March 2005 NACBHDD Newsletter

The monthly newsletter for the National Association of County Behavioral Health and Developmental Disabilities Directors

In this Issue...

• A Note on Our Name: Change Better Reflects NACBHD's Constituency and Interests
• Report on the Legislative Conference
• Medicaid: The Debate Over Historic Reductions Continues
• Medicare Update
• A Local Recovery Success Story: NACBHD Members Discuss What Makes Western Care Coordination Work
• Update on the Campaign for Mental Health Reform
• 2005 Wernert Award Applications Now Available
• New Medicaid and Medicare Resource for Consumers, Families, and Advocates
• SAMHSA Announcements

The 2005 NACBHDD Newsletter series is brought to you by:

A Note on Our Name: Change Reflects Constituency and Interests

As NACBHD members may have already noted from visiting our website or viewing our correspondences and documents, we have formally changed our name to the National Association of County Behavioral Health and Developmental Disabilities Directors. While the acronym remains the same, the new title more accurately reflects the important, and very real, role of county government and county sponsored authorities in developmental disabilities sector. NACBHD members have historically been part of the developmental disabilities community. Therefore, this change not only more accurately represents the nature of our organization, but it also better serves NACBHD in more effectively representing the interests of our members and their constituents in advocacy circles and on Capitol Hill.

Report on the Legislative Conference

NACBHD members learned first-hand the impacts of federal policy making on county behavioral health and developmental disability services. Federal, state, and local officials, as well as advocates shared their knowledge and expertise with our members at the annual Legislative Conference, March 3-5, in Washington, DC. A summary of the conference and links to presentations are provided below.

Thursday, March 3

NACBHD's Legislative Agenda and Priorities
Margaret E. Hanna, Executive Director, Bucks County Drug & Alcohol Commission, Inc., NACBHD Vice Chair, and NACBHD Legislative Committee Chair, presented conference attendees with NACBHD's legislative agenda and public policy priorities for 2005. Click here to view.

Strategizing with Public Policy Experts
Robert Morrison, NASADAD, Andrew Sperling, NAMI, and Liz Savage, the ARC, conducted this session. Each of the presenters shared their organization's priorities and expectations regarding Congressional and agency activities for 2005.

NASADAD provided attendees with a list of the Association's priorities. Click here to view. Although no other documents are posted, conference attendees found the expert panel provided pertinent, timely, and useful information. Presenters explained the President's proposed budget cuts to Medicaid, implications if passed, and potential messages for Congressional restorations. Contact Melissa Staats or Maeghan Gilmore for details at (202) 661-8816.

Campaign for Mental Health Reform and California's Proposition 63
Bill Emmet, from the National Association of State Mental Health Program Directors and Project Director of the Campaign for Mental Health Reform, presented an update to the conference participants. The Campaign-comprised of 11 mental health advocacy organizations-was created to assist SAMHSA and other federal agencies with implementation of the New Freedom Commission's recommendations. Click here to view

Patricia Ryan, Executive Director of the California Mental Health Directors Association, and Sandra Naylor Goodwin, Executive Director of the California Mental Health Institute, provided attendees with insights into how their state was able to achieve the political successes of Proposition 63. California's work could be used to generate momentum across the country. Click here to view.

Friday, March 4

CMS-2005 Agenda
Gale Arden from the Centers for Medicare and Medicaid articulated agency plans and agendas for 2005, and responded to a wide range of questions related to the implementation of the Medicare Modernization Act-Part D for the dually eligible. CMS also handed out a summary of its strategic plan vision for 2005.

CMS representatives provided three websites for members to access regarding implementation of MMA.

• Regarding the drug benefit, www.cms.hhs.gov/medicarereform/
• Frequently asked questions: www.cms.hhs.gov/medicarereform/drugcoveragefaqs.asp
• Submit questions to CMS at: www.mmaissuesform.cms.hhs.gov

Housing and its Importance to the Behavioral Health and Developmental Disabilities Communities
Andrew Sperling from the NAMI and Liz Savage from the ARC updated participants on federal actions regarding housing for individuals with behavioral health and developmental disabilities. They began the presentation with a summary of the history of federal housing programs (HUD) to provide a context for understanding the President's 2006 budget proposal and its potential impact. All housing is discretionary and therefore subject to annual appropriation.

