April 2006 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
The 2006 NACBHDD Newsletter series is brought to you by:
Medicaid Update
For the latest information on the 2006 budget and the proposed 2007 budget and their impact on Medicaid and other issues and areas of concern, see the March 6 DC Update. Click here to view the Update.
CMS Letter to State Medicaid Directors
On March 31, CMS issued a letter to State Medicaid Directors, and NACBHD sent a copy of the letter to members. NACBHD-with the assistance of a consultant-will analyze this letter and then try to explain its impact on services and individuals within the public behavioral health and developmental disability services systems. This is a first in a series of letters that will be issued to guide implementation of the Deficit Reduction Act (DRA) of 2005. This letter focuses on state flexibility related to the design of benefit packages. NACBHD will keep its members informed as more details become available. To view the letter, click here
Update from the National Association of County Human Services Administrators (NACHSA): Families USA documents on Deficit Reduction Act and Medicaid eligibility
NACHSA has forwarded the following information to NACBHD:
Medicaid Deficit Reduction Act Briefs
The consumer advocacy group Families USA has prepared two good primers on changes to Medicaid as a result of the Deficit Reduction Act. One is a six page paper listing and describing overall changes to the program: http://www.familiesusa.org/assets/pdfs/DRA101.pdf.
The other paper specifically addresses the requirement that U.S. citizenship be documented by both applicants for Medicaid and those whose eligibility must be re-determined: http://www.familiesusa.org/assets/pdfs/DRA-Citizenship.pdf.
As a consumer group, Families USA clearly has its point of view - the paper on citizenship has some advice for advocates that may affect those who administer the program at the state or county level.
Verification of Citizenship for Medicaid
CMS may now require states to verify citizenship prior to finding Medicaid Eligibility. The following is a link to a July 2005 HHS OIG report relating to the verification of citizenship for Medicaid:
http://www.oig.hhs.gov/oei/reports/oei-02-03-00190.pdf
Intent of the Deficit Reduction Act
Lena O'Rourke of Families USA sent the following information to DC advocates regarding the intent of the Deficit Reduction Act and the letter from Senator Grassley and Representative Barton. Below is an article from Congressional Quarterly (CQ) about said letter.
HERE'S WHAT WE MEANT ...
The budget savings bill President Bush signed into law last month does not allow states to change cost-sharing requirements for the poorest Medicaid beneficiaries, two key lawmakers have told Department of Health and Human Services Secretary Michael O. Leavitt. In a letter sent Wednesday, Senate Finance Committee Chairman Charles E. Grassley, R-Iowa, and House Energy and Commerce Committee Chairman Joe L. Barton, R-Texas, said the measure also does not allow states to reduce benefits under Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, which provides regular checkups to children on Medicaid. Critics of the bill have contended that the measure (PL 109-171) permits states to increase cost sharing on Medicaid beneficiaries below 100 percent of the federal poverty level and to cut EPSDT benefits. "Congress should not be presumed to have intended to have made so fundamental a change to the Medicaid program as allowing the imposition of unlimited cost sharing on the lowest income Medicaid beneficiaries," the lawmakers wrote. Concerning EPSDT, states are required to provide the same benefits as in current law, Grassley and Barton wrote.
To view the Grassley and Barton letter, click here.
Federal Court Issues Ruling on EPSDT
The following was forwarded by Marcia Rubin, Ph.D. MPH, Director, Research & Sponsored Programs, American School Health Association:
A Federal court in Massachusetts has ruled that the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services provisions of Medicaid require Massachusetts to provide Medicaid-eligible children with any services deemed medically necessary, whether or not the service is currently part of the Medicaid state plan. While the decision applies only to Massachusetts, it may prove to have national ramifications if treated as a precedent in other cases around the country.
The plaintiffs in Rosie D. v. Romney consist of eight named children and a class consisting of "all current and future Medicaid-eligible children under twenty-one years of age who are or might become eligible to receive, but are not receiving, intensive home-based services, including professionally acceptable assessments, special therapeutic aides, crisis intervention, and case management services." Currently this class is estimated to include about 15,000 children. The plaintiffs claimed that the EPSDT provisions of the Medicaid Act require Massachusetts to provide intensive home-based mental health services that will enable children with severe emotional disturbance (SED) to receive treatment and support in their homes and home communities. The plaintiffs maintained that Massachusetts violated EPSDT and the reasonable promptness and equal access provisions of the Medicaid Act, 42 U.S.C. ยงยง 1396a(a)(8) and (30)(A) by failing to inform children and their families about the services to which they are entitled; promptly provide needed home-based services to children, and afford children throughout Massachusetts equal access to certain pilot programs for home-based services.
