Health Association in New York State, Inc.
Friday Fax from Albany
The View From the Lobby: The lobby and chamber of the New York State Senate is a very different place this week. Although the news media is portraying the present state of the budget as contentious and confusing, the faces of the Senators and their staff largely paint a different picture.
For the first time in 20 years, the Governor’s proposed Executive Budget is about to become exactly that --- proposed, and not adopted. As Governor Pataki has grown more resolute in his position, fighting against so-called “job killing taxes” like an income tax surcharge, the Senate has been feeling huge pressure from the voters back home. For the vast majority of the Senate’s constituency, it is the spiraling real property tax that is the greatest concern. And as the issue has heated up, so has the debate’s tone.
Although the public and news media alike abhors the long demonized practice of “3-men-in-a- room budget-making”, Assembly Speaker Sheldon Silver and Senate Majority Leader Joseph Bruno tried for months to engage the Governor in budget talks. After the budget deadline came and went, and with the governor more entrenched than ever in his position, the legislative leaders began to hammer out a budget plan between themselves.
Each had specific needs, and there were some twists and turns along the way. But an agreement was forged that is almost unprecedented in modern New York State – an agreement to pass a legislative budget, far different form the Governor’s and agreement to override the expected vetoes.
Veto override shouldn’t be much of a challenge for the Assembly. Run by Democrats (with a super majority of 103 members), getting the 100 votes necessary should be easy. But it is a different world in the Senate, where the Republicans, who are the same party as the governor, have 37 members, with 42 needed for override.
In all the contention, with rumors and actions of threat and retaliation against individual members of the senate by the governor and his staff, one would expect an air of gloom and foreboding in that chamber. Yet, the appearance is almost the opposite of what one would expect. There is an air of confidence, of relevance – of empowerment.
Capitol Empowerment: In the mental health arena, we define empowerment as people having the ability to make choices. The emboldened feeling one senses watching the Senate these days is empowerment. Senators are poised to make a major choice, one that could change governance and politics as we know it in Albany.
For years, the legislature has reacted to the leadership of a very popular governor who is politically astute – a combination that results in power. But with his poll numbers down and taking a position that appears to leave him no political out, the balance of power seems to be shifting.
So, as one sits in the high backed pews outside the Senate chamber, reading through 650 page budget bills (it’s a living), the atmosphere is a little different. Somebody threw the old script away, and new stars are fashioning new roles each day.
Budget News: Although the process is a long way from finished, with an anticipated round of vetoes and potential overrides looming, the budget being passed as we write this Friday Fax from Albany contains some terrific wins for MHANYS.
The governor’s proposal for the adult home system was not fully funded, as the legislature chose to use 75% of the new money for that program to restore the Governor’s cuts in QUIP.
Other major areas being tackled include some reform of the Rockefeller Drug Laws, partial restoration of the Medicaid/Medicare crossover, and other education and health care restorations.
MHANYS would like to take this opportunity to thank and congratulate everyone that worked with us to make these victories possible. Each one represents the work of numerous dedicated people and organizations, and none of this would have been possible without your help.
Timothy’s Law Takes to the Airwaves: Tom and Donna O’Clair, along with Miss New York City Jessica Lynch, will be traveling central New York next week, talking to media in Binghamton, Syracuse and Rochester about Timothy’s Law. Watch for coverage in newspapers, radio and television Monday, Tuesday and Wednesday next week. Tom and Donna will be on the ABC affiliate in the Capital District next Thursday at noon.
Also, be sure to tune in to The “O’Reilly Factor” on the FOX News Network, Wednesday, March 7th, at 8:00 p.m. The O’Clairs will be talking with host Bill O’Reilly about Timothy and the need to pass Timothy’s Law.
Children’s Mental Health Week: Children's Mental Health Week is nearing. What are you doing to help raise awareness to the importance of this issue? See the Children's Mental Health Toolkit on line at www.mhanys.org. Make things happen in your home town.
May 4th - 10th is Children's Mental Health Week.
In The News:
Bill to aid mentally ill backed
"Timmy's Law" could get passed before a budget. With heavy sponsorship in both houses, the measure would require insurance coverage of treatments for mentally ill patients or chemically dependent people on par with coverage of treatments for other health care.
Key sponsors, Assemblyman Paul Tonko, D-Amsterdam, and Sen. Thomas Libous, R-Binghamton, have agreed to terms of a bill. Libous is simply waiting for a report by the Senate Finance Committee on fiscal impacts of the legislation, he said. He expects the report within two weeks.
