This information comes to us from our colleagues at the Bazelon Center for Mental Health Policy:
Bazelon Center Mental Health Policy Reporter Volume VII, No. 5, July 8, 2008
Congress Reconvenes After July 4 Recess
Some Issues Bang, Some Need a Light
With several happily lopsided bipartisan votes, Congress gave advocates for people with disabilities extra reasons to celebrate 2008’s Independence Day. The Senate followed an earlier House vote in approving a nine-month moratorium on six Medicaid rules that would have restricted access to needed mental health and school-based services. The House overwhelmingly endorsed a compromise reaffirming protections for people with disabilities under the Americans with Disabilities Act. House members also gave solid support to a bill that would halt the neglect and abuse of teens that has prevailed in many residential treatment settings. And appropriators in both houses approved increased funding for critical criminal justice and mental health programs.
Harmful Medicaid Regulations Stopped
Advocates for people with mental disabilities across the country are celebrating success. Efforts in response to Action Alerts like the Bazelon Center's helped convince Congress to delay implementation by the Centers for Medicare and Medicaid of damaging rules on rehabilitative services, targeted case management and school-based administration and transportation services.
The supplemental war-funding bill (H.R. 2642, Supplemental Appropriations Act), approved 96-6 by the Senate and signed by the President on June 30th, includes a moratorium until April 1, 2009 for these three cost-cutting regulations along with three others that involve graduate medical education, a provider tax and public-provider cost limits. A seventh regulation on outpatient services under Medicaid was excluded from the moratorium. See the Bazelon Center’s July 7th Alert for details.
The rules on rehabilitative services and school-based administration and transportation services were scheduled to take effect on June 30th. They had been on hold under a moratorium enacted last year in the Medicare, Medicaid and SCHIP extension Act (P.L. 110-173).
The House voted 349-62 to approve the supplemental funding bill on April 23 with the same delay of the six Medicaid rules, after a successful compromise with the White House.
ADA Amendments Act Wins Amazing House Vote
By an extraordinary margin of 402-17, the House passed the ADA Amendments Act to reverse Supreme Court holdings that had deprived many people with disabilities of the law’s vital protections. The bill would restore the intent of Congress when it enacted the Americans with Disabilities Act (ADA) in 1990.
Over the past decade, courts have supported employers in cases that diminished the protections established by the ADA. In response, over the past few years civil rights and disability advocates worked with congressional staff to craft a bill, the ADA Restoration Act, that would restore these protections.
A few months ago, the business community, apparently concerned about the prospect of that law’s enactment next year, signaled a willingness to negotiate. The bill’s House sponsors, Representatives Steny Hoyer (D-MD) and James Sensenbrenner (R-WI) invited the advocates to work on a compromise with the U.S. Chamber of Commerce and other representatives of the employer community. The remarkable June 25th vote was the result of several months of intense negotiations by this unique alliance.
The bill must still be considered in the Senate, where a version is expected to be approved. If signed by the President—and no veto is anticipated—it would:
- specifically overturn Supreme Court decisions that have caused many people with disabilities whom Congress intended the ADA to cover to lose important protection;
- make it clear that Congress intended the ADA’s coverage to be broad, to cover anyone who faces unfair discrimination because of a disability;
- clarify that the courts must apply a less demanding standard than they have been using to determine who has a disability;
- make it easier for people with episodic impairments to be protected by the ADA;
- afford broad coverage for individuals “regarded as” having a disability under the ADA; and
- make it clear that accommodations need not be made for someone who seeks coverage solely because he or she is “regarded as” having a disability.
In a nutshell, the proposal strikes a balance between protections for individuals with disabilities and the obligations and requirements of employers.
The Bazelon Center is particularly gratified that the ADA Amendments Act will, when approved by the Senate, rescue people with psychiatric disabilities from the “Catch 22” in which the court’s rulings had left them—that when medications reduce their symptoms, however temporarily, many no longer qualify for protection as “disabled” under the ADA.
For details, including the bill's text and a chart comparing the ADA Restoration Act (which is before the Senate) and the amendments, see the Bazelon Center’s June 25th Alert.
What You Can Do
Please visit http://clerk.house.gov/evs/2008/roll460.xml to see your Representative's vote and say thank you by phone, postcard or email.
Call your Senators to express your support of the ADA Amendments Act of 2008. Urge him or her to vote for it when it comes before the Senate.
Mental Health and Criminal Justice Funding
House and Senate Committees with jurisdiction over mental health funding and criminal justice funding are moving forward on their fiscal year 2009 bills.
Appropriations committees in both houses have approved funds for the Department of Justice. The mental health and criminal justice collaboration grant (Mentally Ill Offender Treatment and Crime Reduction Act), funded at $5 million in fiscal years 2006 and 2007 and $6.5 million in fiscal year 2008, was awarded $12 million by the Senate committee and $10 million by the House committee.
The grant program is designed to help states and localities address the growing rate of incarceration of people with mental illness by providing the flexibility to develop collaborative mental health and criminal justice responses to offenders with mental illnesses. Grantees may seek to create or expand programs that intervene at any point in the continuum of criminal justice contact (pre-booking, post-booking, mental health courts and other court-based approaches, re-entry and transitional programs), including crisis-intervention teams and law enforcement training.
The Senate appropriations committee has approved its bill funding community-based mental health services administered through SAMHSA. The Senate committee bill would increase the PATH program by $6.4 million and reject the $144-million cut proposed by the Administration to the discretionary budget (which funds such programs as jail diversion, seniors mental health services and suicide prevention), providing instead a $12.5-million increase. Additionally, the protection and advocacy system would be increased by $1 million, with funding for the children’s mental health services program and mental health block grant at fiscal year 2008 levels ($102.3 million and $421 million respectively).
Although the House appropriations subcommittee approved its version on June 19, the full committee’s approval was stalled after a conflict between Representative Jerry Lewis (R-CA) and Chairman David Obey (D-WI) over the timing of a vote on an unrelated appropriations bill.
- JJDPA Reauthorization Bill Introduced in the Senate
On June 18, Senate Judiciary Committee Chairman Patrick Leahy (D-VT) and Senators Arlen Specter (R-PA) and Herb Kohl (D-WI) introduced legislation to strengthen the Juvenile Justice and Delinquency Prevention Act (JJDPA) to better aid in reducing crime and recidivism within the juvenile justice system. S. 3155, The Juvenile Justice and Delinquency Prevention Reauthorization Act of 2008, would increase federal funding for prevention, intervention and treatment programs, including issues of mental health and substance abuse, and for the improvement of state juvenile justice systems. The bill will likely be considered by the Judiciary Committee in mid-July.
See Chairman Leahy’s introductory statement and a summary of the bill.
- Medicare Mental Health Parity Quest Continues
The search for mental health parity in Medicare coverage continues. The Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), passed by the House by 355-59 on June 24th, was blocked from consideration on the floor by Senate Republicans prior to the July 4th recess. H.R. 6331 would make improvements to Medicare for low-income seniors and those with disabilities who rely on the federal health insurance program for necessary health care. Notably it would end the discriminatory 50% co-insurance requirement for outpatient mental health services (to be phased in over six years to establish parity with other outpatient co-payments of 20%).
Both House and Senate bills would eliminate the 10% Medicare payment cut for physicians (effective July 1) and substitute an increase. Continued efforts by the Senate to pass a Medicare physician payment-fix bill this year will likely include language to eliminate the payment cut retroactively….