Essentially, there are two types of programs that impact persons with disabilities. These are Section 8 and Section 811. Section 8 housing is income-based, meaning that individuals receive a subsidy or voucher if their income is below a certain level. Panel representatives reported that the President's budget could ultimately result in the loss of 80,000 vouchers. Section 811 is a $238 million dollar program that focuses solely on individuals with disabilities. It is project- based (versus tenet based in Section 8) and provides real housing stock. The President's 2006 budget proposes to cut this in half.

Implementing Medicare Drug Reform
Andrew Sperling from the NAMI and Liz Savage from the ARC gave the Conference attendees an overview of the implementation plan for MMA. They highlighted important time frames and the lack of real information regarding the formularies. Both are confident that there will be no effort to delay implementation for the dually eligible. Contact Melissa Staats or Maeghan Gilmore at (202) 661-8816 for more information.

The Future of Medicaid
Jeffery Crowley, Project Director at Georgetown University's Health Policy Institute, described Congressional and Executive plans and activities related to Medicaid Reform. NACBHD's Medicaid and Medicare Committee will detail its proactive agenda for addressing a range of reform proposals expected in 2005. NACBHD members are urged to provide input into the Committee Agenda. Click here to view the presentation

SAMHSA-2005 Agenda
Directors Kathryn Power (CMHS), Beverly Watts-Davis (CSAP), and Westley Clark (CSAT), each presented on the goals and visions of their respective Centers. Click here to view Center Director Power's presentations.

National Association of State Directors of Developmental Disability Services & NACBHD-Partnership Opportunities
Dan Berland from the National Association of State Development Disability Directors (NASDDD) described the Association's 2005 public policy agenda. Lynn Ferrell, Executive Director, Polk County Health Services Inc, and Chair, NACBHD Developmental Disabilities Committee, reacted to Dan Berland's presentation with opportunities for future collaboration. Click here to view the presentation

Saturday, March 5

Faces and Voices & NACBHD-Partnership Opportunities
Patricia Taylor, Campaign Coordinator, Faces & Voices, led a dialogue with conference attendees. FACES & VOICES is the national advocacy campaign for individuals with addictions. Pat Taylor described FACES & VOICES agenda and planned activities for 2005. Conference attendees were engaged as Pat Taylor reviewed the training provided to grassroots efforts across the country. FACES & VOICES also maintains a legislative agenda which includes support for the Second Chance Act (e.g., repealing the ban against educational funding to students with felony drug convictions). NACBHD will showcase FACES in the April 2005 Newsletter.

Sherry Knapp-Brown, Ph.D., Chief Executive Officer, Hamilton County Alcohol and Drug Addiction Services Board, provided several suggestions for how county government might support recovery efforts.

Medicaid: The Debate Over Historic Reductions Continues (Please be Alert for NACBHD's March Washington DC Update for more details on Medicaid and the Budget)

Since NACBHD last reported on the Bush Administration's FY 2006 $2.57 billion budget proposal, which includes reducing Medicaid growth by $60 billion over the next ten years as part of its overall deficit reduction strategy, the House and Senate have both approved budget resolutions, and the National Governors Association has met with the President to express states' concerns about the issue and has produced a document about Medicaid reform principles. At the same time, NACBHD continues discussions with advocacy organizations about the impact of reform and effective advocacy strategies. Detailed information about action in Congress, the National Governors' Association meeting and reform principles document, and NACBHD Medicaid advocacy follows. (For FY 2006 budget background and information about specific Medicaid proposals, see the February newsletter and the February 10 Washington Update.)

Senate rejects Medicaid cuts and approves Bipartisan Commission on Medicaid Reform, House budget resolution keeps $20 billion in Medicaid cuts; pressure to restore cuts likely

