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Shea-Porter Gets Amendment To Improve Hiring At The VA, Passed In US House

American Legion-Endorsed Shea-Porter Amendment Earns Bipartisan Support 

WASHINGTON, DC— Everyone agrees the VA needs help.  Healthcare professionals at the VA are swamped. There is a shortage of qualified health professionals and this is leading to the VA’s failure to care for those who need it.

The VA’s current shortage of mental health providers causes unacceptable wait-times for veterans who need care for mental health conditions, including substance use disorder, post-traumatic stress disorder, and military sexual trauma.  More than 20% of veterans suffering from PTSD also suffer from substance use disorder, and 25% of veterans returning from Iraq and Afghanistan showed signs of substance use disorder.  Between 2010 and 2015, the number of veterans suffering from opioid use disorder increased by 55%.

Yesterday, the U.S. House passed an amendment introduced by Congresswoman Carol Shea-Porter (D-NH01) to improve VA hiring of mental health professionals.

“The VA faces a critical shortage of mental health professionals, including psychiatrists, psychologists, mental health counselors, and peer support specialists. These providers care for our veterans with behavioral health needs that include post-traumatic stress disorder, military sexual trauma, and substance use disorder. Too many of our veterans must wait to receive the mental health care we have promised to them, and some never receive needed care at all,” Shea-Porter said while offering the amendment on the House floor. “In my home state of New Hampshire, we are fighting a fentanyl, heroin and prescription opioid crisis that is disproportionately affecting the veteran community. Increasing mental health provider capacity will allow more of these veterans to enter treatment and, ultimately, recovery.”

Congressman Brad Wenstrup (R-OH), Chairman of the House Veterans Affairs Subcommittee on Health, rose to speak in support of Shea-Porter’s amendment, saying: “It’s critical that VA closely track to mental health vacancies on an ongoing basis so they can be prioritized and filled to prevent any disruptions in care to our most vulnerable veterans. I’m fully supportive of this amendment and grateful to Representative Shea-Porter for submitting it.” 

The American Legion said: “The American Legion thanks Congresswoman Shea-Porter for her amendment, which will improve veterans’ access to critical mental health services, allowing the VA to better serve those who have sacrificed for our nation.”

Shea-Porter’s amendment passed as part of H.R. 1367, a bill to improve the VA’s ability to hire and retain health providers, which would create a database to help match qualified applicants to critical open positions at the VA, facilitating faster hiring. Because of Shea-Porter’s amendment, that database will list open mental health positions if the bill becomes law, improving the VA’s ability to hire needed mental health professionals.

A former military spouse, Shea-Porter understands the challenges facing our military families and veterans. This Congress, she has cosponsored 18 bipartisan bills to improve services for veterans, including the WINGMAN Act, legislation she co-introduced and the House passed earlier this year to make it easier for certified Congressional caseworkers to assist veterans. She has been a leader in the fight to lift the harmful federal hiring freeze that is damaging the VA’s ability to provide care and limiting employment opportunities for returning veterans.

“Our veterans deserve to be treated by professionals who fully understand the veteran experience and veteran-specific mental health conditions. That is why it is so important for veterans to have the option to receive specialized mental health from VA mental health professionals who have the training that will allow them to build trust,” said Shea-Porter on the floor of the House yesterday“There is an urgent need to address this problem. Every day, 20 veterans commit suicide. MST. Opioid. PTSD. These are all crises we need to address. The time to act is now. Please vote yes on this amendment.”

Kuster Hosts Latest Regional Briefing on Opioid Use as Co-Chair of Task Force to Combat Heroin Epidemic

Rep. Kuster talks with stakeholders from the Upper Valley during today’s regional briefing in Lebanon.

Rep. Kuster talks with stakeholders from the Upper
Valley during today’s regional briefing in Lebanon.

“The opioid epidemic has taken a devastating toll on communities across the state, but each region has felt the impact of these dangerous drugs differently,” said Congresswoman Kuster

Lebanon, NH – Today, Congresswoman Annie Kuster (NH-02) brought together stakeholders from across the Upper Valley to discuss their joint efforts to combat the opioid epidemic around the region. This was the latest in a series of regional briefings that Congresswoman Kuster is holding on this topic around the state as the co-chair of the Congressional Bipartisan Task Force to Combat the Heroin Epidemic, which she helped found last year.

