The Bazelon Mental Health Policy Reporter
Issue 2: Volume I : October 21, 2002
Eleventh Hour Politics May Strand Mental Health
Initiatives
With the midterm elections just weeks away and mandatory
appropriations bills and other pressing legislative business at an
impasse, the politics of 11th-hour legislative negotiations could
strand important mental health initiatives until after the
elections.
Lawmakers have already shelved some important issues for people
with disabilities. The 1996 law authorizing the Temporary Assistance
for Families (TANF) program was set to expire at the end of
September, but Congress extended the law until December 31. Members
of Congress now have additional time to hammer out differences
between the House and Senate versions of the bill that would
reauthorize TANF.
Since a substantial number of the program's beneficiaries are
affected by a mental or physical impairment, TANF reauthorization is
of crucial importance to people with disabilities. Adults who
receive TANF benefits were three times more likely than adults not
receiving benefits under the program to have at least one physical
or mental health impairment, according to a study released last year
by the General Accounting Office (GAO). TANF recipients with
impairments were only half as likely to leave the welfare rolls as
those without impairments and when they did they were less likely to
be employed, according to the GAO. In fact, 36 percent of recipients
with impairments had no income source when they left the rolls.
Disability advocates fear that the new work rules in the House
bill may exacerbate this trend and have pushed for provisions to
help states provide supports and services - such as mental health
and substance abuse counseling and job training - that families need
to move toward greater self-sufficiency.
The extension has done little to clarify the bill's future.
Lawmakers are considering a wide array of policy options, from
delaying the rewrite of the law until the next Congress to simply
extending the current law for one to three years.
By postponing action on other important initiatives, the
continuing resolution may give lawmakers political cover for
decisions that might otherwise become election year issues for
voters concerned with mental health policy. But with elections out
of the way, lawmakers could be less responsive to constituent
concerns.
Action on most spending bills - including the Labor Health and
Human Services appropriations bill that funds important mental
health programs through the Department of Health and Human Services'
Center for Mental Health Services - will most likely be delayed
until after the elections.
Other issues may suffer as well. House Energy and Commerce
Chairman Billy Tauzin (R-LA), formerly a supporter of the Family
Opportunity Act's provisions to increase access to mental health
services to children through expanded Medicaid eligibility, appears
to be considering alternatives to the bill's Medicaid provisions.
The bill has bipartisan support in Congress and is endorsed by
mental health and family advocates across the country. Such a
dramatic change could stall passage indefinitely.
At the moment, political assessments on any bill's future are
speculative. But the uncertain political climate after the elections
will almost certainly have important implications for mental health
policy.
Take Action
Lawmakers need to hear from you! Here's how to make sure
your voice gets heard...
Call: Contact Senators and Representatives at their
state/district offices during the recess or call the Capitol
switchboard at 202-224-3121.
Write a letter to:
The Honorable (first and last
name)
United States Senate
Washington, DC 20510
OR
The Honorable (first and last name)
U.S. House of
Representatives
Washington, DC 20515
Email: To contact your member of Congress or Senator
by email, please visit http://www.house.gov/house/MemberWWW.html or
http://www.senate.gov/contacting/index.cfm.
All Senators and members of Congress provide a means of
contacting them on their web page. Be clear and concise in your
message and remember to include your full name, mailing address
and zip code. Most congressional offices will not respond to
email from people outside of their districts, so make sure you
introduce yourself as constituent.
Newsbytes
Senators Introduce Criminal Justice Bill
Several senators last week introduced a bill to address issues
raised by the growing number of children and adults with severe
mental health conditions who are ending up in correctional
facilities. Senators Mike DeWine (R-OH), Patrick Leahy (D-VT), Sam
Brownback (R-KS), Charles Grassley (R-IA) and Maria Cantwell (D-WA)
introduced S. 3147 - "The Mentally Ill Offender Treatment and Crime
Reduction Act of 2002" - to foster local collaborations between the
criminal justice and mental health systems.
The Bazelon Center has withheld endorsement of the bill,
concerned that the legislation neglects pre-booking diversion
strategies, which many experts believe to be and most effective
intervention for people with mental illnesses in the criminal
justice system. The DeWine legislation does not include re-entry
programs to help people with mental illnesses transition from the
criminal justice system to life in the community. Nor does the
bill's narrow focus on treatment acknowledge the critical need for
stable housing, job-related services and other supports in the
community. The Bazelon Center plans to work with the next Congress
on legislation to deal with the criminal justice issue in a more
holistic manner.
Election Overhaul Legislation Clears Congress
The Senate last week joined the House in approving the conference
report on the election overhaul bill (H.R. 3295) drafted in response
to voting difficulties during the 2000 presidential election. The
legislation would provide national election standards and would
authorize almost $4 billion to help states meet those standards.
Under the bill, every polling place would be required to have at
least one voting machine accessible to people with disabilities. The
legislation also would allow a provisional ballot to be cast when
identification is not available - a difficulty sometimes experienced
by people with mental illnesses. The ballot would be counted later
only if the individual can prove eligibility. State opposition
forced removal of provisions to give individuals the right to sue if
the new standards are violated, thus eliminating an effective means
of encouraging compliance with the new standards. The President is
expected to sign the bill soon.
*You will need to download the free Acrobat Reader to view this
file.
Senate-Bound Bill Would Mandate Collection of Names of
People Who Have Been Involuntary Committed
On October 15 the House of Representatives approved (H.R. 4757)
legislation designed to improve the National Instant Criminal
Background Check System (NICS). The legislation, as drafted, raises
concerns over privacy protection issues for people with mental
illnesses and the Bazelon Center has vigorously opposed stigmatizing
language in the bill. The House bill has been forwarded to the
Senate for quick consideration. An attempt earlier this month in the
Senate to pass a version of the bill under a unanimous consent
agreement failed.
*You will need to download the free Acrobat Reader to view this
file.
Restraint and Seclusion Policy Reviewed
Regulations concerning restraint and seclusion standards will be
discussed at a town hall meeting being held by the Department of
Health and Human Services on October 29. The regulations,
promulgated in 1999 after intense lobbying by mental health
advocates, require that a physician or a licensed independent
practitioner (LIP) make a face-to-face assessment of the patient
within one hour of the imposition of restraint or seclusion. The
rules apply to all Medicare and Medicaid participating hospitals
that serve children and adults with mental illnesses, including
psychiatric hospitals. Hospitals and their provider groups have
consistently challenged the requirement.The town hall meeting is
open to the public for participation and attendance.
Available exclusively to our online subscribers, the Mental
Health Policy Reporter supplements the Bazelon Center's action
alerts and legislative updates by providing activists with a regular
bulletin on significant policy developments that affect people with
mental illnesses. Subscribe online at http://www.bazelon.org/takeaction/alerts/subscribe.htm. | 
