Bazelon Center Mental Health Policy Reporter

Welcome to the Bazelon Center for Mental Health Law Policy Reporter. Available exclusively online and to our email subscribers, the Reporter supplements the Bazelon Center’s Action Alerts by providing a periodic bulletin on significant policy developments that affect people with mental illnesses.

Vol. X, No. 3, August 19, 2011

Debt Ceiling Lifted, But Cuts Loom

As Congress debated raising the nation's debt limit or ceiling in recent months, advocates worked to shield important services and supports for children and adults with mental disabilities. The final vote on August 2 brought sighs of relief, but only briefly. Now all eyes turn to the dozen lawmakers on the new “supercommittee,” established to identify deficit-reducing cuts and, possibly, revenue increases. However, advocates must continue to warn the rest of Congress -- who will vote on the committee’s recommendations -- against spending cuts or program changes that would harm people with mental illnesses and other disabilities.

While Members of Congress are back in their districts this month, tell them to protect investments in our country's most critical programs for our most vulnerable Americans.

This issue of the Mental Health Policy Reporter also contains mixed news about housing for veterans with disabilities and service dogs.

In this issue:

Reining in the Deficit: Congress’ (and Advocates’) Work Continues

Deficit reduction will continue as a priority when lawmakers return from their annual August recess. After months working to address the August 2nd Treasury-imposed deadline on the debt ceiling, lawmakers adopted legislation (Budget Control Act of 2011, Public Law 112-25). The Act allows the debt limit to be raised to $2.4 trillion through a two-step process and caps discretionary spending at nearly $1 trillion over 10 years. It also establishes a 12-member bipartisan, bicameral Joint Select Committee on Deficit Reduction, also known as the “supercommittee,” charged with recommending proposals to produce at least $1.5 trillion in additional federal savings, including from entitlement changes, revenue increases and discretionary cuts.

See how your Senators and Representative voted on the Budget Control Act. Other documents of interest include:

The Bazelon Center, together with our colleagues in the low-income and disability advocacy communities, advocated successfully to thwart cuts to entitlement programs -- including Medicaid, Social Security, Supplemental Security Income (SSI),  Temporary Assistance to Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP, the food stamp program) -- in the initial round of budget cuts and from automatic cuts if Congress is unable to agree to at least another $1.2 trillion in cuts before the end of the year. This does not mean, however, that these programs are out of danger, since all are potential targets for cuts by the plan that the Joint Select Committee will put forward for a vote. 

Should the Joint Select Committee fail to produce at least $1.2 trillion in savings, or if Congress rejects its recommendations, an enforcement mechanism called “sequestration” will be triggered. This would phase in, starting in 2013, across-the-board cuts applied equally to defense and non-defense spending, including programs and services administered and funded through SAMHSA. In this case, further cuts to discretionary funding would pile on top of approved reductions and cuts enacted in the fiscal year 2011 omnibus appropriations package.

In sequestration, Medicaid, Social Security, SSI, TANF, SNAP and several other programs are protected from cuts. Medicare beneficiaries would also be protected from cuts if sequestration is triggered, though providers would face payment cuts of no more than 2 percent. (For more information about the sequestration process, see the Center on Budget and Policy Priorities.)

Congressional leaders met the first important deadline of the Budget Control Act by appointing the following members to the Joint Select Committee:

Senate Members:
Sen. Patty Murray (D-WA), Co-chair 
Sen. John Kerry (D-PA) 
Sen. Max Baucus (D-MT) 
Sen. Jon Kyl (R-AZ) 
Sen. Pat Toomey (R-PA)                      
Sen. Rob Portman (R-OH)     

House Members:
Rep. Jeb Hensarling (R-TX), Co-chair
Rep. Dave Camp (R-MI)
Rep. Fred Upton (R-MI)
Rep. Chris Van Hollen (D-MD)
Rep. James Clyburn (D-SC)
Rep. Xavier Becerra (D-CA)

The Joint Select Committee will be the focus of immediate attention, given the fast-track timetable for its members to produce and vote on policy recommendations placing entitlement programs, tax reforms and other important programs on the potential chopping block by November 23. Congress must then vote on the recommendations by December 23. If Congress fails to vote or fails to approve the recommendations, automatic across-the-board cuts will occur.

As the committee deliberates, the Bazelon Center will continue our work to protect Medicaid, SSI and other vital services and supports for adults and children with mental disabilities. (See the Bazelon Center press release Default Averted But Threats Persist to Medicaid, SSI and Other Key Supports.)

What You Can Do

While Members of Congress are back in their districts this month and when they reconvene in Washington, advocates should urge them to:

Veterans Affairs Actions a Mixed Bag

Last year, Congress authorized the U.S. Department of Veterans Affairs (VA) to provide service dogs to individuals with mental illnesses.  When the VA issued its proposed rule this year, the agency limited the program to veterans with physical disabilities, specifically denying service dogs to veterans with mental illnesses. The Bazelon Center filed comments opposing the VA’s abdication of its responsibility, under the authorizing statute and the agency’s own Section 504 rules, to treat veterans with all disabilities similarly. 

However, the VA also took some positive steps this summer for veterans with disabilities. The VA awarded its first grants under its new Supportive Services for Veteran Families (SSVF) program. The August funding was awarded in 85 grants to non-profit organizations and consumer co-ops, which will use the funds to provide supportive services to very low-income veterans living in or moving into permanent supportive housing. 

Earlier, in July, the VA and the U.S. Department of Housing and Urban Development (HUD) awarded the first half of VASH (Vets Assistance for Supportive Housing) rental vouchers. The vouchers will go to homeless veterans for use in private housing.

Both SSVF and VASH require veterans to participate in the case management and supportive services offered in order to be eligible. This requirement, unfortunately, will mean that some vulnerable people will not accept housing because, for example, they have had negative experiences with service systems in the past.

This is why very successful programs, like Housing First, do not require people to participate in services in order to be eligible for housing. Once a person is housed, this type of program will work to engage these individuals and will rely on a positive -- rather than a coercive -- approach. Nonetheless, these VA programs provide much-needed funding that assists with housing-related expenses, including temporary financial assistance for rent, utility bills, security and utility deposits, moving costs, emergency supplies, transportation and child care. (See the VA’s FAQs on SSVF.)

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