Welcome! Available online and to our email subscribers, The Reporter supplements the Bazelon Center for Mental Health Law’s press releases, action alerts, and updates by providing a periodic, in-depth bulletin on significant developments in public policy and law that affect people with mental disabilities.
Vol. XII, No. 4, December 20, 2013
Defeat the Murphy Bill (H.R. 3717)
In This Issue:
The Bazelon Center for Mental Health Law knows the importance of protecting and advancing the rights and opportunities of people with mental disabilities no matter the season. We ask our supporters to take a moment this holiday season to remind Congress that people with mental disabilities are no less deserving of their freedoms and dignity than Americans without disabilities. Please ask your U.S. representative to not co-sponsor H.R. 3717 — a shockingly regressive bill that would do great harm to Americans’ privacy rights and legal representation, and dismantle three decades of building comprehensive mental health services and supports in the community. Read more below about how you can help.
This issue of The Reporter also highlights system reforms the state of Illinois is pursuing to ensure that individuals with mental illnesses are afforded the option to live independently in their own homes in the community. In addition to other topics below, the healthcare reform law (a.k.a. Obamacare or the Affordable Care Act) contains a very important provision that advocates can leverage in the fight against discrimination in insurance coverage, service delivery, and other aspects of healthcare.
In partnership with other disability groups, the Bazelon Center drafted a statement addressing Representative Tim Murphy’s proposed legislation that, if passed, would reverse much of the progress this country has made in the last 30 years in creating comprehensive mental health services and supports.
The bill, H.R. 3717, seeks to eliminate critical legal representation for individuals with psychiatric disabilities, strip their privacy rights, and redirect federal funds from low-cost, innovative community services for high-cost, involuntary services that are ineffective, including involuntary outpatient commitment. The changes sought by the bill fly in the face of major research and experience that have long found little-to-no link between mental health and violence.
What You Can Do
Please call or write your member of the U.S. House of Representatives and urge her/him to not co-sponsor the Murphy mental health legislation, H.R.3717. Click here to find and contact your lawmaker. You can also use the Capitol Switchboard at 202-224-3121. Below you will find talking points followed by detailed explanations.
The bill eliminates critical legal advocacy on behalf of individuals with psychiatric disabilities.
- The bill would eviscerate the primary system of legal advocacy for individuals with psychiatric disabilities, leaving them without means to enforce their legal protections from discrimination in key areas of life, such as education, employment, housing, health care, community living, voting, and family rights. The “protection and advocacy” program for people with psychiatric disabilities has been a leading driver of improvements in mental health service systems for the last several decades.
- The bill cuts funding for the protection and advocacy program by 85%, prevents the program from engaging in systemic advocacy on behalf of people with psychiatric disabilities, and prevents the program from conducting advocacy on any issues except for abuse and neglect.
The bill reduces privacy protections for individuals with psychiatric disabilities.
- The bill would strip away privacy protections under the Health Insurance Portability and Accountability Act from individuals with psychiatric disabilities and provide them with lesser privacy safeguards than everyone else. The bill would give broad latitude to family members and service providers to override the wishes of individuals with psychiatric disabilities to keep information about their mental health treatment confidential. Ironically, it is people with psychiatric disabilities who are often most in need of privacy protections due to widespread prejudices and stereotypes.
The bill redirects federal money from innovative programs to involuntary outpatient commitment, which is expensive and ineffective.
- The bill would prohibit states from receiving federal mental health block grant funds that are used to support innovative services unless they are using involuntary, court-ordered outpatient commitment, an ineffective and costly approach that runs counter to recovery, independence, and choice. The bill would also significantly reduce funding for important and innovative community-based services, in favor of involuntary treatment.
The bill would increase needless institutionalization.
