In addition, there are some other administrative problems which have arisen in a number of centers, which should also be corrected through legislative action by the Congress. These issues include: Occurrences whereby patients who can afford to pay for all services have been seen by center professionals not in the community mental health center to which the patient was first referred or admitted for care, but in their own private practice. This practice can result in serious losses of revenue for the CMHC. The need for tightening of NIMH regulations regarding the appointment of professional staff in CMHC's to ensure that appointments are based entirely upon the qualifications of the individual and his suitability for the position in question. The amount of professional staff time devoted to administration of the center, and the question of whether, in some instances, staff should be devoting greater proportions of their time to clinical services. Despite these problems, however, the fact remains that through the CMHC program the federal government has stimulated development of comprehensive community mental health services and permitted the provision of unique systems of care for the mentally ill. The progress to date could not have been achieved without the federal role. To end that role now would be a tragic mistake. The impact of the federal program is highlighted in a recent study by the National Study Service under an NIMH contract.' The researchers studied four counties in both 1958 and 1970 to determine the factors leading to changes in mental health programs, and to analyze the impact on the development of mental health resources of the establishment of federally funded CMHC's. Two of the counties studied were served by a federally funded center, while the other two were not. The study concluded that: "The study data and findings document and support several significant conclusions about mental health developments in these four counties. First, and perhaps foremost, there has been very substantial progress in the development of mental health resources in all four counties. However, the progress in the two counties with federal funding has been much more substantial than in the two that did not have federal funding. "It is especially significant also that the federal funding enabled the community mental health centers in these two counties to invest much more time in activities other than direct services to clients, and thus to have substantially more impact in such important prevention areas as education and one or more other programs, such as corrections and vocational rehabilitation." At this time, the CMHC program is still growing, and still evolving fairly rapidly as our experience increases. There is very strong support for the concept among professionals and among lay persons in communities served by centers and those where a program is currently being planned. This is evidenced by the fact that there are at this time 68 communities which have applied for a CMHC staffing grant (through the regular program or for childrens services under Part F of the CMHC Act) and were approved by HEW (listed in Attachment I). These grants are unfunded, and will remain unfunded unless Congress acts to extend the legislation. In addition, there are hundreds of communities which were in the process of planning new community mental health services when the program abruptly ceased. (58 of which are listed in Attachment II). There are also many communities (which received a construction grant under Part A of the CMHC Act, assuming that federal staffing grant assistance would be available to asist them in providing comprehensive mental health care) where it will be difficult if not impossible to provide services without further federal assistance. To date, only 58 of the 128 agencies which received Federal construction