David Baxter PhD
Late Founder
NAMI Advocacy Tools & Resources
Needs assessments from across the country point to affordable housing as being one of the greatest needs for people living with mental illness.? NAMI state organizations and affiliates from across the country do an exemplary job of promoting affordable housing and seeking community solutions for this national need.? NAMI Vermont, for example, participates in the Vermont Affordable Housing Coalition.? To review the coalition's objectives for 2006, click here.
An excellent source on the price of housing in your state is Priced Out in 2004: The Housing Crisis for Persons with Disabilities.? The report is co-published by the Technical Assistance Collaborative and Consortium for Citizens with Disabilities Housing Task Force.? A summary and a link to the document are available by clicking here.
Medicare Drug Benefit Update: Consumer and Family Tip Sheet Available to Help Address Coverage Problems; Bills Introduced in Congress to Address Gaps
The Medicare Part D drug benefit is now 45 days old and while many of the problems that plagued the early days of the benefit have been addressed, some problems persist.? Of particular concern to NAMI are coverage gaps faced by low-income beneficiaries with severe mental illness who are concurrently (dually) eligible for both Medicare and Medicaid.
Perhaps the biggest challenge facing the new drug benefit in these early days is the persistent gap between the coverage and transition obligations imposed on drug plans by the Centers for Medicare and Medicaid Services (CMS, the federal agency that administers Medicare) and what drug plans and pharmacies are doing in the real world.? It is no surprise to many NAMI members that the standards that CMS has required of drug plans and pharmacies with regard to coverage for dual eligibles is not always being followed where it really matters (i.e., where a consumer is at a pharmacy counter being told "no.")
In order to help alleviate these problems and provide consumers and families with the tools they need to maintain continuity of care, NAMI has developed a simple one-page listing of the obligations required for all Medicare drug plans serving dual eligibles.? This "tip sheet" also has FAQs explaining cost sharing requirements (including circumstances under which cost sharing can be waived) and the process for getting a drug that is not on a drug plan's preferred list or is subject to a restriction such as prior authorization.? NAMI affiliate leaders are strongly encouraged to download this document and make it available to consumers and families.
NAMI National staff is willing and able to print and ship requested quantities of these guides to state and local NAMI affiliates at no cost.? However, it is important to note that NAMI staff will periodically update this document since CMS is expected to issue new guidance in the coming weeks and months ? in particular as March 31 expiration date of the current initial transition guidance draws closer.? In other words, NAMI wants to be careful to ensure that information provided is timely and completely accurate.
NAMI ~ 2107 Wilson Blvd. ~ Suite 300 ~ Arlington, VA 22201 ~ www.nami.org
Needs assessments from across the country point to affordable housing as being one of the greatest needs for people living with mental illness.? NAMI state organizations and affiliates from across the country do an exemplary job of promoting affordable housing and seeking community solutions for this national need.? NAMI Vermont, for example, participates in the Vermont Affordable Housing Coalition.? To review the coalition's objectives for 2006, click here.
An excellent source on the price of housing in your state is Priced Out in 2004: The Housing Crisis for Persons with Disabilities.? The report is co-published by the Technical Assistance Collaborative and Consortium for Citizens with Disabilities Housing Task Force.? A summary and a link to the document are available by clicking here.
Medicare Drug Benefit Update: Consumer and Family Tip Sheet Available to Help Address Coverage Problems; Bills Introduced in Congress to Address Gaps
The Medicare Part D drug benefit is now 45 days old and while many of the problems that plagued the early days of the benefit have been addressed, some problems persist.? Of particular concern to NAMI are coverage gaps faced by low-income beneficiaries with severe mental illness who are concurrently (dually) eligible for both Medicare and Medicaid.
Perhaps the biggest challenge facing the new drug benefit in these early days is the persistent gap between the coverage and transition obligations imposed on drug plans by the Centers for Medicare and Medicaid Services (CMS, the federal agency that administers Medicare) and what drug plans and pharmacies are doing in the real world.? It is no surprise to many NAMI members that the standards that CMS has required of drug plans and pharmacies with regard to coverage for dual eligibles is not always being followed where it really matters (i.e., where a consumer is at a pharmacy counter being told "no.")
In order to help alleviate these problems and provide consumers and families with the tools they need to maintain continuity of care, NAMI has developed a simple one-page listing of the obligations required for all Medicare drug plans serving dual eligibles.? This "tip sheet" also has FAQs explaining cost sharing requirements (including circumstances under which cost sharing can be waived) and the process for getting a drug that is not on a drug plan's preferred list or is subject to a restriction such as prior authorization.? NAMI affiliate leaders are strongly encouraged to download this document and make it available to consumers and families.
NAMI National staff is willing and able to print and ship requested quantities of these guides to state and local NAMI affiliates at no cost.? However, it is important to note that NAMI staff will periodically update this document since CMS is expected to issue new guidance in the coming weeks and months ? in particular as March 31 expiration date of the current initial transition guidance draws closer.? In other words, NAMI wants to be careful to ensure that information provided is timely and completely accurate.
NAMI ~ 2107 Wilson Blvd. ~ Suite 300 ~ Arlington, VA 22201 ~ www.nami.org
