Bazelon Center Mental
Health Policy Reporter
Welcome
to the Bazelon Center Mental
Health 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.
Volume VI, No. 5, November
7, 2007
Reauthorizations, Appropriations
and Progress for People with Mental Disabilities
In this
issue:
Even faced with the President's veto threats, Congress made
progress this fall in legislation to fund some programs that are
important to children
and adults with mental disabilities. Parity of mental health coverage
in private insurance appears closer to enactment, too, and work
is underway to restore protections against disability-based discrimination.
Children’s Health Insurance Program: Round 2
Legislation to reauthorize the State Children’s Health Insurance
Program (SCHIP) continues to face veto threats, despite strong
support in both chambers of Congress and clarifying changes made
after the President’s rejection of the prior bill (e.g.,
phasing out coverage of childless adults after one year and limiting
federal funds for health coverage to children in families with
incomes up to 300 percent of poverty). Last week the Senate followed
the House in approving the
latest version, H.R. 3963, which would
provide health insurance to roughly 10 million American children.
Although successful, the vote in the House failed to garner sufficient
support for a veto-proof margin, as did its earlier version (H.R.
976), vetoed by the president. Negotiations on the fate of children’s
health insurance continue as few legislative days remain before
the Thanksgiving recess. The current SCHIP authorization, extended
in a continuing appropriations bill, expires on November 16.
H.R. 3963 includes other positive elements:
- It would prohibit the Administration from acting on proposed
changes to Medicaid’s rehabilitation services option
and from taking other steps to restrict reimbursement for such
services.
The bill extends the moratorium until January 2010.
- It would extend,
for the first time, mental health parity protections to SCHIP
children.
- It would eliminate a discriminatory provision that allows
SCHIP plans electing to develop benchmark-equivalent plans
to lower the amount of mental health coverage to 75 percent of
the
coverage
provided in the benchmark plans.
Criminal Justice and Mental Health Collaboration—Improved
Bipartisan legislation to reauthorize and improve the criminal
justice and mental health collaboration grant program, administered
by the Department of Justice, (P.L. 108-414, Mentally Ill Offender
Treatment and Crime Reduction Act) was introduced last week in
both chambers of Congress. Although the current program does not
expire until 2009, the reauthorization appears to be on a fast
track, due largely to bipartisan sponsor support. A voice vote
approval by the House Judiciary subcommittee on Crime, Terrorism
and Homeland Security came just a few days after the bill’s
introduction.
The Mentally Ill Offender Treatment and Crime Reduction Reauthorization
and Improvement Act (H.R. 3992 and S. 2304) was introduced by Representatives
Bobby Scott (D-VA) and Randy Forbes (R-VA) and Senators Edward
Kennedy (D-MA), Pete Domenici (R-NM), Patrick Leahy (D-VT) and
Arlen Specter (R-PA). The House and Senate versions renew the core
MIOTCRA grant program and increase the authorization from $50 million
to $75 million, while also renewing the mental health courts grant.
The legislation would extend the program to FY 20013. In addition,
the bills provide for new grants in need-based areas, including:
greater law enforcement training; effective treatment of female
prisoners with mental illnesses; statewide planning outreach to
coordinate the treatment of incarcerated individuals with mental
illnesses and provide for new interventions; improved screening,
identification and assessment of mentally ill inmates; and increased
coordination of transitional, post release services.
The current program was funded at $5 million in fiscal year 2006
and $5 million in 2007. Congress has doubled its funding to $10
million for fiscal year 2008 (which began October 1), although
that bill has yet to be approved by the President.
What You Can Do
Contact your Senators and Representative to urge them to support
the bill; see a “Dear Colleague” letter from Reps.
Bobby Scott (D-VA) and Randy Forbes (R-VA). The House Judiciary
Committee is likely to mark up the bill this week and thereafter
it will move to the floor, where every vote will matter.
The following members of the House are sponsors of the bill. If
you are a constituent, call or email a thank you; if not, urge
your Representative to join in supporting H.R. 3992, the Mentally
Ill Offender Treatment and Crime Reduction Reauthorization and
Improvement Act.
Rep. Howard Coble [NC-6]
Rep. Keith Ellison [MN-5]
Rep. Sheila Jackson-Lee [TX-18]
Rep. Daniel E. Lungren [CA-3]
Rep. Grace Napolitano [CA-38]
Rep. Jim Ramstad [MN-3]
Rep. Jerrold Nadler [NY-8]
Rep. Todd Russell Platts [PA-19]
Rep. Randy Forbes [VA-4]
Rep. William Delahunt [MA-10]
Rep. Patrick Kennedy (RI-1]
Rep. Bobby Scott [VA-3]
Mental Health Funding Increased But May Face Veto
Well into the fiscal 2008 year, which began October 1, the appropriations
bill (H.R. 3043) that provides funding for the Substance Abuse
and Mental Health Services Administration (SAMHSA) was at last
successfully “conferenced.” The resulting bill has
been approved by the House and Senate approval is expected today.
Its fate remains uncertain, however, as the President continues
to oppose funding levels that exceed his budget.
