April 2005 NACBHDD Newsletter
The monthly newsletter for the National Association of County Behavioral Health and Developmental Disabilities Directors
In this Issue...
The 2005 NACBHDD Newsletter series is brought to you by:
Medicaid Update: Debate Continues; Some Movement to Delay Cuts During House Conference Committee Discussions
Most recent background information
The March 28 Washington Update contains important information about the most recent Congressional and advocacy activity and concerns
around Medicaid, including the Bipartisan Commission on Medicaid Act of 2005 and information on House and Senate budget resolutions.
To view the March 28 Washington Update, click here. For further background information on Medicaid activity,
see the March newsletter.
Some movement to delay cuts during House conference committee discussions
In addition to the information reported in the Washington Update and the March newsletter about the Bipartisan
Commission on Medicaid (the Bipartisan Commission on Medicaid Act of 2005) and the House and Senate budget
resolutions, it is important for members to note that on April 13 43 House Republicans sent a letter to House
Budget Committee Chair Jim Nussle (R-IA) requesting that Medicaid cuts be avoided during conference committee
discussions about the FY 2006 budget. The April 14 "Kaiser Daily Health Policy Report" goes on to explain
that the support of 43 Republicans, along with the support of Democrats (who all opposed Medicaid cuts), could
be the majority necessary "to adopt a nonbinding resolution that would instruct House conference committee members
to eliminate the Medicaid provision from the 2006 budget, according to CQ Today." And, on the Senate side, Senator
Norm Coleman (R-MN) said that Medicaid reductions could be included in the FY 2006 budget but delayed until the
Bipartisan Commission on Medicaid has examined the program.
(www.kaisernetwork.org/daily_reports/rep_index)
Medicaid Resource on State and Federal Funding Data
The Kaiser Family Foundation's Statehealthfacts.org recently added new data on state and federal Medicaid spending, including information related to demographics and the economy, Medicaid and SCHIP, and health costs and budgets. To access this information, see www.statehealthfacts.org.
NACBHD Member & Non-Member Survey: An Opportunity for Input on Crucial Financial and Organizational Data
On May 1, 2005, NACBHD will distribute in electronic format a survey to members and non-members. This survey is critical to establishing the importance of county government and county sponsored authorities in the public behavioral health and developmental disability services systems. The "disconnect" between "inside the beltway" and communities is often revealed to NACBHD staff during meetings, presentations and federal policy making (e.g. SAMHSA grant programs, funding determinations). In order for NACBHD to be recognized, the Association must clearly identify who and what it represents. Given the diversity of authority, planning, funding and service delivery arrangements throughout the county, this is no small task. Fortunately, its value has caught the attention of some at SAMHSA who understand the importance of communities in federal policy making. Given that, SAMHSA is assisting with distribution of the survey (will not review results). Further, the entire project (e.g. from survey to analysis and presentation) is made possible through a SAMHSA grant. This is NACBHD's opportunity to demonstrate that it can conduct a "scientific project" and produce useable results.
Hopefully, it is clear to the members (and will be to non-members who have a stake in the public behavioral health and developmental disability services sectors) that completion of the survey is vital. Please stay alert for distribution. Your assistance is appreciated. Please don't hesitate to contact Melissa Staats with any questions, concerns, or suggestions at (202) 661-8816.
Medicare Update
The March 28 Washington Update contains the most recent information on the January 1, 2006 implementation of the Medicare Modernization Act of 2003 (MMA), including CMS resources, an overview of prescription drug plan coverage, information on Part B, and information on NACBHD's legislative activities. To read the March 28, Washington Update, click here. For more background information on the MMA and MMA-related presentations at the March NACBHD Legislative Conference, see the March newsletter.
In addition, the following MMA-related activities are important for members to note:
First CMS Medicare Ombudsman Announced
The Centers for Medicare and Medicaid Services (CMS) recently announced that it has hired Dan Schreiner to be the ombudsman for all beneficiary concerns related to the MMA. He will be the single point of contact for assistance, complaints, grievances, and appeals. For more information, see the March 22 press release at www.cms.hhs.gov.
