This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network |
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This Web site is a component of the SAMHSA Health Information Network. |
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Center for Mental Health Services
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FY 1997 Appropriation |
President's Request |
FY98 House Subcommittee |
FY98 Senate Subcommittee |
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Knowledge Development & Application |
57,964 |
58,032 |
58,032 |
57,964 |
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Children's Services |
69,896 |
69,927 |
72,927 |
69,896 |
|
P&A |
21,957 |
21,957 |
21,957 |
21,957 |
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PATH |
20,000 |
20,000 |
23,000 |
20,000 |
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Performance Partnership Block Grant |
275,420 |
275,420 |
275,420 |
275,420 |
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Total |
445,237 |
445,336 |
451,336 |
445,237 |
Government Performance and Results Act
SAMHSA submitted the final performance plan to meet requirements of the Government Performance and Results Act (GPRA) with the agency's budget. GPRA mandates that agencies set strategic goals that are measurable and quantifiable, measure performance, and report on the degree to which agencies meet their goals. It requires that strategic plans be tied to agency goals and budget lines. The focus of GPRA is programmatic outcomes (results), rather than process (e.g., spending). Dr. Ron Manderscheid and Dr. Martha Ann Carey are leading CMHS GPRA activities.
Final Rule: Protection and Advocacy for Mentally Ill Individuals Act of 1986
The final regulations will govern activities carried out by the P&A systems under the Act. The rule includes: definitions; basic requirements to determine eligibility for and use of allotments; grant administration; eligibility for protection and advocacy services; annual and financial status reports, and remedial actions; and requirements regarding program facilities, records, and confidentiality.
Fifty-four organizations and individuals commented on the proposed rule. Most respondents were from P&A programs; others included individuals, State chapters of The National Alliance on Mental Illness, and State/county mental health providers. The following national organizations commented: National Alliance for the Mentally Ill, the National Association of State Mental Health Program Directors, the Federation of Families for Children's Mental Health, and the National Association of Protection and Advocacy Systems (NAPAS).
The Department of Health and Human Services analyzed all written comments. The analysis forms the basis for changes which the Department made in the Final Rule. These regulations have cleared the Office of Management and Budget. The Secretary is expected to sign off on them soon and they will then be published in the Federal Register as a Final Rule.
Guidance for Applications (GFAs) and Contracts
CMHS is about to award grants to applications sent in response to earlier GFAs, including Cooperative Agreements for CMHS/CSAT Collaborative Program to Prevent Homelessness—Phase 2; The Community Action Grants for Service Systems Change; Cooperative Agreements on Criminal Justice Diversion Interventions for Individuals with Co-Occurring Mental Illness and Substance Abuse Disorders; HIV/AIDS High-Risk Behavior Prevention; the Housing Initiative; Starting Early/Starting Smart; and Comprehensive Community Mental Health Services Program for Children and their Families.
Center Director's Meetings
Dr. Arons spoke at several meetings over the summer and is scheduled to address many groups this Fall. Chief among these will be his participation in a plenary session panel at the Institute for Behavioral Healthcare, where he is scheduled to co-present with Marian Wright Edelman of the Children's Defense Fund. He will deliver a lecture at the 1997 Institute on Psychiatric Services, "Longitude, the Millenium, and the Future of Psychiatry." In October, he has been invited to speak to the Executive Committee of the Mental Health Policy Working Group in the Center for Social Policy at Harvard's John F. Kennedy School of Government.
In July, Dr. Arons spoke at a meeting for the National Experts of the PROTOTYPES Systems Change Center in Washington, D.C. PROTOTYPES helps design, implement, operate, and evaluate integrated systems of mental health, substance abuse, HIV/AIDS, and trauma services for women and children.
Program Activities and Initiatives
Community Support Program
CSP, in collaboration with consumer affairs staff, is in the process of developing initiatives in the following areas:
Homeless Programs Branch
In April, the Branch cosponsored, with the U.S. Department of Housing and Urban Development (HUD), an expert consensus meeting on the development and operation of Safe Havens. Safe Havens are a specialized type of transitional housing for homeless people with mental illness. The panel made recommendations for planning and partnership, location and architectural considerations, service provision, house rules, and transition to permanent housing. A final report should be released in October.
In June, the Branch convened a meeting of experts from mental health, veteran's services, substance abuse, and health care to consider how to improve institutional discharge in a manner that reduces the risk of homelessness by ensuring that clients are linked to community-based services. A report will be presented to the Interagency Council. The Department of Veteran's Affairs may adopt and test the viability of the discharge planning model.