Earlier this year, the House and Senate approved different versions
of the bill, restoring funding for key programs administered by
the Center for Mental Health Services at SAMHSA that had been zeroed
out by the President’s FY 2008 budget, including the consumer
technical assistance centers and the seniors mental health services
program. Congress also rejected many proposed funding freezes and
provided needed increases in several programs.
The conference produced funding levels for programs at the Center
for Mental Health Services above the President’s fiscal year
2008 budget, except for three core programs that are level funded
at the Administration’s request: the mental health block
grant; children’s mental health services program; and the
PATH program for individuals who are homeless or at risk of being
homeless. Most notably, Congress rejected the $76.4 million in
cuts that the President proposed in the CMHS discretionary budget
(Projects of Regional and National Significance, PRNS) and increased
it by $41.4million over fiscal year 2007 (now at $304.7 million).
The PRNS funds programs that translate the research science into
community based services. See
the chart for details (numbers are
in the millions of dollars).
The Long Road to Mental Health Parity
The House bill to provide equitable treatment of mental health
and addiction services in health insurance plans, the Paul Wellstone
Mental Health and Equity Addiction Act of 2007 (H.R. 1424), has
been approved by the three committees of jurisdiction (Education
and Labor; Ways and Means; and Energy and Commerce). Successfully
thwarted were attempts to substitute provisions from the Senate
version (S.558) (a side-by-side
chart provided by House Committee
staff reviews key differences). Minor changes were made during
the committees’ consideration that will need to be reconciled
prior to a House floor vote (e.g., a benefit standard of Diagnostic
and Statistical Manual language or a Federal Health Benefits Program
reference, and medical management flexibility of health plans).
However, with the preemption issue largely resolved by Senate approval
of S. 558, the Mental Health Parity Act, one of the main areas
of difference between the two bills continues to be their definitions
of covered conditions (whether to allow health plans to decide
for what disorders they provide mental health benefits at parity
or whether to mandate or reference what disorders must be at parity).
What You Can Do
Remain vigilant and continue calling on your Senators
and Representative to support enactment of comprehensive mental
health and addiction
parity legislation without delay.
No Child Left Behind Remains Behind Schedule
House and Senate Committees with jurisdiction over education have
yet to consider legislation that would reauthorize the No Child
Left Behind Act (NCLB). In late summer, the House Education and
Labor Committee released a lengthy discussion draft and sought
public comments, but no formal plans to renew the law have been
announced. Action this year appears unlikely. However, we are pleased
that the committee discussion draft includes references to positive
behavioral intervention and support (PBS). PBS in schools helps
improve social and academic outcomes for students and supports
the improvement of overall school climate for teachers and students
alike (see Way
to Go). The Bazelon Center is spearheading a coalition
called School Success for All Children that has been working to
promote school-wide PBS in the context of NCLB and has endorsed
legislation that embodies this goal, notably the Positive
Behavior for Effective Schools Act (H.R. 3407, S. 2111), sponsored
by Representatives Phil Hare (D-IL), Danny Davis (D-IL), Lynn Woolsey
(D-CA) and David
Loebsack (D-IA) and Senators Barack Obama (D-IL), Richard Durbin
(D-IL) and Bernard Sanders (D-VT) (see the August
6 Mental Health Policy Reporter).
ADA Restoration Act Edges Ahead
Hearings in both houses point to progress for the bill to restore
the protections of the Americans with Disabilities Act that courts
have eroded in recent years (see our August
6 Mental Health Policy Reporter). The Senate committee known as HELP (Health, Education,
Labor and Pensions) has scheduled a hearing on November 15th on
its version (S.1881) of the ADA Restoration Act. The House bill
(H.R. 3195) now has 235 sponsors. It was the subject of an October
4th hearing before the Subcommittee on the Constitution, Civil
Rights and Civil Liberties of the House Judiciary Committee, which
included moving testimony by Cheryl Sensenbrenner, who chairs the
board of the American Association
of People with Disabilities. “The
Supreme Court has substituted its own judgment for the judgment
of Congress,” said Sensenbrenner, “and that is what
has created the need for the restoration of the ADA.” She
explained:
I acquired my spinal cord injury about the same time my sister,
Tara, was born with Down's syndrome. Through her hard work and
the support of our family, Tara graduated from high school, took
college courses, has supported herself through various jobs, and
bought and insured her own car.
…As a consequence of court-made law, we have an absurd
Catch-22. If you manage your disability well, if you do your
best in spite
of your disability, the courts take away your civil rights protections.
That means that because I worked hard in physical therapy,
because I wear a leg brace and walk with a cane, the courts would
find
me "not disabled enough" to have civil rights.
But if I had given up after my spinal cord injury or if Tara had
bought into the low expectations society often had for her-- if
neither of us tried to live to our fullest potential, we would
have been protected under the ADA!
“It’s absurd!” she added. “If you don't
manage your disability well, you have civil rights protections,
but you probably won't be able to hold down a job!”
What You Can Do
Action on either bill is unlikely this year, but
momentum-building is important. You can help now:
If you find the
Bazelon Center's Action Alerts and Mental Health Policy Reporter
informative and useful, won't you consider making a donation
online to help us advocate for children and adults with mental
disabilities?
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