“The opioid epidemic has taken a devastating toll on communities across the state, but each region has felt the impact of these dangerous drugs differently,” said Congresswoman Kuster. “Today was an invaluable opportunity for me to hear from some of the Upper Valley’s leading experts and stakeholders about how the epidemic has affected the region and how we can best work together to establish comprehensive, lasting solutions that will stem the ongoing crisis. As I continue to host these regional briefings across the state, I look forward to bringing conversations like today’s with me back to Congress, where I will keep working with my colleagues on both sides of the aisle to protect Granite State communities from continued opioid misuse and addiction.” 

Congresswoman Kuster was joined for this discussion by Lebanon Police Chief Richard Mello, Lebanon Fire Chief Chris Christopoulos, Lebanon City Manager Dennis Luttrell, and representatives from the Lebanon Area Chamber of Commerce, West Central Behavioral Health, and Dartmouth-Hitchcock’s Addiction Treatment Program, among others. Together, the briefing participants discussed the impact of heroin misuse on the Lebanon community, as well as the specific steps they are taking to combat the growing opioid epidemic throughout the region. Kuster discussed her work in Congress to combat the epidemic, including her work on the Task Force and the recent Special Order she held on the House floor to put a face on addiction.

Kuster has prioritized efforts to address the opioid crisis across the state by convening events on substance use disorders and prioritizing the issue at the federal level through her work in Congress. Last year, Kuster helped introduce bipartisan legislation that addresses several aspects of combatting the growing heroin epidemic across the country, including the establishment of the Interagency Task Force on Heroin Addiction, the reauthorization of vital drug crisis grants, and the revision of treatment administration guidelines for individuals who are unable to receive take-home treatment, among other provisions.

Rep. Kuster talks with stakeholders from the Upper Valley during today’s regional briefing in Lebanon.

Rep. Kuster talks with stakeholders from the Upper
Valley during today’s regional briefing in Lebanon.

Kuster is also the co-chair of the Bipartisan Task Force to Combat the Heroin Epidemic, which frequently brings together experts from across numerous federal agencies to coordinate efforts to combat the epidemic. Earlier this month, she hosted a Special Order in the House to urge her colleagues in Congress to take action; during the Special Order, she and 10 of her colleagues shared the stories of Americans who have been affected by the crisis on the House Floor. Kuster has also spoken at forums and attended briefings and ride-alongs with law enforcement officials in Nashua and Franklin, providing her with a direct look at the challenges facing law enforcement and local communities. Kuster has taken these conversations with her back to Washington, where she continues to lead efforts to bring an end to opioid abuse in New Hampshire.

ICYMI: Irresponsible Republican Budget, Failure to Continue Medicaid Expansion Has Drug Treatment Expansion Plans on Hold

Concord, N.H. – As Republicans continue to play political games with the state budget and refuse to negotiate with Governor Hassan in good faith toward a responsible, compromise budget, irresponsible Republican budget and failure to continue Medicaid expansion “has drug treatment expansion plans on hold.

The Monitor reported that Friendship House in Bethlehem “is looking to hire additional staff in each of the three counties it serves – Coos, Grafton and Carroll – and add more space to its 18-bed treatment facility, but won’t commit until the future of Medicaid expansion is certain.”

WMUR also reported, “Governor Maggie Hassan’s budget called for millions in substance abuse treatment, and while Republicans increased funding as well, it fell short of what the Governor had asked for.”

See coverage roundup below:

WMUR VIDEO: Coverage of Disagreements Over Substance Abuse Treatment Funding

Anchor: “The budget battle in Concord stalling funding to fight the heroin epidemic. Governor Maggie Hassan’s budget called for millions in substance abuse treatment, and while Republicans increased funding as well, it fell short of what the Governor had asked for. Cuts to business taxes remain a major sticking point and the impasse continues.”

Senator Soucy: “We need to do more, we need to keep working, we need to get back to the table to negotiate a more meaningful budget for the people of New Hampshire.”