CMS Releases Transition Guidance for Medicare Drug Plans for Dual Eligible Coverage
On March 17, CMS released guidance to Medicare drug plans regarding "obligation to provide a smooth transition for persons dually eligible for Medicare and Medicaid." (NAMI) NAMI has analyzed the transition guidance and its minimum requirements. See www.nami.org, under "Current Policy Issues."
$31.7 Million Increase in SHIP Funding for Medicare Counseling
On April 11, CMS announced a 50% increase in State Health Insurance Assistance Programs funding (SHIPs). As a partner in Medicare's Education and Outreach, SHIPs will help insure that Medicare beneficiaries are informed about the availability of Medicare prescription drug coverage, the choice of at least two plans, and the availability of extra assistance. General enrollment in the new drug benefit begins November 15, with education and outreach already underway. The additional funding brings increased performance requirements for SHIPs, and community-based SHIPs will educate consumers about the benefit in the coming months. For more information, see the April 11 press release at www.cms.hhs.gov.
Concerns About Initial Distribution of Medicare Applications
A March 29, a New York Times article highlighted concerns with the recent initial distribution of Medicare applications to low-income Americans in 42 zip codes in 21 states, including: the complexity of the seven page application and concerns about income-related questions. The article cited advocates as expecting a lower than five percent return on the form because of its complexity. See www.nytimes.com/2005/03/29/politics/29medicare.
Smoking and Tobacco Cessation Coverage Added to Medicare
CMS announced that Medicare will cover smoking and tobacco use cessation counseling for certain beneficiaries, including Medicare beneficiaries who have "an illness caused or complicated by tobacco use, including heart disease, cerebrovascular disease, lung disease, weak bones, blood clots, and cataracts - the diseases that account for the bulk of Medicare spending today." And, the coverage applies to those who take many of the medications whose effectiveness is complicated by tobacco, including medicines for high blood pressure, blood clots, and depression, as well as insulins. For more information, see the March 22 press release at www.cms.hhs.gov.
Social Security Update
Two items of note related to Social Security are highlighted below:
Extensive Cuts in SSI Possible: Advocates Urged to Contact Congress
Significance of SSI cuts
An April 15 email from Marty Ford, Director of Legal Advocacy for The ARC, details the ongoing House activity around possible extensive cuts to the Supplemental Security Program (SSI) Program as part of the budget reconciliation process. A call-in day to the Hill regarding the issue took place April 12, but the situation has grown worse.
In explaining the significance of the possible SSI cuts, Ford's email says, "Cuts in SSI are likely to means greater costs falling upon state and local governments as people lose their SSI and Medicaid and turn to local governments to try to make ends meet. In addition, already-stretched private organizations such as charities, soup kitchens, and shelters for people who are homeless will find there are more people who need their help. Please share this alert and the attached memo with these officials and organizations and urge them to contact your members of Congress as well. Time is of the essence - these decisions are being made now and over the next week -- so please act early and often!"
Advocacy action
A document provided by Ford outlines the importance of SSI to the children and adults who receive it.
Advocates are urged to use this document when contacting their membership and grassroots, and to in turn,
contact their Members of Congress, especially Senators, directly. Advocates and those concerned about SSI
should urge Senators and Representatives to stick with the Senate budget bill (which has no cuts in SSI,
Medicaid or the EITC), and reject House cuts in order to protect key programs for people with disabilities,
like SSI and Medicaid. Click here to view the document.
Action alerts are posted to the action centers on the websites of The Arc (www.thearc.org) and United Cerebral Palsy (www.ucp.org). These action alerts can be used to create web-based alerts.
A resource on Social Security and other budget policy
The Center for Budget and Policy Priorities (CBPP) has several documents relevant to Social Security and
other current budget and policy issues. Visit the CBPP website at
www.cbpp.org to access them.
