Congress Passes
Continuing Resolution to Fund Programs through November 16th; Senate Action on Labor-HHS Bill Expected After Columbus Day
Recess
Last week, both the House and Senate approved a Continuing
Resolution (CR) that will fund Federal agencies and programs through November 16th at FY 2007 levels. The 2008 fiscal year began on October
1st. The short-term extension will allow additional time for Congress to complete and then negotiate the different spending bills
approved by the House and the Senate, and also to address the President’s repeated assertion that he intends to veto spending bills that
exceed the level requested in his FY 2008 budget.
The House approved the CR by a 404 to 14 vote, and the Senate
approved the legislation by 94 to 1 vote. None of the twelve FY 2008 appropriations bills has been signed into law; the House has
passed all twelve appropriations bills and the Senate has passed four. The Senate is scheduled to vote on the
Commerce-Justice-Science and Defense spending bills during the week of October 1st. Senate leadership has indicated that the
Labor-HHS-Education spending bill will likely be considered during the week of October 15th, following the Columbus Day recess.
House Ways and
Means Committee Approves Paul Wellstone Mental Health and Addiction Equity Act of 2007
On Wednesday, September 26th, the full House Ways and Means
Committee approved H.R. 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” by a vote of 27 to 13. All the
Democrats on the Committee voted for the bill, with three Republicans, Representatives Jim Ramstad (R-MN), Phil English (R-PA) and Jerry Weller
(R-IL), voting with the Democrats for passage. Similar to the Health Subcommittee mark-up held on September 19th, several
amendments were offered by Republican Committee members and defeated largely along party lines; these amendments included: eliminating the
requirement that parity be extended to out-of-network coverage; substituting the Senate scope of coverage language that would eliminate coverage for
all diseases included in the DSM-IV; adding the Senate language from S. 558 that would specifically allow plans to use medical management to
determine medically necessary care; and changing the bill's effective date to January 1, 2009 from the current date of January 1,
2008. The latter amendment was withdrawn by its sponsor Congressman Sam Johnson (R-TX), after Health Subcommittee Chairman Pete Stark (D-CA) agreed
to revisit the effective date issue at conference and said an appropriate effective date would be selected based on when parity is enacted into
law.
Additionally, two amendments were offered that had not been
introduced the previous week in the Subcommittee mark-up. Congressman Weller (R-IL) offered an amendment to change the name of
H.R. 1424 from the "Paul Wellstone Mental Health and Addiction Equity Act of 2007" to the "Paul Wellstone and Jim Ramstad Mental Health and Addiction
Equity Act of 2007" in recognition of Congressman Ramstad’s advocacy on behalf of individuals with addictive disorders and mental
illness. Congressman Ramstad requested that the amendment be withdrawn out of a desire to preserve the legacy of the late Senator
Paul Wellstone. Congressman Ron Lewis (R-KY) also introduced an amendment to exempt plans whose participants' costs increased more than two percent
in the first year and one percent thereafter. This amendment was rejected, with Representative Ramstad as the sole Republican to
join the Democrats for its defeat; both Representative Ramstad and Health Subcommittee Chairman Stark (D-CA) expressed concern that this amendment
could create a loophole and allow plans to unnecessarily opt out of providing parity.
With both the House Education and Labor and Ways and Means
Committees having reported the bill favorably out of Committee, the next step for H.R. 1424 is approval by the House Energy and Commerce Committee,
the third and final committee with jurisdiction over the bill. The House Energy and Commerce Committee has tentatively scheduled a
mark-up for the second week in October.
Special thanks to Carol McDaid and Holly Merbaum of Capitol Decisions
for their assistance in summarizing the Committee mark-up for this article.
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Legislation
with TANF Drug Testing Requirement Introduced in the House; Sanction Includes Loss of Benefits for Entire Family
On September 26th, Congressmen Phil English (R-PA) and Jerry
Weller (R-IL) introduced H.R. 3656, legislation requiring States to drug test TANF (Temporary Assistance for Needy Families) applicants and
recipients suspected of using illicit drugs. In the 109th Congress, Congressman English introduced the same legislation as an
amendment to the “Personal Responsibility, Work, and Family Promotion Act of 2005.”