Concord Monitor: Political uncertainty of expanded Medicaid has drug treatment expansion plans on hold

… But uncertainty about Medicaid expansion’s future is creating pause at a time when advocates say action is critical.

“If you want to build more capacity, you have to have means to pay for it,” said Tym Rourke, chairman of the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery. “No provider is going to expand services because there’s no guaranteed mechanism to pay for care.”

… “Agencies are transforming how they do business to accept folks who now have coverage for their addiction,” said Abby Shockley, executive director of the New Hampshire Provider’s Association. “It’s hard for them to go through all of this infrastructure development, to hire new staff and expand services when they have a lot of uncertainty.”

… The Friendship House in Bethlehem is the only state-funded residential treatment center in the North Country, and officials there see Medicaid expansion as the way to serve a growing need.

“Everybody knows heroin is a problem,” said Michael Coughlin, CEO of Tri-County Cap, which oversees the Friendship House. “We hear all over the North Country the need for more resources. We want to be able to put those in place.”

While the center is beginning to hire more staff, it is holding back on more costly infrastructure investments – like increasing the number of treatment beds – until lawmakers determine the fate of Medicaid expansion.

… the Friendship House is looking to hire additional staff in each of the three counties it serves – Coos, Grafton and Carroll – and add more space to its 18-bed treatment facility, but won’t commit until the future of Medicaid expansion is certain.

… “We will do it if this Legislature keeps this expanded Medicaid alive,” Coughlin said. “Clearly the need is here in the North Country.” [Full story]

With Time Running Out, Pressure Mounts on Senate Republicans to Restore Budget Cuts to Critical Economic Priorities

Concord, N.H. – With time running out for the New Hampshire Senate to develop its budget, pressure continues to mount on Senate Republicans to restore budget cuts to critical economic priorities including transportation, investing in higher education and supporting the state’s most vulnerable citizens.

See coverage roundup below:

Foster’s Editorial: The road ahead may get rougher

… common sense tells us that if our highways and byways are as bad as our readers believe they are, we could be in real trouble down the road.

That’s because road maintenance and repair expenditures have been cut significantly in the two-year state budget recently passed by the N.H. House.

Specifically, the budget proposes spending $4.8 million less on snow removal, $12.4 million less on equipment upgrades and $14.7 million less on paving over the next two years, according to state transportation officials.

State Sen. David Watters, D-Dover, is concerned about the cuts. He believes that if they are carried through to the final state budget, it will mean the elimination of some of the approximately 80 maintenance sheds around the state.

… We won’t argue that the DOT needs stable funding, but we don’t think it should come at the expense of making the state’s roads worse than readers already believe they area. [Full editorial]

Monadnock Ledger-Transcript: Parents worry as HHS budget unfolds

… Renee, 38, was born with Coffin-Siris syndrome, a rare genetic disease that causes significant developmental disabilities. Now, Renee’s parents, Kathy and Mike Washburn of Greenville, anxiously watch state budget proceedings and hope that, at the end of the day, their daughter will be able to continue her independent life.

This year, the House proposed a budget that increases the Health and Human Services budget by $141 million. The additional monies, however, include the settlement of two lawsuits, one involving the state’s mental health resources — $27.3 million — and another involving an increase in the amount the state reimburses hospitals for uncompensated care.

These costs meant other areas had to give, and the developmental disabilities budget was reduced by $26 million. The agencies that use those funds lose much more, according to Alan Greene, executive director of Monadnock Developmental Services. Greene said the funds would have been matched by federal dollars, meaning that while the state saves $26 million, the agencies lose $52 million in support.

… It’s a familiar song-and-dance for the Washburns. When Renee was 16, they placed her on the wait list to receive state services, despite knowing that she would be in the public school system until she was 21. But even after she graduated, it would be another 11 years before the Washburns had access to state funding that allowed care providers to help Renee throughout the day, provide respite care for her parents, and eventually allow her to move into an apartment with a caregiver who helps guide her days.

Kathy said that her greatest fear during each budget season is the loss of that funding, and, she fears, all the progress her daughter has made.

