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 VII, No. 4, May 13, 2008

Make May "Mental Health Advocacy Month"

In this issue:

• Work to End Abuse in Residential Programs for Teens With Mental Health Needs
• Give Support to Community-Based Mental Health Services
• Promote Collaboration Between Criminal Justice and Mental Health
• Unite to Block Harmful Medicaid Regulations--Updated
• Request Supportive Housing for Community Integration
• How to Contact Your Lawmakers

Newsbytes

• San Francisco Will Develop Supported Housing
• Students Have New Guide to Mental Health Rights

Annually, May is declared Mental Health Month. Co-chairs of the House Mental Health Caucus, Representatives Grace Napolitano (D-CA) and Timothy Murphy (R-PA), have introduced a resolution to that effect. H.Res.1134, set to proceed for quick approval under suspension of the rules on Tuesday, May 12th, also outlines statistics on the children’s mental health crisis facing the nation.

This May, the Bazelon Center asks advocates to take advantage of the designation to work for protections and support needed by children and adults with mental disabilities. Your support for a bill in the House can help Congress hold private residential treatment facilities accountable for protecting the teens sent there by their parents. Calls to your lawmakers will also encourage them to reject catastrophic cuts the Administration wants to make in essential mental health services—cuts that would eliminate the transformation grants for states to reduce fragmentation of services, the consumer technical assistance programs and the seniors’ mental health program. Lawmakers also need pressure to increase congressional support for criminal justice-mental health collaboration grants, under-funded at a shameful 11 percent of applications, and to put a one-year hold on the Administration’s harmful Medicaid rules.

Work to End Abuse in Residential Programs

The House Education and Labor Committee is about to mark up “The Stop Child Abuse in Residential Programs for Teens Act of 2008” (H.R. 5876). The bill is sponsored by committee chairman George Miller (D-CA) and Representative Carolyn McCarthy (D-NY). It is a welcomed response to thousands of allegations of child abuse and neglect at private residential programs (therapeutic boarding schools, wilderness camps, boot camps and behavior modification facilities) for teens with emotional, behavioral and mental health needs, reported by the Governmental Accountability Office (GAO).

H.R. 5976 would:

• Keep teens safe with new national standards for private residential programs.
• Prevent deceptive marketing by residential programs for teens by requiring disclosure to parents of qualifications, roles and responsibilities of current staff and of substantiated reports of child abuse or violations of health and safety laws. Programs would also have to provide a link to or web address for information on all private residential programs kept by the U.S. Department of Health and Human Services (HHS).
• Hold teen residential programs accountable for violating the law by requiring HHS to conduct unannounced site inspections at least every two years. Civil penalties up to $50,000 would be levied for every violation of the law and parents would have a federal right to sue program operators that violate the national standards.
• Ask states to step in to protect teens in residential programs by providing grants to states that develop their own standards that are at least as strong as the national standards and inspect the programs in their state at least every two years.

Under Chairman Miller’s leadership, this issue has garnered much-needed attention. The Committee’s website has links to testimony from an April 24 hearing where the GAO and other experts testified and presented a follow-up GAO report.

What You Can Do

Urge your Representative to co-sponsor and support H.R. 5876 today to end abuse and neglect in private residential programs that are intended to help teens with behavioral, emotional and mental health problems.

Thwart Cuts to Essential Community Mental Health Services

The Administration has proposed huge cuts in funding for community mental health services and programs administered by the Center for Mental Health Services (CMHS) within the Substance Abuse and Mental Health Services Administration (SAMHSA) (see the Bazelon Center’s February Mental Health Policy Reporter. Nearly half of CMHS’ discretionary budget would be slashed under the President’s fiscal year 2009 budget proposal. His plan would eliminate the consumer support technical assistance centers, the senior mental health services’ program and the State Incentive Grants for Transformation that support development of comprehensive plans to address fragmentation in states’ public mental health systems.

Now is the time to rev up grassroots support to thwart such cuts to services that provide essential mental health care to children and adults. Join the members of the House of Representatives whose letter calls for an increase of $134 million over FY 2008 for CMHS.

What You Can Do

Contact your Senators and Representative and express your support for the CMHS programs listed in the chart below. Ask them to reject cuts that would stifle innovation and progress. Urge them to support increases that would help close the unmet treatment gap for people with mental disorders.