• In the Senate. On March 17, the Senate voted 52-48 to reject the $14 billion over five years in Medicaid reductions proposed by the Senate Budget Committee, chaired by Senator Judd Gregg (R-N.H.), on March 9. And, the Senate approved the creation of a commission to study reforms in Medicaid. The commission was sponsored by Senators Gordon Smith (R-OR) and Jeff Bingaman (D-NM) and the vote was bipartisan, with the following senators crossing party lines to support it: Chafee (R-RI), Norm Coleman (R-MN), Susan Collins (R-ME), Olympia Snowe (R-ME), Smith (R-OR), Arlen Specter (R-PA), and Mike DeWine (R-OH). Detailed information on the Bipartisan Commission on Medicaid is provided below "What's next?"
• In the House. The House approved its FY 2006 budget resolution by a vote of 218-214, including a proposal by the House Energy and Commerce Committee, which has jurisdiction over Medicaid and Medicare Part B, to find $20 billion of savings over five years.
• What's next? After Congress returns from Easter recess April 4, a House-Senate Conference Committee will meet to reconcile the differences (the date of the Conference has not yet been established). Both House and Senate leaders and the Administration may exert pressure to restore the Medicaid cuts rejected by the Senate. ("Senate Rejects Proposed Medicaid Cuts," www.nami.org) NACBHD will update members on these developments in the April newsletter.

Details on the Bipartisan Commission on Medicaid

Senator Gordon Smith (R-OR) and Senator Jeff Bingaman (D-NM) are the lead sponsors on the Bipartisan Commission on Medicaid Act of 2005, passed by the Senate on March 17, which would make recommendations regarding long-term goals, populations served, financial sustainability, interaction with Medicare and the uninsured, and the quality of care provided, as well as study what works and does not work and make recommendations about service delivery and cost-effectiveness. Represenatives Heather Wilson (R-NM) and Donna Christian-Christensen (D-V.I.) introduced companion legislation in the House. The Commission would consist of 23 members based on the program's stakeholders, including:

• One member appointed by the President
• Two current or former House members appointed by the speaker and minority leader
• Two current or former senators appointed by the majority and minority leader
• Two governors designated by the NGA
• Two legislators designated by the National Conference on State Legislators
• Two state Medicaid directors appointed by the National Association of State Medicaid Directors
• Two local elected officials appointed by NACo
• Four consumer advocates appointed by congressional leadership
• Four providers appointed by congressional leadership
• Two program experts appointed by the Comptroller General

NACo has endorsed the Bipartisan Commission on Medicaid Act of 2005, with a statement from NACo legislative director Ed Rosado: "Through the bipartisan commission bill, we will have a much stronger voice than we do now by having eight state and local voices on the commission compared to five federal representatives. We believe changes to the Medicaid program should be done in a well-thought-out manner rather than through a budget reconciliation process. The commission bill will provide us just that opportunity." (Jennifer Wilson, "Alternative legislation to Medicaid budget cuts introduced," www.naco.org)

Governors Emphasize Medicaid Concerns to President; Make Deal with Congress to Delay Reconciliations Until September.

The nation's governors focused on Medicaid at the recent National Governors' Association (NGA) Winter Meeting and met with the President to relay their concerns. While they did not reach an agreement with the Administration, they did emphasize "cost-curbing experiments" and their focus on Congress to fight against cuts in the program. ((www.nga/commission/issueBriefDetailPrint). And, to allow the NGA time to draft a plan and as NGA Chair Mark Warner (D-VA) said, not be "stuck with a number you have to form a policy around," the House Budget Committee and the House Energy and Commerce Committee reached a tentative agreement with the NGA to delay reconciliations until September. (www.kaisernetwork.org/daily_reports, March 3, 2005).

• NGA Releases Report on Medicaid Reform. The NGA, at its annual Winter Meeting, released a commissioned report on the problems, issues, principles, and options for Medicaid Reform. Authored by Vernon Smith and Greg Moody of Health Management Associates, "Medicaid in 2005: Principles & Proposals for Reform," can be accessed at the NGA website, www.nga.org.

Advocacy and Medicaid reductions

NACBHD continues to be involved in advocacy efforts related to fighting Medicaid reductions. As has been previously noted in the newsletter, counties must stay especially alert to cuts that could affect the "optional services" category as most mental health and developmental disability services fall into this designation. And, a county substance abuse director and NACBHD member emphasizes that substance abuse services are an optional service, and therefore, at great risk for cuts.

• Advocacy statements. Before the most recent Congressional actions on Medicaid and immediately following the February 7 release of the Budget, advocacy organizations released statements in response to the proposed reductions - e.g., Families USA (www.familiesusa.org), the Consortium for Citizens with Disabilities (www.ccd.org), NAMI (www.nami.org), as well as the Campaign for Mental Health Reform (www.mhreform.org), of which NACBHD is a partner.
• From the Campaign for Mental Health Reform:
• In a February 8 statement entitled "Budget Brings More Broken Promises," Campaign project director Bill Emmet said, "The Administration's proposal to cap federal Medicaid spending on 'optional' populations and services - those that states are not required to cover-is a disaster in the making for people who have mental illnesses - and the critical services that they need - are covered under these 'optional' eligibility categories."
• And, the Campaign released a March 17 statement on the House Medicaid cuts. (See the article in this newsletter (Update on the Campaign for Mental Health Reform," and www.mhreform.org .)