grants but no staffing assistance are actually operating a program, and a review indicates most of these 38 are part of a hospital. If the remaining 90 buildings are to house comprehensive community mental health centers, funds to support these programs must come from either the federal government or the 1 The Relative Impact of Various Factors, Including Community Mental Health Centers, in the development of Mental Health Resources, Report of a Study of a Decade of Change in Mental Health Needs and Resources in Four Counties, Using Base-Line Data Obtained as a part of the Study of Community Resources in Mental Health, Made by the Joint Commission on Mental Illness and Health, Completed in 1960, submitted by National Study Service to NIMH pursuant to Contract No. HSM-42-70-108. 21-333 73 - 4 states. Yet there seems little likelihood that the states will pick up all of these costs, for reasons stated above. We hope that later this year, the subcommittee will take a careful look at the CMHC program and find some solution which will enable existing centers to continue their highly effective and essential work, and at the same time enable those communities awaiting the establishment of a CMHC to receive the services they need. Thank you for this opportunity to testify. ATTACHMENT 1 APPROVED-UNFUNDED FEDERAL GRANTS FOR INITIATION OF NEW CMHC'S Pikes Peak Family Counseling & MHC, Colorado Springs, Colo-- Southwest Denver MH Services, Denver, Colo__ $817, 658 334, 454 Leon County MHC,' Tallahassee, Fla- 500, 000 Kalihi-Palama CMHC,1 Honolulu, Hawaii. 309, 741 Snake River Comp. CMHC,' Boise, Idaho_. 613, 397 Region Ten Comp. MHC, Columbus, Ind.. 557, 362 Regional Mental Health Center, Kokomo, Ind 500, 000 Johnson Co. Southwest CMHC, Overland Park, Kans.... 215, 385 Barren River Comp. Care Center,1 Glasgow, Ky. 741, 913 Washtenaw County CMHC, Ann Arbor, Mich. 511, 890 West Central Montana Reg. Comp. MHC, Anaconda, Mont---. 250, 250 North Central Montana Comp. CMHC, Great Falls, Mont. 722, 076 894, 771 Northern New Hampshire MH System,' iLttleton, N.H. Northeast CMHC of Memphis Shelby City, Memphis, Tenn. 374, 796 Murray-Jordan-Toole Mental Hygiene Center, Murary, Utah___ Thalians CMHC of Cedars-Sinai, Los Angeles, Calif_. San Jose CMHC,' San Jose, Calif Emanuel Hospital CMHC,1 Turlock, Calif. Jefferson County MHC. Lakewood, Colo___ Southern New Castle MHC,' New Castle, Del. 1, 492, 480 92, 816 85,684 226, 062 267, 913 St. Joseph's CMHC,1 Tampa, Fla. Palm Beach County Comp. CMHC,1 West Palm Beach, Fla. Montgomery General Hospital CMHC, Olney, Md__. Orange County MHC,1 Goshen, N.Y Wilson Green Mental Health Center,' Wilson, N.C.. Holy Spirit Hospital CMHC, Camp Hill, Pa. ATTACHMENT 1-Continued APPROVED-UNFUNDED FEDERAL GRANTS FOR INITIATION OF NEW CMHC's-continued Meadville City Hospital CMHC,1 Meadville, Pa.... $443, 270 Albert Einstein CMHC. Philadelphia, Pa____ 567, 587 Austin-Travis County MH/MR Center, Austin, Tex.. 712, 963 786, 947 119, 983 Southwest Mental Health Center, Columbus, Ohio‒‒‒‒‒ 625, 475 CHILDREN'S SERVICES Greater Little Rock CMHC, Little Rock, Ark_--_. 146, 350 John Hale Health Foundation, San Francisco, Calif. 241, 040 Wheeler Clinic, Plainville, Conn_-_ 642, 984 The Counseling Center, Bangor, Maine.. 438, 755 Columbia Area Mental Health Center, Columbia, S.C.. 382, 683 404, 025 Dallas County MH/MR Center, Dallas, Tex-- 785, 051 59, 000 Tufts Mental Health Center,' Boston, Mass_. Cambridge-Somerville MH/RC,1 Cambridge, Mass--- INITIATION & DEVELOPMENT [All poverty areas] Alabama Catchment Area M-16C, Mobile, Ala__. Community MH/MR Center, Lawrenceburg, Ind_ MH Association of North Central Massachusetts, Fitchburg, Mass.. Rio Del Norte Planning Committee, Espanola, N. Mex.. Clinton Co. MH Services, Plattsburgh, N.Y_ Franklin County MH/MR Board, Columbus, Ohio_. 