A federal judge found that Massachusetts is violating the federal Medicaid Act by failing to provide home-based mental health services to an estimated 15,000 children with serious emotional disturbance, resulting in "unnecessary confinement in residential facilities or...in costly institutions far longer than their medical conditions require." The judge called the state's efforts to comply with the requirements of the federal law "woefully inadequate, with detrimental consequences to thousands of vulnerable children," citing the defendants' failure to provide adequate assessments, service coordination and home-based supportive services for Medicaid-eligible children with serious emotional disturbances."
The decision describes the EPSDT provisions as requiring that "no Medicaid-eligible child in this country...go without treatment deemed medically necessary by his or her clinician." Most significantly, the Court stressed that the Act requires States to provide all twenty-eight categories of medical assistance, regardless of whether they are in the State's Medicaid Plan. One of these categories, rehabilitative services, obligates States to ensure that eligible children are offered all "diagnostic, screening, preventative, and rehabilitative services, including any medical or remedial services...for the maximum reduction of physical or mental disability and restoration of an individual to the best functional level." In other words, if a licensed clinician finds a particular service to be medically necessary to help a child improve his or her functional level, this service must be paid for by a state's Medicaid plan pursuant to the EPSDT mandate.
The opinion is available online at http://www.masslegalservices.org/docs/RosieD.pdf. A summary of the case, prepared by Massachusetts Legal Services, can be found at http://www.masslegalservices.org/docs/Q_A_Rosie_D_sjs.DOC.
Medicare Update
Initial Transition Period under Medicare Part D-Ends March 31, 2006
CMS sent the following communication to NACBHD at the end of the transition period (March 31):
As the end of the initial, extended transition period for coverage of non-formulary drugs by Medicare Part D plans draws near, CMS is working with its partners to ensure that people with Medicare continue to have access to the medicines they need. Under the original transition policy, plans provided at least a 30-day supply of non-formulary drugs for people transitioning to Part D coverage, and a 90-day supply in long-term care facilities. This policy was subsequently extended from 30 days to 90 days for any beneficiary that had enrolled effective January 1, 2006, and to 60 days for beneficiaries enrolled effective February 1.
Although the extended transition period is ending, beneficiaries who enroll in a Medicare drug plan after April 1 will continue to have access to the original 30-day transition policy (90 days for beneficiaries in long-term care facilities). In addition, CMS has been working closely with plans to ensure that all beneficiaries will continue to have access to necessary treatments under Medicare Part D. Some of the specific steps CMS is taking to make sure beneficiaries can work with plans to get coverage for the prescriptions they need include:
CMS has sent a letter to Part D plans reminding them of their responsibilities following the end of the extended Part D transitional coverage period for initial enrollees. The letter highlights the importance of assuring enrollees' appropriate transition to formulary drugs and making timely determinations on enrollees' exceptions and appeals requests. CMS expects that in situations where plans are unable to meet established timeframes, affected enrollees should be given a temporary supply of the requested prescription drug until the case is fully resolved. Plans' ability to meet contractual timeliness requirements will be monitored closely, and CMS will take prompt action that could include corrective action plans and sanctions in cases where plan delays interfere with enrollees' rights to the drugs they need on a timely basis.
Please find attached a fact sheet on the end of the transition period and a copy of the plan letter.
To access the fact sheet and plan letter, click here.
Please use the data collection tool housed on the NACBHD website if you wish to report how this has impacted consumers in your community. NACBHD uses this information for national advocacy purposes.
CMS Releases Final 2007 Formulary Guidelines for Medicare Prescription Drug Plans
(CMS email correspondence to NACBHD)
Today, the Centers for Medicare & Medicaid Services released the Final 2007 Formulary Guidance for Medicare Prescription Drug plans. The final document and an overview of the changes from the draft guidelines to the final guidelines are attached below. In general, these guidelines are consistent with the 2006 guidelines, which are broader than most public and private health insurance plans. The guidance also clarifies requirements based on this year's experience.