On Tuesday, Kathy testified at the budget hearings, asking that the Senate restore funding proposed by the governor and cut by the House for developmental disabilities, early intervention services and to fully fund the wait list of people awaiting services from the state. It’s not the first time she’s testified in front of the Legislature, and it likely won’t be the last, she noted — Health and Human Services are often eyed for savings during the budget crafting process. [Full story]

Nashua Telegraph Op-Ed: Restore money for rail

J. Christopher Williams is president and CEO of the Greater Nashua Chamber of Commerce. Michael Skelton is president of the Greater Manchester Chamber of Commerce.

The Greater Nashua Chamber of Commerce and the Greater Manchester Chamber of Commerce recently joined together to advocate for the New Hampshire Senate to restore funding in the governor’s budget that would allow the State to continue pursuing passenger rail in southern NH along the Capitol Corridor. Our joint letter of support that was recently sent to the Senate Finance Committee was cosigned by 30 companies based in Nashua and Manchester.

Nineteen of those companies that signed onto this letter are from the Nashua area and include companies like Integra Biosciences, C&M Machining Products, Parallel Wireless, J. Lawrence Hall, and W.H. Bagshaw.

Together with the Manchester Chamber, our two organizations represent more than 1,500 businesses across Southern New Hampshire that employ tens of thousands of our state’s residents and generate millions in economic activity. The Nashua-Manchester corridor also serves as the economic backbone of our entire state; as goes the economic output of our region, so goes the rest of New Hampshire.

Therefore, economic growth along the Nashua-Manchester corridor is important to the overall growth of our entire state’s economy.

The New Hampshire Capitol Corridor rail project could have a transformative impact on New Hampshire’s economy by positively impacting the Nashua-Manchester corridor. We urge the Senate to restore the $4 million in capital funding previously earmarked for the Capitol Corridor’s project development phase. This next phase would allow the state to appropriately vet the feasibility of rail expansion by completing the necessary engineering and environmental analysis of the Capitol Corridor project. If full funding is unavailable, we ask the Senate to consider a phased-funding approach for the project development process.

… At the top of this piece, we specifically referenced companies like Integra Biosciences, Parallel Wireless and C&M Machining Products – just a few of the many companies who cosigned this letter to the Senate, and just a few of the many other companies across our region that understand they need those benefits described above – the ability to attract more young workers in the coming years, along with housing and other mixed-use developments that would sprout around the rail stops and therefore provide appealing places for those workers to live, work and play.

Companies like Integra Biosciences and Parallel Wireless do business around the world, and their work itself is cutting-edge within their respective industries. The 30 companies that signed onto this letter are real-world examples of business entities currently based in southern and who understand our state’s future economic livelihood relies upon connecting New Hampshire’s infrastructure into the rest of New England. Our Manchester-Nashua- Lowell corridor represents the single densest area of population in the entire country that is not currently served by rail. This is not a fact of which our state should be proud, nor is it a fact that speaks well for the ability of our area to attract in the future more companies like those referenced in this editorial and which signed onto our letter of support.

We implore our state senators to consider restoring the $4 million in funding to allow the project development phase of the Capitol Corridor rail expansion project to move forward. Completing this phase will allow for a complete understanding of the costs and benefits of rail expansion and allow policymakers and the public to have the facts needed to consider this important economic opportunity for New Hampshire. [Full op-ed]

The National Union of Healthcare Workers Want DOJ TO Investigate Kaiser Permanente For Excessive Wait Times

NUHW calls on Justice Department to investigate Kaiser Permanente’s long wait times, paper wait lists, and falsified appointment records

Delays in care continue despite $4 million fine by state regulatory agency

Lawsuits demonstrate link between suicides, lengthy delays for patients seeking mental health care treatment

Kaiser Permanente (Ted Eytan Flikr)EMERYVILLE, CALIF. — The National Union of Healthcare Workers (NUHW) sent a letter to U.S. Attorney General Eric Holder last week requesting that the U.S. Department of Justice launch a criminal investigation into Kaiser Permanente’s delayed care and falsification of appointment records, affecting thousands of mental health patients. Kaiser’s practices mirror almost precisely the practices at V.A. clinics throughout the country: patients forced to endure lengthy wait times for appointments; falsified records that conceal these wait times; and bonuses that incentivize managers to maintain low staffing levels.

