Federal Grant Programs Improving Access to Childrens Mental Health Services

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Federal Grant Programs Improving Access to
Childrens Mental Health Services

• Kirsten Beronio
• National Mental Health Association

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Overview

• Comprehensive Community Mental Health Services
  Program for Children and their Families
  (Childrens Mental Health Services Program
  
• Safe Schools/Healthy Students Program
• Keeping Families Together Act

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Need for Improved Access to Community-based
Services

• 5-9 of children have serious emotional
  disturbances (SED) Presidents New Freedom
  Commission on Mental Health, Final Report, July
  2003
• Many more have mental disorders not qualifying as
  SED
  
• Over two-thirds do not receive treatment
  Surgeon Generals Report on Childrens Mental
  Health, January 2001

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Comprehensive Community Mental Health Services
Program for Children and their Families

• To encourage development of comprehensive
  community-based services (i.e. systems-of-care)
  for children with SED
  
• Eligible applicants states, political
  subdivisions of states, territories, Indian tribes

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Services Provided by Grantees

• Diagnosis evaluation
• Individualized service planning case
  management
  
• Outpatient services
• Emergency services

• Intensive home-based services
• Intensive day treatment services
• Respite care
• Therapeutic foster care
• Transitional services

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Matching Fund Requirements and Sustainability

• Grantees must match federal grants dollars with
  local funds
  
• 1 for every 3 federal for first 3 years
• 1 for every 1 federal in 4th year
• 2 for every 1 federal in 5th and 6th years
• According to CMHS, 80 have sustained program
  changes

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Success at Improving Outcomes(Recent evaluation
data from SAMHSA)

• Percentage of kids w/ Dgrade average or below
  declined from 43.7 at intake to 32.2 at 18
  months
  
• Rate of arrests decreased from 12 at intake to
  6.5 at 18 months
  
• Problem behaviors improved or stabilized in 92.5
  of children after six months

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Recent Funding Levels for Childrens Mental
Health Services Program
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House Labor-HHS Appropriations Subcommittee

• Republicans
• Ralph Regula (OH) (Chairman)
• Ernest Istook (OK)
• Roger Wicker (MS)
• Anne Northup (KY)
• Randy "Duke" Cunningham (CA)
• Kay Granger (TX)
• John Peterson (PA)
• Don Sherwood (PA)
• Dave Weldon (FL)
• Michael Simpson (ID)

• Democrats
• David R. Obey, WI (Ranking Member)
• Steny Hoyer (MD)
• Nita Lowey (NY)
• Rosa DeLauro (CT)
• Jesse Jackson, Jr. (IL)
• Patrick Kennedy (RI)
• Lucille Roybal-Allard (CA)

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Senate Labor-HHS Appropriations Subcommittee

• Republicans
• Arlen Specter (Chairman) (PA)
• Thad Cochran (MS)
• Judd Gregg (NH)
• Kay Bailey Hutchison (TX)
• Larry Craig (ID)
• Ted Stevens (AK)
• Mike DeWine (OH)
• Richard Shelby (AL)

• Democrats
• Tom Harkin (Ranking Member) (IA)
• Ernest Hollings (SC)
• Daniel Inouye (HI)
• Harry Reid (NV)
• Herb Kohl (WI)
• Patty Murray (WA)
• Mary Landrieu (LA)

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Safe Schools/Healthy Students

• Program grew out of school shootings in late
  1990s
  
• Bringing mental health, substance abuse, and
  other services to kids where they are most of the
  time in school
  
• Schools are one of the safest places for kids
• Bullying continues to be a problem

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Safe Schools/Healthy Students

• Three year grants to local school districts to
  foster healthy development and prevent violence
  
• Collaborative effort jointly run by SAMHSA, Dept.
  of Justice, Dept of Educ.
  
