Zyprexa

This is known as a "step therapy" requirement, and it was supposed to be waived during the first several months of the Medicare drug program.

But many drug plans are insisting on the requirement, said Galletta.

The start-up of Medicare's huge new drug program has been bumpy for tens of thousands of seniors, and in recent weeks more than 20 states have stepped up to ensure that consumers continue to get their medication.

Another issue for nursing home residents is that early information indicates at least 100,000 of them nationwide somehow got lost in data exchanges and weren't assigned to a Medicare drug plan by Jan.

1, as expected, said Tom Clark, director of policy and advocacy for the American Society of Consultant Pharmacists.

If residents previously received their drugs through Medicaid - a joint state and federal health program for the poor - they shouldn't be charged substantial co-payments on drugs now.

But because of data issues, those co-payments are being billed in many cases.

"I have hundreds and hundreds of these charges sitting on my desk and accruing every day," said John Stoecklin at HealthOne of Southern Illinois, based in Marion.

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And the antidepressant Zoloft-a widely used and highly effective antidepressant.

I have no idea why these drugs are not covered.

Another one is the Prolixin injection, one of the cheapest medications for psychosis.

It is used for people who are noncompliant and it just costs pennies.

Why is this not covered?

It is blindness or stupidity." In order to get these drugs for her patients, Dr.

O'Hagan now has to produce evidence that she has already tried other medications, and she must prove that the client has been on this particular drug a long time.

"I have been calling the Medicare number, but I cannot get through to a human being," said O'Hagan.

"I was on the phone for hours.

Now I am calling the plans.

I got through to one health plan for one person, but I have about twenty others." She also found that the local pharmacist was not honoring the transition policy.

"He does not believe he will be reimbursed." Feeling the political heat, President George W.

Bush has directed Medicare insurers to take immediate steps to cover 30-day emergency supplies of drugs for dual eligible citizens and the Bush administration insisted that low-income co-pays not exceed $5.

Republicans and Democrats seem united in this decision to publicly bolster the transition policy.

Meanwhile, the administrator of the Center for Medicare and Medicaid Services, Mark...

30 from West Oaks Hospital, a care center for mentally ill patients, to the jail at 701 N.

San Jacinto, where he was placed among the general population.

Kelley was transferred to a medical unit at the 1200 Baker facility Jan.

12 after he caused a disturbance.

"The doctors did say that they transferred the papers with him," she said.

"But I looked at his eyes.

I could tell he was sick.

He was off his medication." McWilliams said Kelley's mental disorder was noted when he was booked, but he did not know whether Kelley had been receiving any medication at the jail prior to his move to Baker Street on Jan.

12, when he refused any treatment.

Medical historyAlthough Kelley was not able to communicate information about his medical history to the jail staff, McWilliams was not aware of any effort to contact the family for that information — and neither was Roberson.

"The only time they contacted us was when he passed," she said.

Dr.

Britta Ostermeyer, a forensic psychiatrist and assistant professor of psychiatry at Baylor College of Medicine, said jails have a responsibility to ensure that all mental health inmates receive the proper treatment, including psychiatric care, and should recognize psychotic behavior like what Kelley exhibited in his final days "not as a sign of being bad, but as a sign of som...