Bazelon Center Applauds President's Focus on
Mental Health
ADMINISTRATION'S ANNOUNCEMENT IS A GOOD FIRST STEP, SAYS LEADING MENTAL
HEALTH ADVOCACY GROUP
Washington, DC (April 29) - President Bush today made important first steps
toward improving access to mental health, according the leading national legal
advocacy organization for people with mental illness and mental retardation.
"The President should be commended for acknowledging mental health as a priority
for his administration," said Chris Koyanagi, Policy Director for the Bazelon
Center for Mental Health Law. There is a lot of work to be done before people
who need access to care will feel the benefits, but we look forward to working
on these issues with the Administration."
In a statement in New Mexico today, President Bush said that he would support
legislation requiring private insurers to increase parity for coverage of mental
health services. The President also announced the formation of his New Freedom
Commission on Mental Health to examine the state of the public mental health
system.
The President's New Freedom Commission on Mental Health is intended to study the
dire state of public mental health systems in America and make recommendations
for solutions. The commission will consist of 15 people, including top mental
health experts from the states and others. Michael Hogan, the Director of the
Ohio Department of Mental Health, will chair the commission.
"Nobody wants to see another study that just sits on the shelf," said Koyanagi.
"Fortunately, the commission is headed by a very qualified individual and should
be small enough that it can come up with some workable solutions to the crises
facing public mental health systems."
While there are an estimated 44 million adults with diagnosable mental
disorders, state spending on mental health has plummeted by 30 percent since
1955 when adjusted for inflation and population growth. State and federal
funding comprised more than half of the $68 billion spent on mental health
services in 1996.
More state psychiatric hospitals were closed in the first half of the 1990s than
in the 1970s and 1980s combined. The resources previously allocated to these
institutions were not reinvested in the alternative services necessary to meet
the needs of the same population in the community.
"It is no exaggeration to say that public mental health systems are on the brink
of collapse," said Koyanagi. "Many individuals with the most serious mental
illnesses now receive limited services, or, in some cases, no services at all."
Mental health advocates are calling for a major overhaul of the system. Last
year, the Bazelon Center released two significant documents on the subject:
Disintegrating Systems, which details the sad state of public mental health
systems; and a model law to address the system's inadequacies.
"Today's announcements by the Administration are an important first step, but
they should not be the last, "concluded Koyanagi. "We need a fundamental
reassessment of the way we look at mental health services in this country."
Source: Bazelon Center
Bush Proposes Mental Health
Parity
By DARLENE SUPERVILLE The Associated Press
WASHINGTON (AP) - Lisa Cohen has been discriminated against for much of her
life. Not because of race, sex or religion, but because of health.
She suffers from bipolar disorder and a blood irregularity. They're both serious
illnesses, but her health insurer treats them differently.
``I could go to the hematologist when I needed to, walk in, pay my $10 co-pay
without a problem,'' Cohen, 34, of Bordentown, N.J., says of her treatments for
the excess platelets in her blood.
But ``there were always issues around payment'' when she sought treatment for
the bipolar disorder, also called manic-depressive illness, which causes
excessive mood swings.
Such disparities in treatment seemingly would disappear under a proposal
endorsed Monday by President Bush.
Congress is debating whether to require health plans to grant ``mental health
parity'' in their coverage.
Bush long has favored such legislation. As Texas governor, he signed a narrow
version of ``parity,'' and he has worked behind the scenes in Washington to
broker a bill.
``Our country must make a commitment: Americans with mental illness deserve our
understanding, and they deserve excellent care. They deserve a health care
system that treats their illness with the same urgency as a physical illness,''
Bush said Monday after a private session at the University of New Mexico, where
he heard how getting treatment for mental illness can ravage families.
Some 54 million Americans suffer from mental illness.
Bush was joined by Sen. Pete Domenici, R-N.M., a sponsor of the legislation
whose daughter suffers from schizophrenia, which affects a person's thinking,
feelings and actions.
The president also created a 15-member panel to study how to improve the mental
health treatment system and gave it a year to report back with recommendations.
He was endorsing no specific proposal, a spokesman said.
At issue is whether parity should apply to dozens of diagnosed mental illnesses,
as the Senate bill calls for, or only to the major mental diseases.
A limited parity law that expired last year barred employers from setting lower
annual or lifetime limits on mental health coverage than for other ailments,
which had become common. It did not prevent them from requiring higher
co-payments or deductibles for visits to a psychiatrist.
Business and insurance groups and some Republicans are gearing up for the fight.
They contend such a requirement would add billions of dollars to the
ever-increasing cost of health care.
Such costs are expected to grow at a rate of 7.3 percent annually through 2011,
the federal Centers for Medicare and Medicaid Services reported last month.