• School district grantees must have formal
  partnership with local mental health dept.s and
  law enforcement agencies

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Issues Grantees Must Address

• Improving access to school and community mental
  health services
  
• Increasing availability of alcohol and drug use
  prevention and early intervention
  
• Establishing early childhood development and
  psychosocial development programs
  
• Implementing programs to discourage violence and
  bullying and improve security

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Safe Schools/Healthy Students

• Total of 166 school districts funded since 1999
  see www.sshsevaluation.org
  
• Grant announcement this spring
• Funding has been stagnant for past several years
• Contact Appropriators about need for improved
  access to mental health services for kids

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Keeping Families Together Act (S.1704/H.R. 3243)

• A bill to help prevent custody relinquishment
  parents of children with SED being forced to
  relinquish custody to get needed mental health
  services
• In 2001 alone, 12,700 children were placed in
  child welfare or juvenile justice solely to
  access mental health services in 19 states
  General Accounting Office, April 2003

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Keeping Families Together Act (S.1704/H.R. 3243)

• Grant program modeled after SAMHSAs Childrens
  Mental Health Services Program
  
• Help states fund an array of community-based
  mental health and family support services for
  children at risk or already subjected to custody
  relinquishment
• 55 million over six years to fund 10 states

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Keeping Families Together Act (S.1704/H.R. 3243)

• Matching requirement
• Year 3 - 1 state for 2 federal
• Year 4 - 1state for 1 federal
• Years 56 - 2 state for 1 federal
• Encouraging sustainability of services

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Keeping Families Together Act (S.1704/H.R. 3243)

• Interagency task force SAMHSA, Admin. For
  Children and Families, Dept. of Justice, Dept. of
  Education
  
• Improvement to Medicaid waivers for home and
  community-based care to enable states to use
  this funding stream for children in psychiatric
  residential treatment facilities (in addition to
  those in hospitals)

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Senate Health Education Labor and Pensions
Committee

• Republicans
• Judd Gregg (NH) - Chair
• Bill Frist (TN)
• Mike Enzi (WY)
• Lamar Alexander (TN)
• Christopher Bond (MO)
• Mike DeWine (OH)
• Pat Roberts (KS)
• Jeff Sessions (AL)
• John Ensign (NV)
• Lindsey Graham (SC)
• John Warner (VA)

• Democrats
• Edward Kennedy (MA)
• Christopher Dodd (CT)
• Tom Harkin (IA)
• Barbara Mikulski (MD)
• James Jeffords (VT)
• Jeff Bingaman (NM)
• Patty Murray (WA)
• Jack Reed (RI)
• John Edwards (NC)
• Hillary Clinton (NY)

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House Energy and Commerce CommitteeRepublicans

• Joe Barton, (TX) ( Chairman )
• Billy Tauzin (LA)
• Ralph Hall (TX)
• Michael Bilirakis (FL)
• Fred Upton (MI)
• Cliff Stearns (FL)
• Paul Gillmor (OH)
• James Greenwood (PA)
• Christopher Cox (CA)
• Nathan Deal (GA)
• Richard Burr (NC)
• Ed Whitfield (KY)
• Charlie Norwood (GA)
• Barbara Cubin (WY)
• John Shimkus (IL)
• Heather Wilson (NM)

• John Shadegg (AZ)
• Chip Pickering (MS)
• Vito Fossella (NY)
• Steve Buyer (IN)
• George Radanovich (CA)
• Charles Bass (NH)
• Joseph Pitts (PA)
• Mary Bono (CA)
• Greg Walden (OR)
• Lee Terry (NE)
• Mike Ferguson (NJ)
• Mike Rogers (MI)
• Darrell Issa (CA)
• Butch Otter (ID)
• John Sullivan (OK)

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House Energy and Commerce CommitteeDemocrats

• Albert Wynn (MD)
• Gene Green (TX)
• Karen McCarthy (MO)
• Ted Strickland (OH)
• Diana DeGette (CO)
• Lois Capps (CA)
• Michael Doyle (PA)
• Christopher John (LA)
• Tom Allen (ME)
• Jim Davis (FL)
• Jan Schakowsky (IL)
• Hilda Solis (CA)
• Charles Gonzalez (TX)

• John Dingell (MI)( Ranking Member )
• Henry Waxman (CA)
• Edward Markey (MA)
• Rick Boucher (VA)
• Edolphus Towns (NY)
• Frank Pallone (NJ)
• Sherrod Brown (OH)
• Bart Gordon (TN)
• Peter Deutsch (FL)
• Bobby Rush (IL)
• Anna Eshoo (CA)
• Bart Stupak (MI)
• Eliot Engel (NY)