Oct 2 – 8th, Silent Awareness Week

Some facts on Mental Health Awareness Week (from National Council on Community Behavioral Health Care)

Most people don’t know mental illness contributes significantly to a public health crisis

• 50% of US adults will develop mental illness in a lifetime

• 1 in 4 people experience a mental disorder in a given year

• 1 in 17 people live with a serious mental health illness

Most people don’t recognize mental illness as a physical health crisis

• Chronic disease is associated with mental illness

• 40%  of the people with mental illness do not seek treatment

• Those inflicted are stigmatized negatively by society

• Recovery rates of 65-80% depending on the diagnosis and treatment

Most people don’t realize the costs related to mental illness without treatment

• $1 dollar spent on treatment saves $7 in crime and criminal justice costs

• 24 states decreased provider reimbursement rates for Medicaid decreasing accessibility to providers

• Consequences of medication disruptions

• Silence is killing and costing unnecessarily

Most people won’t act upon these facts, but CFC is counting on you!

• Speak to your friends, co-workers and family to openly discuss mental illness

• Write a letter by Oct 24^th describing any difficulties that you or your loved ones may have experienced (denials, given generic rather than prescribed, unable to obtain prescription that works).  Send to P&T Committee, address below and let CFC know you’ve done so.

• Call your legislators and the administration to increase reimbursement rates for Medicaid providers

• Post on your FB status: Almost 40% of people with mental illness & substance use disorders never get treated.

Letters to be sent to P&T Committee, HP Enterprise Services, PKL Coordinator, 195 Scott Swamp Road, Farmington, CT 06032-3124

Observation vs. Admission Status for Seniors upon Hospitalization: Know before you go

Problem
Federal regulations have changed the hospital admission procedure for Medicare recipients. Hospitals are required to admit Medicare patients under the “observation” status while patients receive full medical treatment in a hospital bed. This status can be longer than 48 hours and generally without the patient’s knowledge.

What this means to you
• Medicare recipients are billed for 20% co-payments and full prescription costs when admitted to a hospital under “observation.” More money out of your pocket to pay for hospital care that should be covered by Medicare Part A.
• Medicare will not cover a skilled nursing facility (SNF) if there is less than three consecutive days of inpatient care (not counting the date of discharge). You will be responsible for the cost of a SNF, with an average cost of $350/day.
• Medicare has increasingly denied admission for inpatient status.
• You lose your right to appeal Medicare denials.

Solution – Passage of proposed US Legislation: S. 818 and H.R. 1543, the “Improving Access to Medicare Coverage Act of 2011.”
• Amends the Medicare statute’s definition of “post-hospital extended care services” to include observation status as inpatient in the hospital, thereby covered under Part A.
• Alleviate the problem of shifting costs to the beneficiary and hospital.
• Prevents poor care and frequent readmissions.
• Retroactive beginning January 1, 2011 but beneficiaries must appeal within 90 of enactment.

Action
Contact and demand that the CT delegation co-sign the bills and request them to persuade other state delegations to do the same. (Contact information on back).

Congressman Joseph Courtney (Sponsor of HR.1543)
Washington             Norwich                    Enfield
202-225-2076         860-886-0139         860-741-6011
Web courtney.house.gov/

Congresswoman Rosa L. DeLauro
Washington           New Haven           Middletown          Naugatuck              Derby
202-225-3661       203-562-3718       860-344-1159       203-729-0204       203-735-5005
Web delauro.house.gov/

Congressman Christopher Murphy
Washington           New Britain           Meriden                 Danbury                     Waterbury
202-225-4476       860-223-8412       203-630-0815       203-798-2072          203-759-7541
Web chrismurphy.house.gov/

Congressman James Himes
Washington                   Bridgeport/Stamford
202-225-5541               866-453-0028
Web himes.house.gov/

Congressman John Larson
Washington                  Hartford
202-225-2265              860-278-8888
Web larson.house.gov/

Senator Joseph Lieberman                                                     Senator Richard Blumenthal
Washington              Hartford                                                 Washington                     Hartford
202-224-4041          860-549-8463                                       202-224-2823                860-258-6940
Web lieberman.senate.gov/index.cfm/contact/email     Web blumenthal.senate.gov/contact/

Caring Families Coalition is a nonpartisan advocacy coalition that unites groups, families, and individuals, and encourages collective action to improve or protect health care. We provide members with information, trainings and opportunities to advocate for positive change. CFC does not sell health care products or accept money from health care companies.