Office of External Liaison
The Office continues to make information about CMHS more widely available. During National Mental Health month in May, OEL issued six media advisories to boost awareness about the role CMHS plays in providing leadership as the Nation's mental health delivery system changes. The headlines were: "SAMHSA Awards Emergency Services and Disaster Relief Grants," "CMHS Explores Work Supports for People with Mental Illness," "Mental Illness is Not a Full-time Job," "CMHS Unveils New Initiatives to Improve Lives of People with Mental Illness," "National Technical Assistance Meeting of State Representatives," and "SAMHSA Begins New Studies of State Substance Abuse and Mental Health Services." CMHS also provided the background information for Secretary Shalala's radio actualities on HHS radio.
In August, the OEL consumer affairs component, in collaboration with the Associate Director for Medical Affairs, sponsored a historic meeting of 20 psychiatrists and mental health consumer advocates from across the Nation to discuss partnership activities to improve mental health services. Dr. Arons addressed the meeting. In addition to forging an improved mutual understanding of one another, the participants agreed to work on a series of recommendations, including: improving the training of psychiatric residents by using consumer presenters to discuss issues of respect, understanding and cultural competency; replicating similar dialogue meetings on State and local levels; and expanding employment opportunities for consumers. A full report of the meeting, consisting of specific recommendations to CMHS, States, professional organizations, and others is scheduled to be released this Fall.
SAMHSA's National Mental Health Information Center continues to grow: inquiries and responses have more than doubled since the last issue of the Information Center Bulletin. In an average month, the Information Center now receives over 7,000 calls to the electronic bulletin board system (BBS), tallies over 5,000 "hits" to the award-winning World Wide Web site, responds to almost 2,000 Americans who call the toll-free telephone number, and distributes over 10,000 publications. In addition, the Information Center has added more than 90 new publications to the BBS and Web site, such as a searchable version of the Mental Health Directory 1995, a CMHS publication which lists over 18,000 organizations; the Consumer Managed Care Network Platform for Action; and several "Toolkits" funded by CMHS and developed by the Evaluation Center, a CMHS technical assistance center, at the Human Services Research Institute.
Office of Managed Care
The parity report should be completed in November. Jeffrey Buck, Ph.D., Associate Director, anticipates providing a detailed summary to the Advisory Council at the December meeting. The Office is engaged in a number of managed care activities, such as contracting with the George Washington University Center for Health Policy for ongoing analyses which include annual reports on all Medicaid managed care contracts; developing technical assistance guides for providers, public purchasers, and consumers that address contract negotiation; supporting a project that will produce a series of legal briefs on procurement, contracting, and contract execution issues that will come out over the next two years; and producing a series of in-depth specialty reports on contracting issues.
Major Projects for Next Quarter
Surgeon General's Report on Mental Health
CMHS expects Secretary Shalala to formally concur with an Office of the Surgeon General request that SAMHSA take the lead in developing a Surgeon General's Report on Mental Health. Discussions began in the Department in July 1996 when Vice President Gore indicated an interest in such a report during the unveiling of the Surgeon General's Report on Physical Activity and Health.
Surgeon General's Reports are highly specialized publications which carry the weight of the individual responsible at the highest level of Government for speaking to and protecting public health interests. As a result, certain precepts must be followed. For example:
SAMHSA and CMHS are in the early stages of planning the Report. SAMHSA will be working in partnership with NIMH and involving other NIH Institutes to develop it. The overall goals are likely to be directed at shedding light on the stigma associated with mental illness and to normalize the topic for the general public. SAMHSA expects to illustrate the diverse ways in which mental illness presents in everyday life, similarities to physical illnesses, the value of prompt and appropriate treatment intervention, and the positive consequences expected from intervention.
Over the next several months, CMHS will enlist a number of participants from diverse backgrounds and organizations as the Report is developed. The first such opportunity will be a planning board, primarily comprised of participants from key Federal and non-Federal organizations and leaders in the field of mental health research and services.
Both CMHS and NIMH are committing sufficient FY 1997 startup funding and staff time to begin developing the Report. More details about the Report should be available at the December Council meeting. By then, SAMHSA will have received official direction from the Secretary.
Child, Adolescent, and Family Branch
Up to 9 new grants will be awarded under the Comprehensive Community Mental Health Services Program for Children and Their Families. This will bring to 31 the portfolio of 5-year grants designed to implement and evaluate systems of care for children and adolescents with serious emotional disturbances and their families in States and communities. Macro International, which currently holds the contract for evaluation, evaluate the new sites as well.
Twenty-eight awards will be made to continue for a fifth year Statewide family network support projects in 26 States and the District of Columbia. These grants are designed to demonstrate the effectiveness of family controlled organizations in creating and maintaining support networks for families who have children and adolescents with serious emotional disturbances, and in promoting systems of care for this population.
