under the age of 21.

• Because Medicaid is a primary source of funding for mental health services, any cuts to services or eligibility that result from this proposal would threaten health outcomes for all who rely on these services

What you can Do:

• Contact Governor McGreevey and encourage him to reject the Bush proposal.

• Contact your Congressperson and Federal Senators (Lautenberg and Corzine) down in D.C. and urge them to oppose the Administration’s Medicaid reform proposal. Tell them that it was because the poor couldn’t afford health insurance that the federal government created Medicaid. In trying times like these, previous administrations have dipped into the treasury to keep the program going. Emphasize the importance of Medicaid services for children and adults with mental health needs in N.J. and the tragic consequences that result when mental health treatment and needs are not met, including increased homelessness, institutionalization, crime and suicide. Log onto our website at www.mhanj.org for contact information.

MEDICAID: THE STATE ISSUES

As reported in last month’s edition, on a state level the Governor’s FY ’04 Budget proposes the following ways to cut Medicaid Fee For Service costs:

• Elimination of dental coverage for adults.
• Co-payments for emergency room visits, outpatient visits and prescription drugs.
• Preferred Drug Lists (PDLs)

Consumers need your help. Contact your legislators in the State Assembly and Senate. Tell them not to cut Medicaid. Tell them not to balance the budget on the backs of the poor and disabled! For sample a letter and contact information, please log onto our website at www.mhanj.org.

On March 6th, A685, which would require child support to continue past the age of majority if the child has a mental or physical disability causing the child to be financially dependent on the parent, passed the Assembly Family, Women and Children Services Committee. The bill was sponsored by Assemblywoman Loretta Weinberg (D37), Assemblyman Paul Sarlo (D36) and Assemblyman Neil M. Cohen (D20). Now on to Assembly Appropriations.

On March 10th, A2539, which revises receivership status and makes it easier to revitalize abandoned property and turn it into affordable housing passed the Assembly Appropriations Committee. The bill was sponsored by Assemblywoman Bonnie Watson Coleman (D15) and Assemblyman Jerry Green (D22). Now on to the full Assembly.

The Effort for Full Insurance Parity in the State of New Jersey takes a giant leap forward! On March 10th, S1520 as amended (bill was combined with S1633, The Behavioral Health Parity Bill) passed the Senate Health Committee. It was sponsored by Senator Barbara Buono (D18), Senator Richard James Codey (D27), Senator John J. Matheussen (R4) and Senator Joseph Vitale (D19). Now on to Senate Appropriations.

CONSUMER ADVOCATES OF THE MONTH

Thanks to all who opened their hearts and minds at the Consumer Advocacy Partnership’s Consumer Budget Forum

To the 30 consumers who shared their personal stories in a public forum before over 170 consumers, advocates, providers, legislators and administrators: Sam Laskin, Regina Sessoms, Annette Wright, Vinnie Polisano, Dennise Babin, Judy Banes, Valerie Fox, Patrick Martin, Linda Valentine, Wayne Vivian, Madeline Bell, Richard Green, Joe Cinko, Donna Nicholls, Lisa Negron, Mai Tai MacDonald, Anna Phillips, Paula Gallant, Peter Blumenthal, Anne Moseby, Jean Kellam, Victor Boatwright, Susan Carle, Bruno Ciampa, Virginia Nelson, Shalet Richardson, Maureen Mayer, Carole DeTaranto, Fred Sanders, and Derek Greene, we salute you. On behalf of the thousands of children and adults with mental illness in the state of New Jersey who cannot yet, or may never be able to speak up for themselves, we thank you from the bottom of our hearts.
 

Join MHANJ’s Legislative Network! Contact
C. Chin at 973.571.4100 Ex. 37  or cchin@mhanj.org