The 2007 Formulary Guidelines outline how CMS will review Medicare prescription drug benefit plan formularies to assure that beneficiaries receive clinically appropriate medications at the lowest possible cost. Development of this review process was built on two key requirements in the MMA:
(1) assuring that drug plans provide access to medically necessary treatments for all and do not discriminate against any particular types of beneficiaries, and
(2) encouraging and supporting drug benefit management approaches that are proven and in widespread use by plans today.
For 2007, CMS will continue to require Part D plan formularies to include all or substantially all drugs in the immunosuppressant, antidepressant, antipsychotic, anticonvulsant, antiretroviral, and antineoplastic classes in order to maintain the level of protection currently being provided to beneficiaries who are being treated with drugs from these six classes of clinical concern. In addition, CMS will continue to look to existing industry best practices to determine whether plans' use of utilization management tools like prior authorization, step therapy and quantity limits is consistent with current industry standards as well as appropriate guidelines that might be found from expert organizations.
Click here for the formulary guidelines and for the changes.
NACBHD comments on guidelines. NACBHD commented on the guidelines. To view the letter that NACBHD sent to CMS, click here.
CMS Fact Sheet on Assisting Individuals with Limited Income
Recently, Melissa Staats sent members an important fact sheet from CMS regarding how CMS is assisting people with limited income and resources to take advantage of comprehensive Medicare prescription drug coverage. To access the fact sheet, click here.
Other Medicare Modernization Act Resources
Mental Health Part D Website Has Latest Information. The Mental Health Part D web site (www.mentalhealthpartd.org) provides up-to-date information and resources related to Part D of the new Medicare law. (Several mental health advocacy organizations developed the site: the American Association of Community Psychiatrists, the American Association of Geriatric Psychiatry, the American Psychiatric Association, the National Association of State Mental Health Program Directors, the National Council for Community Behavioral Healthcare, and Treatment Effectiveness Now, as well as NAMI and NMHA.) The groups involved, as well as NACBHD (Melissa Staats participates in routine calls with the groups), continue to work together to assess concerns and problems and relay them to CMS. For a full description of the site and what it offers, see the Early January 2006 newsletter, and for a detailed description of problems with access, copays, appeals, see the March newsletter. For the latest on Part D, see www.mentalhealthpartd.org.
The National Mental Health Association has developed a consumer workbook that is comprehensive and easy to understand. It can be accessed at:
http://nmha.org/federal/MedicareConsumerWorkbook.pdf.
NAMI Tip Sheet for Dual Eligible Consumers and Families Available Online. Pharmacies do not always follow the CMS guidelines outlined for the transition process. In order to provide consumers and families with information about the obligations required of all Medicare drug plans, the National Alliance for the Mentally Ill (NAMI) has made a tip sheet for dual eligible consumers and their families available online. This tip sheet also has FAQs explaining cost sharing requirements and the process for getting a drug that is not on a drug plan's preferred list or is subject to a restriction, such as prior authorization. NAMI will update the tip sheet as CMS publishes new guidance in the coming weeks and months. Click here to access the tip sheet or see www.nami.org.
Update on the Campaign for Mental Health Reform
The Campaign for Mental Health Reform continues to actively work with national advocacy partners, including NACBHD, on critical issues.
Campaign releases statement on establishment of the Senate Caucus on Mental Health Reform, the March 29 President's New Freedom Commission Meeting, and the March 29 National Awards Dinner. The Campaign issued a press release on its most recent activities, including the Senate Caucus on Mental Health Reform, the March 29 President's New Freedom Commission Meeting, and the March 29 National Awards Dinner. The First Annual Awards Dinner for Leadership in Mental Health was attended by Margaret Hanna, Chair of the NACBHD Board of Directors and Executive Director of the Bucks County Drug & Alcohol Commission; Jim Dill, Treasurer of the NACBHD Board and Executive Director, Alabama Council of Community Mental Health Boards; and Maeghan Gilmore, NACBHD Senior Policy Analyst. Afshin Khosravi, founder and chief executive officer for Trilogy Integrated Resources, the organization that coordinates NACBHD's web site, also attended the event. Over 300 people attended the dinner, with Mike Wallace serving as host.
For a complete information on the Senate Caucus on Mental Health Reform, the March 29 President's New Freedom Commission Meeting, and the dinner, click here to view the press release.