For more information, please contact:
Eva Csejtey, CFC Organizer Sarahí Almonte, CFC Organizer
860.230.5008 or eva.csejtey@ucanct.org 860.524.0502 or sarahi.almonte@ucanct.org

This information was provided by a panel on Observe Vs. Admit – The New Limbo Land for Hospital Patients with Medicare, sponsored by Senior Resources – Agency on Aging.

Agreement Made to Improve the Rate Review Process for Health Insurance

It was looking very dismal for CT’s health care reform this legislative session when Governor Dannel Malloy allowed the partnership bill, HB:6308 to pass without his signature and vetoed SB:11, addressing the rate review process for certain insurance premiums. This was suppose to be the year of health care reform with the majority of Democrats in the Senate, House and the Administration that ran campaigns supporting health care reforms.  Health care policy was looking to move forward in cost maintenance and coverage expansion for the people of Connecticut.  The way it turned out, CT residents might have been better armed with a Republican Governor as they would know what to expect from health insurance lobbyists.

The partnership bill has been debated for years as the right thing to do for Connecticut, as it pools municipalities and other groups to gain lower costs, not only for individuals but for the state as well.  Since the partnership bill saved cents and made sense, it was enacted and it prepares the state to plan for the federally mandated insurance exchange by 2014.

The insurance rate review process has been under the microscope as the high rates of insurance premiums escalated 20-47% even in the current economic downturn. At the same time, profit margins and CEO bonus pay continued to rise in the insurance industry. However, bills introduced in CT Legislature to improve the transparency of the rate review process failed.  This year the bill passed unanimously in the Senate and a wide margin in the House only to become vetoed by Governor Malloy (see previous posting for his response) and not overridden by Legislators.

With the assistance of CT citizens who spoke out and called their legislators, a compromise to change the current regulation of the insurance rate review process was reached between the Administration, Commissioner of Insurance, and Health Care Advocate. Thomas Leonardi, as the new chosen Commissioner, reluctantly agreed as he promotes his office will uphold their responsibility to protect citizens from price gouging by health insurance companies.  It is up to CFC members to follow the course in the next six months and prepare to bring another bill up in February 2012, the next legislative session, if he does not hold to his promise.

The struggle is not over with the door slightly ajar to expand health care coverage to all residents of CT in 2014.  Governor Malloy’s decision to invite a health insurance company to return their headquarters to CT demonstrates that he is pursuing private enterprise over health care costs and accessibility.  It is up to CT residents to keep him informed of their health care needs and find solutions to current systems in accessing affordable and quality health care.  Governor Malloy needs to be reminded that a healthy resident is an asset to CT’s workforce.

 

SB:11 vetoed by Governor Dannel Malloy – Take Action!

Governor Malloy vetoed the bill that protects individual, family, small group and long term insurance policy.

The Problem: Health care insurance premiums have risen 135% in Connecticut in the last 10 years. This rate of increase is among the highest in the nation.

The Solution: SB11 was passed by the State Legislature so that consumers could take a serious look at any proposed increase in premiums that was more than 10%. The bill allowed the State Attorney General and the Health Advocate to intervene to protect the interests of consumers in these rate cases.

Governor Malloy has already chosen which side he is on – the insurance companies! His arguments:

• SB11 “would add approximately $181,800 to the current budget, which is already under great stress.” The truth is all costs would be paid by the state’s insurance fund which is paid for by the industry and not taxpayers.
• SB11 “will increase the cost of health insurance for Connecticut’s residents, not decrease it as SB11 intends.” The truth is that the Insurance Department denied a 20% increase for existing individual policy holders when forced by public demand to hold a public hearing only months after the same Insurance Department approved a 47% increase for new policy holders without a public hearing.

Caring Families Coalition wants to know:

     WILL YOU CALL YOUR LEGISLATORS TO OVERRIDE THE VETO?

ACTION REQUIRED BEFORE JULY 25th

Tell your representatives to vote for affordable health care for all CT resident -  Support SB: 11 veto override!