Other Medicaid news of note

• Two members of Congress say the federal government is misinterpreting Medicaid law; jeopardizing children's mental health services. A March 8 Newsday article reported that state Medicaid programs in California, New Jersey, New York, Texas, and Virginia were audited and asked to repay more than $10 million because the federal government has misinterpreted federal Medicaid law. Senator Susan Collins (R-ME) and Representative Henry Waxman (D-CA) sent a letter to CMS administrator Mark McClellan and acting HHS inspector general Dan Levinson stating, "Because the loss of these funds could threaten the viability of institutions that provide critical mental health services, these audits are a direct threat to the health of needy children," and they cite a 1972 exemption that allows Medicaid payments for children's inpatient psychiatric hospital services." (Kevin Freking, "Lawmakers Say Audits Threaten Counseling," www.newsday.com/news/politics/wire/sns-ap-children-mental-health)
• Medicaid Has History of Overpaying for Drugs. Investigators from the Government Accountability Office recently reported that CMS does not enforce the federal requirement that drug companies cut their prices for drugs bought under Medicaid, and that Medicaid often pays too much for drugs. While the GAO could not state the amount of money overpaid, in one case, it was reported that proper accounting with one manufacturer would have increased savings to Medicaid by 16 %. Spending on drugs has grown rapidly and accounts for 10% of all Medicaid spending. (Robert Pear, "Report Says Medicaid Overpays for Drugs," www.nytimes.com/2005/03/08/08drug.)

Resource on Medicaid and the Budget. The Center on Budget and Policy Priorities offers up-to-date information on Medicaid, as well as information on the House and Senate proposals. See www.cbpp.org.

NACBHD will continue to keep members informed about Medicaid Reform in the newsletter and in Washington Updates.

Medicare Update

• Delay on the Implementation of the Dual Eligible Benefit is Doubtful
• Medicare Drug Benefits Costs May Be Higher Than Projected

Delay on the Implementation of the Dual Eligible Benefit is Doubtful
On March 8, Senator Jay Rockefeller (D-WVA) proposed legislation that would delay by six months the implementation of the benefit for the 6.4 million individuals dually eligible for both Medicare and Medicaid. (Currently, dual eligibles will have access to the Medicare drug benefit starting January 1, 2006, and Medicaid will no longer cover their prescriptions. There is a planned November 15 to December 31, 2005 window for dual eligibles to choose their Medicare drug plan. Dual Eligibles who do not select will be auto-enrolled into the lowest cost plan without regard to formulary or cost sharing.)

However, advocates at the Legislative Conference and those questioned more recently about the likelihood of a delay indicate that it is extremely unlikely.

NACBHD will keep members informed of any changes in this important transition. (Capitol Hill Watch, Kaiser Daily Health Policy Report, March 10, 2005, www.kaisernetwork.org/daily_reports)

Medicare Drug Benefits Costs May Be Higher Than Projected
During the 10-year period from January 1, 2006 through 2015, the Medicare prescription drug benefit is projected to cost $849 billion, according to recent information from the nonpartisan Congressional Budget Office (CBO). However, CBO's projection does not include potential savings that could make the cost projection lower than the Administration's projected cost of $724 billion over 10 years. (Alan Fram, "Congressional Analyst Raises Medicare Cost Estimate," www.detnews.com/2005/politics/0503/07/polit-108301.

Background information on the MMA, CMS regulations, and the MMA. For the most recent detailed information on the final CMS regulations regarding the Medicare Modernization Act of 2003, concerns specifics to dual eligibles, CMS's outreach plans, and resources, see the February newsletter.

A Local Recovery Success Story: NACBHD Members Discuss What Makes Western Care Coordination Work

It is "a real rethinking of what we in mental health services do," -- a rethinking of moving the system away from management to recovery.

