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The Bazelon Mental Health Policy ReporterVolume III : Issue 2 : February 23, 2004
What's in this Issue?Feature Article: Medicaid Waiver Can Help States Serve Children Newsbytes
Medicaid Waiver Can Help States Serve Children(Feb. 23, 2004)—As the effectiveness of Medicaid’s home- and community-based waiver becomes increasingly evident, it’s all the more clear that Washington should take the lead to help states use the waiver to serve children with mental health needs.
This month, Indiana became the fourth state granted a waiver to its state Medicaid plan to allow use of Medicaid dollars to fund home- and community-based services for children with mental health needs. "This is going to jump-start our ability in Indiana to expand services because now there is a way to pay for those services," Suzanne Clifford, director of the state's Division of Mental Health and Addiction, told the Associated Press. How much children’s mental health services are ultimately expanded in Indiana remains to be seen, but results in the three other states with the waiver are favorable. Kansas, New York and Vermont have increased access to services and reduced traumatic out-of-home placements while cutting the cost of serving children. Unfortunately, the waiver is underutilized nationally and access to home- and community-based services for children remains limited. Without access to appropriate services, children with mental or emotional disorders are at greater risk of school failure, substance abuse, interaction with the juvenile justice system and suicide. "Across the country, we have never prioritized children's mental health services the way they need to be prioritized. As a result, children rarely get the services they need," said Indiana’s Clifford. The President’s fiscal year 2005 budget offers reason for hope. For the third year in a row, it would fund demonstration projects in several states to promote community-based care using Medicaid’s waiver for home- and community-based services. Up to 10 states could then 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. The projects will expand services in the 10 states and further demonstrate nationally the effectiveness of using the waiver—a good next step toward helping states fund services for children with mental or emotional disorders. Congress will consider the projects along with other spending priorities in the President’s budget. Let’s hope lawmakers recognize the importance of this issue and do all they can to help states better serve children with mental health needs. NewsbytesNew Civil Rights Bill IntroducedImportant civil rights legislation to fix damage done by recent court rulings that have limited the scope and enforcement of anti-discrimination laws was introduced in Congress last week. The Fairness Act of 2004 (H.R. 3809 and S. 2088) is sponsored by Senator Edward Kennedy (D-MA) and Representative John Lewis (D- GA). “The Fairness Act would provide an essential correction in the wildly misguided course now being plotted by judges who would subvert the will of Congress and deny people who have been discriminated against their day in court,” said Bazelon Center staff attorney Jennifer Mathis in a statement to the media. Controversial Nominee AppointedOn Friday, Feb. 20, President Bush made a recess appointment of William Pryor, Jr. to the 11th Circuit Court of Appeals while the Senate was out of session, sidestepping a filibuster that had blocked the controversial nomination. The Bazelon Center has opposed Pryor’s nomination, noting that the former Alabama attorney general has fought aggressively to prevent people with disabilities from enforcing their rights under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. As Alabama Attorney General, he helped secure a 5-4 U.S. Supreme Court ruling in the Garrett case, significantly weakening the Americans with Disabilities Act’s protections against employment discrimination by states. Under the terms of the recess appointment, Pryor will serve on the 11th Circuit until the end of 2005. Pryor’s appointment follows a similar recess appointment last month of Charles Pickering, another nominee opposed by the Bazelon Center and other civil rights groups. Bazelon Center Calls on President to Help People with Mental Illnesses Transition from Jail to the CommunityResponding to President Bush’s proposal in his State of the Union Address for $300 million for a federal prisoner re-entry initiative, the Bazelon Center has called on the President to instruct federal agencies to review federal eligibility requirements that can prevent inmates with mental illnesses from accessing necessary supports in the community. “As a country, we must act to improve services and supports for people with mental illnesses returning to the community,” said Bazelon Center policy director Chris Koyanagi, citing the critical need to address recidivism among people with mental illnesses who come in contact with the criminal justice system. It now appears the Administration would use the money to supplement existing programs to help inmates transition from jail or prison to life in the community, offering little new for people with mental illnesses.
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