Transinstitutionalizing the mentally ill: still filling the prisons.

Nationally, 4 times as many mentally ill people are now in prisons than in hospitals.
Arizona ranks as one of the worst offenders...

(image from Correctionsone.com)

I've seen this journalist doing research in the field - excellent reporting. Between her and Bob Ortega, the prisons have been getting a close look at by the AZ Republic these days. What's about to happen here is catastrophic. The Arizona Department of Corrections is the last place we should be sending people with mental illness - and it's the next place many will be heading. Someone has to fill all those new private prison beds, after all...the good prisoners will go to them, and the mentally ill will be kept in the fire traps they call state prisons.

Paul Rubin's Phoenix New Times article about the murder of Shannon Palmer comes to mind when I think of people who never should have been in prison to begin with - and wouldn't have, if our mental health system wasn't already so damaged and our communities so gutted of basic resources. Phoenix is so certain that more police are the answer that they're taking it out of the food tax - thank God we have the resources to arrest the poor when they steal to feed their families now.

Anyway, if we don't spend our tax dollars in the community folks - BEFORE people feel the need to call the police - we'll be spending it keeping a lot of these folks in horrendous conditions behind bars. We already are, sadly - for every one mentally ill person we hospitalize in Arizona, we put over nine more in jail or prison. Only Nevada is more brutal to their mentally disabled.

Needless to say, our disability rights advocates in this state have a lot of catching up to do if they're going to protect these folks all the way to prison and back. Most seem to stop at the courtroom door, I'm afraid...

---------from the Arizona Republic-------

Mental-health cuts: Experts fear long-term costs

Mary K. Reinhart - Sept. 22, 2011 12:00 AM
The Arizona Republic

Arizona taxpayers are providing fewer services to fewer people with serious mental illnesses than they were last year, for annual savings of roughly $50 million.

But the short-term savings from state budget cuts threaten to have long-term consequences for patients, providers and the community, mental-health experts say.

The budget reductions eliminated services for about 12,000 Arizonans who don't qualify for Medicaid, removing the foundation of a system intended to keep the seriously mentally ill, healthy and out of emergency rooms, hospitals, jails and prisons.

State lawmakers instead provided money for generic medication and additional funding to beef up a statewide crisis-response system to help prevent people from falling through the cracks. But in the 15 months since this population lost case management, brand-name prescription drugs, therapy, transportation and other benefits, more than 2,000 people have stopped receiving any state-funded services and are unaccounted for.

Local and county jails, emergency responders and hospitals often shoulder the costs when people with untreated serious mental illness, such as schizophrenia and bipolar disorder, fall into crisis.

The precise financial costs to those entities are unknown, but health professionals do know that it's far more expensive to treat people who have spiraled into crisis than to keep them stable. And once in crisis, health professionals say, it's more difficult for people to rebound, which means those higher costs continue to recur.

"It's a penny-wise and pound-foolish approach," said Bill Kennard, former executive director of the National Alliance on Mental Illness' office in Phoenix. "More people in jail and prison with mental illness, more time that law enforcement spends dealing with a health issue as opposed to a public-safety issue."

The costs

The state has not conducted an analysis that compares ongoing treatment with crisis costs.

But a March 2011 study that examined proposed mental-health cuts in Texas put the average daily cost of services at $12 for adults, compared with $401 a day in the state's mental hospital, $137 a day for a jail inmate with mental illness and $986 for an emergency-room visit.

The study, by Health Management Associates for the Texas Conference of Urban Counties, also showed that gaps in services put those discharged from psychiatric hospitals and jail at greater risk of relapse, readmission and recidivism.

Janey Durham, who is in charge of a workshop program at Mesa's Marc Center, said she lost 120 people to the budget cuts, including a man diagnosed with schizophrenia who deteriorated almost before her eyes. The non-profit agency center provides job training and other services to the mentally ill and developmentally disabled.

Durham said the man, a former alcoholic in his 50s, worked hard at his job in the manufacturing warehouse, at maintaining his sobriety and in treating his mental illness. But soon after the budget cuts forced him to switch to a generic medication, Durham said, he stopped taking his medication, started drinking again and grew increasingly paranoid, plagued by voices in his head.

Over the past year his erratic, disruptive behavior led Marc Center employees to call Mesa police at least once. He is believed to be homeless, she said, but contact with him has been sporadic since last winter.

Clarke Romans, who runs the NAMI office in Tucson, said a once-eager volunteer has been reluctant to leave her house since last summer, when her anti-psychotic Seroquel was replaced with a generic drug. Many of the most commonly prescribed brand-name psychoactive medications have no generic equivalent. Generics in some cases are less effective or have side effects that deter people from taking them, health officials say.

"She's been suicidal. She has not been able to come in and volunteer. She kind of hides in her house," Romans said. "These are people who are suffering in silence."

Before the budget cuts last July, individuals with serious mental illness were entitled to a full array of community-based services, from supportive housing to intensive case management and in-patient hospitalization, regardless of their income.

