The Bazelon Mental Health Policy Reporter
Issue 2: Volume I : October 21, 2002

Eleventh Hour Politics May Strand Mental Health Initiatives

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With the midterm elections just weeks away and mandatory appropriations bills and other pressing legislative business at an impasse, the politics of 11th-hour legislative negotiations could strand important mental health initiatives until after the elections.

Lawmakers have already shelved some important issues for people with disabilities. The 1996 law authorizing the Temporary Assistance for Families (TANF) program was set to expire at the end of September, but Congress extended the law until December 31. Members of Congress now have additional time to hammer out differences between the House and Senate versions of the bill that would reauthorize TANF.

Since a substantial number of the program's beneficiaries are affected by a mental or physical impairment, TANF reauthorization is of crucial importance to people with disabilities. Adults who receive TANF benefits were three times more likely than adults not receiving benefits under the program to have at least one physical or mental health impairment, according to a study released last year by the General Accounting Office (GAO). TANF recipients with impairments were only half as likely to leave the welfare rolls as those without impairments and when they did they were less likely to be employed, according to the GAO. In fact, 36 percent of recipients with impairments had no income source when they left the rolls.

Disability advocates fear that the new work rules in the House bill may exacerbate this trend and have pushed for provisions to help states provide supports and services - such as mental health and substance abuse counseling and job training - that families need to move toward greater self-sufficiency.

The extension has done little to clarify the bill's future. Lawmakers are considering a wide array of policy options, from delaying the rewrite of the law until the next Congress to simply extending the current law for one to three years.

By postponing action on other important initiatives, the continuing resolution may give lawmakers political cover for decisions that might otherwise become election year issues for voters concerned with mental health policy. But with elections out of the way, lawmakers could be less responsive to constituent concerns.

Action on most spending bills - including the Labor Health and Human Services appropriations bill that funds important mental health programs through the Department of Health and Human Services' Center for Mental Health Services - will most likely be delayed until after the elections.

Other issues may suffer as well. House Energy and Commerce Chairman Billy Tauzin (R-LA), formerly a supporter of the Family Opportunity Act's provisions to increase access to mental health services to children through expanded Medicaid eligibility, appears to be considering alternatives to the bill's Medicaid provisions. The bill has bipartisan support in Congress and is endorsed by mental health and family advocates across the country. Such a dramatic change could stall passage indefinitely.

At the moment, political assessments on any bill's future are speculative. But the uncertain political climate after the elections will almost certainly have important implications for mental health policy.

Take action

Lawmakers need to hear from you! Here's how to make sure your voice gets heard...

Call: Contact Senators and Representatives at their state/district offices during the recess or call the Capitol switchboard at 202-224-3121.

Write a letter to:
The Honorable (first and last name)
United States Senate
Washington, DC 20510

OR

The Honorable (first and last name)
U.S. House of Representatives
Washington, DC 20515

Email: To contact your member of Congress or Senator by email, please visit http://www.house.gov or http://www.senate.gov. All Senators and members of Congress provide a means of contacting them on their web page. Be clear and concise in your message and remember to include your full name, mailing address and zip code. Most congressional offices will not respond to email from people outside of their districts, so make sure you introduce yourself as constituent.

Newsbytes

Senators Introduce Criminal Justice Bill

Several senators last week introduced a bill to address issues raised by the growing number of children and adults with severe mental health conditions who are ending up in correctional facilities. Senators Mike DeWine (R-OH), Patrick Leahy (D-VT), Sam Brownback (R-KS), Charles Grassley (R-IA) and Maria Cantwell (D-WA) introduced S. 3147 - "The Mentally Ill Offender Treatment and Crime Reduction Act of 2002" - to foster local collaborations between the criminal justice and mental health systems.

The Bazelon Center has withheld endorsement of the bill, concerned that the legislation neglects pre-booking diversion strategies, which many experts believe to be and most effective intervention for people with mental illnesses in the criminal justice system. The DeWine legislation does not include re-entry programs to help people with mental illnesses transition from the criminal justice system to life in the community. Nor does the bill's narrow focus on treatment acknowledge the critical need for stable housing, job-related services and other supports in the community. The Bazelon Center plans to work with the next Congress on legislation to deal with the criminal justice issue in a more holistic manner.

• Learn more about the criminalization of people with mental illnesses.

Election Overhaul Legislation Clears Congress

The Senate last week joined the House in approving the conference report on the election overhaul bill (H.R. 3295) drafted in response to voting difficulties during the 2000 presidential election. The legislation would provide national election standards and would authorize almost $4 billion to help states meet those standards. Under the bill, every polling place would be required to have at least one voting machine accessible to people with disabilities. The legislation also would allow a provisional ballot to be cast when identification is not available - a difficulty sometimes experienced by people with mental illnesses. The ballot would be counted later only if the individual can prove eligibility. State opposition forced removal of provisions to give individuals the right to sue if the new standards are violated, thus eliminating an effective means of encouraging compliance with the new standards. The President is expected to sign the bill soon.

• Read the bill text or PDF*
• Learn more about voting rights

*You will need to download the free Acrobat Reader to view this file.

Senate-Bound Bill Would Mandate Collection of Names of People Who Have Been Involuntarily Committed

On October 15 the House of Representatives approved (H.R. 4757) legislation designed to improve the National Instant Criminal Background Check System (NICS). The legislation, as drafted, raises concerns over privacy protection issues for people with mental illnesses and the Bazelon Center has vigorously opposed stigmatizing language in the bill. The House bill has been forwarded to the Senate for quick consideration. An attempt earlier this month in the Senate to pass a version of the bill under a unanimous consent agreement failed.

• Read the House bill text or PDF*
• Learn more, read the Bazelon Center's August 20 Legislative Update

*You will need to download the free Acrobat Reader to view this file.

Restraint and Seclusion Policy Reviewed

Regulations concerning restraint and seclusion standards will be discussed at a town hall meeting being held by the Department of Health and Human Services on October 29. The regulations, promulgated in 1999 after intense lobbying by mental health advocates, require that a physician or a licensed independent practitioner (LIP) make a face-to-face assessment of the patient within one hour of the imposition of restraint or seclusion. The rules apply to all Medicare and Medicaid participating hospitals that serve children and adults with mental illnesses, including psychiatric hospitals. Hospitals and their provider groups have consistently challenged the requirement.The town hall meeting is open to the public for participation and attendance.

• For more information on the meeting, visit the October 11 Federal Register online.

Available exclusively to our online subscribers, the Mental Health Policy Reporter supplements the Bazelon Center's action alerts and legislative updates by providing activists with a regular bulletin on significant policy developments that affect people with mental illnesses. Subscribe online at http://www.bazelon.org/takeaction/alerts/subscribe.htm.