New CCD Fact Sheets on Social Security Available
The Consortium for Citizens with Disabilities (CCD) Social Security Task Force recently released seven facts sheets on Social Security benefits for people with disabilities and the impact of major program changes. Topics addressed include: benefits for consumers and their families, how social security is funded, how individual accounts will affect social security, and how proposed changes will impact those with disabilities and their families. To access the sheets, see the CCD web site at www.c-c-d.org.
NACBHD Commissioned Report on Access to Child and Adolescent Psychiatric Services Now Available
During 2004, the NACBHD was in a contract with the New York State Conference of Local Mental Hygiene Directors (CLMHD). CLMHD contracted with NACBHD to write a paper on improving access to child and adolescent psychiatric services in New York State. CLMHD has made this report available on its website at www.clmhd.org. NACBHD members are encouraged to review the document for possible leads in their own states and to better understand the scope of services NACBHD can provide.
Update on the CDBG Elimination Proposal
NACBHD covered issues related to reorganization of the Community Development Block Grant Program (CDBG) in the February newsletter. As reported in the April 8 "NACo Legislative Bulletin," since then, Senator Norm Coleman (R-MN) has collected signatures from Republican senators to reiterate support for CDBG. The deadline for collecting signatures was April 12. For more information on the CDBG elimination proposal and NACo budget priorities, see the "Legislative Bulletin" at www.naco.org, under "Advocacy."
Wernert Award Applications Due May 12
The Technical Assistance Collaborative (TAC) and The Lovell Foundation, in collaboration NACBHD, are pleased to announce the availability of the sixth annual Thomas M. Wernert Award for Innovations in Community Behavioral Healthcare. These organizations are committed to supporting and honoring innovations in community behavioral health and will show their support by awarding $10,000 to a state, county, or community-based, non-profit organization providing exemplary behavioral health services. The award program seeks to identify and give national recognition to a program that demonstrates innovation and creativity while ensuring community and consumer participation.
This award is given in memory of Tom Wernert, the former Executive Director of the Lucas County Mental Health Board, in Toledo, Ohio. The winning program will embody the ideas and ideals with which Mr. Wernert exercised leadership in public behavioral healthcare.
Eligible programs are state, county, or community-based private or non-profit agencies providing behavioral healthcare services that have been in operation for at least 12 months.
Application packages and information about past winners are available at the TAC website at www.tacinc.org. The deadline for applications is May 12, 2005. For a complete application, please contact Evette Jackson at (617) 794-3614, or download it from the TAC website at www.tac.org/wernert.pdf.
Campaign for Mental Health Reform: Expect Capitol Hill Briefing on Screening May 11, Release of "Call to Action" June 1
NACBHD spoke with Bill Emmet, project director at the National Association of State Mental Health Program Directors, and project director for the Campaign, about recent Campaign activities.
Capitol Hill briefing on early intervention and screening across the life span scheduled for May 11. A new effort involving the entire Campaign is a series of briefings for Hill staffers. The first briefing, scheduled for May 11 and sponsored by Senator Gordon Smith (R-OR) and others, including Senator Jack Reid (D-RI), will cover early intervention and detection of mental disorders across the life span, with an expectation that there will be questions about mental health screening of children due to the recent publicity around this issue. The Campaign hopes to have a briefing in the House on the same day. Other briefing topics may include the mental health needs of individuals returning from combat.
State-Informed Federal Policy Initiative -- Call to Action: Release Scheduled for June 1. The Campaign's project to gather information on state and local transformation efforts and determine the implications for federal policy is in process, with plans to release the final document (not yet formally named) June 1. Emmet notes that the Call to Action, whose primary audience will be Congress, will include a number of proposals for federal action to advance the goals and recommendations of the New Freedom Commission.
Campaign Director. The Campaign has issued a job posting for a Campaign Director, who Emmet says the Campaign hopes will step up the Campaign efforts to a higher strategic level -- someone with significant Hill experience who can envision and strategize where the Campaign wants to go. Interviews for the position are underway.
Medicaid. Other recent Campaign concerns have focused on Medicaid. A March 17 press release from the Campaign reflects the Campaign's concern about the devastating effect of Medicaid reductions at the local level See www.mhreform.org, "House Medicaid Cuts Devastating for American with Mental Illnesses, Say Advocates," for the press release.