Bob Long, Director of Planning and Quality Improvement, Onondaga County
Department of Mental Health, and co-chair of the Western New York State Care
Coordination Steering Committee, commenting on Western Care Coordination.

We envision a future when everyone with mental illness will recover. . .

Vision Statement, Final Report of the President's
New Freedom Commission on Mental Health

The issue of recovery has been touched upon in several NACBHDD Newsletters, mostly in the larger context of national mental health system transformation, such as the President's Commission on Mental Health. This month, NACBHD had the opportunity to talk with representatives of a program involving local NACBHD member organizations directly involved in a recovery-oriented effort that has been up and running since 2002 - before the Final Report of the President's Commission on Mental Health was issued. In addition to Long, NACBHD member Kathleen Plum, R.N., Ph.D., Director of Mental Health Services, Monroe County Office of Mental Health, Adele Gorges, Project Director, and Brian Phillips, Peer and Family Coordinator, spoke with NACBHD about the Western New York Care Coordination Program (WNYCCP), which involves six New York counties - Monroe, Erie, Genessee, Wyoming, Chautauqua, and Onondaga. Monroe, Chautauqua, and Onondaga are NACBHD member counties.

Background
In the late '90s, New York State pursued special needs plans (SNPs). SNPs were created as the state's effort to provide managed care to the behavioral health population. In response to the development of SNPs, several counties founded regional consortia (so that they may bid to be a SNP). There was a central state consortium and a western state consortium. Although the state legislature failed to reauthorize the SNP initiative, the western state consortium continued. In 2002, the western consortium became the Western Care Coordination Project (WNYCCP). Staff was hired in July 2002, and that also was the date of first enrollment of clients in some counties.

Program structure and goals
A project description document provided by WNYCCP best describes the program and its goals: WNYCCP is "a collaborative initiative by six county governments, the New York State Office of Mental Health, providers and consumers, to transform community services systems serving people diagnosed with serious mental illness. The goal of the program is to create systems that are responsive to the interests of consumers, ensure access to high quality services, and promote recovery. Service delivery is based upon an individual services plan developed in partnership with consumers and their families."

The specific goals of the program are:

• Alignment of providers and consumers' interests based on the principles of person- centeredness, person-centered planning and recovery.
• Empowerment through individual service planning that promotes choice.
• Coordination of services delivered by multiple providers.
• A rehabilitation and recovery model of services.
• Implementation of evidence-based best practices.
• Allocation of resources based on individual need.
• Improved information systems that provide timely, useful information.
• Performance measure by outcomes.

A collaborative structure is the foundation of the program's success.
"The collaborative structure has been key to the success we've had," says Adele Gorges. This collaboration is evident at the project level and is duplicated in almost the same manner at the county level. While the Steering Committee makes policy-level decisions about program values, goals, initiatives, and objectives, implementation decisions are made at the county level.
A description of the structure:

• The Steering Committee. WNYCCP is directed by a steering committee of five representatives from six counties, three providers, three peers/family members, and two ex-officios from the New York State Office of Mental Health. Long and Plum are co-chairs of the Steering Committee.
• The Peer Advisory Group. A peer advisory group, with two representatives from each county, meets monthly and advises the Steering Committee and recommends the three voting members from its groups who will serve on the Steering Committee.
• The Work Group Subcommittees. Work group subcommittees composed of Steering Committee members and representatives from the stakeholder community deal with ongoing and time-limited issues.
• At the county level. The Director of Community Services for each county leads the implementation of the project in their county, and each county has a local advisory group, which includes providers and consumers, who work with the County Mental Health Department to implement the program. Each county has its own plan for enrollment timelines and procedures, and for clinical, regulatory, fiscal, and technical initiatives.
• Collaboration among the counties. Plum reports that there is collaboration among the six counties, which has brought "tremendous richness" to the discussion. Long points out that one county may get ahead on an initiative and that the others can then learn from this. With the six counties covering about 2.5 million people, there are a lot of different perspectives and strengths.

Coordinated Care Services, Inc. provides project management. Full time staff includes Adele Gorges, the Project Director, and Brain Phillips, the Peer and Family Coordinator.

A recovery system of care that is person-centered and person-driven
In addition to crediting the collaborative structure for the program's success so far, the group emphasized the person-centered focus of the program, noting that the goal is to transform to a recovery system of care, which is person-centered and person-driven, much like the six goals of the President's Commission on Mental Health. In fact, the program description document refers to the relationships between providers and consumers as based on "the principles of person-centeredness, person-centered planning, and recovery."

