Congress Approves Budget Resolution; Appropriations Committees Begin Work on FY 2008 Funding Bills
On May 17th, both the House and the Senate voted to adopt a $2.9 trillion budget
resolution for the 2008 fiscal year. The budget blueprint sets discretionary spending at $956 billion, $23 billion more than the
President’s budget request. The House approved the budget by a 214 to 209 vote, with 214 Democrats voting for the legislation, and 196
Republicans and 13 Democrats voting against the resolution. The Senate approved the budget blueprint with a 52 to 40 vote; Senate Democrats and
both of Maine’s Republican Senators Susan Collins and Olympia Snowe voted in favor of the budget resolution.
Some of the House Appropriations Subcommittees have begun their work on the FY 2008
spending bills, holding mark-up or review sessions during the week of May 21st. It has been reported that the House Labor, Health and Human
Services, and Education (Labor HHS) Subcommittee spending bill is expected to be reviewed early on in the appropriations process this year.
Both the House and the Senate have adjourned for the Memorial Day recess and will not return to session until the week of June 4th.
More information about the budget resolution approved by the House and the Senate can be found at: http://thomas.loc.gov/.
House Floor Action on Second
Chance Act Reentry Legislation Delayed
The Second Chance Act, legislation that seeks to help States and localities better
address the needs of individuals reentering from the criminal justice system, was scheduled for a House vote on May 15th. However, this vote
was postponed due to concern that there would be contentious floor action and that the bill might not have enough votes to be approved. The
Second Chance Act currently has 92 bipartisan co-sponsors in the House; to approve the Second Chance Act under the suspension calendar, two-thirds of
the House, or 290 Members, must vote in favor of the legislation. Staff has indicated that the bill’s sponsors are currently working with
the House leadership to schedule another vote and address concerns raised by certain Republican members who have expressed opposition to the
bill.
Senators Joe Biden (D-DE), Arlen Specter (R-PA), Sam Brownback (R-KS), and Patrick
Leahy (D-VT) are the lead co-sponsors of the Senate version of the Second Chance Act; this legislation, S. 1060, currently has 18 bi-partisan
co-sponsors. It is expected that a hearing on S. 1060 will be scheduled in the Senate Judiciary Committee in the coming weeks. The text,
status and a list of co-sponsors of both versions of the Second Chance Act can be found at: http://thomas.loc.gov/.
Senate Committee on Health,
Education, Labor, and Pensions Convenes First Hearing on SAMHSA Reauthorization of the 110th Congress
On Tuesday May 8th, the Senate Health, Education, Labor and Pensions (HELP) Committee
held a hearing entitled, “Transforming Mental Health and Substance Abuse Systems of Care: Community Integration and Recovery.”
The hearing was chaired by Senator Jack Reed (D-RI), a senior member of the HELP Committee, at the request of committee Chairman Edward Kennedy
(D-MA) who was traveling overseas in Ireland. Committee members participating in the hearing included Senators Burr (R-NC), Murkowski (R-AK),
Murray (D-WA) and Enzi (R-WY). Panelists providing witness testimony to the Committee included: Representative Patrick J. Kennedy (D-RI); Dr.
Terry Cline, Ph.D., Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA); Lisa Halpern, Consumer and Member of the
National Alliance on Mental Illness (NAMI); Rodger McDaniel, Deputy Director of the Wyoming Mental Health and Substance Abuse Services Division; and
Terry Lee Allebaugh, Executive Director of Housing for New Hope, Inc. in Durham, North Carolina.
In his opening statement, Senator Reed emphasized that mental health and substance
abuse are major national problems and that Congress wants to improve SAMHSA’s ability to serve people who need care. He stated that
significant progress has been made toward reducing the stigma associated with mental health and substance abuse problems, but that more needs to be
done. Senator Reed also expressed his particular interest in improving the network of community mental health providers, strengthening the links
between housing and supportive services for homeless populations with substance abuse and mental health disorders, and exploring ways to enhance the
workforce pipeline in the field of mental health and substance abuse treatment.
In his opening comments, Senator Enzi stated that the Committee would be working in a
bi-partisan way to strengthen the nation’s substance abuse and mental health care delivery system. He commented on his interest in the
flexibility of various grant programs and making sure that local communities have the flexibility necessary to meet their unique needs. Senator
Enzi stated that, “today’s system of services for mental health, substance abuse, and homelessness is fragmented and
disconnected,” and that, “State and local communities, who are on the front lines, can provide the best approach to the prevention and
treatment of mental health, substance abuse and homelessness.” Senator Enzi expressed his belief that substance abuse is an illness that
is treatable, especially when the course of treatment begins as early as possible. Additional issues Senator Enzi identified were the role of
SAMHSA in disaster and emergency response and the need for Congress to address the growing epidemic of methamphetamine use in the United States.
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Witness Testimony
Representative Patrick Kennedy’s testimony focused
on three overarching themes: driving the development and use of the evidence base; dramatically improving the coordination of mental health,
substance abuse, and primary care; and expanding investment in prevention. Congressman Kennedy highlighted his concern with the inadequacies of
the current system for mental health and substance abuse care in this country, pointing to the fact that most people in need of treatment don’t
get it and those who do often don’t get the benefit of the latest science. Congressman Kennedy expressed frustration that care for mental
illnesses and substance abuse is segregated, often nearly entirely divorced from the rest of health care and even from each other. Rep. Kennedy
stated that, “without opening the door to merging the block grants, it should be possible to enable providers -- or even better, to encourage
them -- to deliver the most effective, integrated care to individuals with co-occurring disorders.” Representative Kennedy’s
recommendations also include:
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Creation of a permanent Commission for Evidence-Based Mental Health and Substance-Use
Health Care; this Commission would be responsible for strengthening, consolidating, and coordinating the synthesis and dissemination of evidence-based
best practices and would provide a “good housekeeping seal of approval” to prevention, screening, diagnosis, and treatment practices
supported by science; and for creating a research agenda by identifying areas where strong evidence is lacking.