``With so much at stake, it is more important than ever to use diligence and
discretion when it comes to adding costly new mandates to an already
overburdened system,'' said Karen Ignani, president and chief executive officer
of the American Association of Health Plans.
Ninety percent of employers cover significant mental conditions that cause
functional impairment, said the Health Insurance Association of America. A broad
mandate for parity, it said, would amount to a ``hidden tax on businesses and
workers.''
Advocates such as Stephen Bacallao, however, think parity would cost less in the
end because the mentally ill would be able to get the full range of treatment
they need before resuming their lives.
Bacallao, co-president of the Orlando, Fla., area chapter of the National
Alliance for the Mentally Ill, believes his son, Gerard, suffered a
schizophrenic relapse seven years ago because the hospital prematurely
discharged him after the family's $10,000 lifetime cap on inpatient mental
health care ran out. He was then cared for at the family's - and later the
public's - expense.
``If somebody has a heart attack, we don't just leave them laying on the street.
They get the best treatment,'' he said. ``So why shouldn't we do that with the
brain.''
Cohen's insurer covers $45 of the $140 her psychiatrist charges per session, and
limits her to 30 inpatient days yearly, any one of which may be traded for two
outpatient visits.
``I think one of the biggest worries for people (with) mental illness is `What
if I have to be hospitalized?''' she said. ``For my mental illness, I constantly
have to make choices and sacrifices.''
So does Martin Stanley, who said he hesitates to put his son, Ben, 13, in the
hospital again for treatment of bipolar disorder. Last year, the Ogden, Utah,
family had used up their 30 days by August and fears - because it's still early
in the year - that it could happen again.
``We believe he needs to be in the hospital again. But we keep asking ourselves,
`Do we use all of our hospital benefits now, or do we wait until it gets
worse?''' Stanley said.
Bush Talks Mental Health Coverage
By SANDRA SOBIERAJ The Associated Press
ALBUQUERQUE, N.M. (AP) - President Bush threw his weight Monday behind the idea
- if not the details - of legislation guaranteeing equitable insurance coverage
for mental health services....
``We must work for a welcoming and compassionate society, a society where no
American is dismissed and no American is forgotten,'' Bush said in an
Albuquerque speech decrying the stigma and ``hidden suffering'' associated with
mental disease.
In New Mexico, Bush said he would try to broker a compromise this year between
champions of mental health insurance ``parity'' - led by Sens. Pete Domenici, R-N.M.,
and Paul Wellstone, D-Minn. - and Republican and business-sector opponents who
fear insurance premiums will spike if the government mandates that policies
cover mental diseases the same way they cover physical illness.
Bush did not get into the contentious details, but did say he would support
anything that would ``significantly run up the cost of health care.''
Employer groups and insurers are lined up to fight. ``Not one more dime. Not one
more dollar. Not one more bill that raises health care costs,'' plead new print
ads running back in Washington.
Domenici's legislation would mandate equitable coverage for a whole gamut of
mental illnesses. A law Bush signed as governor of Texas ensured coverage parity
mostly for severe psychiatric disorders and only on a limited number of
insurance policies.
Bush pointed to that law as evidence of his record on the issue.
Any federal legislation, he said, ``must prevent plans from applying less
generous treatment or financial limitations on mental health benefits than are
imposed on medical or surgical benefits.''
Specifics aside, the president's broad recognition of the current inequities
means the mentally ill might ``finally see the day when their suffering and
economic ruin might actually come to an end,'' said Domenici, whose family
budget was strapped for years by the uninsured costs of treating his daughter's
schizophrenia.
Bush named Dr. Michael Hogan, director of the Ohio Department of Mental Health,
to lead a new 15-member presidential commission to make recommendations in the
next year on closing gaps in the nation's mental health system without spending
any additional money....
Bush Endorses Improved Mental Health Benefits
By Patricia Wilson April 29, 2002 Reuters
ALBUQUERQUE, N.M. - Breaking ranks with many fellow Republicans, President Bush
(news - web sites) on Monday urged Congress to confront the stigma of mental
illness by forcing health insurers to treat psychiatric and physical disease
equally.
"Mental disability is not a scandal," Bush said at the University of New Mexico.
"They deserve a health care system that treats their illness with the same
urgency as a physical illness."
Bush did not endorse any specific legislation, but he promised to work with
Republican Sen. Pete Domenici of New Mexico who was at his side. Domenici, whose
daughter suffers from mental illness, has long championed federally enforced
parity guaranteeing that insurance for mental health disorders is as
comprehensive as that offered for other illnesses.
"We are making progress but ... there's a lot to do and some of the greatest
health needs and obstacles and stigmas concern mental health," Bush said. "We
are determined to confront the hidden suffering of Americans with mental
illness."
