Over 12,000 low income Arizona residents  loose much of their public mental health coverage today.  Important coverage like non-generic medications, group and individual therapy, case management, housing and transportation assistance as just an example.  Where are these people to go?  What are they to do?

Some have struggled for years to find the right medication “cocktail” and now the rug is being pulled out from under them. They won’t be able to afford the newer, more effective drugs that can cost thousands of dollars a month and they won’t have a therapist or case manager monitoring their changes.  Many are the “working poor” who make just a few too many dollars to qualify for the the state’s medicaid system, AHCCCS;  also  in jeopardy of loosing millions.

Yes, it looks like it could get even worse since  Congress may not extend the states Medicaid assistance. Medicaid assistance from the federal government was voted against by the U.S. Senate last week.  Without it, Arizona’s health care budget falls further into the red.  In a letter to Arizona members of Congress, Governor Brewer complained that “(I)t has become clear that Congress does not have the will to assist states in addressing the very problem that it created.” Based on her combative attitude displayed recently all over the media, I will be surprised if any “Fed” will pay attention.

I guess you can tell I’m angry, but instead of complaining, I wish she would use the same “take charge” attitude towards our state’s health care system as she does toward our illegal immigration issues where no expense spared is the mantra.  We’re soon to be using our local city and state law enforcement officers to enforce federal immigration laws.  Plus, there always seems to be more money to build more prisons to house the additional “illegal immigrants.”  What about using money to house and treat some of our state’s most vulnerable citizens?

The Obama administration launched a new health care reform website yesterday that provides information to the public on “the full range of public and private health insurance plans” that fits their specific circumstances. Mandated by the health reform law, the site will show users how their options “will change in coming years” as the law takes effect. – The Progress Report, July 1, 2010

2009 federal poverty levels have been extended until May 31, 2010 – thank goodness for now. But, given the poor economy the levels may drop and more people could loose their benefits because of it.
It’s all explained in this most recent article from the U.S. Department of Health and Human Services below.

Extension of the 2009 Poverty Guidelines Until at Least May 31, 2010

[ Federal Register Notice, January 22, 2010, (initial extension of guidelines until March 1) — Full text ]
[ Prior Poverty Guidelines and Federal Register References Since 1982 ]
[ Frequently Asked Questions (FAQs) ]
[ Further Resources on Poverty Measurement, Poverty Lines, and Their History ]

Congress has taken action to keep the 2009 poverty guidelines in effect until at least May 31, 2010.

Congressional actions on this matter have been in response to a decrease in the annual average Consumer Price Index (CPI-U) for 2009, projected during 2009 and announced on January 15, 2010 (see http://www.bls.gov/news.release/archives/cpi_01152010.pdf, Table 1A).  In the absence of legislative change, this decrease — the first since the poverty guidelines began to be issued in 1965 — would have required HHS to issue 2010 poverty guidelines that were lower than the 2009 poverty guidelines; that would have led to the “reduction in eligibility” referred to in the Congressional explanatory language quoted below.  Congress took several actions on this matter:

1.  On December 19, 2009, the Congress enacted and the President signed the Department of Defense Appropriations Act, 2010 (Pub. L. 111-118), which included a provision affecting the poverty guidelines.  Section 1012 of this law (as originally enacted, before subsequent amendment) stated that:

Notwithstanding any other provision of law, the Secretary of Health and Human Services shall not publish updated poverty guidelines for 2010 under section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 9902(2)) before March 1, 2010, and the poverty guidelines published under such section on January 23, 2009, shall remain in effect until updated poverty guidelines are published.

The Congressional Record (House) (December 16, 2009, p. H15370) provided the following explanation of this Congressional action in Pub. L. 111-118:

Section 1012 includes a provision to freeze the Department of Health and Human Services poverty guidelines at 2009 levels in order to prevent a reduction in eligibility for certain means-tested programs, including Medicaid, Supplemental Nutrition Assistance Program (SNAP), and child nutrition, through March 1, 2010.