Mental-health advocates argue that city and county law enforcement, hospitals, jails and homeless shelters have picked up some of the costs of caring for the seriously mentally ill who lost benefits. Over the past year, many of these venues have seen an increasing number of people with severe mental illness.

State lawmakers made the cuts to help close a $1 billion deficit in fiscal 2011. House Appropriations Committee Chairman John Kavanagh, R-Fountain Hills, said the state's financial crisis forced lawmakers to cut $3 billion over four budget cycles, and all of the cuts carried some consequences.

"The question is, are the consequences so dire that it shouldn't be done? We don't believe so," Kavanagh said. "The changes really were not dramatic. . . . We're still providing these people with treatment."

Treatment, recovery

Publicly funded mental-health treatment can be highly effective, and the vast majority of people can improve their quality of life and relieve symptoms, such as hallucinations or depression, with consistent therapy, medication and other support.

But experts say treatment and services must be comprehensive and consistent.

"I don't think these kinds of services are luxuries for people with mental illness. They are part and parcel of their treatment for an underlying disorder," said Dr. Paul S. Appelbaum, a Columbia University psychiatry professor and past president of the American Psychiatric Association. "Unless you provide a package of services, just throwing pills at them isn't going to do it."

Those who work closely with the mentally ill say that is the situation for thousands of Arizonans who are ineligible for Medicaid. And they worry that people who stopped showing up at their assigned clinics may have become incarcerated, homeless, hospitalized or homebound.

Dennis Culhane, a University of Pennsylvania professor and nationally known expert on homelessness, said studies show people with serious mental illness who are not receiving regular, supportive services are more likely to become homeless.

Culhane's own research has shown that it costs less to provide apartments and other permanent housing for people who are homeless than to provide emergency shelter and services. People with serious mental illness who become homeless, he said, "have significant secondary costs," including emergency, hospital and incarceration costs.

Once they have fallen into crisis, the road back to recovery can be much harder.

"Untreated psychiatric illness is just more difficult to treat," said Dr. Jason Caplan, chief of psychiatry at St. Joseph's Hospital and Medical Center. "You have an increased risk of relapse. It's just harder to get you back."

Repeat visitors

Case management was a key benefit lost to the non-Medicaid mentally ill. Among other things, caseworkers helped people who were jailed or hospitalized to transition back into society and tried to prevent their relapse.

People often lose their housing while they're locked up and, if they're on probation or court-ordered treatment, they have a list of rules to follow upon release.

Now, there is no one to meet people as they are released from jail or a psychiatric hospital.

In Maricopa County, 54 people with serious mental illness were released to the street or to a homeless shelter in the past year after being stabilized at one of the Valley's two urgent psychiatric care facilities, according to Magellan, the for-profit contractor that administers behavioral-health care in the county.

Dr. Dawn Noggle, mental-health director for Correctional Health Services, which provides health care at Maricopa County's jails, said the seriously mentally ill are staying in jail longer. And, she said, police have arrested some more than 30 times for a variety of crimes, mostly low-level non-violent offenses, such as trespassing or theft, or probation violations.

Incarceration and prosecution of the mentally ill doesn't just affect taxpayers who foot the bill, she says.

"What happens after they get felonies? And there is an incredible impact on families," she says. "It's not just the immediate financial costs. It's the social costs as well."

There also are repeat customers at the county's psychiatric hospital, where the budget cuts mean court-ordered evaluations must be completely redone for people discharged only weeks earlier. Staff at the county's Desert Vista Behavioral Health Center, which handles involuntary commitments, say it's a new phenomenon.

In the past, people were typically court-ordered to continue treatment for at least a year, long after they were discharged from the hospital. Since the budget cuts, judges have been dismissing court-ordered treatment for non-Medicaid patients upon their discharge, reluctant to require them to participate in services, such as therapy and job training, they no longer have. Within months, some of those people are brought back for a new evaluation, a costly legal and medical process that delays treatment for several days.

"It's taking an enormous amount of resources to redo something that's already been done," said Sherry Fraley, legal-services manager.

Reach the reporter at 602-444-8603.

Uninsured are 40% more liklely to die like this...

the dying are taxpayers, too:
AZ families deserve AHCCCS.
Arizona State Capitol, PHOENIX
(February 28, 2011)

Still waiting on that Obamacare out here...Brewercare is killing us.

----------------------------

Man Dies From Toothache, Couldn't Afford Meds

By CARRIE GANN
ABC News Medical Unit

Sept. 2, 2011

A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.

According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.

The tooth infection spread, causing his brain to swell. He died Tuesday.

Calls to Willis' family were not immediately returned. University Hospital in Cincinnati, where Willis was admitted, did not comment, citing federal privacy laws.

"People don't realize that dental disease can cause serious illness," said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. "The problems are not just cosmetic. Many people die from dental disease."

Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.

"When people are unemployed or don't have insurance, where do they go? What do they do?" Silverstein said. "People end up dying, and these are the most treatable, preventable diseases in the world."

Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.

Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.

"People want to believe there's a safety net that catches all of these people, and there isn't," said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians. He noted that it is often young men who are the most likely to lack health coverage.

Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.

"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."

There are a number of free dental clinics in operation around the country, where dentists volunteer to provide care to those without health insurance. But even if Willis had access to a free dental clinic, Stream said he still may not have been able to get the care he needed for his infection. "The wait is often months at these clinics, and this young man died within two weeks of his problem," Stream said.

Silverstein operates three free dental clinics in the San Diego area. "We're overwhelmed right now," he said. "We can't take any new patients."

St Patrick's Day: Immigration Bill Teach-in at the Capitol.

I actually missed all the protests myself, today - the students and teachers at the capitol and the arrest of George Bush - so I got my fix down at ASU's Taylor Mall on 1st St. - that's looking North towards my place past Roosevelt.

A cop came by as I was wrapping it up - he was rolling around one of those silly motorized unicycle things they stand on (I'd fall down laughing if they actually chased me down in one - except that they'd probably shoot me for it. I think the cops who use their weapons the most tend to be the laziest). He took in my message, my camera, and my costume for a moment, admonished me to be sure to stay off of ASU property with a smile, and left me to carry on.

---------------------------------

No wonder we need to add another 5,000 state prison beds - they're for the teachers, nurses, and children who defy the state. This is what happens when you give the bad guys an inch in the AZ Legislature - they want it ALL for themselves and their kin at the expense of the rest of us. I just want to go into the Senate during the pledge of allegiance or prayer opening each session and scream at the top of my lungs : "What is wrong with you people?!!!"


But they'd just lock me up and order a Rule 11 Hearing on the grounds I might shoot someone (I'm not the crazy one, I can assure you. Nor do I own a gun). This legislature has gone insane and very few people seem to notice it these days - there are 26 anti-immigrant bills pending: Go to Border Action Network to read them and act. This post addresses only four of them. Where are the armies of resistance - did everyone just go back to their lives and hope the whole SB1070 thing would blow over soon?


If a different person screamed at the legislature every day, they'd have a much harder time burying me - I'd volunteer to be the first. Or we could be more discreet (and maybe live to fight another day)- we could each just go in quietly with a t-shirt that says: "FUCK AZ FASCISM!" that we prominently display to the Senate floor once inside...they'll quickly ban EVERYONE from committees and sessions to prevent anyone from expressing their disgust and outrage at their conduct.



My hopes for overthrowing the state government are no doubt unrealistic; this is Arizona, after all, not Libya, where people will fight and die for their freedom and rights while we stand impotently by, chastising the man murdering them. There's only a handful of people showing up to protest Pearce et al each day anymore - we're still probably outnumbered by the bad guys' lobbyists on the inside. Never mind that we've plunged deep into a moral abyss here at their direction.


The vast majority of these people do not represent me, I assure you. Mine are relatively cool, though, because I live among artists, anarchists, and other poor people. We kind of get it, as a community.


You know what this state would do if we took over the AZ Senate like people in other states are taking back their Houses? Brewer would make Gaddafi seem pretty tame in squashing a real rebellion here...which is maybe what people voting for those fascists need to see, up close: blood in the streets, before giving her power to constitute her own little army of white supremacists to call out on us...


They sure don't care about bodies in the desert, here - or the children in the schools, young parents dying without health care, or any of the rest of us, for that matter. It's the Me Party Senate of Russ Pearce.

I really hope Mesa recalls that mean SOB they empowered to lead this pack of mad lemmings they call Republicans in this state. Too bad Fountain Hills doesn't have enough of a collective political clue or heart to recall John Kavanagh - he must be working out okay for enough of them, though I know there sure are families suffering there. Just try to be a single parent or live on a teacher's salary there.


That guy doesn't think our taxes should be used to cover health insurance for "these people". He knows damn well the people he's condemned to die are taxpayers, too. No one does anything in Arizona without paying the state their sales taxes - they're shifting as much as possible off the rich that way, on to the poor, while making the middle class think that it's being bled dry by the shiftless bodies populating our AHCCCS rolls, and that the feds are into socialism (hardly!)...


That sales tax last year was passed by voters on the claim that it would help spare education and other cuts, by the way. Advocates for the poor were even begging us to do so in order to save their programs, despite the negative impact the tax itself would have on so many families already on the edge. Now look at where we're at: she's cutting our programs despite taking more money from us, and now she's trying to lower business taxes despite the budget crunch. (It's part of the plan to make the tax shift shuffle permanent.)


Brewer's really got her priorities for The People straight - she'll dump $20,000/person per year to incarcerate drug and property offenders who we can't even keep safe inside, but she won't fund the schools adequately or support neighborhood programs that are key to protecting kids from being both victimized and criminalized in the first place. That's not a difficult connection to make - it would also be consistent with the trends towards evidence-based practice standards across the judiciary and in corrections. The people spending a billion dollars a year of our tax dollars on state prisons and extensive community surveillance aren't paying attention to outcomes of research or the consequences of the legislation they push on the public, though - they just twist data to justify pursuing their objectives. (which are apparently not really to prevent crime - just to punish it. Somehow that doesn't make me feel any safer knowing they're in charge).