268, 532 127, 163 150, 640 45, 148 49, 720 50,000 49, 956 50,000 48, 650 49,990 50,000 36, 472 47, 404 East Los Angeles Health Task Force, Los Angeles, Calif. Board of Co. Commissioners Multnomah Co., Portland, Oreg‒‒‒‒‒ ATTACHMENT 2 CMHC STAFFING GRANT APPLICATIONS PENDING WHEN APPROVAL PROCESS Ozark Guidance Center, Box 515, Springdale, Ark__ Tucson East CMHC, 36 North Tucson Blvd., Tucson, Ariz Central City CMHC. 4272 South Broadway, Los Angeles, Calif. Resthaven Psychiatric Hospital, CMHC, 765 West College St., Los $300, 000 85, 684 300, 000 241, 040 2, 610, 750 238, 378 250, 021 1, 739, 879 Sacramento County, MH Services (East), Sacramento, Calif.. 179, 636 Comp. Mental Health Services, of East Central Indiana, Inc., Muncie, 199, 757 Silver Spring Takoma Park, 7600 Carroll Ave., Takoma, Md_ 303, 399 Pine Belt Reg. MH & Retardation Complex, Suite 406, Carter Bldg., St. Francis Hosp. CMHC, Gordenville & Mount Auburn Rd., Cape Southeast Jackson Co. CMHC, Lees Summitt, Mo.... 1 Indicates poverty. ATTACHMENT 2-Continued CMHC STAFFING GRANT APPLICATIONS PENDING WHEN APPROVAL PROCESS Thousand Hills CMHC. Kirksville, Mo---- Lutheran Mental Health Center, 415 South 25th Ave., Omaha, Nebr. Lincoln-Lancaster MHC, 1107 Lincoln Benefit Life Bldg., Lincoln, North Platte Psychiatric Clinic (Great Plains Mental Health Center), St. Joseph's Hospital CMHC, 2305 South 10th St., Omaha, Nebr. Washoe Co. Center, Nev.. So. Comp. CMHC, Nevada___ Community Ctr. for MH Inc., 2 Park Ave., Dumont, N.J. $894, 771 1, 563, 517 Mercy Hospital of Watertown, 218 Stone St., Watertown, N.Y... 1,505, 699 3,038, 742 2,895, 210 9,796, 783 North Central Hamilton Co., Inc., Cincinnati, Ohio.. S.E. Cleveland CMHC, Cleveland, Ohio___. Concerned Citizens CMHC, Toledo, Ohio.. S.W. Pittsburgh CMHC, 2005 Sarah St., Pittsburgh, Pa-- Northeast CMHC, Roosevelt Blvd. & Adams Ave., Philadelphia, Pa.__ Child Guidance Center, West Philadelphia Consortium, 1700 Bain- City-County Clinic, P.O. Box 669, Johnston, Pa... Divine Providence CMHC, 1100 Grampian Blvd., Williamsport, Pa--- Centerville Clinic, Inc., R.D. No. 1, Fredericktown, Pa Central Montgomery MH/MR Center, 1100 Powell St., Norristown, St. Francis General Hospital, 45th St., Pittsburgh, Pa... MH/MR Center for Hidalgo County, P.O. Drawer 1108, 1425 South Bear River Mental Health Center, County Courthouse, Bringham Windham County MH, 67 Main St., Brattleboro, Vt.--- 3,962, 215 140, 780 Windsor County MH, Hospital Professional Bldg., P.O. Box 6, Springfield, Vt.. Falls Church-Fairfax County, 4100 Chain Bridge Rd., Fairfax, Va___ 533, 115 Department of MH & Hospital, P.O. Box 40, Salvada, Va.. N. Panhandle CMHC, 2000 Eoss St., Wheeling, W. Va.. Allegany County Health Department, Willow Brook Rd., P.O. Box 690, Cumberland, Md__. General revenue sharing funds have been allocated for community mental health center programs by some local governments, although on a national basis CMHC's have not been able to obtain any significant revenues from this source. This fact is emerging from the National Council's survey of members regarding the use of General Revenue Sharing Funds. (All responses are not yet in, a full summary will be sent to you as soon as it is available). Local and state governments have now received revenue sharing allocations for Many states and localities will have surpluses during this fiscal Eligibility Centers are eligible to receive funding from both state and local governments under the new proposed regulations published in the Federal Register, February 22, 1973. The only restriction placed on the use of general revenue sharing funds for community mental health centers is that, Revenue sharing may not be used to provide the state or local matching required under any federal categorical grant program (this would apply to staffing, alcohol and drug abuse staffing grants, children services staffing grants, etc). |