A Federal Register notice about this initial extension of the 2009 poverty guidelines was published on January 22, 2010. (See Federal Register, Vol. 75, No. 14, January 22, 2010, pp. 3734-3735.)

2.  On March 2, 2010, the Congress enacted and the President signed the Temporary Extension Act of 2010 (Pub. L. 111-144), which included a provision affecting the poverty guidelines.  Section 7 of this law amended Section 1012 of the Department of Defense Appropriations Act, 2010, by replacing “March 1, 2010” with “March 31, 2010”.  The effect of this was to extend the 2009 poverty guidelines until at least March 31, 2010.

3.  On April 15, 2010, the Congress enacted and the President signed the Continuing Extension Act of 2010 (Pub. L. 111-157), which included a provision affecting the poverty guidelines.  Section 6 of this law amended Section 1012 of the Department of Defense Appropriations Act, 2010 (as amended by Pub. L. 111-144), by replacing “March 31, 2010” with “May 31, 2010”.  The effect of this was to extend the 2009 poverty guidelines until at least May 31, 2010.

We will provide updated information about the post-May-31 period when it becomes available.

The 2009 poverty guidelines figures that will remain in effect are given below.

NOTE:  The poverty guideline figures below are NOT the figures the Census Bureau uses to calculate the number of poor persons.
The figures that the Census Bureau uses are the poverty thresholds.

The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia
Persons in family	Poverty guideline
1	$10,830
2	14,570
3	18,310
4	22,050
5	25,790
6	29,530
7	33,270
8	37,010
For families with more than 8 persons, add $3,740 for each additional person.

2009 Poverty Guidelines for Alaska
Persons in family	Poverty guideline
1	$13,530
2	18,210
3	22,890
4	27,570
5	32,250
6	36,930
7	41,610
8	46,290
For families with more than 8 persons, add $4,680 for each additional person.

2009 Poverty Guidelines for Hawaii
Persons in family	Poverty guideline
1	$12,460
2	16,760
3	21,060
4	25,360
5	29,660
6	33,960
7	38,260
8	42,560
For families with more than 8 persons, add $4,300 for each additional person.

SOURCE: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199–4201

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Go to Further Resources on Poverty Measurement, Poverty Lines, and Their History

Go to Frequently Asked Questions (FAQs).

Return to the main Poverty Guidelines, Research, and Measurement page.

Last Revised:  04/19/10

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After attending the forum hosted by the Community Partnership of Southern Arizona last week I am no less concerned about what is going to happen to the covered benefits for the huge population of adults with serious mental illness that do not qualify for the state’s Medicaid system (AHCCCS) after July 1st.  The Assistant Deputy Director from the Arizona Health Services Division of Behavioral Health Services explained some of the impact the cuts would have and offered a few suggestions on how the impacts might be minimized.

“Thinking outside the box” was a phrase heard repeatedly and for many attending that answer was not enough to calm their fears. For a population accustomed to difficulties  finding appropriate mental health care that particular phrase has become a mantra.

One question about how the non-title XIX residents will be covered if they are currently in the Arizona State Hospital was never answered.

Of major concern to me is the misguided thought by some in Phoenix that people that are currently taking some of the more expensive, newer anti-psychotics, mood stabilizers and anti-depressants  can now be administered some of the older, less expensive drugs to save money.  What he forgot to say when talking about the older, less expensive medications is that they don’t work for some people.  Hence the reason for being prescribed the newer, more effective medications. Plus, the newer medications don’t have some of the debilitating side effects  that the older medications cause.  (Although, I must admit all of these medications do have some sort of negative side effect)

Even when a certain medication is successfully treating some of the symptoms today,  next week, next month or next year it may loose it’s efficacy and a new medication will need to be introduced; most likely a newer drug.

The state’s crisis system which had up until recently seen some positive advances is now experiencing limited funding as well.   It was suggested at the meeting that family members “step up” to the plate and do what they can to cover the shortages like manning all night crisis phone lines, etc.  on a volunteer basis.  Hum…….I guess that might work if their loved one isn’t in a crisis because their newly prescribed medication is working!