The law is named after Timothy O'Clair, a 12-year-old from Rotterdam. He hanged himself in his closet in March 2001. His father, Tom O'Clair, said his son couldn't get more than 30 days of hospitalization or 20 office visits when he suffered long bouts of depression or violent behavior.
roil fight over drug access: Firms awarding funds to nonprofits opposing
proposed Medicaid rules. By Elizabeth Benjamin
A fight over the governor's plan to limit access to some prescription drugs for Medicaid recipients has intensified with the revelation of big drug companies' donations to some nonprofit groups who oppose the program.
Some are questioning the groups' motives in seeking to block a program that would likely cost their benefactors millions of dollars. Even if the opposition is not connected to the drug companies' money, critics said, the fact that organizations took the funds sets up a potential conflict of interest.
"Around the country, the drug companies have rampantly used their extraordinary financial resources to fund advocacy groups, some of which are phony organizations and some of which are legitimate," said state Assemblyman Richard Gottfried, D-Manhattan. "It's an abuse of those organizations, and it certainly undermines their credibility."
In his 2003-04 budget, Gov. George Pataki called for a preferred drug list that would limit Medicaid patients to cheaper equivalents of high-cost, brand-name drugs. Medications not on the list could be added if companies agree to provide the state an enhanced rebate. To prescribe off-list drugs, doctors would first need prior authorization from the state.
The goal is to save money on pharmaceuticals -- the fastest-growing category of Medicaid spending. The Pataki administration says a preferred drug list would save $5.7 million this fiscal year and $123.5 million in 2004-05 once it is fully implemented.
The organizations that have accepted money from big drug companies or the association that represents them, the Pharmaceutical Research & Manufacturers of America -- PhRMA -- say the cash isn't driving their opposition. They insist the program will block access to medication for poor people and put the state's finances before its residents' health.
"I have never been in a situation where anybody from a drug company has tried to influence our legislative activities ... We don't want a preferred drug list because it's not good medicine," said Joseph Glazer, president of the Mental Health Association in New York State.
MHANYS received approximately $50,000 from PhRMA last year and another $50,000 in 2001 for advocacy and projects, Glazer said. It has received nothing this year, he said.
Glazer said MHANYS accepted the contributions in part because it faces the same dilemma as all nonprofits: tough economic times.
"We get our support from wherever we can get it," Glazer said.
Dennis DeLeon, president of the Latino Commission on AIDS, estimated his organization receives approximately $100,000 a year from drug companies for AIDS education programs.
Lorraine Cortes-Vasquez, president of the Hispanic Federation, an umbrella organization of 76 Latino health and human service groups, said her group has "always had a relationship" with drug companies, although she didn't detail how much they contribute.
Nonprofits are not required to list donor names on the annual financial forms they submit to the state attorney general.
DeLeon and Cortes-Vasquez came to Albany April 8 as part of a coalition of Latino leaders who oppose creating a preferred drug list in New York. Both said the drug companies' money has not influenced them.
"I don't even know what their position is on this issue," Cortes-Vasquez said. "The Latino community's access to health services is already compromised, and anything that would further jeopardize or interfere with that is something we're against.'
The pharmaceutical industry's fight against preferred drug lists and other government programs they consider harmful has been well-documented. The industry responded by filing lawsuits, hiring lobbyists, and funding sympathetic nonprofit organizations through "unrestricted educational grants."
"We certainly have worked with like-minded organizations on these issues around the country," said PhRMA spokesman Jeff Trewhitt. "We give them grants; we don't dictate how they use the money."
Public Citizen, a Washington, D.C.-based public interest organization, has issued several reports on PhRMA's efforts, including its heavy subsidization of nonprofit advocacy organizations. Among those groups is the Seniors Coalition, the 60 Plus Association and the United Seniors Association, all based in Virginia, which have spent millions of dollars on public education efforts -- like mailings and television advertisements -- that happen to support PhRMA's view on many healthcare issues.
Critics call this "AstroTurf" lobbying -- a take-off on grassroots lobbying, which has its genesis in a community. Members of the Seniors Coalition came to Albany in January for a MHANYS event denouncing a preferred drug list.
Good-government advocates said PhRMA's recruiting of nonprofit groups is similar to a tactic employed by big tobacco companies, which give millions of dollars to nonprofits and elected officials.