Homeless Programs Branch
Phase II of the collaborative project with CSAT will begin. Up to 7 grants will be made. The grantees represent a mix of program interventions for the prevention of homelessness among people with dual disorders.
The branch will implement a housing initiatives program using cooperative agreements with up to 10 housing sites and a coordinating center to handle issues of cross-site collaboration and data pooling. The initiative will test the effectiveness of supported housing with an alternative housing approach. During the first year, each site will conduct a fidelity study of its housing models to ensure that clearly different housing models are present. Grantees who successfully complete this process evaluation will then progress to an outcome evaluation.
Survey and Analysis Branch
The MHSIP Consumer-Oriented Report Card continues to be a major focus of the branch. Twenty States were awarded State Reform Grants in 1996 to test the report card under field conditions, and additional awards are being made this month. The report card measures the accessibility, prevention, and outcome of mental health programs.
The MHSIP Consumer-Oriented Report Card also will provide the platform for feasibility assessment work under the Block Grant set-aside. This work will enhance States' management and reporting capacities and will serve as a starting point to compare performance indicators among State mental health systems. Initial results are expected in February, 1998.
Two workgroups, under the guidance of the Survey and Analysis Branch, are developing methodological standards for outcome systems; content standards for outcome assessment for adult and child and youth populations; and management standards for the use of outcome results. Outcomes play a progressively growing role in payment systems. Initial products are expected later this Fall.
The Branch is awarding a contract to conduct a national survey of mental health consumer self-help activities. The self-help movement in the United States has mushroomed as both a substitute for and complement to traditional specialty mental health services. This survey will provide CMHS and the field with essential information about this increasingly important segment of the service system about which we have no national information.
Organizational/Personnel Updates
1997 Secretary's Award for Distinguished Service: Lynn Harvey Clement and Gary DeCarolis, M.Ed., both of the Child, Adolescent and Family Services Branch, Judith Katz-Leavy, M.Ed., of the Office of Policy, Planning, and Administration, and Mary Westcott, Ph.D., of the Director's Office for the Division of Knowledge Development and Systems Change, were recognized for their outstanding contributions to the "Starting Early, Starting Smart Early Childhood Collaboration Team" at the Departmental Honor Awards Ceremony in May.
Office of the Director: Patricia Rye, J.D., as is a Special Assistant to manage activities associated with the proposed Surgeon General's Report on Mental Health. She has been involved in development of similar reports on a variety of public health topics over the course of her 18-year Public Health Service career, including the Report of the Presidential Commission on the HIV Epidemic. She comes to CMHS from CSAT.
Office of External Liaison: Michael Malden is the new Information Center Government Project Officer. He comes to the Information Cener from the Federal Aviation Administration, where he was responsible for developing and maintaining a news service on the World Wide Web. He brings to the Information Center his expertise in graphics and electronic information.
Office of Managed Care: Catherine Acuff, Ph.D., is working for a year under an arrangement with the American Psychological Association. She has been in private practice for the past years in Windsor, CT, and currently is the Chair of the American Psychological Association's Committee on Professional and Practice Standards and the CAPP Task Force on Ethics and Managed Care.
Shelagh Smith, M.P.H, C.H.E.S., most recently worked in the CMHC Monitoring Branch within CMHS. Her previous positions include NIMH (policy, 1990-91), NCI (evaluation of Cancer Communications, 1985-90), and CMS (analyst in the Office of Demonstrations and Evaluations, 1980-85).
Judith Teich, M.S.W, joins the office as a Social Science Analyst. She spent 6 years at HRSA, participating in the program evaluation and strategic planning processes, and conducting research on the delivery of primary care services. She helped establish the first Community Mental Health Center in Israel, in the early 1970s, and worked in child and adolescent psychiatry in several major New York teaching hospitals.
Child, Adolescent and Family Branch: Rolando Santiago, Ph.D., has joined the staff as a Public Health Analyst. He will be responsible for oversight of the national evaluation of the Comprehensive Community Mental Health Services Program for Children and Their Families.
Emergency Services and Disaster Relief Branch: Beth Nelson, M.S.W., was selected as Branch Chief in May. Ms. Nelson received the Administrator's Award in 1994 for her work on the Northridge Earthquake Project. That same year she was the first CMHS staff to be selected for a Government-wide executive leadership program, along with 200 other Federal employees nationwide. In addition to her disaster work, she has a special interest in promoting upward mobility and career development opportunities. She has been with the Branch since July 1993; before that, she worked in mental health policy at NIMH.
Homeless Programs Branch: Gigi Belanger is now the ACCESS project officer, replacing Jim Morrow, who has moved to the State Planning and Systems Development Branch. After 2 ˝ years with the branch, Ms. Lynn Aronson, Housing Resource Manager, under an intergovernmental personnel agreement with Connecticut, leaves her position at the end of September to relocate to California.
