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

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.

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.

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.

 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.