# Presentation: 479642

## Federal Grant Programs Improving Access to Children’s Mental Health Services

- Kirsten Beronio
- National Mental Health Association

## Overview

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

## Need for Improved Access to Community-based Services

- 5-9% of children have serious emotional disturbances (SED) – President’s 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 General’s Report on Children’s Mental Health, January 2001

## 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

## 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

## 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

## Success at Improving Outcomes(Recent evaluation data from SAMHSA)

- Percentage of kids w/ “D”grade 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

## Slide 8

## Recent Funding Levels for Children’s Mental Health Services Program

| FY 2002 | FY 2003 | FY 2004 | Admin.
Request |
| --- | --- | --- | --- |
| $96.5 million | $98.5 million | $102.4 million | $106 million |

## 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)

## 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)

## Safe Schools/Healthy Students 

- Program grew out of school shootings in late 1990’s
- 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

## 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

## 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

## Safe Schools/Healthy Students

- Total of 166 school districts funded since 1999 – see _[www.sshsevaluation.org](http://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

## 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

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

- Grant program modeled after SAMHSA’s Children’s 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

## 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 5&6 - $2 state for $1 federal
- Encouraging sustainability of services

## 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)

## 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)

## House Energy and Commerce CommitteeRepublicans

- 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)

## House Energy and Commerce CommitteeDemocrats

- 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)