Interagency Agreements and Memoranda of Understanding
CSP and the Indian Health Service will support an evaluation of the effect of recommendations documented in proceedings entitled: Journey of Native American People with Serious Mental Illness, and Journey of Native American People with Serious Mental Illness—Building Hope.
Major Meetings and Workshops
SAMHSA National Conference on Women, September 21, in Phoenix, AZ. The conference is called "Cycles, Challenges, and Changes: Making a Difference in the Lives of Women, Their Families and Their Communities." Dr. Chavez will give the keynote address. In addition, Susan Salasin, Director of the CMHS Women's Mental Health Program, will be one of the presenters during the session entitled, "Intimate Outrages in Treatment: Perpetuating Violence Against Women." Also, work coming out of the GAINS Center, a CMHS technical assistance center, will be highlighted in a session entitled, "Creating Sanctuary: Services for Women with Co-Occurring Disorders in the Criminal Justice System."
SAMHSA will also participate in the Latino Behavioral Health Institute in Los Angeles from September 9-13.
Child, Adolescent, and Family Branch
Gary DeCarolis, Branch Chief, gave the keynote speech, "Communities Can Care for the Mental Health Needs of All Their Children: A Nation Moving Forward," at the Utah Mental Health Conference, in May, Park City, UT.
Velva Spriggs, Director of Systems Planning and Development Program, attended a meeting of the advisory board of the National Technical Assistance Center for Children's Mental Health at Georgetown University in May, in Washington, DC.
The Branch sponsored a technical assistance meeting for grantees of the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances and Their Families Demonstration Program in June, Santa Barbara, CA.
Community Support Program
The second National Consumer, Family, and Advocate Leadership Conference on State Health Care Reform and Managed Care will be held in Timonium, MD, on October 16-19. The conference will bring together all major groups concerned about consumer and family issues in managed behavioral health care. It will provide up-to-date training on health care reform and managed care to leaders in State coalitions who represent major constituency groups. Contracting issues and contract language will be emphasized. The program will draw heavily on the experiences of three State coalitions that receive intensive technical assistance from the National Managed Care Consortium.
Homeless Programs Branch
The branch held its semi-annual Access to Community Care and Effective Services and Supports (ACCESS) grantee meeting in June, in Bethesda, MD.
On September 18-19, the branch will cosponsor the National Executive Training Institute: Developing State-Level Partnerships Between Housing and Mental Health Agencies. The goals of the meeting are to assemble teams of key decision makers in State mental health and housing agencies to promote new State-level partnerships that will lead to expanded access to affordable housing for people with serious mental illnesses. The audience will include teams from up to 20 States and will include senior-level policy makers, consumers, and family members.
On September 26, the branch will cosponsor the Community Team Training Institute on Homelessness (CTTIH) in Washington. This multiagency project includes a national competition in which five cities are chosen to bring 10-member teams for a week of intensive training and strategic planning to address integration of services. The Federal partners then provide the cities with up to 1 year of follow-up support to implement their strategic plans.
Office of Managed Care
Jeffrey Buck, Ph.D., Associate Director, will make a presentation entitled "Issues and Trends in Parity" at the Behavioral Healthcare Tomorrow Conference on September 23 in Washington, DC.
Survey and Analysis Branch
The Branch sponsored and convened the National Conference on Mental Health Statistics in May, Washington, D.C. Branch Chief Ron Manderscheid, Ph.D., participated in many meetings, including the Consensus Conference on Practice Guidelines; a meeting of the CMHS Child Outcomes Workgroup; the Annual Meeting of The National Alliance on Mental Illness; and the Annual New York State Mental Health Institute.
Dr. Manderscheid served as an international reviewer of reforms of the Australian mental health care system.
Dr. Manderscheid will conduct an executive seminar on the MHSIP Consumer-Oriented Report Card at the Behavioral Healthcare Tomorrow Conference in Washington, D.C.
Recent and Forthcoming Publications
Flynn, L.M., Manderscheid, R.W., Smith G.R., and Steinwachs, D.M. "Principles for Assessment of Patient Outcomes in Mental Health Care," Psychiatric Services, Vol. 48, No. 8, 1997.
Dr. Manderscheid has two articles forthcoming: one on the MHSIP Report Card activities in Behavioral Healthcare Tomorrow, the other will be on the crisis of quality in managed behavioral health care in the Journal Of Mental Health Administration.
Buck, J.A., and Umland, B., "Covering Mental Health and Substance Abuse Services," Health Affairs, 16(4), 1997.
KEN97-0043
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