FEDERAL LEGISLATIVE BRIEFING Presentation to NAMI Convention June 19, 2005

1. FEDERAL LEGISLATIVE BRIEFING Presentation to NAMI Convention June 19, 2005 Andrew Sperling, Darcy Gruttadaro & Ron Honberg NAMI Policy Staff andrew@nami.org, darcy@nami.org, ronh@nami.org

2. Current Threats to Medicaid • Budget resolution requires $10 billion in reductions to federal Medicaid spending over 5 years (FY 2006 - FY 2011) • House Energy & Commerce and Senate Finance Committees expected to act in September • National Governors Association reform proposal • HHS led reform commission -- role of Secretary Leavitt • Congressional heroes: Senators Smith (OR) & Bingaman (NM), Congresswoman Wilson (NM)

3. Medicaid Reform -- Key NAMI Priorities • Protecting beneficiaries with mental illness from the impending $10 billion cuts • Optional services for mandatory populations (prescriptions drugs, intensive case management for SSI recipients) • Curbing the use of restrictive policies with respect to prescription drug coverage (PDLs, step therapy, prior authorization) • Oppose efforts to cap federal Medicaid matching funds • Long-term role for Medicaid -- health care safety net for the most vulnerable v. coverage for working uninsured

4. Keeping Families Together Act (S. 380, HR 823 • Legislation to help end custody relinquishment • Three mechanisms. • Grants to states • Federal Interagency Taskforce • Removing statutory barriers to Home and Community Waivers.

5. KFTA, cont. • Key Committees of jurisdiction. • House Energy and Commerce Committee (see www.energycommerce.house.gov for members) • Senate Health, Education, Labor and Pensions (HELP) Committee (see www.help.senate.gov for members).

6. Family Opportunity Act (FOA - S. 183/HR 1443) • Expand Medicaid access to treatment for children with disabilities, including children with severe mental illnesses. • Cost sharing for Medicaid coverage on a sliding scale basis. • Like KFTA, removes statutory barriers to Medicaid Home and Community Based waivers.

7. NAMI Opposes Campaign by Anti-Screening Groups • Representative Ron Paul of Texas has introduced legislation, the Parental Consent Act of 2005 (H.R. 181), that prohibits the use of federal funds for mental health screening. • Bill includes stigmatizing language in the findings section. • Stifles efforts to support state and local programs for youth.

8. Anti-Screening Campaigns Rife with Misinformation • False information about NFC report -- “mandatory screening,” “without parental consent.” • Campaign of misinformation fueled by anti-psychiatry, anti-medication and anti-government groups.

9. Affordable Housing Programs • Access to decent, safe and affordable housing in the community is the cornerstone to recovery • Access to an ongoing rent subsidy is critical for SSI recipients -- SSI = 18.5% of average median income, 105% of SSI = average fair market rent for 1-bedroom • Rent subsidies can be tenant-based or project-based • Supportive housing works!!

10. Current Threat to HUD Programs • Section 811 -- capital advance & project-based v. tenant-based rental assistance -- renewals v. new units • Section 811 proposed for 50% funding reduction for FY 2006 (from $238 million, down to $120 million), all funding would be directed to rent subsidy renewals -- no funding for new project-based units • Section 8 -- President’s budget proposes a $1.08 billion increase • HR 1999/S 771 -- Proposals to reform Section 8 would eliminate extremely low-income targeting, protections for people with disabilities inadequate

11. Insurance Parity • Driven by NAMI principles -- Mental illnesses are real, treatment works (if you can get it), there is no justification for health plans to cover treatment for mental illness on different terms and conditions • Strong bipartisan support -- 69 Senate cosponsors, 241 House cosponsors, vocal support from President Bush • New bill will be different -- focus will be on equity for durational treatment limits and financial limitations • State parity protections v. federal ERISA exemption

12. Mental Illness Research & Services Funding for FY 2006 • NIMH: FY 2006 request - $1.418 billion, $6 million increase over current level • SAMHSA: FY 2006 request - $26 million request for “Mental Health Transformation” grants, level funding for Mental Health Block Grant ($432.8 million), PATH ($54.8 million), Childrens Mental Health ($105.2 million), Jail Diversion ($4 million v. $7 million), Suicide prevention/Garrett Lee Smith Act ($16.5 million)

13. Mental Illness Research & Services Funding for FY 2006 • Veterans: House FY 2006 funding bill for the VA designates $2.2 billion for mental illness treatment services, out of a total projected FY 2006 budget for veterans' medical care of $20.995 billion, $1.6 billion above FY 2005 level and $1 billion above the President's request (report language directs the VA toward greater investment in mental illness services & research)

14. Decriminalizing Mental Illness • Mentally Ill Criminal Offender Treatment and Crime Reduction Act (P.L. 108-414) • Resources for jail diversion, reentry, mh treatment in correctional facilities, and training. • $50 million sought in FY 2006 • “Soft” earmark in House CSJ Appropriations bill through Byrne grant program • Senate scheduled to mark up later in June