The Bazelon Mental Health Policy Reporter

Volume III : Issue 1 : January 22, 2004

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What's in this Issue?

• Feature Article: 2004 Preview

Newsbytes

• Lawmakers Finalize Spending Bill
• Supreme Court Hears Key ADA Case
• Bazelon Center Honors Maine Senator

2004 Preview

It’s only January, but 2004 promises to be a hot year for key mental health legislation. In this Reporter, we look at some of the priority issues for 2004.

Mental health advocates will continue to fight discrimination by private insurers against people with mental illnesses. Senate Minority Leader Tom Daschle (D-SD) has identified mental health parity legislation as a key priority for lawmakers to consider when they return.

The statement comes nearly two years after President Bush called on Congress to pass a mental health parity bill that he could sign. Negotiations on the “Senator Paul Wellstone Mental Health Equitable Treatment Act” (S. 486, H.R. 953) have repeatedly stalled, despite broad bipartisan support for the bill.

To break this congressional logjam, some parity supporters are now considering an alternative modeled on parity legislation passed in 1996. Like that law, the compromise would require parity in private insurance coverage of lifetime and annual dollar limits for mental health and medical/surgical services. The alternative would also require parity for day and visit limits, co-insurance and co-payments, deductibles, and maximum out-of-pocket expenses. The compromise does not explicitly require parity in coverage for a specific list of mental disorders—a contentious item in other versions of the bill.

Another priority issue is reauthorization of the Substance Abuse and Mental Health Services Administration (SAMHSA), which provides critical funding for programs to help people with mental illnesses. Advocates hope to use the reauthorization as a springboard for needed reforms to the nation’s public mental health system. The Bazelon Center and others will urge lawmakers to give the agency the resources to help realize the fundamental transformation in mental health services the President’s New Freedom Commission on Mental Health called for last year. Specific reforms include better integration of physical and behavioral health, encouraging effective consumer-directed services, ending the fragmentation of services for children with mental or emotional disorders and making available resources to support single, coordinated service plans for adults with mental illnesses.

The lingering debate on reauthorization of the Individuals with Disabilities Education Act (IDEA) will likely be resolved this year. The House passed IDEA legislation last April (H.R. 1350), but reauthorization stalled when the Senate failed to pass its bill (S. 1248) before recessing for 2003. Neither version would protect students with disabilities from discrimination as well as current law does. However, the Senate bill would preserve functional behavioral assessments that help prevent unfair exclusion and enable school administrators to design effective behavioral interventions and supports to reduce or eliminate behaviors that may otherwise interfere with learning. Senate Majority Leader Bill Frist (R-TN) has indicated that IDEA reauthorization will be a top priority this year.

Other bills to watch include the Keeping Families Together Act (S. 1704 and H.R. 3243) and other bills to close the gaps in services for children with mental or emotional disorders, possible legislation on changes to Medicaid, reauthorization of the Temporary Assistance for Needy Families program (H.R. 4 and S. 1523), annual spending bills and legislation introduced last year to help divert people with mental illnesses from the criminal justice system (S. 1194).

It’s too early to say what might or might not be accomplished in this election year, but lawmakers are sure to have their hands full dealing with these and other important issues.

Newsbytes

Lawmakers Finalize Spending Bill

The Senate has approved final passage of the conference report on a catch-all omnibus spending bill to fund a number of federal agencies (H.R. 2673), including those that support community-based mental health services and programs. Despite early promises that lawmakers would finish work on must-pass spending bills before recessing last year, Congress failed to complete work on federal appropriations for fiscal year 2004, which began Oct. 1, 2003, before recessing last year. Programs are currently funded at fiscal year 2003 levels, under a resolution set to expire January 31.

• Learn More about the Omnibus Spending Bill

Supreme Court Hears Key ADA Case

On Tuesday, Jan. 13, the Supreme Court heard oral arguments in State of Tennessee v. George Lane and Beverly Jones, a case that could severely limit enforcement of key provisions in the Americans with Disabilities Act (ADA) that protect millions of people with disabilities from discrimination by public entities in courtrooms, schools, health care and other areas. A decision in the case is expected sometime this summer.

• Learn More about Tenn. v Lane and Jones

Bazelon Center Honors Maine Senator

On Tuesday, Dec. 2, 2003, the Bazelon Center and more than 100 mental health advocates, supporters and family members gathered to honor Senator Susan Collins (R-ME) for her efforts to address serious problems in the nation’s children’s mental health system. Senator Collins convened a July hearing on the shocking prevalence of custody relinquishment to obtain mental health services for children with mental or emotional disorders. In October, Collins and several other dedicated children’s advocates in the House and Senate introduced The Keeping Families Together Act. The bipartisan bill would improve coordination between agencies that serve children with mental and emotional health needs and to expand access to home- and community- based services.

• Learn More about Senator Collins' Work

• Urge your Senators and Representative to co-sponsor the “Keeping Families Together Act” by sending them a message at http://www.congress.org. Remember to identify yourself as a constituent.

• Share your story. If you are a parent who has relinquished custody of your child to obtain needed mental health services, lawmakers need to hear from you. By humanizing the issue, your story can help lawmakers understand the desperate need for change.