One key difference between the V.A. scandal and the mental health care crisis at Kaiser is that lawsuits have demonstrated links between patient deaths and delays in care.

Kaiser, with 9.3 million members, is the nation’s largest nonprofit HMO and has been touted by President Obama as a model for quality and efficiency in health care. Yet Kaiser’s record on mental health services shows that private-sector health care is just as rife with scandal as the public-sector V.A. In 2013, California’s Department of Managed Health Care (DMHC) affirmed claims by whistleblowers and levied a $4 million fine — the second largest fine in the agency’s history — against Kaiser for violating state healthcare laws. According to the DMHC’s director, the agency’s actions were “a result of the seriousness of the deficiencies and the failure of Kaiser to promptly correct them.” The HMO also has been hit with two class-action lawsuits for violating patients’ rights and denying them access to mental health care, which allegedly contributed to the suicides of some Kaiser members.

Despite the DMHC fine, Kaiser patients and clinicians report that Kaiser continues to force patients to wait weeks and sometimes months to receive basic care. In 2013, two class-action action lawsuits were filed against Kaiser alleging that patients seeking mental health care treatment committed suicide while waiting for care. In a separate action in 2013, Kaiser agreed to pay $9 million to the families of children with autism spectrum disorders after Kaiser illegally denied them access to appropriate therapy.

In addition, NUHW has filed a lawsuit against Covered California, which violated its own rules when it allowed Kaiser to participate in the state health exchange despite Kaiser’s serious violations. Under the Affordable Care Act, Kaiser has added nearly a quarter million new members to its rolls, exacerbating its failures to provide timely and appropriate mental health care.

Kaiser’s own mental health clinicians — psychologists, therapists, and psychiatric social workers — first blew the whistle on these unconscionable practices in 2011 and documented Kaiser’s practices in a comprehensive report, “Care Delayed, Care Denied.” After a 15-month investigation, the DMHC affirmed the clinicians’ findings and cited Kaiser for multiple violations of California law, including the following:• Kaiser committed “systemic access deficiencies” by failing to provide its members with timely access to mental health services. Instead, thousands of Kaiser’s patients were required to endure lengthy waits for appointments in violation of California’s “timely access” regulations.

• Kaiser’s internal record-keeping system contained numerous problems — including a parallel set of paper appointment records that differed from the HMO’s electronic records — that hid patients’ lengthy wait times from government inspectors.

• Kaiser failed to adequately monitor and correct its violations of state law. Records show that Kaiser was aware of its violations, but failed to take action to correct the problems.

• Kaiser provided “inaccurate educational materials” to its members that had the effect of dissuading them from pursuing medically necessary care and violated state and federal mental health parity laws.

While Kaiser Peramanente is systematically understaffing its mental health services and denying appropriate care to its paying members, the HMO is enjoying record profits — more than $2 billion a year for the past five years, $12.5 billion since 2009, and $1.1 billion in the first quarter of 2014 alone. And Kaiser lavishes huge compensation packages on its top executives: the CEO’s salary is $11.4 million and 22 executives make more than $1 million and have nine retirement plans each.

For more information, see NUHW.org/caredenied.

President Obama Signs Gun Reform Orders, And Yes You Get To Keep Your Guns

Today only 33 days after the horrific shootings at Sandy Hook the people are finally getting real gun reform.  And no the President is not take away all your guns. He even said so today.

“Like most Americans, I believe the Second Amendment guarantees an individual right to bear arms. I respect our strong tradition of gun ownership and the rights of hunters and sportsmen.  There are millions of responsible, law-abiding gun owners in America who cherish their right to bear arms for hunting, or sport, or protection, or collection.”

In a briefing to the press the President laid out his new executive actions to reduce gun violence.  The President and Vice President both spoke about the need to stop the senseless violence and tragedies that are happening more and more.

President Obama stated: “I’m going to do my part.  As soon as I’m finished speaking here, I will sit at that desk and I will sign a directive giving law enforcement, schools, mental health professionals and the public health community some of the tools they need to help reduce gun violence.”

Some of the items include a universal background check on all weapons sales. A ban on all military style assault weapons with a 10 round magazine limit.  President Obama is also pushing funding out to schools to hire additional resource officers, increasing funding to police departments, and better mental health programs. Read all the proposals.