Long says a substantial investment has been made in person-centered training, with 6-14 days of training supported by the Office of Mental Health; and, parallel to person-centered training for staff, is training for organizations on how to be more "person-centered friendly." While the concept of person-centeredness raises concerns about risk management, a person-centered planning video that provides a brief introduction to person-centered planning and how it works has been developed to address this.

Collaboration and person-centeredness
Phillips, Peer and Family Coordinator, says "the collaboration has been there from day one." He explained that one of consumers' biggest frustrations has been the perception that every facet of their lives is related to their illness. And he noted, the decision-making of every day life should be left up to the consumer; decisions used to be made apart from the consumer, with care coordinators struggling over things that didn't seem to be any of their business. Person-centered care asks "What is important for the individual?" This entails listening to the person being served and getting to know them as a person.

A quality of life self-assessment allows consumers to rank whether they are satisfied or not, and brings up conversations that they may never have had before. And Phillips notes that while the process is not happening overnight, the progress needs to be emphasized. He has seen "lives turned around in the last year." He says that what people are asking for is a safe place to live, relationships, enough money to go to the movies - in essence, "the stuff of every day life."

What is recovery?
Plum reports that recovery is individually-oriented, with no set definition - achieving a life worth living as defined by that individual, and Phillips notes that not recognizing that recovery is individually-oriented as defined by the individual can be a real pitfall to success. Of course, there are some common ingredients that are part of recovery - such as housing needs, interpersonal relationships, and work. Pulling in the resources for individual needs was cited by the group as one of the biggest challenges.

Phillips says that the person-centered approach is to reconnect people with communities, and that these are approaches that often don't cost that much extra. For example, he cites a program for purchasing homes that he described as long-time dream for many consumers is now coming true. These are the same things everyone needs and utilizes, or natural supports, found in areas such friends, family, and churches. With natural supports and person-centeredness, consumers develop their own social networks. For example, in one of the rural counties, there has been tremendous support for the local grange, which is an agriculturally-based fraternal organization. Other natural supports might include the Rotary Club, Kiwanis, the gym - those natural supports that are open to anyone in the community and that don't focus on a psychiatric diagnosis.

The group agreed that recovery and a person-centered orientation involve recognizing that the people being served are the experts in their own lives. This applies to family members too. Gorges says person-centeredness and peer involvement is permeating the whole system, so that consumer involvement has gone beyond what was initially planned. Some counties have peers working on policies.

Person-centered outcome indicators regularly and objectively assess whether goals are accomplished, and demonstrate the effectiveness of the program and that people are in recovery.

Financial implications
The impact of dollars saved appears to be broad, with reduced hospitalizations, reduced utilization of support services, and reduced emergency room admissions. Phillips points out that the natural supports in the community, such as those mentioned above, are not vulnerable to budgetary cuts.

And while everyone is concerned about Medicaid and housing issues, WNYCCP has moved in a direction that may help address this concern. The program needs to be self-supported, and they see financial and fiscal reform as part of the project. The finance system would reflect the change in culture and program design, which will hopefully help insulate them from possible Medicaid reform and other reductions. They have just embarked on a grant initiative from the state Office of Mental Health, which involves flexible funding. Flexible funding would help sustain person-centered recovery. For example, if an individual wanted to get a job, but needs clothing, flexible funding would allow for addressing this need.

Community reaction. There is a growing awareness about the project in the community, and mental health providers are enthusiastic about it. A January 25 Democrat and Chronicle profile of the program drew over a 100 calls. (Donna Jackel, "Fresh Path to Mental Health: The Focus is on Making Clients Architects of Their Own Recovery," www.democratandchronicle.com)

For more information
For questions, contact Adele Gorges at AGorges@ccsi.org or at (585) 613-7656. For more information on the program, see www.carecoordination.org.

Look for more articles on the Western New York Care Coordination Program initiatives in future newsletters.

Update on the Campaign for Mental Health Reform

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.

Medicaid. Emmet reports that the Campaign's most immediate 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.

State-Informed Federal Policy Initiative -- Call to Action. 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 have the final document out in May, which is Mental Health Month. 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.

