Support New Spending in FY 2005 Bush Budget; Oppose Cuts

Read the President's Budget The Office of Management and Budget's Resources on the President's Fiscal Year 2005 Budget Request Final Report by the President's New Freedom Commission on Mental Health The Campaign for Mental Health Reform Support the Bazelon Center. Your tax-deductible donation helps the Bazelon Center keep you informed on important developments in mental health law and policy. Not a Subscriber? Sign up now to receive action alerts and updates from the Bazelon Center.

February 12, 2004 —Earlier this month, the Bush Administration released its budget request with federal spending priorities for the next fiscal year. The Bazelon Center needs your help to secure promised increases for mental health spending and prevent some significant cuts outlined in the President's budget.

Despite a difficult fiscal climate, the proposed budget would provide a much-needed boost to federal mental health spending related to the findings of the President's New Freedom Commission on Mental Health. Unfortunately, while proposing to increase the Center for Mental Health Services' (CMHS') total budget, the Administration has also called for cuts in some of CMHS' critical community-based programs.

Transforming Mental Health Care

The President’s budget seeks $44 million for State Incentive Grants for Transformation to promote the “fundamental overhaul” recommended by the Commission. These new grants would support development of comprehensive state mental health plans and services designed to end fragmentation in the public mental health system and ensure the provision of services and supports to address unmet mental health needs.
In the first year, state agencies serving people with mental illnesses—mental health, criminal justice, child welfare and others—would primarily use funds for interagency planning. In later years, up to 85 percent of grant funds could be used to build direct service capacity, with the remaining 15 percent directed to continuing support for state planning and coordination.

Another new program is the Samaritan Initiative. This would help service providers better serve people who are homeless by funding outreach and direct services and supports to address mental health, substance abuse and/or primary health care needs. The initiative would involve the Departments of Health and Human Services (specifically, CMHS), Housing and Urban Development and Veterans Affairs. The President has proposed $10 million for CMHS’ participation in this multi-agency effort.

Other Increases

The children’s mental health program and the grant program to assist individuals who are homeless or at risk of being homeless (PATH) both received increases in the President’s budget request ($3.6 million and $5.5 million, respectively). Funding for both has increased in recent years, and each has positive evaluations from the Office of Management and Budget for producing favorable outcomes.

The Administration also proposed a $1.3 million increase for the mental health block grant, the largest federal program supporting community-based mental health services.

Proposed Cuts

Unfortunately, other CMHS-funded programs did not fare so well:

• The seniors mental health services program would be eliminated.
• The protection and advocacy systems for people with mental disorders would receive no new funding
• The jail diversion program, which received increased funding in fiscal 2002-2004, now faces some $3 million in cuts. The program has helped communities develop an array of community-based diversion programs to serve the mental health needs of people with mental illnesses who have become involved in the criminal justice system.
• The budget proposes level funding for other important discretionary budget programs, including the post traumatic stress disorders program, the school anti-violence initiative and the consumer-run technical assistance centers.

Medicaid

Block Grant Proposal

The President’s budget again calls for greater state flexibility in Medicaid. However, it contains no specific mention of last year's stalled proposal to eliminate Medicaid's entitlement and replace it with a block grant program. This would have had a devastating impact on people who rely on Medicaid for health and mental health care.

Home- and Community-Based Services

For the third year in a row, the Administration has proposed funding demonstration projects to promote community-based care as an alternative to institutionalization in a residential treatment facility, using Medicaid’s home- and community-based services waiver. The projects would allow states to use Medicaid dollars to pay for home- and community-based services for children currently residing or at risk of placement in either psychiatric hospitals or residential treatment facilities.

Only four states (New York, Kansas, Vermont and, most recently, Indiana) now make available Medicaid home- and community-based waiver services for children with serious emotional disturbance at risk of out-of-home placement. This demonstration would help ten more states use the approach to serve children in the community.

Even with the demonstration, funding for home- and community-based services for children would remain extremely limited. The Bazelon Center and others continue to support a statutory change to the Medicaid law to make it easier for all states to use the option.

Take Action Now

Congress now begins work on a budget resolution and individual spending bills. Contact your members of Congress and ask them to support adequate mental health funding. Urge your Senators and Representative to:

• Support the new CMHS State Incentive Grants for Transformation and the Samaritan Initiative;
• Reject cuts to the jail diversion program and termination of the elderly mental health services program; and
• Promote comprehensive community-based mental health services by supporting funding increases for the mental health block grant, the PATH program and the children’s mental health services program.

The House and Senate Labor-HHS Appropriations Subcommittees will play a key role in deciding funding for community mental health services. It is especially important that you contact your Senators and Representative if they are listed below.

Senate Appropriations Subcommittee for the Departments of Labor, Health and Human Services and Education:

Alren Specter (R-PA)-Chair
Thad Cochran (R-MS)
Judd Gregg (R-NH)
Larry Craig (R-ID)
Kay Bailey Hutchison (R-TX)
Ted Stevens (R-AK)
Richard Shelby (R-AL)
Mike DeWine (R-OH)
Tom Harkin (D-IA)-Ranking Member
Ernest Hollings (D-SC)
Daniel Inouye (D-HI)
Harry Reid (D-NV)
Herbert Kohl (D-WI)
Patty Murray (D-WA)
Mary Landrieu (D-LA)

House Appropriations Subcommittee for the Departments of Labor, Health and Human Services and Education:

Ralph Regula (R-OH)-Chair
Ernest Istook (R-OK)
Roger Wicker (R-MS)
Anne Northup (R-KY)
Randy Cunningham (R-CA)
Kay Granger (R-TX)
John Peterson (R-PA)
Don Sherwood (R-PA)
Dave Weldon (R-FL)
Mike Simpson (R-ID)
David Obey (D-WI)-Ranking Member
Steny Hoyer (D-MD)
Nita Lowey (D-NY)
Rosa DeLauro (D-CT)
Jesse Jackson, Jr. (D-IL)
Patrick Kennedy (D-RI)
Lucille Roybal-Allard (D-CA)

If your Senators or Representative are not on one of the subcommittees, ask them to contact a subcommittee member to express support.

Contacting Memebrs of Congress

You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121 or by using the form below.