Bush was reprising his "different kind of Republican" image from the 2000
presidential campaign but faces some key opposition from Republican leaders in
the U.S. House of Representatives, as well as business groups, who fear
legislation would significantly increase the cost of health insurance. Some
studies have estimated, however, that premiums would rise as little as 0.9
percent if it was enacted.
The White House said any bill must prevent health plans from applying less
generous treatment or financial limitations to mental health benefits than are
imposed on medical or surgical benefits without markedly raising costs.
More than 48 million Americans currently have no health insurance and the
mentally ill often have a hard time finding jobs that are key to getting
coverage.
Bush also announced the formation of a 15-member federal commission to develop
recommendations on improving the nation's mental health care system. The panel
will report in a year.
SENATE VOTE SOON
The far-reaching bill offered by Domenici and Sen. Paul Wellstone, a Minnesota
Democrat, would require federally mandated parity. The U.S. Senate is expected
to vote on it within the next few weeks.
For instance, a patient could not have a $5 co-pay for a cholesterol drug but
have a $50 co-pay for an antidepressant drug. Nor could a patient have unlimited
doctor's visits for, say, diabetes but have a cap on how many times a mental
health provider could be seen.
Domenici wants to cover all mental illnesses listed in the standard diagnostic
manual. A bill Bush signed while governor of Texas covered mostly severe
psychiatric disorders.
Later on Monday, Bush will visit south central Los Angeles, the site of riots 10
years ago that exposed the city as a volatile mix of racial tension, social
neglect and disparity between rich and poor.
There he was to discuss his plan to allow faith-based organizations to share in
the federal funds available to deliver social services.
Outrage following the 1992 acquittal of four police officers of beating black
motorist Rodney King turned into the some of the darkest days in the history of
Los Angeles.
Violence, arson and looting that erupted in the run-down area left 54 people
dead and some $1 billion in property damage.
With control of Congress and key governorships at stake in November elections,
Bush also resumed his heavy fund-raising schedule, bringing to more than 20 the
number of appearances he has made for Republican candidates since ending a
post-Sept. 11 hiatus on politicking.
After the speech, Bush headlined a $500,000 luncheon for Rep. Heather Wilson of
New Mexico and on Monday night and Tuesday in California, is expected to raise
as much as $4 million for Bill Simon, who is trying to deny Democratic Gov. Gray
Davis (news - web sites) a second term.
Source:
http://story.news.yahoo.com/news?tmpl=story&u=/nm/20020429/ts_nm/bush_dc_72
----------------------
Improving Access to Quality Mental Health Care
Today's Presidential Action (White House Press Release from its Website)
In a speech at the University of New Mexico, President Bush today announced his
plans to improve access to quality, effective mental health care. The President
announced that he will work to pass federal mental health parity legislation to
eliminate disparities in the coverage of mental health benefits.
The President also announced the formation of the President's New Freedom
Commission on Mental Health to develop recommendations on improving the nation's
mental health service delivery system. Background on Today's Presidential Action
Each year, millions of Americans suffer from mental illness. Many adults and
children are significantly disabled by severe and persistent mental illness.
Untreated mental illness is a great national problem.
The stigma of mental illness often discourages patients from seeking care
despite the existence of new drugs and therapies that have vastly improved the
chances for effective treatment and recovery. Without access to necessary and
effective quality care, far too many Americans will live with untreated mental
illness that too often can lead to homelessness, drug and alcohol addiction or
incarceration. Parity in Mental Health Benefits
Despite the advances that have been made in the science of mental health
treatment, many health plans unfairly treat coverage for mental health benefits
by imposing copayments, deductibles or limits on outpatient visits that are more
restrictive than those placed on physical illness.
The President has a history of supporting parity legislation. In 1997 as
Governor of Texas, he signed legislation into law that required plans to provide
fair treatment to patients with severe mental illnesses.
The President will work with Senator Domenici and other leaders in the House and
Senate to reach an agreement on mental health parity legislation that can pass
Congress and be signed into law. The legislation must prevent plans from
applying less generous treatment or financial limitations on mental health
benefits than are imposed on medical or surgical benefits. The President's New
Freedom Commission on Mental Health
Currently, numerous Federal, State and local government entities oversee mental
health programs, policy, funding and the diverse network of public and private
providers. More efficient organization and coordination could assist these
providers in ensuring effective treatment is received by those in need.
To address this issue, President Bush is establishing the President's New
Freedom Commission on Mental Health. The Commission will be composed of fifteen
members, appointed by the President, and seven ex-officio members from executive
branch agencies. The Commission will identify the needs of patients, the
barriers to care, and investigate community-based care models that have success
in coordinating and providing mental health services. The Commission will have
one year to recommend immediate improvements that can be implemented by all
aspects of the public and private mental health system to improve coordination
and quality of services with existing resources.
