xxAACP Newsletter, Volume 14, Number 2, Spring 2000
SAMHSA Reauthorization and Why You Should Care
It has been 8 years since the original authorization of SAMHSA, and it is 5 years overdue for reauthorization. The importance of reauthorizing a law or a Federal agency is not so much to secure its funding. Programs whose authorization has expired usually continue to get their funding approved by the Congressional appropriations process, but, without reauthorization, it is very difficult for the agency to develop and implement new programs. In the field of mental health and substance abuse treatment, there have been substantial developments in the past 8 years, so it is extremely important that new legislation be passed to bring SAMHSA up to speed on certain issues.
The SAMHSA reauthorization was one of the major tasks that I worked on during my year as a legislative fellow in the office of Senator Kennedy. In collaboration with other members of the Senate Health, Education, Labor and Pensions Committee, we developed a fairly good bill that eventually passed in the Senate. The main elements of that bill involved:
- Changes to some of SAMHSA's processes, especially with regard to its relationship with the state mental health and substance abuse agencies. This allows more flexibility for states in how they use their SAMHSA funds and how they report it back to SAMHSA, but also involves an agreement that the states will participate in a process to develop more consistent national outcome measures.
- Increased funding levels for many of SAMHSA's current programs, especially the Mental Health Block Grant.
- Various new program initiatives reflecting the changes in mental health and substance abuse clinical needs and the advances in how services can and should be delivered. These include new programs to address co-occurring disorders, child and adolescent mental health and substance abuse issues, psychological trauma services for witnesses and survivors of community and domestic violence, the interface between behavioral services and primary care, service for populations in corrections settings, improved services to homeless persons with mental illness, and increased protections and reporting requirements associated with seclusion and restraint in psychiatric facilities.
- There is also the troubling "Charitable Choice" provision that would allow "faith-based" substance abuse service provider organizations to compete for Federal funds without altering the religious nature of their operations. This is certainly a Constitutionally questionable provision, because of its apparent violation of the separation of church and state, but one that, for reasons too lengthy to include in this report, had to be included in the bill in order for it to receive sufficient support from the Republicans to pass. Suffice it to say that the bill's positive provisions were felt to outweigh this provision's problems, some of which may be susceptible to court challenges.
I have described many of these initiatives in my reports from D.C. during the year I was in the Senate. (The actual bill and related documents can be found on the web at http://www.loc.gov/ by going to the site called Thomas - for Thomas Jefferson, which is where all Congressional Records are posted. The bill is entitled the Youth Drug and Mental Health Services Act (S.976) and can be located by using either its title or bill number in the search window. This is a very useful web site, in that you can locate many important legislative documents very easily.)
The SAMHSA legislation is currently awaiting action in the House Commerce Committee, but may fall victim to election year politics. This is a very important and timely bill that will benefit community based mental health and substance abuse service programs. Your support is critical. You can be effective by contacting your Congressional delegation to express your desire to have the bill passed as soon as possible, in particular to contact House members to have them put pressure on the Commerce Committee chairman, Representative Bliley from Virginia, to have his committee act on the bill during this session.
David Pollack
Representative at Large
David Pollack, MD
Medical Director, MHSW
710 SW 2nd
Portland, OR 97204-3112
Office: (503) 228-0373
Home: (503) 638-6089
Fax: (503) 494-6578
/ 273-8390
Email: dapollack@aol.com
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2000 Table of Contents