"The captains of American industry don't give money away for kicks; they're trying to build support that they don't normally have," said Blair Horner, legislative director for the New York Public Interest Research Group.
should realize that taking corporate cash has consequences, Horner said.
Advocates on both sides of the preferred drug list debate expressed dismay that the issue of drug company contributions is muddying the question of whether the program will help or hurt Medicaid recipients.
Supporters say a preferred drug list would save the state millions of dollars at a time when it is facing an $11.5 billion deficit and escalating health care costs.
At least 24 states have instituted a preferred drug list for Medicaid or passed legislation to create one, according to the National Conference of State Legislatures. Another 10 have bills pending.
Pataki already is moving forward with his plan. In February, the state issued a request for proposals from companies to help identify low-cost drugs that have the same effect as more expensive medications and to run a prior-authorization call line. The proposals were due April 22; a contract will be awarded this summer, according to Robert Hinckley, Pataki's senior deputy secretary for health and human services.
Pataki's plan calls for some exemptions, including for drugs used to treat HIV/AIDS, mental illness and transplant patients.
Activists want more public input and consumer protections built into New York's preferred drug list, and would prefer the state Legislature to be involved rather than see the governor act alone.
Hinckley said the preferred drug list will be created via an "open and thought-out process to ensure that appropriate drugs are accessible to Medicaid recipients at an affordable cost to the taxpayers."
Gottfried, chairman of the Assembly Health Committee, is drafting a bill for a preferred drug system with more consumer protections and public involvement.
"One of the things I've been arguing to these advocate groups is that unless the Legislature enacts a more consumer-friendly bill, the governor's consumer-hostile plan is going to take effect," Gottfried said. "Based on many years of observing the Medicaid process, I believe the development of a preferred drug list based on good science and an open process could be of value."
closures blocked: State justice, lawmakers throw up obstacles to governor's
plan to shut down three psychiatric centers. By Elizabeth Benjamin
Gov. George Pataki's plan to close three psychiatric hospitals and merge two mental health research centers by July 1 unraveled Monday as the state Legislature prepared to block the measure and a state Supreme Court justice ruled the governor cannot legally implement it.
Part of the Senate and Assembly's two-way budget agreement includes keeping open hospitals in Elmira, Middletown and Syracuse, according to legislative aides and mental health advocates. The deal also prevents the consolidation of Rockland County's Nathan S. Kline Research Institute with Manhattan's New York State Psychiatric Research Institute.
Pataki called for the closures and merger in his 2003-04 budget and estimated the plan would save $84.5 million annually and eliminate 950 state jobs.
The Legislature has identified $28 million in savings -- largely because of the early retirement of state workers -- that will allow the facilities to remain open in 2003-04, according to an aide to Assembly Mental Health Committee Chairman Peter Rivera.
Legislative leaders determined the hospitals and research centers would bring in more money by continuing to collect fees and win grants than Pataki's plan would generate in savings, said the aide, Guillermo Martinez.
Mental health advocates supported the governor's plan but wanted the savings from the closures and consolidation to be reinvested in community treatment programs. Under Pataki's plan, the savings wouldn't be reinvested until 2004-05.
Advocates were upset Monday that the two-way budget agreement did not include the Community Mental Health Reinvestment Act, which expired in 2001.
"We would be disappointed if they can find the money to keep outmoded state hospitals whole but not to restore the promise of community reinvestment," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.
Martinez said the Senate and Assembly will address reinvestment outside the budget process, which advocates fear will leave it vulnerable to a veto by Pataki.
As budget talks continued, state Supreme Court Justice Joseph Teresi ruled Monday that Pataki is violating state Mental Hygiene Law by moving forward with the closures and merger without giving a 12-month notice or obtaining legislative approval.
In a bill that accompanied his budget proposal, Pataki included language that would waive that requirement. Last month, two state employee unions - the Public Employees Federation and the Civil Service Employees Association - sued Pataki to stop him from implementing his plan.
The ruling "gives breathing room so that decisions affecting the well-being of thousands of New Yorkers with mental illness can be made in a thoughtful way," PEF spokeswoman Denyce Duncan Lacy said.
Pataki spokeswoman Suzanne Morris responded: "While we have not seen Judge Teresi's decisions, we're confident that the comprehensive plan we advanced will ensure the best possible care in more modern, updated facilities that are located nearby - while also ... targeting future savings toward community reinvestment."
next time, we remain,