A series of Capitol Hill briefings. A new effort involving the entire Campaign is a series of briefings for Hill staffers. The first briefing, planned for the last week in April, 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. Other briefing topics may include the mental health needs of individuals returning from combat.

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.

2005 Wernert Award Applications Are Now Available

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.

New Medicaid and Medicare Resource for Consumers, Families, and Advocates

The Kaiser Family Foundation recently released two new Medicaid and Medicare guides for people with disabilities, their families, and advocates. Navigating Medicare and Medicaid, 2005: Resource Guides for People with Disabilities, Their Families, and Their Advocates covers basic information about the programs, the application process, policies for durable medical equipment, where people with disabilities can get help in applying for Medicaid, how to appeal coverage decisions, and whether a beneficiary can be employed and still receive coverage. The guides are available in pdf and html formats at www.kff.org.

SAMHSA Announcements

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. "Transforming our nation's mental health system requires us to expand how we look at public and personal health care," SAMHSA administrator Charles Curie said. "Everyone from public policymakers to consumers and family members must come to understand that mental health is a vital, integral part of overall health. These grants will help change the way in which the mental health system provides effective treatment and ultimately how consumers and families recover." It is expected that 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: 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 http://www.grants.gov/ or from the SAMHSA web site. Applicants are encouraged to apply on-line through a new service at http://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 SystemTransformation."

From a March 4 SAMHSA press release:

$4.4 Million Available for Older Adults Mental Health Grant Program

SAMHSA announced the availability of FY 2005 funds for the Older Adult Mental Health Targeted Capacity Expansion (TCE) Grant Program to help communities provide direct services and build the necessary infrastructure to support and meet the diverse mental health needs of older persons. Direct services to be funded under this grant program must be supported by a strong evidence base. It is expected that approximately $4.4 million will be available to fund up to 11 awards to build a solid foundation for delivering and sustaining effective mental health outreach, treatment, and prevention services, as well as resources to support the direct delivery of services to adults 60 years and older. The annual award amount will be approximately $375,000 to $400,000 per year for up to three years. The actual award amount may vary, depending on the availability of funds. The grants will be awarded by SAMHSA's Center for Mental Health Services.

WHO CAN APPLY: Eligible applicants are domestic public and private nonprofit entities (State, local or tribal governments; public or private universities and colleges; community- and faith-based organizations; and tribal organizations may apply). Applicants must comply with the requirement to address the target population of persons 60 years of age and older who are at risk for or are experiencing mental health problems.

HOW TO APPLY: Application for No. SM-05-012 are available by calling SAMHSA's clearinghouse at 1-800-729-6686, or by downloading the application from http://www.grants.gov/ or from the SAMHSA web site. Applicants are encouraged to apply on line through a new service at http://www.grants.gov/.

APPLICATION DUE DATE: MAY 5, 2005

ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Betsy McDonel Herr, at 240-276-1911 or e-mail to betsy.mcdonelherr@samhsa.hhs.gov. For questions on grants management issues, contact Kimberly Pendleton at 276-2401421 or e-mail to kimberly.pendleton@samhsa.hhs.gov .

From a March 2 SAMHSA press release:

$3.35 Million Available for National Training and Technical Assistance Center for Child and Adolescent Mental Health

SAMHSA announced the availability of FY 2005 funds for a cooperative agreement to serve as a national resource and training center to promote the planning and development of child and family centered systems of care for children and adolescents with, or at risk for, a serious emotional disturbance and their families. It is expected that approximately $3.35 million will be available to fund one cooperative agreement for a national training and technical assistance center for child and adolescent mental health. Of this amount, approximately $250,000 is included to provide technical assistance for State capacity building to grantees initially funded in FY 2004 under the Child and Adolescent Mental Health and Substance Abuse State Infrastructure Grants program. The annual award amount will be approximately $3.35 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: Eligibility is limited to domestic public and private nonprofit entities including State, local or tribal governments, public or private universities and colleges, community and faith-based organizations and tribal organizations.

HOW TO APPLY: Applications for No. SM 05-013 are available by calling SAMHSA's clearinghouse at 1-800-789-2647, or by downloading the application from http://www.grants.gov/ or from the SAMHSA web site.

APPLICATION DUE DATE: April 29, 2005

ADDITIONAL INFORMATION: Applicants with questions on program issues should contact Michele Herman at (240) 276-1924 or e-mail to nancy.davis@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 .