Collaboration Between Criminal Justice and Mental Health Programs

The Mentally Ill Offender Treatment and Crime Reduction Act (P.L. 108-413, also known as MIOTCRA), administered by the Department of Justice, needs increased funding to meet the high demand for collaborative mental health and criminal justice responses to offenders with mental illnesses. MIOTCRA grantees may create or expand programs that intervene at any point in the continuum of criminal justice contact (pre-booking, post-booking, mental health courts and other court-based approaches, re-entry and transitional programs). They can also fund crisis intervention teams and providing law enforcement training. For more information about the program, visit the Justice Department's Justice and Mental Health page.

Of the 250 grant applications submitted in 2006, only 11 percent were funded, supporting programs in only 28 communities nationwide. In 2007, an additional 27 communities in 16 states received grant awards. While an improvement, this still left the vast majority of communities without much-needed funding to undertake this difficult effort. The grant received $5 million in fiscal years 2006 and 2007 and $6.5 million for fiscal year 2008.

Several Senators and Representatives have expressed support for continued funding in letters sent to the chair and ranking member of the respective appropriations subcommittee with jurisdiction over the Department of Justice (see House and Senate letters). Join these congressional backers and express your support for increased funding for MIOTCRA.

What You Can Do

Urge your Senators and Representative to increase funding for MIOTCRA to address the increasing incarceration of people with mental illnesses that’s rapidly reaching a point of national crisis.

Help Block Harmful Medicaid Regulations

Efforts continue to enact a moratorium on seven Medicaid regulations that would severely affect access by vulnerable beneficiaries to needed Medicaid services, including those provided through Medicaid’s rehabilitation option, case management option and school-based administration and transportation services (see the Bazelon Center’s April 21 Action Alert). The bill, already approved by the House, is likely to be attached this week as an amendment to legislation that provides supplemental funding for operations in Iraq and Afghanistan.

What You Can Do

Ask your Representative to support a moratorium on Medicaid regulations issued by the Centers for Medicare and Medicaid Services, as outlined in H.R. 5613, The Protecting the Medicaid Safety Net Act of 2008, on the supplemental appropriations bill for the military. Remind him or her of the overwhelming House passage of H.R. 5613 and the support from a range of diverse stakeholders.

May 15 update: With the moratorium intact, the bill passed by a vote of 256 to 166.

Supportive Housing Is Essential for Community Integration

On April 10, Representatives Christopher Murphy (D-CT) and Judy Biggert (R-IL) introduced the Frank Melville Supportive Housing Investment Act of 2008 (H.R. 5772)to help address the enormous and unrelenting housing crisis faced by millions of low-income people with disabilities.

H.R. 5772 would authorize a new Section 811 Demonstration Program that fulfills the promise of true community integration as envisioned in the Americans with Disabilities Act. It would also make long-overdue reforms and improvements to the existing Section 811 production program and spur the creation of thousands more new units every year.

Historically, the Section 811 program has been one of the most successful programs available through the U.S. Department of Housing and Urban Development (HUD) to create new supportive housing units. However, the future of Section 811 is jeopardized by an outdated statute and program models, excessive HUD bureaucracy and rapidly declining production levels. In addition, for the past four years the Administration has proposed drastic cuts in the program—-cuts that Congress has so far rejected.

For details see an analysis by the Technical Assistance Cooperative.

What You Can Do

Urge your Representative to help alleviate the terrible lack of supportive housing for people with disabilities that stands in the way of true community integration. Urge him or her to co-sponsor H.R. 5772.

How to Contact Your Lawmakers

Newsbytes

• San Francisco to Develop Supported Housing

The Mayor and Board of Supervisors of San Francisco, California, have given their final approval to last November’s landmark agreement in Chambers v. San Francisco, creating a new program called “Success at Home,” described as a single door to independent living. Pending final approval by the court, the agreement commits the city to lease up to 500 scattered-site supported apartments for people have otherwise been or would be confined in the 1,100-bed Laguna Honda nursing home and coordinate their transition, matching each individual to needed supportive services. The federal court has scheduled a fairness hearing in September—the last step before final approval.

• Campus Mental Health: Know Your Rights!

A new guide offers assistance to college and university students who want to seek help for mental illness or emotional distress. Campus Mental Health: Know Your Rights!, written by Leadership21, an advisory committee for the Bazelon Center, is now available online in both HTML and PDF versions. The guide offers information to help students find and use mental health resources on campus and safeguard their rights. The 20-page booklet will be published in print form later in the year.

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