Mental Health Association of Greater St. Louis	1905 S. Grand Blvd. St. Louis, MO 63104 314-773-1399 Info@mhagstl.org

March 10, 2005

MHA  has available BUMPER STICKERS which say "Just Say NØ to Mental Health and Medicaid Budget Cuts…Save our Safety Net!" -- just for the asking.

To get one or two, email  me back with your snail mail address and we will send them out pronto (Missouri residents only).   We recommend putting the sticker on the rear window.  Shows off better and comes off easily.  Please do not request some unless you plan to put them on your car(s).

UPDATE:  Last week, Senator Chuck Purgason filed SB 539, which proposes deep cuts to Medicaid that reflect Governor Blunt's intent, as included in his January State of the State remarks.  Among other things, the cuts would negatively impact eligibility, optional services, and require co-payments for covered services as follows:

1)Eligibility for elderly and disabled would be reduced to the SSI standard, or about 74% of the federal poverty level.  Individuals with incomes above $579/month and couples with incomes above $869/month would lose Medicaid.

2)  Coverage would be eliminated for services including dental, podiatry, optometric, comprehensive day rehabilitation, hospice care, orthopedic devices and prosthetics, eye glasses, dentures, hearing aids, wheelchairs.

3)  Co-payments for all covered services would be required to the extent allowed by federal law.  (There's a clause in this bill that states, if approval is obtained from the Centers for Medicare & Medicaid, a provider could terminate future services, under certain circumstances, to a recipient who had unpaid co-payments.)

4)  Statute language that authorizes Medical Assistance for Workers with Disabilities (MAWD) and General Relief would be eliminated.

5)  Entitlement status would be removed for the Consumer-Directed Personal Assistance Services Program, replacing it with "subject to appropriations" language.

6)  Numerous other current coverage negatively impacted.  For full text of the bill, please click on the link below.

http://www.senate.mo.gov/05info/pdf-bill/intro/SB539.pdf

If you would like to receive a copy of a Preliminary Summary and Analysis of the Medicaid Provisions in Senate Bill 539, by Joel Ferber, Managing Attorney, Legal Services of Eastern Missouri , email me back and I can send it as an email attachment.

If you would also like to receive a copy of The County Level Economic Impact of Proposed Cuts in Medicaid Spending in Missouri, written Joel Ferber, J.D., Heather Bednarek, Ph.D., and Muhammad Islam, Ph.D. of St. Louis University, email  me back and I can send it as an attachment.



NOTICE: RESTORATION OF FUNDS

ON MARCH 9, 2005 THE HOUSE COMMITTEE OF APPROPRIATIONS FOR HEALTH, MENTAL HEALTH AND SOCIAL SERVICES VOTED TO RESTORE DMH FUNDING FOR ADA, CPS AND MRDD COMMUNITY SERVICES, AS WELL AS TO ELIMINATE CO-PAYS FOR THESE SERVICES. THEY ALSO VOTED TO RESTORE FUNDS FOR HOSPICE CARE, AMBULANCE SERVICE, OXYGEN, WHEELCHAIRS, DIABETIC SUPPLIES AND EQUIPMENT, AND PROSTHETICS.  See the St. Louis Post-Dispatch  front page article below.  Will send more detail when we have it.

House counters Blunt's cuts
BY VIRGINIA YOUNG
Post-Dispatch Jefferson City Bureau
03/09/2005

JEFFERSON CITY - House Republicans have drafted a plan that would preserve health care and social services for thousands of elderly, disabled and mentally ill people targeted for cuts in Gov. Matt Blunt's budget.

In the biggest change, the proposal would provide $57 million for psychiatric services and drug abuse treatment for people who don't qualify for Medicaid.

Also salvaged: nearly $15 million for in-home services to help elderly people remain independent and avoid moving to nursing homes.

Medicaid, the health care program for the poor, would keep covering the cost of wheelchairs, prosthetics, home oxygen equipment, hospice care, emergency ambulances and diabetic supplies - services Blunt proposed eliminating.

While people would face tighter financial criteria to qualify for Medicaid, the new rules for the elderly and disabled would be less strict than Blunt proposed. Precise figures on the number of people losing coverage were not available.