                      Senate Democrats  800-842-1420

                        Senate Republicans  800-842-1421

                      House Democrats  860-842-8267

                         House Republicans   860-842-1423

Let Caring Families organizers, Eva and Sarahi know if you will support a veto session by attending.  CFC will keep you posted on when it will be.

Please report back on the response you received by calling Eva Csejtey or Sarahi Almonte at Caring Families Coalition.

CT Moves Forward on Health Care Reform

Caring Families Coalition would like to thank all the individuals and groups who acted on improving CT’s health care delivery system.  Your voices were heard and systemic changes have been passed.  Below is a synopsis of the legislation that passed. 

 SustiNet was consolidated with the partnership bill, HB: 6308 and maintains the changes in our health care delivery system with its focus on prevention, offering affordable health care and the pooling of groups and individuals.

SustiNet features:

• A SustiNet Health Care Cabinet in the Lt. Governor’s office will integrate health care reform, promote initiatives to improve health and spend the state’s health care budget in a cost efficient way.
• A new Office of Health Reform and Innovation will support the Lt. Governor’s office and Cabinet and function as the state’s central coordinator of health policy.
• The bill directs the SustiNet Health Care Cabinet to produce a business plan for a nonprofit insurance option.
• The SustiNet Health Care Cabinet will assess the feasibility of the state offering the Basic Health Program (designed to serve people with incomes between 133% and 200% of federal poverty level) beginning in 2014.
• SustiNet opens the state employee plan to municipalities in 2012 and state related nonprofit organizations in 2013.

How does SB:11: An Act Concerning the Rate Approval Process affect me?

 CT’s Dept. of Insurance has been approving insurance rate increases submitted by insurance companies for individual policies, thereby incurring 20-47% rate hikes for some premium holders.  This bill will add transparency to the rate review process as well as expand it to include small groups and long term care policies to keep premiums affordable.

• For rate requests over 10%, a symposium can be requested to review in detail and publicly the reason for the increase.The Dept. of Isurance Commissioner, Attorney General or Health Care Advocate can request a symposium with a limit of 10 per year.
• The public will be notified of the symposium date, time and place and it will be conspicuously publicized on the Dept. of Insurance website.

• The Attorney General and/or the Health Care Advocate may present evidence and information, question the insurance representatives and present a closing argument at any rate filing symposium.

Although progress has been made this year, the economic climate will keep health care services in the forefront with federal and state deficit budgets.  Your assistance to remain proactive to keep these needed reforms to expand and improve our health care delivery system is vital.

What do I need to do with this information?

• SB:11 needs your assistance in making sure Governor Malloy will sign the bill.  Please call his office to encourage this process.  Telephone: Local: 860-566-4840, Toll-Free 1-800-406-1527 or email  http://www.governor.ct.gov/malloy/cwp/view.asp?a=3998&q=479082
• HB:6308 has a timeline that needs to be monitored
  • 2011 Appointees for the SustiNet Health Care Cabinet which begins working in September and for the Consumer Advisory Board.
  • 2012 Towns may join state employee plan and Nonprofit business plan to be completed.
  • 2013 Qualified nonprofits may join state employee plan
  • 2014 The integrated health care system should include the state employees, Medicaid and Husky, Health Insurance Exchange, Basic Health Program and Nonprofit Option by 2014.
•  The nonprofit option cannot begin until 2014 due to lack of state funding.  In 2014, the federal government will be assisting states with funding.  In the meantime, individuals or small groups with pre-existing conditions will be subjected to high rates.  Most likely, as with the federal health care law in state courts, repealing HB:6308 will be the focus of the opposition.  Your personal testimony of the hardships you are experiencing as a result of your lack of health coverage is needed to reinforce the need.
•  The Medicare and Medicaid programs are in danger of being privatized due to federal budget deficits.  Opposition forces attempt to trim and delete these programs rather than seek decreasing in other areas such as military spending.  Your personal testimony on how you and/or your family would be affected if these programs were to be eliminated or transferred to proft companies is necessary to fight these ongoing battles.
• Are you concerned where you will spend your savings; in your own home or in a retirement facility? Do you know if it is worth paying for a long-term insurance plan?  It is time to be proactive and innovative in determining and demanding your future health care needs.

Caring Families Coalition is a nonpartisan advocacy coalition that unites groups, families, and individuals, and encourages collective action to improve or protect health care. We provide members with information, trainings and opportunities to advocate for positive change. CFC does not sell health care products or accept money from health care companies.

