Advocates, It has been a long Legislative session and MHANC has issued many alerts due to the terrible budget cuts proposed. Advocacy works and your efforts have helped to restore some of those cuts, as well as raise revenue needed to keep needed services and supports for people with mental illness. Our work is not yet done! The NC House and Senate are still considering budget policies that will harm people with mental illness. Please take action today. If you have questions about these or other mental health policy issues please contact MHANC policy staff Erin McLaughlin 919-981-0740 x507
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or Jennifer Mahan at 919-981-0740 x270 or
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In this Issue:
Budget Update
Mental Health Medication Access
ACTION: Keep Access to Mental Health Medications
Budget Update: House and Senate Conferees began meeting last week but are still at odds over cuts to health and human services (see the listing of proposed cuts/restoration at www.mha-nc.org ). House and Senate also cannot agree on tax revenue packages; The Governor’s office and Senate are pushing for increases that would total 1.5 billion, while the House is reluctant to extend revenue increases beyond 1 billion. Without agreement on a revenue package, both the sources and amounts of new revenue, budget negotiations must continue based on an assumption of around 900 million being added back into the budget in new revenue. With around 1.5 billion in stimulus funds, and 900 million in taxes, budget conferees must still find 2.4 billion in cuts. The Senate passed an open ended continuing budget resolution that would keep the state operating at 85% of its current funding; the House amended the Senate resolution but limited it to July 15. Both CRs stop salary increases, close vacant positions, and stop state grants which are subject to the proposed budget reductions, but do allow projects using federal stimulus dollars to move forward. View the CR here: http://www.ncleg.net/Sessions/2009/Bills/Senate/HTML/S311v3.html
The House has not passed their final version, calendared for June 29th. Its unclear if the Senate will concur, or if the two resolutions will need to go to conference committee to be passed before the end of the fiscal year on Tuesday June 30th.
Medication Access: One of the significant cuts in the House version of the Medicaid budget involves 40 million in "savings" to be found by implementing a preferred drug list in North Carolina's Medicaid program. For a number of years medications for mental illness and for HIV treatment have been exempt from preferred drug lists, prior authorization, fail-first programs, and other strategies that limit access to life changing and life saving medications. Despite the increasing number and type of medications to treat mental illnesses that have been developed in the last two decades, drug treatment for mental illness remains a highly individualized matter. Mental health medications are not interchangeable: medications sometimes have similar impact on symptoms of the mental illness, but have varied side effects and results for each individual taking them. National studies show that many people must change medications during the course of treatment because they stop working or the side effects become intolerable.
The bottom line: there is no nationally accepted evidence-based medication protocol for mental illnesses. Limiting choices for individuals with mental illness results in an increase in use of crisis services, hospitalizations and contact with law enforcement. States who have implemented preferred drug lists have repealed their use for individuals with mental illness. We need to help people find the right treatment and help them stay with it so they can live healthy. The state can employ many strategies that will still save money (and not just in the medication line item) that still allow choice and flexibility in choosing the medication that is right for an individual with mental illness.
ACTION: Tell the NC GA House and Senate Budget Chairs, and Leadership, that you are opposed to a preferred drug list for mental health medications in Medicaid. Please share your story of how these medications have helped you or those you care about recover from mental illness and the impact if they were changed or lost. Personal contacts are best, please use our message below as a starting point to tell why you want to keep access to medications.
House and Senate Leadership
Senate President Pro Tempore, Marc Basnight
919-733-6854
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Senate Majority Leader, Tony Rand
919-733-9892
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Speaker of the House, Rep. Joe Hackney
919-733-3451
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House Majority Leader, Rep. Hugh Holliman
919-715-0873
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Appropriations Chairs:
Sen. Linda Garrou,
919-733-5620
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Sen. Charles Albertson
919-733-5705
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Sen. A.B. Swindell
919-715-3030
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Sen. Charles Dannelly
919-733-5955
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Rep. Henry (Mickey) Michaux
919-715-2528
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Rep. Alma Adams
919-733-5902
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Rep. Martha Alexander
919-733-5807
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Rep. Jim Crawford
919-733-5824
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Rep. Phillip Haire
919-715-3005
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Rep. Maggie Jeffus
919-733-5191
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Rep. Joe Tolson
919-715-3024
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Rep. Douglas Yongue
919-733-5821
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The Message:
Mental health medications are not interchangeable. Effectiveness and ability to tolerate side effects varies greatly for individuals with mental illnesses. People with mental illness need access to a wide range of medication options.
Strategies like preferred drug lists (PDLs) and prior authorization have been shown to reduce access and increase the use of more costly crisis services.
Keep the mental health medication exemption language in place and allow the Secretary of DHHS to determine how best to find "savings" in the Medicaid drug program.
[A brief fact sheet on "The Truth About Preferred Drug List for Mental Illness" can be found on our website at http://www.mha-nc.org/english/mha_pdf/Access%20to%20Meds%20Fact%20Sheet_6%2026%2009%20(2).pdf ]