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Partnership between SAMHSA and the Department of Education to broaden the role of
school-based mental health personnel as well as expand collaborative programs such as Safe Schools/Healthy Students, a discretionary grant program
that provides communities with Federal funding to implement a coordinated and comprehensive plan of activities, curricula, programs, and services
that focus on creating safe school environments, promoting healthy childhood development, and preventing youth violence and alcohol, tobacco, and
other drug use.
Dr. Cline’s testimony focused on the need for strengthening SAMHSA’s
service delivery systems. Dr. Cline began by commenting on the economic and human costs of undiagnosed and untreated mental and substance use
disorders, and the enormous role that substance use and mental health disorders play in increasing our nation’s health care costs.
Further detailing these costs, Dr. Cline cited a recent report by HHS' Agency for Healthcare Research and Quality, which found that almost one-fourth
of all stays in U.S. community hospitals for patients age 18 and older in 2004—7.6 million of nearly 32 million stays—involved
depressive, bipolar, schizophrenia and other mental health disorders or substance use related disorders and the need to identify and intervene early
before such conditions require a hospital stay.
Dr. Cline’s testimony highlighted the importance of data collection efforts and
the valuable information provided on the substance abuse treatment system. Dr. Cline emphasized the critical role that the block grant plays as
the cornerstone of the publicly funded treatment system and the role of SAMHSA in partnering with health care professionals to expand use of screening
and brief interventions to identify the full spectrum of substance users as a routine part of standard health care and provide brief, cost-effective
interventions to help them cease substance use once discovered. Dr. Cline also stated SAMHSA’s plans to continue the Strategic
Prevention Framework grant program to accomplish the President’s goal of reducing youth drug use and also spoke of SAMHSA’s expectation
to continue working with ONDCP to support the over 750 grantees funded through the Drug-Free Communities grant program while targeting funding to
areas of greatest need for various prevention interventions and services.
Ms. Lisa Halpern spoke about her work in Dorchester, Massachusetts providing
peer-directed and operated services, support and education to promote recovery and about her personal story of recovery from mental illness.
Ms. Halpern expressed that there needs to be much reform to improve quality of care in the mental health system. Referring to the SAMHSA
reauthorization process, Ms. Halpern expressed support of outcome measures in the mental health system and of the creation of a Federal
Interdepartmental Task Force on Mental Health that would include representatives from the federal agencies that administer programs for children and
adults living with mental illness and substance abuse disorders.
Mr. Rodger McDaniel, Deputy Director of the Wyoming Mental Health and Substance Abuse
Services Division, made three broad recommendations to the Committee in crafting SAMHSA reauthorization legislation: to use scientific research on
addiction to shape policy; to improve the treatment and prevention systems through flexible funding; and to implement outcome measures to ensure
accountability. Mr. McDaniel spoke as a member of NASADAD, the National Association of State Alcohol and Drug Abuse Directors, detailing how
combined state, federal and local community efforts were helping to curb drug abuse and to support prevention and treatment initiatives. Mr.
McDaniel also spoke about how Wyoming is preparing for veterans returning from Iraq and Afghanistan with mental health and substance abuse treatment
needs. Mr. McDaniel noted that the rate of alcohol dependence is greater among the veteran population than among others and that there is a
well known linkage between post traumatic stress disorders and substance abuse and addiction.
In his testimony to the Committee, Mr. Terry Lee Allebaugh, spoke about his work to
prevent and eliminate homelessness as Executive Director of Housing for New Hope, Inc. in Durham, North Carolina. Specifically, Mr. Allebaugh
spoke about SAMHSA’s support for New Hope’s work through the P.A.T.H. (Projects for Assistance in Transition from Homelessness)
program. Speaking of the estimated 744, 300 people in this country who are homeless, Mr. Allebaugh expressed the need for funding to be
targeted toward services for homeless people in a number of different federal agency budget. In addition, Mr. Allebaugh urged the Committee to
include in SAMHSA reauthorization legislation introduced by Senators Reed and Burr, the “Services for Ending Long-term Homelessness
Act.” Mr. Allebaugh explained that this legislation includes a detailed plan for services for homeless people, including mental health
and substance abuse treatment as well as health education and recovery activities.
For complete witness testimony please visit: http://help.senate.gov/Hearings/2007_05_08/2007_05_08.html
Children’s Mental Health
Parity Legislation Introduced in the Senate
Senators Kerry (D-MA), Domenici (R-NM), Smith (R-OR) and Kennedy (D-MA) recently
introduced S. 1337, the “Children’s Mental Health Parity bill.” Under the legislation, in the case of a State child health
plan that provides both medical and surgical benefits and mental health or substance abuse benefits, S. 1337 would require that the financial
requirements and treatment limitations applied to mental health or substance abuse benefits be no more restrictive than those applied for medical and
surgical benefits under the same plan.
After being introduced in the Senate, the bill was sent to the Senate Finance Committee for further
review. Text and status of S. 1337 can be found at: http://thomas.loc.gov/.
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