President's Budget Signals Low Priority for Community-Based Services for Adults and Children with Severe Mental Health Disorders

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April 17, 2001—President Bush released the details of his fiscal year 2002 budget proposal to Congress. Typically, the Administration delivers the budget to Congress the first Monday in February. However, earlier this year the Administration unveiled a "blueprint" with a snapshot of the overall budget, but no information on mental health funding. The details now available show that the nearly $2-trillion budget plan would allow only a small overall increase in discretionary spending.

With large increases for certain areas (defense-related, health research and education, for example) spending for mental health services is reduced. The discretionary-grant fund in the Center for Mental Health Services (CMHS) is cut and other CMHS programs are frozen at last year's levels. These programs include the mental health block grant, children's mental health services program and state grants for homeless persons (PATH). In addition, several newly authorized CMHS programs would receive no funding at all under the Bush budget.

Congress will soon begin putting together the annual appropriations bills that actually fund the federal government. Whether Congress will override the Bush proposals and increase spending for community mental health services is a question. States are under pressure to expand access to community services to comply with the Supreme Court's 1999 decision in Olmstead v. L.C., but the Administration's budget offers them no assistance in this task.

The Bazelon Center calls upon the mental health advocacy community to come together and urge legislators to continue to support funding advances for important mental health services.

Details of the Bush Budget

• The mental health block grant to states, which funds community mental health services for adults with serious mental illnesses and children with severe emotional disorders, comports with the "most integrated setting" mandate of Olmstead and is the federal government's largest mental health services program. In the previous two fiscal years, the block grant increased more than $127 million. This helped the block grant, which had not kept up with the rate of inflation, gain some ground on increasing service needs. The Bush budget would freeze the mental health block grant at $420 million. As a result, many states could receive fewer dollars in FY 2002.

• The children's mental health services program would be level funded at $92 million.

• The PATH grant program, for services to people with severe mental illnesses who are homeless or at risk of being homeless, would be frozen at $37 million.

• The protection and advocacy system, providing legal assistance to people with mental disorders, would be level funded at $30 million.

• The Center for Mental Health Service's discretionary budget, known as the Programs of Regional and National Significance (PRNS), is cut by $16 million (from $203 million to $187 million). However, the cut would not affect $90 million level funding for one of the PRNS, the Safe Schools/Healthy Students program that supports school-violence prevention and mental health and early intervention services.

• Many new CMHS programs authorized last year with the passage of the Child Health Act (P.L. 106-310) still await funds so that service grants may be awarded.

• The substance abuse side of SAMHSA would gain funding, however. There is an increase for the Center for Substance Abuse Treatment (CSAT) as part of a drug treatment initiative aimed at reducing the treatment gap for individuals with addictive disorders. The substance abuse block grant to states, now approximately $1.66 billion, would have a $60 million increase. A $40- million increase is also proposed for CSAT's various PRNS.

Action Needed Now

Contact your members of Congress and ask them to speak out in favor of mental health funding. Specifically, urge your Senator and Representative to:

1. Support needed increases in programs that provide community-based mental health services, such as the mental health block grant, PATH program and children's mental health services program.

2. Reject cuts in the programs that would apply research science to improve practice. The CMHS discretionary program, referred to as the Programs of Regional and National Significance, should have the same priority as proposed increases to NIMH research aimed at biomedical advances.

3. If your Senator or Representative is not on the Labor-HHS Appropriations Subcommittee (see list below), ask him or her to contact a subcommittee member and express these concerns.

Explain the importance of community-based services and emphasize the Surgeon General's Report on Mental Health and the 1999 Supreme Court decision in Olmstead v. L.C.

• The Surgeon General's report highlighted how many effective treatments there are, but how poorly they are funded and implemented in practice. (For more information, seee the Bazelon Center's mental healthcare page)

• Olmstead requires states to create less restrictive programs for inappropriately institutionalized people with mental disabilities. Increasing the availability of community-based mental health services through programs funded by the Center for Mental Health Services is a significant way for legislators to help reduce barriers to community care.

A copy of the President's FY 2002 budget proposal is available at: http://w3.access.gpo.gov/usbudget/index.html or at http://www.whitehouse.gov/omb/budget/

What You Can Do

Phone: You can reach members of your congressional delegation by calling 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 Representative and find email forms at http://www.congress.org.

Help spread the word! Please copy and disseminate this Action Alert to others concerned about access to mental health services for children and adults.