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MHA/NC Letters By John Tote
An Advocate's Perspective:
A Real Head Scratcher
Released: Thursday, July 16, 2009
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In my nearly sixteen years as Executive Director of the Mental Health Association in North Carolina, rarely have I seen a legislative session that has caused me to scratch and shake my ever-balding head as much as this one has – and for so very many reasons.
We in the advocacy community have worked to make issues such as severe mental illness and traumatic brain injury exempt from the death penalty (not exempt from guilt or prison), but have seen so many self-described pro-life Legislators continue to vehemently support it. Also, while we are still struggling to get a budget passed, we have seen Democrats not taking care of core constituent groups such as those in Health & Human Services and Education. Now we are at the point where suddenly 48 cents per person per day for tax increases seems untenable to many of them. (We must acknowledge that the Governor, though, at great political risk, is not one of these. She has vigorously supported new revenue to save services and lives.) We have also heard Republicans (when they are not answering every question or proposal with a ‘no’ and nothing more) come up with, “Well, let’s turn the clock back three, four, five years on what we spend as a State.” I don’t know about you, but I don’t remember those years as the golden days for our state’s mental health system.
Recently I was asked by a family member, in all seriousness I might add, if it was a surprise to Legislators that the budget was due June 30th. I answered, “No, but unfortunately this is nothing new…it’s part of the game.” I may enjoy political theater and games as much as the next political junkie, but this year the stakes are too high. People’s well-being – people’s lives – are hanging in the balance.
While it appears at the moment that some of the cuts will not be as severe as we had originally feared, any cut will be devastating. Even the level that is supposedly good in some people’s eyes is horrific. It will devastate communities across
North Carolina, not only from a service perspective but also from an employment perspective. We could potentially lose more than 50,000 to 60,000 jobs across the State. Many of these jobs are in small, rural communities. What happens then for our economic development? What happens to our tax base? What will our legislators do next year? Is 48 cents a day really too much to save a job…or a life?
It is also sad to me that as the budget process “progresses,” the last true line of defense for those with mental illness in our State is to have routine access to medications. There has been protection in statute for the past several years for those with mental illness needing medications. Many, though, have now sought to remove this protection saying that doctors prescribe mental health medications for other health reasons. Unfortunately, there are those that see this area as “easy pickings” for a few dollars. In truth, this “savings” is an illusion. Individuals will visit emergency rooms and other hospital services, which will drive up costs. Additionally, people will get caught up in the criminal justice system or become homeless. From a human standpoint, we are harming someone’s well being in many, many ways. From making them first fail on a drug, to denying them access to additional medications to overcome devastating side-effects.
Over the next few days, we literally must get through this process, secure a budget, and move forward. We must, as a State, finally have significant discussions concerning our pathetic tax structure, our needlessly painful budget process, and most of all, what our strategic plan for
North Carolina will be. The170 members of the General Assembly must step up, put egos, politics and self-interest aside, and understand that they represent our state’s more than nine million citizens, including the most vulnerable of our citizens – none of whom want to be on Medicaid or in need of the mental health system. So, let’s stop the finger pointing. Let’s stop the head scratching, and let’s make a true difference in the lives of those that count on key programs of
North Carolina ’s public healthcare system That’s one advocate’s perspective.
John Tote
Executive Director
MHA/NC
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