NAMI Releases Grading the States 2006
The National Alliance for the Mentally Ill (NAMI) recently released Grading the States 2006: A Report on America's Health Care System for Serious Mental Illness. Look for an in-depth interview with Ron Honberg, J.D., NAMI national director for policy and legal affairs, and a lead author on the report, in the May newsletter. The report can be accessed at www.nami.org.
2006 NACBHD Meeting Schedule
This year, in a planning effort to more effectively address member advocacy and networking interests, NACBHD will not be holding a summer or fall conference; instead there will be two board meetings. The first will take place August 4 in Chicago in conjunction with the NACo Annual Conference, and the second will take place in October (tentatively October 17-18) in Michigan in conjunction with the Michigan Association of Community Mental Health Boards. Hotels for both meetings are being arranged, and information will be posted on the website as soon as it is available. NACBHD members are encouraged to attend these meetings even if they are not Board members. However, these are meetings at which only the Board votes.
A proposal from the program committee (approved by the Board in March) that explains the changes can be accessed by clicking here.
Map of NACBHD Membership Will Soon Be Available on Website
NACBHD has been collaborating with the National Association of Counties (NACo), of which it is an affiliate, on a national membership map, which will be overlaid with Congressional districts. The map, which was presented at the Legislative Conference, will show where points of advocacy are nationwide. The map will be posted on the NACBHD website. Look for more information on the membership map in the May newsletter.
NACBHD Members Can Now Quickly Query the Membership and Gain Insight
NACBHD members can now informally and easily gain insight from one another on important issues by simply passing on their question to the NACBHD staff at mstaats@nacbhd.org. Melissa Staats will distribute the question to the membership.
May Is Mental Health Month
May is Mental Health Month, and the National Mental Health Association is offering a variety of planning and activity ideas, fact sheets, and information online. This theme for this year's observance is "Mind Your Health," which recognizes the mind-body connection and emphasizes the latest research demonstrating that overall health involves both mental and physical well-being. In addition, there will be a special Childhood Depression Awareness Day this year. Materials and information can be accessed at www.nmha.org.
SAMHSA and TCA National Returning Veterans Conference
Robert W. Anderson, Ph.D., NACBHD Board Member and Director of Community Services, Allegany and Stuban Counties, New York, attended the March 16-18 SAMHSA and Therapeutic Communities of America (TCA)-sponsored national conference on returning veterans entitled: "The Road Home: National Conference on Returning Veterans' and Their Families' Behavioral Health." Anderson recently spoke with NACBHD about the conference and the impact of returning veterans on county behavioral health, with an emphasis on overlooked areas and questions never asked before.
Conference overview
According to the conference overview, participants included federal, state, and local public and private agencies, primary care providers, community health and prevention specialists, substance abuse and mental health care providers, educators, advocacy groups, policy makers, consumers, veterans, members of tribal communities, and those interested in issues facing returning veterans and their families. The purpose of the conference was to provide evidence-based information and approaches that can help veterans and their families build resiliency to prevent and to treat mental health disorders (including PTSD), substance abuse disorders, suicide, and/or co-occurring disorders. And, the information from SAMHSA states "As the servicemen and servicewomen who have been engaged in combat return home to their families and communities, SAMHSA recognizes the many challenges they may face. This successful transition will be aided by the collaboration of many partners to identify, prevent, and treat substance use and mental health disorders."
Background on mental health issues and returning veterans
Anderson noted that the recently published article "Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq and Afghanistan," Charles W. Hoge, MD, et al, JAMA, March 1, 2006, Vol., 295, No. 9, provides a good summary of the high use of mental health services associated with individuals returning from service in Iraq or Afghanistan.
Key point from the conference
Anderson has been working with veterans since 1971, including veterans from the Vietnam War, the Korean War, and World War II, and has been involved in debriefings of individuals involved in 9/11 efforts. He highlighted many important points of the conference, noting that the current situation with returning veterans is forcing those involved in helping the veterans to ask questions never asked before.
Anderson has already met with his local VA to get some publicity for veterans in May, which is mental health month, and to acknowledge what veterans have been through. NACBHD will keep members informed of any pilot projects related to returning veterans through the newsletter.
