National Council Public Policy Update

National Council Public Policy Update November 15, 2007

The National Council Public Policy Update of 11/15/2007 begins with an update of the Second Chance Act which passed the House on November 13 [ HR 1593 ] on a vote of 347 to 62. How did your member of Congress Vote? Mine, Vern Buchanan [R-Fl-13], voted Yea.

The Second Chance Act, introduced by Representative Danny Davis on March 20, re-authorizes the Adult and Juvenile Offender State and Local Reentry Demonstration Program, in order to help prisoners transition into life in their communities upon release. Treatment for mental health and substance abuse disorders are a high priority of the Act, given the high rate of relapse when treatment is not available to those leaving prison.

Although the Second Chance Act has been introduced in each of the previous two Congresses, Tuesday night’s vote was the first time it was voted on by the Full House.

In the Senate, the Reducing Recidivism and Second Chance Act of 2007 [S. 1060] was introduced by Senators Joseph Biden [D-DE], and Arlen Spector [R-PA], Sam Brownback [R-KS}, and Patrick Leahy [D-VT]. S.1060 was approved by the Senate Judiciary Committee on August 2, and supporters of the bill expect it to be voted on by the full Senate before the end of the year.

The National Council is part of a coalition of groups lobbying for support of this important issue. The broad coalition includes groups such as the Legal Action Center, National Alliance to End Homelessness, Mennonite Central Committee, National Association of Counties and Volunteers for America.

On October 17, Senators Jack Reed [D-RI] and Gordon Smith [R-OR] introduced legislation that includes provisions to co-locate primary care and specialty medical care in community-based mental health and addiction treatment organizations. In addition, the bill includes training and loan assistance programs designed to address the recruitment and retention of qualified behavioral healthcare workers, particularly in health professional shortage areas.

The Community Mental Health Services Improvement Act [CMHSIA][S. 2182] would amend the Public Health Service Act to include provisions to co-locate primary care and specialty medical care in community-based mental health and addiction treatment organizations.

Mental illness is just as deadly and serious as physical illness, said Senator Smith. Suicide takes the lives of more than 30,000 people each year, with more than 700,000 attempts. While effective treatment exists for most people, access to care continues to be a challenge in many parts of Oregon. A federal commitment is needed to ensure care is available when and where it is needed.

Under the CMHSIA, four grant programs would be created, funding a variety of clinical practice improvements and workforce retention efforts. Programs include:

$50 million to support the co-location of primary care services within community mental health and addiction treatment provider agencies. This initiative seeks to meet the primary care needs of persons with serious mental illnesses.

$10 million to help states, territories, and Indian tribes or tribal organizations develop and implement innovative programs to address the behavioral health workforce needs of designated mental health professional shortage areas. Awardees can use the grants for loan forgiveness and repayment programs, placement and support activities, and other programs to support behavioral health professional recruitment efforts, with an emphasis on racial and ethnic minorities.

$20 million to support tele-mental health in medically underserved areas. Grants would fund both infrastucture improvements and provision of services.

In addition, the CMSIA would also require the institute of medicine [IOM] to report to Congress on the paperwork burden faced by community behavioral healthcare providers.

In related news, Senator Smith also introduced the Community-based Mental Health Infrastructure Improvement Act [S. 2183] on October 17.

The bill would amend the Public Health Service Act to create a new grant program that will explicitly support the construction, expansion, and modernization of facilities used to provide mental health and addiction treatment services. The bill also allows for the construction or structural modification of facilities to permit the integrated delivery of behavioral health and primary medical care services.

2. The National Council for Community Behavioral Healthcare, PUBLIC POLICY UPDATE, October 18, 2007