As I said earlier: "What is wrong with you people?!!"


It's really quite disturbing that Kavanagh chairs the Appropriations Committee - the problem in our legislature won't be alleviated just by getting rid of Russ Pearce (though it's a good start). Who does he think "these people" are on AHCCCS, anyway? I've lived in Fountain Hills, and know a few good people there still: unless they do something about their elected representatives, they're hurting themselves and their kids, too.


AHCCCS patients aren't just our neighbors, they're OUR LOVED ONES - they're US - when we get leukemia, can't work, have to re-finance our homes and go bankrupt because the Republicans in Congress are determined to undo employer health care mandates. How can anyone raking in less than $250,000/year buy into what these people are up to?


You wouldn't know it by the Tea Partiers' promotions of their own entitlement and privilege while depriving others of any, but very few of the citizens of Fountain Hills can actually withstand that kind of economic devastation. Of course, our legislators and good sheriff needn't worry about that because they're pretty well taken care of. The rest of us need a safety net held by the entire community, though, when struck by disaster: no less so when that disaster is cancer or Hepatitis C than when it's an earthquake, tsunami, or hurricane. That's when people can be at their best.


It's a natural response for people to extend themselves when suffering is visible...if it hits home, particularly. My mom's whole town - Fountain Hills - has organized around helping her get to her chemo and radiation treatments in the next few weeks. Her illness hasn't burdened the people who love her - it's given us all a chance to give back, and makes us stop to take the time to be present in the day.


Why would Kavanagh want to discourage that impulse - it's what makes us better people. Compassion and generosity of that kind helps build stronger, more resilient, and less crime-ridden communities, too. Invest in more of that, instead of the vitriol that people like these guys spew, and we can start closing down the prisons and bringing people back home.


They are "our people", you know - like it or not. Many are, anyway - not the sociopaths who go out of their way to harm others, but the ordinary Americans who got convicted of breaking a law - not all those in prison are really guilty, you know. Similarly, not all the guilty are in prison - remember that. Some of them actually make the laws.


My mom's a retired teacher, by the way, who would have never turned in a child for being undocumented. This legislature will criminalize people like her if they can, and steal our health insurance and retirement benefits for their own pet projects - like suing the federal government (i.e. the American People - us TAXPAYERS you're so valiantly championing in our House and Senate buildings every day.)

So what about "Boycott Arizona!" does the rest of this country not understand, anyway? We could use your help out here, America. Especially you musicians and artists - what's the deal with coming to the Dodge in Phoenix, anyway: look at these people! If you think you're progressive and you're coming here to perform, you are selling our people OUT!


Get on with the Boycott, tell these people you're canceling conferences and vacations and performances here because our fascism is growing beyond SB1070 (give them an inch and they'll take your child here), and be serious about the damage you do! These legislators are criminalizing and killing people out here - don't you get it? You could be next, too - your state lawmakers may well be modeling your next laws after these below! Look at Georgia! (not surprisingly, they neglect and abuse their prisoners, too. ) Tell them you're supporting the workers of Wisconsin, instead of businesses here.

PLEASE SEND HELP!!!

And stay tuned to blogs like Fires Never Extinguished, O'odham Solidarity Across Borders , Censored News, Survival Solidarity, Resistance to SB1070, and Chaparral Respects No Borders for the stories from the resistance to this fascist beast in the Deep Southwest that you seldom ever Google. We don't just want reforms. We want revolution and a sane, decent world where people are taken care of when they get ill instead of being imprisoned for being no more than a nuisance.

---------------------------------

I know a lot of the folks going to this thing, but we didn't conspire about this post, and my promoting their event here isn't suggesting that anyone affiliated with Promise Arizona agrees to any of the above editorial. I take full responsibility for what I put up here...

--------------------------

Anti-Immigration Bill Teach-In
Thursday, March 17 · 12:00pm - 3:00pm


Arizona State Capitol
(Wesley Bolin memorial across the street from the flagpole)
1700 West Washington St. / Phoenix, AZ


Promise Arizona


Promise Arizona We're organizing this teach in to ensure that members of our community understand the process and are equipped to with the knowledge needed to fight against these laws! *Please wear your PAZ t-shirts (or white t-shirts)

If you can't make it, call your senators and tell them to vote no on laws that will attack our families and economy!

English: 866-794-6052
...Spanish: 866-891-0358


· SB1611- “Immigration Omnibus” or the “Throwing Arizona Under-the-Bus” bill –Sponsored by Senator Russell Pearce, this bill is a 30-page, measure requiring business owners, police officers, apartment renters, school employees, and others to verify citizenship, notify immigration and in some cases, failure to do so could result in loss of licenses, certification or imprisonment.

· SB1308 and 1309 – “Eroding Children’s Futures and the Constitution” bills. Two bills introduced by Senator Ron Gould to create a new Arizona Citizenship that excludes children born to parents in the U.S. without immigration authorization. The bills are an attempt to ignite a national legal battle challenging the 14th amendment of the Constitution’s recognition of birthright citizenship.