In all, the House proposal would restore about $97 million in state money and $142 million in federal money that Blunt wanted slashed in the health, mental health and social services budgets.

The committee considering those agencies' budgets received the plan early Wednesday and began considering it Wednesday night. The chief author, Rep. Jodi Stefanick, R-St. Louis County, declined to comment before the meeting.

Democrats called the plan a good first step but said they would seek to add more. For example, Medicaid services that remain on the chopping block include dental care, hearing aids and eyeglasses.

Some critics objected to the plan's financing, which would require premiums from more middle-income families enrolled in the subsidized Children's Health Insurance Program.

Blunt has said that program is a good investment and should remain intact.

Officials with area alcohol and drug treatment centers greeted the legislative developments with cautious optimism Wednesday.

Stephen Huss, president of the Comtrea mental health agency in Jefferson County, said he will remain "very, very nervous" until final action is taken on the budget. Huss said Blunt's proposed cuts would have meant the closing of Comtrea's Athena Center near De Soto, a residential center for alcoholics and drug addicts.

"It seems that people are realizing, 'Gosh, you just can't wipe out an entire safety net.'" he said.

Gary Busiek with the Salvation Army said the proposed cuts would have forced the agency to shut down its alcohol and drug program at Harbor Light Center.

"We were starting to look at doomsday planning, trying to deal with large numbers of people who wouldn't be able to get treatment," Busiek said. Reinstatement of the cuts, he says, "makes sense on so many levels."

Critics of the cuts have lobbied hard for the money to be reinstated, saying loss of the programs would result in more spending for jails, prisons and hospital treatment.

Connie Neumann, executive director of Catholic Charities' Queen of Peace Center, which operates drug and alcohol programs for low-income women, said, "I feel like Santa Claus just came" after hearing the news.

"It means that lives will be saved," she said.

And Janet Woodburn, director of Bridgeway Counseling Services, which treats people with drug and alcohol addiction, said she was thrilled by the news.

Still, she said, "it's a long process and it's still long from over."

After the House committee approves the plan, it must still win full House approval. Then it will move to the Senate.

Blunt has said the state's $19.2 billion operating budget cannot be balanced without severe Medicaid cuts.

For example, Missouri currently covers the elderly and disabled if they earn no more than the federal poverty level. Blunt would lower that threshold to 75 percent of poverty, or $579 a month for a single person. The House plan would soften the blow, setting the limit at 85 percent.

Blunt also would require people on Medicaid to make co-payments for many services. The House plan would scrap many of the co-payments, such as those proposed for in-home services.

Some Medicaid providers were celebrating the tentative changes Wednesday.

"We really are thrilled," said Cindy Baird, executive director of the Missouri Hospice and Palliative Care Association. "We feel that hospice is the right thing for end-of-life care."

But the money has to come from somewhere. For example, Republicans would save $23 million by requiring premiums from families in the children's subsidized health plan and $29 million by annually re-evaluating the eligibility of everyone on Medicaid.

Ruth Ehresman, the policy director of Citizens for Missouri's Children, said requiring more parents to pay premiums would force many families to drop their coverage. Children in the program often have severe or chronic health problems, and their parents cannot afford private insurance.

"We're very disappointed," Ehresman said. "Gov. Blunt has made a clear commitment to protect children and children's health care, and this is backing off that promise."

Proposed restorations

A plan by House Republicans would restore some cuts suggested by Republican Gov. Matt Blunt.

Among the items restored would be:

$57 million for psychiatric and drug treatment for non-Medicaid patients.

$14 million for in-home services to keep senior citizens out of nursing homes.

Home oxygen equipment, hospice care, emergency ambulances and diabetic supplies for Medicaid recipients.

Bill Smith of the Post-Dispatch contributed to this report.
Reporter Virginia Young
E-mail: vyoung@post-dispatch.com
Phone: 573-635-6178

Marge Parrish
Associate Program Director
Mental Health Association of Greater St. Louis
1905 South Grand Blvd.
St. Louis, MO 63104
314-773-1399  voice
314-773-5930  fax
www.mhagstl.org

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