No Child Left Behind News: Department of Education Rule Gives Schools More Flexibility in Testing Disabled Students
Disability advocates took note of an April 7 CQ Today release that examined a Department of Education ruling that would help states meet the standards of the No Child Left Behind Act. The rule will now allow up to 2% of special-needs students to alternate assessments, instead of assessments at their grade level. Currently, 1% of special educations students, such as those with severe disabilities like mental retardation, are allowed to take an alternate test. NACBHD is working with the Developmental Disability Committee to determine the impacts of this change. Further updates will be provided.
New Report Confirms Mental and Substance Use Disorders Spending Concentrated In the Public Sector
National Expenditures for Mental Health Services and Substance Abuse Treatment 1991-2001, was released March 29 and is available in the online edition of Health Affairs at www.healthaffairs.org or through the SAMHSA website at www.samhsa.gov. The report analyzes mental health and substance abuse expenditure trends, and notes that Medicaid has become the largest payer of mental health care, with prescription drugs the fastest growing area of spending. Private insurance support for substance abuse has declined, with the public share of substance abuse spending increasing. Informative charts and graphs are included in the report.
Faces & Voices of Recovery: Focus on Removing Barriers to Recovery from Addiction
Pat Taylor, Campaign Coordinator for Faces & Voices of Recovery, spoke at the March Legislative Conference about the organization's agenda and activities for 2005, and recently, she spoke with NACBHD in more detail about the campaign's ongoing work.
The organization was founded in Fall 2001, and received 501c3 status last year. People from all pathways to recovery from all over the country are part of the effort. Currently, two staff members and an intern, a very active leadership and volunteers around the country drive the organization's activities. (Faces & Voices is organized into 13 regions with a Board of Directors). Taylor has previous experience in the alcohol and substance abuse policy arena; previously she worked on the Alcohol Policies Group at the Center for Science and the Public Interest, and she was Deputy Director at Ensuring Solutions for Alcohol Problems.
Understanding recovery from addiction and removing barriers to recovery
Taylor notes a special concern about the understanding of recovery from addiction. The public seems to understand recovery from addiction as the process of trying to be free of alcohol or substance addiction. While there is no formal definition of recovery from alcohol or substance addiction on the Faces & Voices website, Taylor says that "recovery involves being free from addiction." Faces & Voices is working hard to remove discriminatory barriers to people getting on with their lives. There are barriers in terms of housing, treatment, access to services, food stamps, and legal barriers - all noted in the Faces & Voices platform (see below).
Taylor provides a typical example of a barrier to recovery. In some states, someone with a drug conviction who has worked as a barber while they were in jail cannot get a license to work as a barber when they are out of jail, which is a barrier to the process of getting on with one's life.
The Right to Addiction Recovery Platform
Faces & Voices' Right to Addiction Recovery Platform, developed last year, is on the website's home page, and addresses barriers to recovery and individuals getting on with their lives. The opening sentence of the platform reads, "A new life, free from addiction to alcohol and other drugs, is a reality for millions of Americans and tens of thousands more get well every year." The platform addresses these key areas:
Current and Upcoming Activities
While the platform addresses many issues that Faces & Voices will be addressing over the coming years, Taylor emphasizes several areas the organization is now involved in or will be involved in in the near future. In all the activities, there is an emphasis on getting the message out that people do recover and that there is hope.
Faces & Voices Resources
Website and contact information
To access the information above or for more information about Faces & Voices, see the website at
www.facesandvoicesofrecovery.org or
contact Pat Taylor at (202) 737-0690 or by email at pat.taylor@verizon.net.
May Is Mental Health Month
The theme for this year's Mental Health Month is MIND Your Health. MIND Your Health emphasizes the mind-body connection and the latest research on the link between mental and physical health. The National Mental Health Association (NMHA) offers materials to launch a Mental Health Month campaign in communities. Materials can be downloaded from the NMHA website and include: planning, activity, educational and media outreach resources, as well as material for children, including a Childhood Depression Awareness Day section. See www.nmha.org.