· SB1405 –“Turning Health Providers into Health Deniers” bill. This bill introduced by Senator Steve Smith would require hospital employees to verify the citizenship of people seeking emergency and non-emergency medical attention and to notify immigration agents if someone cannot prove they are authorized to be in the U.S.
· SB 1407 - “Schools as Immigration Checkpoints” Requires the Arizona Department of Education (ADE) to collect data from school districts on populations of students who are enrolled and who cannot prove lawful residence in the United States (U.S.) Schools who fail to comply would result in loss of funding.

Brewercare is killing us! DREAM of LIFE Walk!!!

Saturday's DREAM of LIFE Walk for the surviving patients on the AHCCCS transplant list was amazing - these are my photos with a brief news piece from ABC15.com at the bottom. Here are the video clips.

Along those same lines, here's the article from Russ Pearce's Me Party Senate Appropriations Committee this week, which voted 8-5 to eliminate the MEDICAID for Arizonans altogether, so our friends awaiting transplants will soon have much more company among the people the state has decided to allow to withhold life-saving medical care for.

Ironically, no matter how ill or disabled a person is in this state, we still end up paying the government a hell of a lot through the very sales taxes that are supposed to be spent on the welfare of the people....and I want my taxes to go to AHCCCS before anyone else needlessly dies. I'm sick of the legislature extorting me for their salaries while they kill my people by pissing away my money on suing the feds over immigration and setting up committees to pick and choose which federal laws Arizona wants to nullify because they give too many people rights and health care and other essential things.

No wonder people are talking about seceeding from the state. What ignorant, self-righteous dolts we have running this show. If I knew it was that easy to nullify laws, I would have written my own constitution and criminal code a long time ago and told the feds and state where to go myself.



















































'Dream of Life Walk' aimed to raise awareness about AHCCCS funding cuts

ABC15.com
Posted: 5:55 PM
March 5, 2011


* By: Mike Pelton

PHOENIX - A Valley man who needs a new liver, along with dozens of others, marched to the state capitol Saturday, in hopes of raising awareness about the importance of funding the state’s Medicaid program, Arizona Health Care Cost Containment System (AHCCCS).

Francisco Felix has cancer and needs a liver transplant. He is one of the 98 people who lost coverage when Governor Jan Brewer approved cuts to AHCCCS, a move that aimed to help solve the state’s massive budget deficit.

“We are asking for the funds for the transplants,” said Felix, whose cousin, Lulu translated for him.

People from all across the Valley gathered at a Phoenix church this morning for a ‘Dream of Life Walk’. They marched to the capitol in hopes of raising awareness about the issue. Governor Brewer, however, isn’t in Arizona. She sent out a message on Twitter late Friday night that said she is in Alaska on vacation.

The cuts to AHCCCS were made last year as part of the new budget. It left 98 people who needed transplants without funding from the program. Two have died since the cuts were made.

“By subtracting this funding from them, these 96 remaining people will die,” said Dr. Richard Darling, who attended Saturday’s march. “It won't be that long either because some of them are very, very ill.”

State leaders have said the cuts were necessary because of the dire budget issues.

But for Felix, he and his family have resorted to selling food at local events to help raise money. They sell hot dogs, chips and drinks, in hope of getting enough money to pay for the transplant. They said they need about $500,000 and including donations, have raised about $100,000.

“I’m going to be fighting, I’m not going to give up,” Felix said.

Dying to save Kavanagh $$$: AHCCCS Transplant Patients

Anyone out there from Fountain Hills who is not being accurately represented by John Kavanagh, please speak now. He will be wreaking havoc in our legislature this year, and you folks should rein him in before he hurts anyone else...

---------------------------------

No to transplant funds House, Senate panel chairmen will not give proposals a hearing

by Mary K. Reinhart - Feb. 3, 2011
The Arizona Republic

Arizonans who lost coverage for lifesaving organ transplants had political winds at their backs last fall, with national media attention and a sympathetic key Republican lawmaker.

But Rep. John Kavanagh's support has evaporated, and there now appears little chance legislators will restore funding to return nearly 100 people to waiting lists for heart, liver, bone-marrow and lung transplants.

"I've kind of lost hope," said Randy Shepherd, a Mesa father of three who needs a heart transplant. "I don't know how long we can bang our fists on the wall and continue to be ignored before we decide to be quiet and go away."


Last spring, lawmakers made sweeping cuts to the state's health-care program for the indigent to help bridge a budget shortfall of more than $3 billion, which amounted to nearly one-third of state revenues.

Kavanagh, the House Appropriations Committee chairman, said in November that he was concerned lawmakers had based their decision to deny coverage on flawed data provided by the Arizona Health Care Cost Containment System, the state's Medicaid program. He said he planned to hold a hearing to consider newer statistics showing better patient outcomes.

Now, he says that the mortality data called into question by leading transplant physicians here and across the country look solid and that additional information provided by the same doctors failed to persuade him to reconsider.