President Obama stated, “We will make it easier to keep guns out of the hands of criminals by strengthening the background check system.  We will help schools hire more resource officers if they want them and develop emergency preparedness plans.  We will make sure mental health professionals know their options for reporting threats of violence — even as we acknowledge that someone with a mental illness is far more likely to be a victim of violent crime than the perpetrator.”

This statement to the country won high praise from some of the more vocal organization against gun violence including the Brady Campaign to Prevent Gun Violence.

“The Brady Campaign stands with the President and Vice President in supporting these comprehensive policy recommendations to address gun violence. The White House has shown tremendous leadership in convening stakeholders and engaging the country in a conversation that the Brady Campaign and so many Americans have been calling for in the wake of Aurora, Newtown, and the 32 gun murders that happen every day in our country …. We also re-affirm the Brady Campaign’s commitment to lead the way toward better public health and safety education programs regarding the almost 300 million guns already in the hands of mostly law-abiding citizens. I strongly believe that now it’s up to us to make real change happen.”

The President of the American Federation of Teachers, Randi Weingarten, also commended the President on his actions today in a written statement.

“The tragic events of Newtown must serve as a clarion call for immediate action to keep our communities safe from gun violence and ensure schools are the safe sanctuaries our children need to learn and grow. We applaud President Obama and Vice President Biden for heeding this call for action with a series of common-sense, balanced proposals that will make our nation safer.”

My Congresswoman, Carol Shea-Porter had this to say after hearing the Presidents plan.

“I agree with the President’s comprehensive approach to addressing gun violence,” said Congresswoman Shea-Porter.  “I will not and cannot forget the never-ending scenes of families and communities in shock and mourning, and I will not ignore the calls of our citizens to do something to help stop the violence.  I support responsible gun ownership because Americans have a right to hunt or defend themselves, and they also have a right to expect to be safe as they go about their daily lives.”

So as you can plainly see, nobody wants to take away your guns.  We all just want to see our work, our schools, our churches, and our cities be safer places.

To Address NH’s Mental Health Problems, We Must Increase Funding To Mental Health Care

As we grieve with the families of Newtown, Connecticut, we should take a moment to reflect on the condition of New Hampshire’s mental health system.

“Mental health care in New Hampshire has become a game of musical chairs.  Budgets are tighter, meaning fewer treatment beds. And patient numbers keep rising, meaning more people left without treatment.  The wait for a bed at NH Hospital, the state’s only psychiatric hospital, is often days, and those waiting stay in windowless emergency rooms occasionally requiring security if the patients get agitated. It is not uncommon for a dozen people to wait at Concord Hospital on a weekend hoping a bed at NH Hospital will open.”  Read the full Business NH article here.

According to a 2011 Dartmouth College Policy Brief,

Over the past decade, the demand for mental health services in New Hampshire has greatly increased while the system has been affected by numerous budget cuts. This has led to reduced or closed programs, staff shortages, layoffs, and extended waiting lists. In addition to direct impacts on the mental health system, the budget cuts have also led to an increased usage in other areas such as correctional facilities, the judiciary system, and emergency rooms.

And that was written before the latest budget cycle – which, among other cuts, sharply reduced the CHINS (Children in Need of Services) program.

[mantra-pullquote align=”right” textalign=”right” width=”33%”]“A certain, probably substantial percentage of these kids — their behavior is going to get worse if they don’t get help,” Lightfoot said [/mantra-pullquote]

The nearly 1,000 children in a given year — 400 to 500 at any given time — who have traditionally been served through CHINS would be reduced to about 50.  “A certain, probably substantial percentage of these kids — their behavior is going to get worse if they don’t get help,” [Jack] Lightfoot said. “When they don’t get help for whatever issue, they become more likely to become a more serious criminal. I think we have to be very careful about that.”

Read the full Fosters article here.

One week ago, the state Department of Health and Human Services announced it would soon reopen a dozen beds at NH Hospital, and would seek additional mental health funding in the next budget cycle.  NH Hospital has closed three units with 60 beds since 2009. Read the full Union Leader story here.

 

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