The Bazelon Mental Health Policy Reporter
Issue 1: Volume II : January 16, 2003

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In this Issue:

New Congress Brings Likely Action on Mental Health Funding, TANF

Newsbytes

• Public Sector Recommendations Released
• Amendment to Restraint and Seclusion Rule Considered
• SAMHSA Considers Changes to Mental Health Block Grant
• Bazelon Center Releases Mental Health Courts Paper
  

New Congress Brings Likely Action on Mental Health Funding, TANF

When the 108th Congress convened January 7 under new leadership, it faced a number of unresolved issues from the last Congress, including several key measures affecting people with mental disabilities.

Unfinished spending bills from the 107th Congress will be one of the first issues that the newly Republican-controlled Congress has to address. Appropriators hope to pass an omnibus appropriations bill before the President's State of the Union Address on January 28. This spending bill will include fiscal year 2003 appropriations left unresolved when Congress adjourned in November, including the Labor, Health and Human Services (Labor HHS) spending bill that provides funds for many community mental health services.

The Bush Administration's 2003 budget request had cut funding for several mental health programs, but a Senate committee restored many of those dollars last year. However, advocates fear those monies may be absent from the final spending package signed into law, believing that appropriators may ultimately cede to the White House position on the spending.

Another high-priority issue is reauthorization of the Temporary Assistance for Needy Families (TANF) program. Before adjourning, the 107th Congress extended the welfare program's authorization until this year. Congress now faces a self-imposed March deadline for reauthorizing TANF and House and Senate committee leaders have promised to fast-track consideration of welfare reform.

In a press statement released this week, President Bush called on lawmakers to enact the administration's welfare reform agenda - a proposal that would expand program recipients' work requirements and reduce states' flexibility to count substance abuse and mental health counseling toward their work quota. The proposal also freezes important TANF funding for the next five years, without regard to inflation.

Advocates believe that the President's proposal would fuel cuts to needed services for these individuals and unfairly sanction TANF recipients, including those with mental disorders, who may need supportive services to get a job and remain employed. TANF recipients are three times more likely to have at least one physical or mental health impairment than adults not receiving benefits under the program, according to a GAO study.

While action seems imminent on TANF and unfinished fiscal year 2003 spending bills, other issues important to people with mental disabilities are emerging as priorities in the 108th Congress. These include reauthorization of the Substance Abuse and Mental Health Services Administration and the Individuals with Disabilities Education Act. The Bazelon Center Mental Health Policy Reporter will report on these stories as they develop.

• Read President Bush's Press Statement on TANF
  

Newsbytes

Recommendations Presented to Mental Health Commission
Bazelon Center policy director Chris Koyanagi last week presented policy recommendations to the President's Commission on Mental Health on behalf of several national mental health organizations. The groups recommended changes in public policy on employment services and disability benefits, children and adolescents, co-occurring mental health and substance abuse disorders, criminal and juvenile justice systems, evidence-based practice and research, housing, workforce development, Medicaid and Medicare.

• View the recommendations

Amendment to Restraint and Seclusion Rule Considered
Three House members have expressed concerns with a Centers for Medicare and Medicaid Services (CMS) proposal to amend the 1999 rule that requires a face-to-face evaluation by a physician or licensed independent practitioner within one hour of the commencement of the restraint or seclusion of an individual. The regulations apply to hospitals- including psychiatric hospitals- that participate in the Medicare and Medicaid programs. In a January 9, 2003 letter to CMS, Representatives Pete Stark (D-CA), John Dingell (D-MI) and Ted Strickland (D-OH) expressed their concern over efforts to weaken this patient protection. In October, the Advocates Coalition for the Appropriate Use of Restraints testified in support of the existing requirement.

• Read the House members' letter on restraint and seclusion
• Read an article on the proposed rule change from the American Medical Association News

SAMHSA Considers Changes to Mental Health Block Grant
The Substance Abuse and Mental Health Services Administration (SAMHSA) is requesting comments on its proposal to replace what is known as the mental health block grant with a "Performance Partnership" grant program. SAMHSA's Center for Mental Health Services (CMHS) has proposed a number of measures that states must report regarding their state systems. These measures were developed in collaboration with state mental health authorities, but have not yet been reviewed by other interested parties. Public comments on the change are due within 60 days of the proposal's December 24, 2002 publication in the Federal Register.

• Read the proposal

Bazelon Center Releases Mental Health Courts Paper
The Bazelon Center has released "The Role of Mental Health Courts in System Reform", a position paper that examines the use of mental health courts in the United States as a response by communities to the increasingly common arrest and incarceration of people with serious mental illnesses.

• Read the report

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.