"Almost everybody died," Kavanagh said of certain transplant patients during a budget hearing Wednesday. "That's powerful stuff statistically."

While AHCCCS data from 2006 to 2007 showed that 13 of 14 patients who received bone-marrow transplants from unrelated donors died within the first year, doctors provided broader statistics that showed nine of 19 transplant patients were still alive, a 47 percent survival rate similar to the national average.

"Why are we relying on incomplete, old data? What other business would do that?" said Rep. Anna Tovar, D-Phoenix, a transplant survivor who received bone marrow from her brother in 2001. "If we can't take care of our most critically ill Arizonans, then we aren't doing our job."

Democrats have introduced four transplant-related bills, and Tovar is introducing four more today, including a measure to provide private matching dollars from the New Life Foundation for state transplant funding.

Four have been assigned to appropriations panels and the other four are expected to be.

Kavanagh, R-Fountain Hills, and Senate Appropriations Committee Chairman Andy Biggs both said Wednesday that they will not hear them, which effectively kills the bills.

"We're not doing the budget in pieces," said Biggs, R-Gilbert, adding that Gov. Jan Brewer's staff told him she won't consider legislation to restore transplant coverage.

Brewer spokesman Matthew Benson said the governor's position hasn't changed since the transplant cuts took effect Oct. 1.

"We don't have the money," he said. "And who's going to lose coverage to pay for it?"

Arizona and Brewer received national attention after Goodyear father Mark Price, a leukemia patient, came forward with his story. Price was denied coverage for a bone-marrow transplant and put a human face on Arizona's deep budget cuts. An anonymous donor came forward to pay for his transplant, but Price died Nov. 28.

The AHCCCS cuts, which included annual physicals, podiatry and emergency dental care, saved $5.3 million this fiscal year, but the state loses about $20 million in matching federal funds. The services are considered optional under Medicaid rules.

Brewer's budget for the coming fiscal year proposes eliminating 280,000 people from AHCCCS to help balance a $1.15 billion budget deficit. Brewer has asked federal health officials for permission to waive a requirement to maintain Medicaid eligibility.

Meanwhile, Biggs has introduced a bill to repeal AHCCCS, which would mean the loss of about $7.5 billion in federal funds.

Under Senate Bill 1519, the state's current $2.5 billion Medicaid contribution would be divided among services for people who need long-term care, those with serious mental illness and the developmentally disabled.

Sinema's AHCCCS Bill: Dream a little dream for me...

New Coalition Seeks to Restore Arizona Medicaid Funding

98 Arizonans were promised then denied coverage for life saving organ transplants. New Coalition forms to pressure legislature and Governor to restore funding.


FOR IMMEDIATE RELEASE
Jan 13, 2011

For more information contact:
Bob Aronson
904-434-6512
Jacksonville, Florida
bob@baronson.org
http://bobsnewheart.wordpress.com

New Coalition Seeks to Restore Arizona Medicaid Transplant Funding

A powerful new organization has been formed to help restore Medicaid coverage for Arizona organ transplant patients and to prevent similar cuts in other states. The mission of “The Dream of Life Intervention Coalition” (DLIC) is to help patients with life-threatening health conditions get or keep Medicaid and/or Medicare insurance coverage.

The DLIC will emphasize four points in its campaign:

1. Denying Medicaid patients organ transplants is a death sentence. Transplants are their only option for living. (Two have already died in Arizona and 30 more could die this year. Many children will be left with one parent, others could become orphans).

2. If we don’t reverse the Arizona situation it could be seen by other states as permission to do the same thing and these death panels will begin to spread across the nation (If that happens, thousands if not millions could be sentenced to death and despair by budget slashing, heartless politicians. What’s next, banning chemo or radiation therapy for cancer patients? Is that what America is about?)

3. DLIC strongly believes that sending people to their death is no way to solve budget problems (doing so flies in the face of the constitutional guarantee that our government exists to protect its citizens and provide for their general welfare. The constitution does not say that killing citizens is permissible if it will save money.)

4. We do not want to allow these issues to go unaddressed and therefore encourage medical tourism or influence migration to other states or countries that have more accessible health benefits (that would shift the burden to regions that are unprepared to absorb the impact while maintaining the human and moral commitment to be socially responsible for our citizens).

Circumstances

On October 1, 2010 the state of Arizona told 98 of its legal citizens that Medicaid would not cover life saving organ transplants despite having promised them earlier that the procedures would be covered. Since that order, two of the 98 have died and another is said to be selling her belongings in order to move somewhere where Medicaid will cover her liver transplant. Governor Jan Brewer says the cuts were made to help reduce the state’s budget deficit. She remains opposed to restoring the funding.

Last Monday January 10, 2011, leaders of several advocacy groups joined in a conference call with Arizona senate Minority leader David Schapira and State Senator Kyrsten Sinema (D) to discuss the issue. Senator Sinema has introduced a bill she says would provide more than enough money to restore transplant funding and provide millions more to help reduce the state’s budget deficit.