SAMHSA Announcements
The following information is highlighted from recent SAMHSA news releases.
From an April 8 press release:
SAMHSA Releases "Know Your Rights" Brochure: All-Inclusive Guide Informs Those in Recovery from Alcohol or Drug Problems About Legal Rights and Overcoming Discrimination
SAMHSA released a new brochure for people in substance use disorders treatment and recovery, their allies, advocates, and employers. "Are You in Recovery from Alcohol or Drug Problems? Know Your Rights" provides information about federal laws that protect against discrimination in employment and job training, housing, health care, education, and government services and programs.
Written in partnership with the Legal Action Center, "Know Your Rights" brings information about federal laws to people in recovery, and is available in both English and Spanish. Sponsored and produced by SAMHSA's Center for Substance Abuse Treatment, the brochure helps identify discrimination, addresses federal laws and protections, and provides useful resources.
To obtain the brochure, or for more information, call (800) 729-6686 or on the web at www.ncadi.samhsa.gov.
From a March press release:
SAMHSA Issues Group Therapy Guide for Substance Use Disorders Treatment
A comprehensive guide on the use of group therapy in the treatment of substance use disorders is now available from SAMHSA. The consensus panel that created "Substance Abuse Treatment: Group Therapy" emphasized that group therapy is effective treatment and is a cost effective way to deliver treatment, and that group therapy offers a number of advantages to patients, including positive peer support, a reduction in their sense of isolation, real-life examples of people in recovery, and help from peers in coping with substance abuse and other life problems.
The guide, Treatment Improvement Protocol #41 in SAMHSA's Treatment Improvement Protocol (TIP) series, contains detailed, state-of-the-art information about group therapy modalities, techniques, and practices valuable to substance abuse treatment counselors as well as supervisors and trainers of counselors. Tips are consensus documents formulated by nonfederal clinical researchers, clinicians, program administrators and client advocates who evaluate all relevant clinical and health services research findings.
The new TIP describes five group models that are common in substance abuse treatment: psychoeducational groups, skills development groups, cognitive-behavioral groups, support groups, and interpersonal process groups. The TIP also offers information about specialized types of groups that do not fit neatly into the five-model classification, but are common in substance abuse treatment, and groups that focus on solving a single problem.
Group therapy is not equivalent to 12-Step program practices, the TIP emphasizes. Rather, they are complementary components in the recovery process. Group therapy, led by a professional substance abuse practitioner, should be conducted in a manner that increases the complimentary relationship between the professionally led group and 12-step programs, the TIP explains. Group therapy addresses all the symptoms experienced by the patient, using specific behavioral and psychological approaches. Twelve-Step groups address only one specific component of recovery - abstinence.
TIP 41, DHHS Publication No. (SMA) 05-3991, can be ordered through SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville, M.D. 20847-2345, or by calling 1-800-729-6686.
From a March 1 SAMHSA press release:
$18.8 Million Available for State Grants to Transform Mental Health
SAMHSA announced the availability of FY 2005 funds for cooperative agreements with states to support infrastructure and service delivery improvements that will help build a solid foundation for delivering and sustaining effective mental health and related services. Approximately $18.8 million will be available to fund approximately 6-13 cooperative agreements to support an array of infrastructure and service delivery activities. The average annual award amount will range from $1.5 million to $3 million per year for up to five years. The actual award amount may vary, depending on the availability of funds. The cooperative agreements will be administered by SAMHSA's Center for Mental Health Services.
WHO CAN APPLY: Please note that eligibility is limited to the immediate office of the Chief Executive Officer in the States, Territories, the District of Columbia, and federally-recognized American Indian/Alaska Native Tribes or Tribal organizations. Eligibility is limited because recipients of the Mental Health Transformation State Incentive Grants must have the ability to leverage and coordinate multiple sources of funding and other resources in order to achieve the goals of the President's New Freedom Commission on Mental Health.