H.R. 3656 would require TANF applicants and recipients to
undergo a physical test designed to detect the use of any controlled substance, if the State had substantial evidence that the individual unlawfully
used controlled substances in the past six months. If the test, or other indicators determined by the State, showed that an
individual was likely to have engaged in the use of controlled substances in the previous six months, provision of TANF cash assistance to the family
of the individual would be suspended until a subsequent test indicated that the individual was substance-free. Once it has been
determined that an individual is likely to have unlawfully used such a substance in the six-month period, the individual’s TANF
self-sufficiency plan would need to address the use of the substance; in addition, H.R. 3656 would require, as a condition of receiving other
non-cash benefits, that the individual comply with the self-sufficiency plan, including the provisions that address the substance use and require
drug tests as the State sees fit. States would be responsible for determining what the self-sufficiency plan would include; drug
addiction treatment services are not specifically mentioned in the legislation nor is funding for treatment provided. TANF
benefits would be terminated for three years for the family of an individual who failed three to six consecutive drug tests.
Under the legislation, any State that failed to comply with H.R.
3656’s provisions would lose between five and ten percent of their family assistance grants. The Secretary of Health and
Human Service would determine the exact percentage to withhold from the State depending on the severity and frequency of non-compliance.
Following its introduction, H.R. 3656 was referred to the Committee on Ways and
Means, where the legislation awaits review. Text and status of H.R. 3656 can be found at: http://thomas.loc.gov/.
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Gang
Prevention Legislation Introduced in Congress; Bill Seeks to Improve Access to Education and Job Services for Young People in the Juvenile Justice
System
On July 24, 2007, Congressman Alcee Hastings (D-FL) introduced H.R.
3168, the “Path to Success: Gang Prevention through Community Partnerships Act.” H.R.3168 authorizes a $20 million Department of
Education grant program for community colleges that partner up with juvenile detention centers to provide life, social, academic and vocational
skills to at-risk youth. H.R. 3168 contains a number of provisions aimed at helping young people in the juvenile justice system
obtain educational and employment services.
H.R. 3168 seeks to encourage community supported programs
that:
-
provide eligible youth with counseling and referrals to resources related to
health, housing, job training, and work-place readiness
Under the legislation, the Secretary of Education could award
two-year renewable grants to community colleges that partner up with juvenile detention centers and secure juvenile justice residential facilities
for individuals re-entering the community and pursuing a high school diploma, a general equivalency diploma (GED), vocational training, other
alternative post-secondary educational programs or an associate’s degree. The program provided through grant funds would be
required to include required classes for the completion of a degree, provide a variety of academic programs with various completion requirements,
offer flexible academic programs, and provide each participant with an individual education plan that, at a minimum, fulfills the requirements for a
certificate or diploma.
Community colleges could use grant funds to:
-
Establish a mentoring program administered by a program coordinator, in
consultation with counselors, law enforcement officials and other community members, that can help at-risk individuals transition from detention to
release
Each grantee would be required to submit to the Secretary of
Education a report documenting the results of the program and evaluating the effectiveness of the activities.
After its introduction, H.R. 3168 was referred to the House
Education and Labor Committee where the legislation awaits review. H.R. 3168 currently has nineteen Democratic co-sponsors. The
text and status of H.R. 3168 can be found at: http://thomas.loc.gov/.
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Legislation
Aimed at Better Integrating Health Care Delivery Introduced in the House; Bill Includes Provisions for Addiction and Mental Health Treatment
Services
On September 18th, Congressman Gene Green (D-TX) introduced H.R.
3561, legislation that would authorize a grant program aimed at better integrating health care delivery. Congressmen Joe Baca
(D-CA), Adam Smith (D-WA), and Zach Wamp (R-TN) are cosponsors of H.R. 3561, the “Community Coalitions for Access and Quality Improvement Act
of 2007.” Primarily concerned with expanding and coordinating the delivery of health services, H.R. 3561 seeks to increase
access to health care for low-income and uninsured populations. In determining grant eligibility, priority would be given to
applicants who seek to expand drug and alcohol addiction and mental health treatment services.
Grants authorized in H.R. 3561 would be awarded to
consortiums of federally qualified health centers, rural health clinics and networks, hospitals with low-income utilization rates greater than
twenty-five percent, public health departments, and either private health care providers or organizations serving the uninsured and low-income
individuals. In awarding the grant, the Secretary of Health and Human Services would place emphasis on the consortium’s
proposed expansion of mental health and substance abuse services, as well as the community served, proposed coordination between providers, and
demonstrated collaboration with state and local governments.
Not more than twenty percent of the funds awarded under the grant
would be eligible for direct patient care, as the focus of the grants would be to better develop and coordinate health care in communities. The grant
program, which would be administered by the Department of Health and Human Services, would authorize $75 million in funding for the 2008 fiscal year,
with $25 million additional funds authorized for each fiscal year thereafter, through 2012.
Following its introduction, H.R. 3561 was referred to the House
Energy and Commerce Committee where the legislation awaits review. Text and status of H.R. 3561 can be found at: http://thomas.loc.gov/.
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