Peer Support Agencies Save States Money
Some people up here still think I saved New Hampshire’s network of peer support agencies in 2003. Actually, the directors and members of the state’s 15 peer support agencies saved it, but it could not have happened without me.
Members of peer support agencies persuaded the Republican majority in the state Legislature to reject the 60% budget cut the governor and state mental health bureaucracy had proposed for the 15 peer support agencies.
As chair of the state’s Mental Health Consumer Advocacy Council (called the ConsumerCouncil in shorthand), I was captain of the team fighting for peer support agencies.
A Crippling Blow to Peer Support Agencies
A 60% cut down to $1 million for the coming year, for all 15 peer support agencies combined, meant closing half the centers completely, leaving the rest with no money for support and recovery programs, just day care for adults.
Most everyone in the state had seen a conservative austerity trend coming before the 2002 election. The Consumer Council held a 2-day retreat to train members of peer support agencies to be effective legislative advocates (lobbyists).
We thought we would use those skills to support the state mental health budget, but when we saw the actual budget proposal in February, 2003, it contained that crippling cut for peer support agencies.
So we decided to use what we’d learned at the retreat to oppose the mental health budget, and advocate for the peer support agencies.
Peer Support Agencies and Republican Values
In 2002, voters elected Craig Benson, an extremist conservative businessman with no government experience, who ordered draconian cuts in, state spending, especially on health and human services.
The Republican majority in the NH Legislature was not extreme like Benson, who took office in January 2003.
Most NH Republican lawmakers believed in frugal, efficient, competent government that stayed out of people’s wallets and personal lives.
They wanted people to be empowered, employed, and independent, for their own dignity, not just to save money on state human services.
The Consumer Council had Medicaid statistics proving that peer support agencies, which are so much cheaper than Community Mental Health Centers (CMHC’s), save the state serious money, in addition to making members of peer support agencies more independent and empowered.
People active in peer support agencies, who also received medical services in CMHC’s, used fewer units of the most expensive Medicaid services than people who used only CMHC’s: hospital beds, emergency room visits, one-on-one visits in the community with CMHC staff, and psychiatrist visits.
The study, by the Dartmouth Psychiatric Research Center, compared what Medicaid calls “high utilizers of services” to other high utilizers.
Convincing Members of Peer Support Agencies They Could Convince the Legislature
Peer support agencies could count on support from all the Democrats, and we could convince enough Republicans to defeat the budget cut, I believed, if I could first convince the directors and members of the peer support agencies that it was possible. Without active participation by members all over the state, peer support agencies were doomed.
The directors of the peer support agencies were highly motivated to save their programs, protect their members, and keep their jobs. But the members had never “fought City Hall” before, and were used to being ignored by policy makers.
We could win if enough members of peer support agencies told enough Republican Legislators that peer support fosters Republican values: independence, self-sufficiency, and employment.
NH’s Unique State Legislature
The NH House has 400 members; the state Senate, 24. They all get paid $100 per year and have no personal staffs. They post their home phone numbers on the Legislature’s website.
Since they can’t be experts on every issue, members get their information from their party leaders, the state bureaucracy, lobbyists, and voters in their districts, who tell them how a bill will affect them personally.
By far, personal stories from voters in their districts are the input they value most, and hear the least. Three calls from constituents on an issue is a groundswell, and five is an earthquake, if the calls come from people in the representative’s home district, who can vote for them. House elections are often decided by less than 100 votes, and big money is not a factor. In fact, conspicuous spending on a House race, beyond brochures and yard signs, usually backfires.
It was perfect for an organized grassroots lobbying campaign by members of peer support agencies, provided the representatives thought they were being lobbied by interested individual citizens, not an organized campaign. They ignore petitions, form letters, phone messages, and post cards that say the same things in the same words. They require no thought or effort by the voter.
Everyone would have to tell his own story, write his own letter, in his own words, about how peer support agencies improved the self-esteem, sense of self-worth, employability, and social networks.
Peer Support Agencies Became a Grassroots Lobby
Our peer support agencies could save their programs by telling enough lawmakers their personal stories of how peer support agencies help them, and what losing them would mean.
In their own words, their stories should strike Republican values: peer support agencies give them more independence from government benefits, and many could truthfully say they got their first jobs in years thanks to a current work history they got first in peer support agencies. They had become proud taxpayers, not dependent, stigmatized tax consumers.
The directors of the peer support agencies, in every region, made sure their members made the phone calls, wrote the letters, and attended the budget hearing in the Statehouse and the rally outside on the lawn. No other human service lobby did that in 2003, especially the CMHC’s.
We told our success stories to the Legislature; CMHC’s, who were competing with peer support agencies for the same money, sent a paid lobbyist. That backfired. Lawmakers started asking, if CMHC’s are as poor as they say, how can they afford to pay a lobbyist?
Selling Peer Support Agencies Through the Media
I coordinated the media effort, and made the media contacts. The conservative NH Union-Leader, the state’s largest, most influential, newspaper, ran a story about peer support agencies under the headline “Budget cut will cost the state money.” The person I talked to there got it.
Two of the state’s three TV stations covered the rally, and the Associated Press sent the story to every newspaper in the state. The smaller TV station opened its evening news with a member of one of the peer support agencies crying straight into a camera, “They can’t close that center. They just CAN’T close that center.”
The big, influential station showed a clip of me addressing the members of peer support agencies from Daniel Webster’s statue on the Statehouse lawn: ”We are NOT the helpless people who were released from asylums 25 years ago. We have a voice, and we will be heard.”
State Mental Health Director Supports Peer Support Agencies
When reporters covering the rally asked Geoffrey Souther for a comment as head of the state mental health authority, Geoff was caught between his governor and his own strong belief in the value of peer support agencies.
“I’m not going to tell you $1 million is enough for 15 peer support agencies,” Mr. Souther told the media. “Peer support agencies empower people. This rally proves it. Nothing like this could have happened five or 10 years ago.”
A few weeks later, the Legislature created a new line in the budget for peer support agencies, with enough money to maintain all 15 locations.