HOW TO APPLY: Applications for No. SM 05-009 are available by calling SAMHSA's clearinghouse at 1-800-789-2647, or by downloading the application from www.grants.gov, or from the SAMHSA web site. Applicants are encouraged to apply on-line through a new service at www.grants.gov.
APPLICATION DUE DATE: June 1, 2005
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Nancy Davis, Ed.D., at (240) 276-1866 or e-mail to mhtsig@samhsa.hhs.gov . For questions on grant management issues, contact Kimberly Pendleton at (240) 276-1421 or e-mail to kimberly.pendleton@samhsa.hhs.gov . Information about pre-application technical assistance may be found at http://www.samhsa.gov/. Click on "MHT SIG" under "Mental Health System Transformation."
From a March 24 press release:
$7.6 Million Available for Community Treatment and Services Center
SAMHSA announced the availability of FY 2005 funds for community treatment and services centers under the National Child Traumatic Stress Initiative to promote the local use of best practices for children and adolescents who have experienced trauma. Approximately $7.6 million will be available to fund 19 grants to improve treatment and services for children and adolescents in the United States who have experienced traumatic events. The average annual award amount will range from $400,000 per year for up to four years. The actual award amount may vary, depending on availability of funds. The grants will be administered by SAMHSA's Center for Mental Health Services.
WHO CAN APPLY: Domestic public and private nonprofit entities such as community-based organizations, out-patient clinics, faith-based organizations, public or private universities, psychiatric or general hospitals, units of state or local governments, federally recognized tribes and tribal organizations and partnerships of multiple clinical centers, programs and/or community service providers.
HOW TO APPLY: Applications for No. SM-05-006 are available by calling SAMHSA's clearinghouse at 1-800-729-6686, or by downloading the application from www.grants.gov. The grant announcement is a modified version of an earlier funding announcement. Applicants are encouraged to apply on-line through a new service at www.grants.gov.
APPLICATION DUE DATE: May 17, 2005
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Christine L. Guthrie, M.P.H. at (240) 276-1847 or e-mail to christine.guthrie@samhsa.hhs.gov. For questions on grant management issues, contact Kimberly Pendleton at (240) 276-1421 or e-mail to kimberly.pendleton@samhsa.hhs.gov.
From a March 24 press release:
$2.4 Million Available for Jail Diversion Grant Programs
FY 2005 funds are available for Targeted Capacity Expansion Grants for Jail Diversion programs to divert individuals with mental illness away from the criminal justice system and into community-based, integrated mental health and substance abuse treatment and support services. Approximately $400,000 will be available per grantee in FY 2005 for six grants for up to three years. The grants will be administered by SAMHSA's Center for Mental Health Services.
WHO CAN APPLY: Chief executive of a state; political subdivisions of states; and Indian tribes and tribal organizations, acting through agreements with other public and nonprofit entities to develop and implement programs to divert individuals with mental illness away from the criminal justice system and into community-based services. All applications must be signed by the chief executive of the state, political subdivision of state, Indian tribe, or tribal organization.
HOWTO APPLY: Applicants for No. SM-05-011 are available by calling SAMHSA's clearinghouse at 1-800-729-6686, or by downloading the application from www.grants.gov. Applicants are encouraged to apply on line through a new service at www.grants.gov
APPLICATION DUE DATE: May 24, 2005
ADDITIIONAL INFORMATION: Applicants with questions on program issues should contact David Morrissette, DSW, at (240)-276-1912 or e-mail david.morrissette@samhsa.hhs.gov. For questions on grant management issues, contact Kimberly Pendleton at (240) 276-1421 or email to Kimberly.pendleton@samhsa.hhs.gov.
Network of Care Now Maintaining NACBHD Website
A special note of thanks to the Network of Care, who is now maintaining the NACBHD website and distributing the newsletter and the Washington Update. NACBHD is happy to join in this additional effort with the Network of Care. Several NACBHD member counties have already joined the Network of Care and have access to the many resources available through the Network. The May newsletter will update the membership on the counties involved in this effort and their perspective on the Network resources.