The conference call revolved around ways in which DLIC could assist with the effort to restore funding. While the Governor’s office says the transplants would cost nearly $5 million, Jennifer Carusetta, legislative liaison for Arizona Medicaid, says cutting transplants would only save $800,000 in the current fiscal year, and only $1.4 million for a full year.
Participating in the call was William Remak Chair of the National Association of Hepatitis Task Forces (NAHTF), two time liver transplant recipient and cancer survivor; Julie Acklin, Arizona Director of the NAHTF; Bob Aronson, heart transplant recipient and founder of Save the Arizona 98 and Facebook’s Organ Transplant Initiative; Patricia Lupole, Director of the Hepatitis C Veterans group (thehvcvets.com) and Flor Felix representing her husband and some other Arizona citizens who have been denied Medicaid covered organ transplants. We will soon announce other members.

Senators Schapira and Sinema said that while Democratic support for the bill was strong, some in the Republican majority were willing to review it while others were less enthusiastic. As a result the new group, Dream of Life Intervention Coalition, decided unanimously to embark on a nationwide campaign to bring greater visibility to the Arizona situation and to rally public opinion to put increased pressure on Arizona officials to restore Medicaid covered organ transplant funding. Additionally DLIC will work to help ensure that Medicaid cuts throughout the country at state levels do not result in restricting life saving interventions for people in dire circumstances.

DLIC is working on a more detailed communication plan and will soon provide the public with steps they can take to begin the campaign to stop the dying by restoring funding.

***William (Bill) Remak, BSMT, BSPH, SGNA, AHCJ., has initiated coordinating this collaborative effort in response to the pleas and desperation demonstrated by the families of the chronically ill from the neighboring state of California where he sits on the steering committee of the California Chronic Care Coalition. Bill said.” No state public servant or elected official should sacrifice the lives of their constituents as a means to flex their political party muscle or power by using policy to destroy the fabric of our value as human beings. It defeats the core of our ability to thrive as a nation and can only lead to the devastation of mankind.”

-30-

“Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired and success achieved.” -Helen Keller (1880 – 1968)

# # #

Dream of Life Intervention Coalition is an non profit advocacy group that seeks to help patients with life-threatening health conditions get or keep Medicaid and/or Medicare insurance coverage. Our first project is to restore Arizona Medicaid funding for the 98 people who were denied organ transplatns. Bob Aronson is the founder of Save the Arizona 98 www.savethearizona98.com and Facebook's OrganTransplant Initiative.

Have a Heart 4 AHCCCS Transplant Patients

FRANCISCO FELIX: Father of 4 beautiful girls.
Hepatitis C AHCCCS Patient on Liver Transplant Waiting List.
Needs $500,000.
Car Wash today and Tomorrow.

--------------------

My friend Julie Acklin and I spent a few hours today with the friends and family of Francisco Felix, a Hepatitis C patient in need of a liver transplant. He actually had a match donated to him by a family friend who passed away in November, but he couldn't afford the $200,000 tab - and the state refused to step up to pay it.

Francisco is one of 98 patients in our state (now 97, I believe, with Mark Price's death) who lost funding this fall for their desperately needed organ and tissue transplants through the Arizona Health Care Cost Containment System (AHCCCS - Arizona's name for Medicaid, which is less and less accessible under our compassionate conservatives). Several of the links I've embedded in this post will help you find out who voted for and against the cuts, but I can tell you it was pretty much a party-line thing. A week or so ago I protested at the Capitol and blogged on this issue, too (see "Bury My Heart in An AHCCCS Patient").

13-year old Carlos Olivas, Jr. (above, with Jessica Felix) also hit the Capitol to protest and has been everywhere fund-raising recently. I met him at the car wash today, and he's an amazing kid. Read the CNBC story about him if you need some inspiration to stop talking and take action for these folks. He's pretty humble about it, but as I understand it, he's single-handedly raised nearly $2,000 for the cause so far. Really, all those kids out there today were heroes; just a few (including Francisco's daughters) are pictured here.

The AZ Senate Democrats have filed a bill to restore the transplant funding, but they aren't the ones in control of the state legislature - the Republicans are, so lobby the Governor and your lawmaker for it hard, reminding them that it's our money they're depriving Arizona's families of, not theirs.

Anyway, the occasion today was a yard sale and car wash being held to raise money for Francisco, who will now need about $500,000 for his transplant and related expenses. A lot of people turned out, but I don't think we raised enough. In fact, I'm sure we didn't.


There will be another fundraiser for him tomorrow as well, so please bring your dirty cars, a little cash, and some rich friends or Republican legislators to support the cause.

It's being held from 7am-3pm at the entrance to Acclaim Charter School at 7624 W. Indian School Rd., on the West side of Phoenix between 76th and 77th Ave.

The easiest way I found to get there from my place on Central and Roosevelt was to hop on the I-10 going West, take the 75th Ave exit North, and head up to Indian School Road, where you'll make a left, going West again. About 1/4 mile down the road you'll see a ton of eager children on your right (probably waving hot pink signs) imploring you to wash your car. Turn in it even if it's already clean.