- The bill would fundamentally change the Medicaid program by allowing states to obtain federal Medicaid reimbursement for inpatient psychiatric hospital services for non-elderly adults. These services have been the responsibility of states since the beginning of the Medicaid program almost fifty years ago. The exclusion of federal funds for these services has been an important means of promoting community integration. Federal reimbursement for these services would result in large numbers of individuals with psychiatric disabilities being served needlessly in hospitals, driving mental health systems backward.
In an effort to expand scattered-site supportive housing for people with serious mental illnesses, the Bazelon Center continues to be very active in ensuring the best possible implementation of a model settlement agreement we achieved in Illinois. Williams v. Quinn, as the case is known, is a class action involving the community integration claims of thousands of individuals with serious mental illnesses who have been consigned to mental health nursing homes. Our focus on scattered-site supportive housing is essential to community integration, because this kind of housing is integrated (i.e., scattered throughout the community’s mainstream housing stock) and residents with mental illnesses receive the services and supports that they need to live successfully in their own homes.
As a result of significant advocacy by our staff, the state of Illinois is making numerous changes to better implement the Williams settlement. For example, the state is developing new services so such that class members can receive additional help with daily living skills, have around-the-clock access to peer support services, and benefit from better integration of medical and mental health services. The state is also developing new crisis services to divert people from emergency rooms, psychiatric hospitals, or adult homes.
In addition, the state is retraining the agencies that assess nursing home residents for transition to community settings, to ensure that these assessments reflect the preferences and capacities of the individual and the requirements of the settlement. So far, approximately 786 individuals have either moved into community settings (almost exclusively in scattered-site supportive housing) or have signed a lease and are in the process of transitioning out of their nursing homes into such housing.
In response to a request for information from the U.S. Department of Health and Human Services, the Bazelon Center drafted comments with the Consortium for Citizens with Disabilities Rights Task Force concerning the anti-discrimination provision, Section 1557, of the Affordable Care Act (also known as healthcare reform or Obamacare).
Our comments focused on certain types of discrimination the ACA can help address, such as: the failure to cover the needed services essential for individuals with psychiatric disabilities to live in their own homes; setting reimbursement rates that result in needless institutionalization; failing to offer coverage that is as effective for individuals with disabilities as for individuals without disabilities; and failing to offer coverage that is as effective for individuals with a particular type of disability as for individuals with other types of disabilities.
While they do not include all of our desired changes, the Obama administration’s final regulations of Section 503 of the Rehabilitation Act will provide significant opportunities to increase employment for people with disabilities, including those with psychiatric disabilities. The employment rates for people with disabilities remain far below the employment rates for any other group tracked by the Bureau of Labor Statistics, and people with significant disabilities participate in the workforce at less than one-third the rate of the general population. The new Section 503 rules are an important step to help address this problem.
We commend the Labor Department’s efforts to ensure that Section 503 includes a goal that 7% of each part of federal contractors' workforces will be individuals with disabilities. Such a goal has long been necessary to make implementation of Section 503’s affirmative action requirements meaningful and to more closely align these requirements with current affirmative action obligations relating to race, ethnicity, and gender.
The Bazelon Center has consistently sought to ensure the voting rights of individuals with mental disabilities as we recognize that the right to vote is a key component of self-determination. At the request of the National Council on Disability (NCD), Bazelon Center staff testified at the first hearing of the Presidential Commission on Election Administration concerning the voting rights of people with psychiatric disabilities and made recommendations on topics the Commission should address. President Obama created the Commission to improve voters' experiences at the polls, in response to excessively long lines and other matters in the 2012 election.
The Bazelon Center also participated in a roundtable discussion at NCD where the commissioners were also invited to participate. The Bazelon Center subsequently contributed to NCD’s written comments to the Commission, and submitted our own comments as well.
The Bazelon Center applauds the U.S. Senate for confirming Chai Feldblum for a second term on the Equal Employment Opportunity Commission (EEOC). Commissioner Feldblum has been a strong advocate for people with disabilities and has earned a second term to continue her work.