By Holly West
Don’t mess with our meds!” “Save our group homes!” “Don’t cut the budget!”
Those are just a few of the shouts leveled outside the N.C. Legislative Building in Raleigh Tuesday as people with mental illness and their advocates gathered to be heard.
The rally was organized by the Wake County chapter of the National Alliance on Mental Illness. Speaker after speaker expressed concern over how the state budget will address two issues concerning mental health: prior authorization for psychiatric medications and funding for group homes for people with mental illness.
Prior Authorization
The Senate’s budget plan would require Medicaid recipients to get prior authorization – approval by a Medicaid reviewer – for all mental health drugs. The House of Representatives’ plan only requires prior authorization after four brand-name prescription drugs have been dispensed.
Speakers at the rally opposed prior authorization, saying it slows down the process of getting medications to people with mental illnesses and in some cases makes it impossible for them to get prescriptions at all. Many newer anti-psychotic drugs can be quite expensive, costing in the hundreds of dollars per month.
Elizabeth Wurtzel, a NAMI volunteer who has bipolar disorder, said prior authorization could limit people’s ability to get the best treatment available.
“Just like diabetes or blood pressure, if a new medication that worked better came on the market, somebody would be outraged if they weren’t allowed access to that medication,” she said.
Marianne Kernan, chair of Linden Lodge Foundation, which operates a group home, said she worries this legislation would make it hard for people like her son to find the right medications.
“My son, for 20 years, has been looking for medication,” said Kernan, who complained that often people at Linden Lodge residence can’t get the medications they need until after they’ve had a problem.
We’ve been on every single psychotropic there is, every one. As a matter of fact, half of the people in Linden Lodge have,” she said.
Kernan called it “cruel and inhumane treatment” to force people to display psychotic symptoms before allowing them medications instead of preventing them in the first place.
Durham psychiatrist Bryce Reynolds said one study showed that 29 percent of participants who were required to obtain prior authorization for their medications discontinued treatment, and, of those, 80 percent relapsed.
“I can’t imagine telling a patient, ‘You and I know what you need, but I can’t give it to you,’” he said.
Reynolds said the study also showed that hospitalization rates and emergency department visits increased when patients were required to get prior authorization for medications.
It’s for this reason that the speakers said the state would be better off keeping things the way they are.
The state’s going to end up paying more money if that happens to people than if they give them the drugs that they need,” Wurtzel said.
Marianne Kernan said it was important to inform General Assembly members of the consequences of this proposed legislation. She said if legislators knew about how many problems prior authorization could cause, they wouldn’t consider legislating it.
“If it was their family member, they just wouldn’t do it,” Kernan said.
After the rally, advocates and group home residents visited legislators’ offices to plead their case.
Stacey Hirshman and Lisa Jennings, two Raleigh moms whose teens have mental illnesses, spoke with Rep. Craig Horn (R-Weddington) about the problems with prior authorization and the need for group home funding.
Horn said he welcomes speaking with mental health advocates so he can cast informed votes, but was non-committal.
Group homes
Both chambers’ budgets set up a pilot program that would implement a system of paying for residents of group homes depending on how much help they need. The program would be tried out in four to six counties over the coming year.
The House plan would also give $8 million to group homes for personal care services, a cut from last year.
Under the Senate plan, counties not included in the pilot program would receive no group home funding for the upcoming year. Advocates said this could force many group homes to close.
Elizabeth Wurtzel said it’s nothing she hasn’t seen before.
“They shut down certain programs and you have to find a new program,” she said. “I suffer from bipolar illness and both my parents do as well, and we’ve struggled.”
Group home advocates say the programs help keep people from ending up living on the streets.
“They may keep people out of prison because it gives them a place of security, so it gives them a place to stay,” said James Bouwknegt of Raleigh, who attended the rally.
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