President's Budget Slights Mental Health

Plan Doesn't Address Gap in Community Services, Drops Important Support Programs

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February 7, 2002—President George W. Bush's federal budget plan for fiscal year 2003, released February 4, falls extremely short of the need in terms of mental health spending. Although the President has committed his Administration to implement the Supreme Court's Olmstead order to end unnecessary institutionalization, his $2-trillion budget plan (available at: http://www.whitehouse.gov/omb/budget/) fails to address thegrowing gap in community-based services for adults and children with serious mental disorders.

Given the Administration's stated priorities of defense and "Homeland Security," the talk of spending deficits and a short election-year budget cycle, mental health advocates must weigh in early to support funding for community mental health services.

Community-Based Mental Health Services at Risk

The President's budget requests no new funding for the Center for Mental Health Services (CMHS) overall.

The mental health block grant, which provides comprehensive community mental health services to adults with serious mental illnesses and children with severe emotional disturbances, would again be level-funded ($433 million). Such "freezing" of funds would cut 25 states' grants. Though the grants are small, they are an important source of flexible funds for state and community mental health systems.

• The children's mental health services program is essentially level funded at $97 million.
• Funding for the protection and advocacy system that provides legal assistance to individuals with mental disorders is frozen at $32 million.

Homeless and Jail Diversion Programs Increased

The only significant increase in the CMHS budget is for the PATH grant program that provides services to people with severe mental illnesses who are homeless or at risk of being homeless. The President proposes a $7 million increase to reach out to 163,000 homeless individuals in an effort to provide mental health and substance abuse treatment services as well as adequate housing. This increase would bring the program's total to $47 million for fiscal year 2003.

Other National Projects Risk Losses

The budget plan would cut the CMHS discretionary budget, which funds demonstration grants and projects of national significance (PRNS), by $7 million (from $230 million to $223 million).

Among the PRNS are a seniors' mental health services program, youth anti-violence initiative and suicide-prevention program. Some were authorized last year but still await funds. Any reduction to the PRNS could jeopardize these important service programs. The Bazelon Center strongly believes that PRNS must keep pace with increases given biomedical research in order to continue translating and applying the research science into best practices at the state and community levels.

One PRNS that will receive an increase is a jail diversion grant program, first funded in FY 2002. The budget proposes a $1-million increase, funding this program at $5 million. However, given that 16% of jail inmates nationwide are identified as having a mental illness and that many of them would be better served through diversion to mental health treatment, $5 million is a woefully inadequate level of funding.

Center for Mental Health Services	Fiscal Year 2001	Fiscal Year 2002	Bush Proposal Fy 2002	Difference FY02 and Bush Proposal
Discretonary (PRNS)	203.6	239	223	-7
Mental Health Block Grant
420	433	433	0
Children's Mental Health	91.7	96.7	96.7	0
PATH	36.9	39.9	46.9	+7
Protection and Advocacy	30	32.5	32.5	0

The chart above summarizes funding of CMHS programs for FY 2001 and 2002 compared to the Bush budget proposal.

Funding for Substance Abuse Treatment Would Increase

In contrast to its treatment of CMHS, the Administration gives priority to the Center for Substance Abuse Treatment (CSAT). The budget calls for a $60 million increase to the substance abuse block grant and a $67 million increase for treatment services under the targeted capacity expansion program.

Bush Budget Would Eliminate Current Consumer-Run Centers

The President's budget recommends completely eliminating the three existing National Consumer-Run Technical Assistance Centers, funded through CMHS. Much of this funding is invested in self-help recovery, peer-to-peer support and promotion of the community integration required by the Supreme Court's Olmstead decision. By cutting the only funding for consumer-run services at the national level, the budget plan conflicts with the core message promoted in his New Freedom Initiative for people with disabilities, which President Bush himself announced last December.

Medicaid Expansions: Some New, Some Missing

The President proposes several new Medicaid legislative initiatives, some of which he announced in his New Freedom Initiative. Three new demonstration programs for people with disabilities would cost $207 million over five years. One is targeted to children with mental disorders, to provide home- and community-based waiver services for children living in psychiatric residential treatment facilities. While useful, this program would be available only to a few states and would be time-limited and dependent on federal appropriations. The other programs would fund respite services for caregivers of disabled adults, and respite services for caregivers of children with severe disabilities.

Missing from the proposed Medicaid expansions is the Family Opportunity Act, designed to enable families to take personal financial responsibility for their child's severe health and/or mental health care needs by allowing them to buy into the Medicaid program. The Administration has turned its back on these families, who must often choose between turning custody of their child over to the state or declaring bankruptcy so their child can become Medicaid-eligible.

Although the Family Opportunity Act was supported last session by 238 members of Congress and the budget resolution included $7.9 billion for it over 10 years, neither house acted on it.

Action Needed Now!

Contact your Senators and Representative and ask them to support funding increases for the CMHS programs that provide community-based mental health services to children and adults with severe mental health disorders. Specifically, urge them to:

• reject funding "freezes" for programs aimed at providing comprehensive community-based mental health services, such as the mental health block grant and children's mental health services program;
• reject cuts in the discretionary budget for the Center for Mental Health Services (CMHS), known as the Programs of Regional and National Significance, which applies research knowledge into "best practices" at the state and local levels;
• reject cuts to the three National Consumer-Run Technical Assistance Centers and restore the $1.2 million a year funding provided for them by the Center for Mental Health Services; and
• support increases to the PATH program ($7 million ) as included in the President's budget.

What You Can Do

If your Senator or Representative is not on the Labor-HHS Appropriations Subcommittee (see list), ask him or her to write to the subcommittee requesting these actions.

• Phone: You can phone Senators and Representatives through the Capitol switchboard at 202-224-3121.
• Write or fax a letter to:
  • The Honorable (first and last name), United States Senate, Washington DC 20510
  • The Honorable (first and last name), United States House of Representatives, Washington DC 20515
• Email is rarely read. If you must email, it's critical to begin the message with your name, address and zip code to show that the message is from a constituent. You can look up your Senator or Representative and find email forms at http://www.congress.org.

Spread the word!

Please forward this Bazelon Center Action Alert to others who care about people with mental illnesses and urge them to contact their members of Congress right away.