Wednesday, January 13, 2010

Reductions in Montana's Mental Illness Treatment Services

Dear NAMI Montana Members and Friends,

I know that a lot of you have read the articles about cuts to mental health services and you're worried. Those fears are justified. The State of Montana's budget is in tough shape and the weak economy has led to a sky rocketing demand for state-funded mental illness treatment. The reality is that it will be harder to access that care.

What We're Facing

Here is a breakdown of the cuts and service reductions as I see them based upon conversations with state personnel and an analysis of the available articles on the subject. (These articles are available at the News section of our website).

The most glaring reductions of services stem from the high demand on the Mental Health Service Plan (MHSP). The State is sharply reducing services, such as case management, and eliminating others, such as day treatment, to prevent MHSP from running out of money. On a personal level, these service reductions will really hurt many Montana families. On the state level, these service reductions risk funneling sick people from cost-effective outpatient care to more expensive placement at the Montana State Hospital or Department of Corrections.

The Governor canceled a $4.5 million renovation of the receiving hospital at the Montana State Hospital at Warm Springs. On top of that $4.5 million, it looks like the Department of Public Health and Human Services is facing a 5% reduction in its budget. It would be a good bet to expect later cuts beyond that 5%.

NAMI Montana has asked the Governor's office to please consider all of the reductions in the mental illness treatment system, including the cancelled renovation at the State Hospital, to ensure that Montanans with serious mental illnesses and their families don't bear more than our share of the burden of the budget cuts.

How You Can Get Involved

The most effective method of getting your voice heard on this issue is to contact Governor Schwietzer's office directly. His phone number is (406) 444-3111. You can write to him through the Governor's website, http://governor.mt.gov/contact/commentsform.asp. You can also send him a letter at this address:

Governor Brian D. Schweitzer
Office of the Governor
Montana State Capitol Bldg.
P.O. Box 200801
Helena MT 59620-0801

It's your state and your mental illness treatment system. Don't be afraid to express your views on how that system should be affected by the upcoming budget cuts.

Sincerely,
Matt Kuntz
NAMI Montana

Monday, January 11, 2010

No Good Deed Goes Unpunished

The National Alliance on Mental Illness for Montana (NAMI Montana) works with and against politicians all of the time. We don’t care whether someone is a Democrat or a Republican. The real issue for our organization is whether the politician is trying to help the one-in-five Montana families affected by serious mental illnesses. In many instances, we’ll support a politician on one issue and then fight them on another. With Montana’s suicide rate repeatedly among the highest in the country, we can’t afford to be ideologues. There’s just too much at stake.

In August of 2008, I met with Senator Baucus’s staff to provide input to their efforts to improve the healthcare system. NAMI’s position is simple. We’d like to get as many people access to medical care as possible. We also think that insurers should not be able to provide less coverage for biological brain disorders than they do for illnesses in other parts of the body. While many of our members may have different opinions about what the overall medical care treatment system should look like, those are our general goals.

Senator Baucus’s staff said that the Senator also supported those objectives and they felt we would be happy with their legislation. Then we discussed some of the challenges that they expected the legislation to face. The Senator’s staff was very clear that it was going to be hard to get a healthcare bill through the Senate. Anything too liberal or too conservative would fail. A bill with too high of a budget would also fail. They had to put aside utopian visions in favor brass tacks ways to improve the current system.

In the year and a half since that meeting, the healthcare reform debate stewed and then exploded. The men and women fighting for and against the legislation have been repeatedly tarred and feathered. For the most part, NAMI Montana stayed out of it. NAMI National has a federal advocacy staff that read every bill and fought for each point. But as far as we were concerned, Senator Baucus knew what Montana families affected by serious mental illness wanted and we trusted him to deliver it.

It’s too early to know what the final legislation is going to look like, but I asked NAMI’s Federal Advocacy Director to examine the Senate Bill to determine whether Senator Baucus kept his promise to our families. According to his analysis, the expansion of Medicaid eligibility alone will extend “health coverage and security to literally millions of Americans living with serious mental illness, including childless adults not able to qualify for Medicaid in their state.” The Senate bill also specifically requires that all of the health plans offered through new health insurance exchanges comply with the federal parity law that requires insurance companies to provide coverage for mental illnesses to the same degree they cover other illnesses. With those provisions, the Senate Bill honors Senator Baucus’s commitments to Montana families affected by serious mental illnesses.

The Senate Bill goes far beyond those provisions to protect the public from some of the more insidious practices in the insurance industry such as prohibiting the use of pre-existing health condition exclusions and caps on insurance payouts. The Senate Bill also provides for guaranteed issue and guaranteed renewal of coverage in the individual and small group markets. These consumer protection provisions will make a big difference in the lives of Montana families who are unfortunate enough to have a family member become seriously ill.

Senator Baucus, thank you for sticking your neck out to improve America’s healthcare system. When the dust settles, your efforts are going to improve the lives of a lot of Montana families. We really appreciate it.

Sincerely,
Matt

Matt Kuntz is the Executive Director of the National Alliance on Mental Illness for Montana (NAMI Montana).