Health Care Reform Bill passes House

The Health Care Reform Bill, HB:6308 cleared the House on Friday evening by an 88-48 vote. Thank you to all who contributed by taking actions to make this happen.

Now it will come up for a vote in the Senate.  CFC is asking members to join in a show of support at the Capitol wearing red shirts and calling your Senator to encourage the passage of this major health care reform bill.  The best time to be at the Capitol is Wednesday, Thursday and Friday, 4-6 pm.  Let me know what you can do.

Democratic Caucus  800-842-1420 begin_of_the_skype_highlighting            800-842-1420      end_of_the_skype_highlighting

Republican Caucus 800-842-1421 begin_of_the_skype_highlighting            800-842-1421      end_of_the_skype_highlighting

Join CFC at the Capitol this week for SustiNet, new bill number, HB:6308

Major health care reform will be voted on in the State House Legislator possibly tomorrow. It will then be voted on the following week in the Senate. This legislation is a compilation of bills (including SustiNet) that have been introduced to improve our current health care delivery system to provide quality, affordable and accessible health care.
Please show support with Caring Families Coalition members and other organizations that have been working hard to pass this important legislation at the Capitol on Wednesday, Thursday, and Friday afternoons and evenings. Wear your red shirt!

Health Care Legislation Needs Your Support

Governor Malloy and your Senator needs to hear from you NOW!

Tell them why health care reform is important to you and ask them to deliver choices to CT residents; public and private options along with a change in the delivery of health care.

For the Governor call:  1-800-406-1527 begin_of_the_skype_highlighting            1-800-406-1527      end_of_the_skype_highlighting

For the Democratic Senators call:  1-800-842-1240 begin_of_the_skype_highlighting            1-800-842-1240      end_of_the_skype_highlighting

For the Republican Senators call: 1-800-842-1421 begin_of_the_skype_highlighting            1-800-842-1421      end_of_the_skype_highlighting

Thank you for taking action today.

Free Workshop to Improve Advocacy Strategies for Developmental Services

The A.J. Pappanikou Center on Disabilities and The Kennedy Center
are sponsoring a free workshop on Improving Hospital and Nursing Home Care for Persons with Developmental Disabilities

This workshop will focus on challenges experienced by people with developmental disabilities in hospitals and nursing home settings. Discussion will explore advocacy strategies to improve services and outcomes, and alternatives to nursing home placements.
Presented by: Gerard Kerins, MD, FACP – Hospital of St. Raphael
Anne Broadhurst and Chris Gaynor – Office of Protection and Advocacy

Date:          Tuesday, May 24, 2011
Time:          1:30 pm to 4:30 pm (Registration – 1:00)
Location:  Fairfield University – Barone Campus Center – Oak Room
                     1073 N. Benson Rd., Fairfield, CT
Please register at http://www.surveymonkey.com/s/B5QZS52 by May 16, 2011

Planning CT’s Health Insurance Exchange

The State of CT is holding public forums on the Health Insurance Exchange which is under policy development and inviting consumers of health care to design and learn the purpose and functions of the Exchange.   The Exchange is a result of the Patient Protection and Affordable Health Care Act which professes to provide a marketplace for consumers to shop for and enroll in health insurance.   Important concerns for health care consumers that need to be questioned at these meetings include:

• Privacy policy.  (1) a commitment to obtaining explicit consent from patients, (2) a mandate for robust privacy and security  mechanisms and (3) recourse for individuals victimized by a data breach.  Recommend an opt-in policy.
• Representation.  Both consumers and small business should be represented on the board.  An Advisory Committee  might be a good recommendation to insure that the consumer voice is heard.
• Conflict of Interest.  Groups or individuals who are going to profit from the exchange should be excluded from serving on the board — especially insurers or brokers.  The board should be serving the consumers on the exchange, not special interests.
• Non-Profit Choice.  There aren’t enough choices of insurance in Connecticut for small employers and individuals.  A  non-profit public option, such as SustiNet should be offered as one of the choices.

Please join one of the meetings below:

Hartford, CT                                                       Windham, CT

May 9, 2011                                                        May 17, 2011

6:00-7:30 pm                                                      6:30-8:00 pm

Public Library, Downtown                            Windham Middle School

500 Main Street                                                 123 Quarry Street