Source:
http://www.whitehouse.gov/news/releases/2002/04/20020429.html
Executive Order President's New Freedom Commission on Mental Health
By the authority vested in me as President by the Constitution and the laws of
the United States of America, and to improve America's mental health service
delivery system for individuals with serious mental illness and children with
serious emotional disturbances, it is hereby ordered as follows:
Section 1. Establishment. There is hereby established the President's New
Freedom Commission on Mental Health (Commission).
Sec. 2. Membership. (a) The Commission's membership shall be composed of:
(i) Not more than fifteen members appointed by the President, including
providers, payers, administrators, and consumers of mental health services and
family members of consumers; and
(ii) Not more than seven ex officio members, four of whom shall be designated by
the Secretary of Health and Human Services, and the remaining three of whom
shall be designated -- one each -- by the Secretaries of the Departments of
Labor, Education, and Veterans Affairs.
(b) The President shall designate a Chair from among the fifteen members of the
Commission appointed by the President.
Sec. 3. Mission. The mission of the Commission shall be to conduct a
comprehensive study of the United States mental health service delivery system,
including public and private sector providers, and to advise the President on
methods of improving the system. The Commission's goal shall be to recommend
improvements to enable adults with serious mental illness and children with
serious emotional disturbances to live, work, learn, and participate fully in
their communities. In carrying out its mission, the Commission shall, at a
minimum:
(a) Review the current quality and effectiveness of public and private providers
and Federal, State, and local government involvement in the delivery of services
to individuals with serious mental illnesses and children with serious emotional
disturbances, and identify unmet needs and barriers to services.
(b) Identify innovative mental health treatments, services, and technologies
that are demonstrably effective and can be widely replicated in different
settings.
(c) Formulate policy options that could be implemented by public and private
providers, and Federal, State, and local governments to integrate the use of
effective treatments and services, improve coordination among service providers,
and improve community integration for adults with serious mental illnesses and
children with serious emotional disturbances.
Sec. 4. Principles. In conducting its mission, the Commission shall adhere to
the following principles:
(a) The Commission shall focus on the desired outcomes of mental health care,
which are to attain each individual's maximum level of employment, self-care,
interpersonal relationships, and community participation;
(b) The Commission shall focus on community-level models of care that
efficiently coordinate the multiple health and human service providers and
public and private payers involved in mental health treatment and delivery of
services;
(c) The Commission shall focus on those policies that maximize the utility of
existing resources by increasing cost effectiveness and reducing unnecessary and
burdensome regulatory barriers;
(d) The Commission shall consider how mental health research findings can be
used most effectively to influence the delivery of services; and
(e) The Commission shall follow the principles of Federalism, and ensure that
its recommendations promote innovation, flexibility, and accountability at all
levels of government and respect the constitutional role of the States and
Indian tribes.
Sec. 5. Administration. (a) The Department of Health and Human Services, to the
extent permitted by law, shall provide funding and administrative support for
the Commission.
(b) To the extent funds are available and as authorized by law for persons
serving intermittently in Government service (5 U.S.C. 5701-5707), members of
the Commission appointed from among private citizens of the United States may be
allowed travel expenses while engaged in the work of the Commission, including
per diem in lieu of subsistence. All members of the Commission who are officers
or employees of the United States shall serve without compensation in addition
to that received for their services as officers or employees of the United
States.
(c) The Commission shall have a staff headed by an Executive Director, who shall
be selected by the President. To the extent permitted by law, office space,
analytical support, and additional staff support for the Commission shall be
provided by executive branch departments and agencies.
(d) Insofar as the Federal Advisory Committee Act, as amended, may apply to the
Commission, any functions of the President under that Act, except for those in
section 6 of that Act, shall be performed by the Department of Health and Human
Services, in accordance with the guidelines that have been issued by the
Administrator of General Services.
Sec. 6. Reports. The Commission shall submit reports to the President as
follows:
(a) Interim Report. Within 6 months from the date of this order, an interim
report shall describe the extent of unmet needs and barriers to care within the
mental health system and provide examples of community-based care models with
success in coordination of services and providing desired outcomes.
(b) Final Report. The final report will set forth the Commission's
recommendations, in accordance with its mission as stated in section 3 of this
order. The submission date shall be determined by the Chair in consultation with
the President.
Sec. 7. Termination. The Commission shall terminate 1 year from the date of this
order, unless extended by the President prior to that date.
GEORGE W. BUSH THE WHITE HOUSE, April 29, 2002.
Source:
http://www.whitehouse.gov/news/releases/2002/04/20020429-2.html
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