chevron-down Created with Sketch Beta.
May 01, 2014

ABA opposes legislation to cut mental health program

The ABA is opposing a proposal to cut authorized funding for Protection and Advocacy for Individuals with Mental Illness Act (PAIMI) programs and to bar the programs from using funds to provide critical legal services on behalf of groups of individuals with serious mental illness.

In a March 31 letter to the House Energy and Commerce Subcommittee on Health, ABA Governmental Affairs Director Thomas M. Susman explained that PAIMI mandates that Protection and Advocacy agencies (P&As) in every state and territory protect and advocate for the rights of individuals with mental illness and investigate incidents of abuse and neglect of these individuals in all public and private facilities and in community settings. The agencies also have the authority to provide legal representation and other advocacy services to people with severe mental disabilities.

Provisions in H.R. 3717, the proposed “Helping Families in Mental Health Crisis Act of 2013,” would reduce PAIMI funding from $36 million to $5 million, an action that the ABA maintains would leave the 57 state and territorial programs without vital funds that are used to protect and serve some of the nation’s most vulnerable citizens. Last year, P&As under the federally funded PAIMI program provided information and referral services to 35,500 individuals and provided training to more than 80,000 individuals, family members, mental health planners and social service professions.

In addition, more than 15,000 individuals received critical legal services through systemic advocacy and litigation − legal assistance that would be prohibited under H.R. 3717. Susman highlighted the efforts of Disability Rights of Washington, a PAIMI agency that joined others in filing a class action lawsuit to compel intensive, individualized mental health services for Medicaid-eligible young people in their communities. The case led to an agreement allowing for additional treatment of children at home rather than in psychiatric facilities.

During an April 3 subcommittee hearing on H.R. 3717, David L. Shern, president and CEO of Mental Health America, agreed with the ABA and said that the legislation should seek to improve PAIMI rather than dismantle it. “While the system surely can be improved and might benefit from the use of more alternative dispute resolution techniques like psychiatric advance directives and mediation-oriented dispute resolution, the wholesale abandonment of the PAIMI function would be disastrous in our current systems.” he testified.

Another witness, Nancy Jensen, described how a P&A helped shut down Kaufman House, an abusive group home in Kansas where she lived. She testified that, since the law was enacted in 1986, PAIMI has been “vital in assuring appropriate treatment” for individuals with mental illness as well as for youth and adults with autism and other developmental disabilities who also have co-occurring mental health issues.

Rep. Tim Murphy (R-Pa.), chairman of the House Energy and Commerce Subcommittee on Oversight and Investigations, introduced H.R. 3717 following a year-long study by the subcommittee of federal mental health programs. The legislation, intended to “reorient federal funding for mental health,” includes provisions to establish a new position of assistant secretary for mental health in the Department of Health and Human Services. The ABA, while opposing the PAIMI provisions, has no specific policy on other parts of the legislation.

The material in all ABA publications is copyrighted and may be reprinted by permission only. Request reprint permission here.