National Governors Association Announces Task Force on TANF
On March 13, the National Governors Association issued a news release announcing that it has formed a new task force on TANF. The news release is reprinted here in its entirety.
Governors Join Together to Develop Recommendations for HHS
WASHINGTON, D.C. - The National Governors Association (NGA) today announced an 8-member Task Force on TANF (Temporary Assistance for Needy Families).
The Task Force, led by NGA Chairman Arkansas Gov. Mike Huckabee and NGA Vice Chair Arizona Gov. Janet Napolitano, was created to assist the Department of Health and Human Services as it develops the regulations necessary to implement the newly reauthorized program. Governors hope to ensure that any regulations by HHS enable states to maximize state flexibility and build upon their past successes.
Other members of the Task Force include: California Gov. Arnold Schwarzenegger; Minnesota Gov. Tim Pawlenty; Nevada Gov. Kenny Guinn; New Jersey Gov. Jon Corzine; Pennsylvania Gov. Ed Rendell; and Washington Gov. Christine Gregoire.
"Ten years ago, governors worked with Congress to reform the nation's welfare system," said Huckabee. "A cornerstone of that partnership was the ability of states to implement innovative approaches and initiatives to assist families in need through greater state flexibility. Governors want to ensure the state-federal TANF partnership continues."
"The work of this task force will be critical to ensuring state flexibility, a basic tenet of welfare reform, is continued in the TANF program," said Napolitano. "Governors are committed to assisting needy families in reaching self-sufficiency through work, and the recommendations we develop will ensure we are successful in that endeavor."
TANF was recently reauthorized for 5 years in the Deficit Reduction Act (DRA) of 2005.
NACBHD Letter in Governing Magazine
In collaboration with NACo, NACBHD recently submitted a letter to Governing magazine regarding their publication of a summary report on Medicaid and the States. The Pew Center on the Study of the States conducted the study and prepared the summary. To view the letter, click here. The original letter is on the NACBHD website.
Access Article for State Legislators on Mental Health Screening
The National Conference of State Legislators recently published an article in their State Health Notes on Mental Health Screening. Darcy Gruttadaro, JD, Director, Child & Adolescent Action Center, the National Alliance on Mental Illness (NAMI) and Mindy Greiling, a state legislator from Minnesota, who is also the chair of the NAMI national BOD policy subcommittee on children, were interviewed for the article. Gruttadaro characterized the article as "a balanced view of mental health screening" in an email to Melissa Staats. To access the article, see www.ncsl.org/shn.
CSAT and ACF Conference on Meth and the Impact on Child Welfare
The Center for Substance Abuse Treatment (CSAT) and the Administration on Children, Youth and Families are co-sponsoring the conference "Methamphetamine: The Child Welfare Impact and Response" May 8 and 9 at the Hyatt Regency Crystal City in Arlington, Virginia. For more information and to register for the conference, see http://www.esi-conference.info.
Discounted Rate on Mental Health Weekly for NACBHD Members
Wiley & Sons, the new owners of Mental Health Weekly, are offering NACBHD members a year subscription to Mental Health Weekly for $329. This price is more than 50% off the normal personal subscription price of $687.
To subscribe, members should call: 1-877-762-2974. When ordering, members must quote their special discount code, which is your association name: NACBHD.
Report on Autism and Early Intervention, Optimal Treatment, and Policy Challenges Now Available Online
On December 16, 2005, the Brookings Institution and The Help Group, co-sponsored by Cure Autism Now and Autism Speaks, with additional support from the Karmazin Foundation and Michael Fux, held the conference "Autism and Hope." The conference addressed the challenges of autism, modern treatment methods, and national policy. Conference proceedings are now available online and contain expert panel discussions about facts and figures and the historical context for understanding autism, the debate over optimal treatment approaches and the broad consensus on the importance of early and intensive intervention, and public policy challenges related to accessibility and affordability. The report of the conference proceedings is available at http://www.brookings.edu/comm/conferencereport/20051216autism.pdf.
SAMHSA Announcements
From a March 31 SAMHSA release:
$3.3 Million Available for Prevention of Methamphetamine Abuse
SAMHSA announced the availability of FY 2006 funds for grants to support expansion of methamphetamine prevention interventions and/or infrastructure development. The grants will help communities expand prevention interventions that are effective and evidence-based with the goal of reducing or delaying the use of methamphetamine abuse.