While you're waiting for your vehicle shop at NAPA Auto Parts (the guy there threw his support behind this whole thing), hit the yard sale for things you might (or might not) need, buy a Francisco Felix t-shirt, or mosey on to the back of the lot to pick up a couple of tacos. If you're really brave, turn your clean car over to me and the kids to have your back window painted. The photos throughout this post should give you an idea of what I mean.




If you can't make it tomorrow, don 't worry - you can still give to Francisco's fund. In fact, that's all I really want for Christmas, so if you really love me, go to the NTAF and donate today.

Thank you in advance for your support.

Feliz Navidad, mis amigos y amigas.



(hope I got that right... Love to all.)

Bury my Heart in an AHCCCS Patient

I felt strong enough for the first time in weeks to go out chalking today, so headed up to the Capitol Complex and Wes Bolin Park, one of my favorite spots to practice my free speech (That's 17th Ave I'm on, between W. Washington and W. Jefferson, right across the street from the legislators and governor's office buildings. The media and visitors and legislative aides all cross that sidewalk from the parking lot to get over there).





















Kids were all over the place singing Christmas Carols, and naturally curious about what I was writing about. So I told them about the people who are so sick that their insurance plans wouldn't cover their most critical medical treatment, and how they needed the state to pay their medical bills through the AHCCCS program - which the Arizona republican governor and legislature, the ultimate compassionate conservatives, decided isn't going to pay for their organ transplants anymore.



Then I told the kids that if Governor Brewer doesn't restore that funding, those people will die. I even named some of them: Coach Tiffany Tate, a cystic fibrosis patient who needs a double lung transplant, Randy Shepherd, a father of 3 who needs a heart transplant, and Francisco Felix, a survivor - so far - of the deadly damage of Hepatitis C. His dying family friend even tried to give him her liver, but AHCCCS still wouldn't pay for the transplant.


I didn't mention "Death Panels" to the kids, though - I thought what I told them was heavy enough already.


In the meantime, someone called the Capitol Police on me ( they always do), assuming that what I was doing was a crime. They all know my name now, but wanted to see some ID anyway - and tried to convince me that my conduct was, in fact, against the law - they just weren't going to arrest me because I was technically in the territory of the Phoenix Police.

One of the guys was actually pretty nice about trying to intimidate me in to leaving (not this one above - he was really hostile to me when I was caught alone by him on Halloween night). I was actually pretty much done for the day, but stayed long enough to argue with the cops that not only was my mode of expression not criminal (I keep it on the ground and on city sidewalks), but that the vigor with which the state solicits the poor to harvest our organs upon our death, while justifying why we or our loved ones aren't deserving of receiving transplants in life is truly criminal.


They didn't put up much of a fight on that one.

Here's the finished product - not the greatest picture, but you get the gist...

I signed it "future organ donor against Brewercare."

Happy World Human Rights Day

Future Organ Donor Against Brewercare

Today is International Human Rights Day. This would be the perfect time for Governor Jan Brewer to call a special session of the legislature to pass a bill that would restore the cuts to AHCCCS funding for transplant patients - including liver transplants for people with Hepatitis C.

I find it deeply disturbing that as an Arizona citizen living in poverty, my own organs would be harvested by this state only to be doled out to the privileged few. Clearly the poor are still good enough to be preyed upon, but not worthy enough to be saved...

Is that really what Republicans stand for here?

On that note, I'm dropping this $7 check off at the Capitol Executive Building for the Governor today. Read the article below for an explanation...

--------------from myfoxphoenix.com----------

Patients Desperately Needing Transplants Share Stories

They call on governor to restore AHCCCS cuts

Published : Tuesday, 07 Dec 2010, 5:16 PM MST

PHOENIX - Doctors, transplant patients and Democratic lawmakers blasted what they refer to as "BrewerCare" Tuesday, calling for Governor Jan Brewer to restore the money slashed from the state's Medicaid program AHCCCS.

A news conference was held at the state Capital. Among those in attendance were four people waiting for transplants for themselves or their loved ones, and called for Brewer to do something now before its too late.

Four Arizona families in need of transplants issued an emotional plea. A woman with cystic fibrosis, a father of 3 who needs a heart transplant, a man with hepatitis C and cancer, and another man who needs a heart transplant, had their stories told.

Surrounded by several Democratic lawmakers, they called for Jan Brewer to restore the money slashed from the state's transplant program.

"If the state budget were the average American salary, the cost to restore the funding would be $7. $7 to save people's lives," says Democratic Rep. David Schapira.

House Republican Jon Kavanagh says the decision to cut certain transplants was based on incomplete data that showed low success rates. He says he's still waiting for a report.

"I have the data summary here from the group of doctors including Mayo, saying significant survival rates, but they never gave us the number, they never gave us the data, we need facts," he says.

Democrats want the governor to call a special session, or use federal stimulus funds to cover the cost. However, a spokesperson for the governor's office tells me that funds were used already for job creation, education and public safety. He says even if the funds were available, they wouldn't cover the costs necessary.