It is expected that $3.3 million will be available to fund 9-11 awards. The annual award is expected to be from $300,000 to $350,000 per year for up to 3 years. The actual amount may vary, depending on the availability of funds. The grants will be awarded by SAMHSA's Center for Substance Abuse Prevention.
WHO CAN APPLY: Eligible applicants are domestic public and private nonprofit entities. State and local governments; territories; federally and state recognized tribes; urban Indian organizations; public or private universities and colleges; community- and faith-based organizations; and tribal organizations may apply.
HOW TO APPLY: Applications for No. SP-06-005 are available by calling SAMHSA's clearinghouse at 1-800-729-6686, or by downloading from www.Grants.gov or www.samhsa.gov. Applicants are encouraged to apply on line using www.Grants.gov.
APPLICATION DUE DATE: Must be received by May 16, 2006.
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Wilma Pinnock at 240-276-2421 or e-mail wilma.pinnock@samhsa.hhs.gov. For questions on grants management issues, contact Kimberly Pendleton at 240 276-1421 or e-mail Kimberly.pendleton@samhsa.hhs.gov.
From a March 14 SAMHSA press release:
SAMHSA Announces Changes to National Registry of Evidence-Based Programs and Practices
SAMHSA has announced release of a report detailing enhancements being made to the agency's National Registry of Evidence-based Programs and Practices (NREPP). The report was published in the March 14 Federal Register. Historically NREPP has been a nationally recognized tool useful for identifying and promoting effective interventions to prevent substance abuse. The changes being instituted, following extensive public review and comment, will broaden NREPP, creating a resource for the latest information on the scientific basis for and practicality of specific programs and interventions designed to prevent and/or treat mental and substance use disorders. The new protocols and procedures will help reduce the significant lag-time between the generation of new scientific knowledge and its application by community-based prevention and treatment programs and providers. The changes provide transparency, accuracy, and timeliness of both the NREPP process and the end product registry itself. The report describes: The broadened base of NREPP to include not only substance abuse prevention but also treatment of substance use and mental disorders, and prevention of mental health problems. The new process through which programs and practices will be identified and evaluated for initial and ongoing inclusion in NREPP; How the new presentation of NREPP content can promote better decisions by state and community programs looking for models that will work for them; The public process - and a summary of the more than 130 public comments - that helped drive the shape and structure of the new NREPP.
For more information about the new NREPP, including a copy of the report, click on "National Registry of Evidence-based Programs and Practices FRN" under the "Quick Picks" section on the SAMHSA home page at www.samhsa.gov.
From a March 24 SAMHSA press release:
SAMHSA Seeks Nominations of Mental Health Consumers to Honor at Second Annual Voice Awards
SAMHSA invites the general public to nominate mental health consumers for recognition at the 2006 Voice Awards. The Voice Awards acknowledge the leadership of mental health consumers - individuals who have received or are receiving mental health services for a mental health problem - in helping to raise awareness and understanding of mental health problems, thus reducing stigma and discrimination nationwide. The awards program also recognizes the writers and producers of television programs and movies that provide accurate portrayals of people with mental health problems.
Mental health consumers throughout the United States have played a vital role in demonstrating that people with mental health problems are valuable, contributing members of their schools, workplaces and communities. Their work to raise awareness and understanding and reduce stigma helps ensure that people are able to access services and supports that assist recovery.
Consumer nominations for the Voice Awards will be accepted through Friday, April 21, 2006, online at www.allmentalhealth.samhsa.gov/voiceawards. Self-nominations are welcome. Eligible nominees must be mental health consumers who have made outstanding contributions that helped lead efforts to reduce the discrimination and stigma associated with mental health problems; personally demonstrated that recovery is real and possible; and made a positive impact on their communities, workplaces and/or schools. Additional consideration will be given to nominees who have made a positive impact on special populations such as older adults, racially and ethnically diverse groups and rural communities.
The Voice Awards are part of the National Anti-Stigma Campaign, a three-year program sponsored by SAMHSA in conjunction with the Ad Council, to reduce the stigma and discrimination faced by people with mental health problems.
WHO: Mental health consumer leaders
WHAT: Nominations for Voice Awards
WHEN: Nominations due Friday, April 21, 2006
WHERE: www.allmentalhealth.samhsa.gov/voiceawards
