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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.



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.
Las Vegas Mental Health Center, Las Vegas, Nev-__

722, 076

894, 771

Northern New Hampshire MH System,' iLttleton, N.H.
Christ Hospital CMHC,' Jersey City, N.J

[blocks in formation]

Northeast CMHC of Memphis Shelby City, Memphis, Tenn.

374, 796

Murray-Jordan-Toole Mental Hygiene Center, Murary, Utah___

[blocks in formation]

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.
Northside Hospital Comp. CMHC, Atlanta, Ga---
MHC of St. Joseph County, South Bend, Ind__.
Southern Bluegrass Comp. Care Center,' Danville, Ky.
Western Kentucky Region I CMHC,' Paducah, Ky---
Acadiana MHC, Lafayette, La__.

Montgomery General Hospital CMHC, Olney, Md__.
Erich Lindemann CMHC,' Boston, Mass_.
Philadelphia Psychiatric Center,' Philadelphia, Pa-
Mayaguez CMHC,1 Mayaguez, Puerto Rico_-.
Tufts Mental Health Center,' Boston, Mass..
Greater Lynn CMHC Program,1 Lynn, Mass-
South Central Montana Reg. MHC,1 Billings, Mont_.
Community Center for Mental Health, Dumont, N.J.
Rutgers CMHC, New Brunswick, N.J_.
Brookdale Hospital CMHC,1 Brooklyn, N.Y._
Buffalo General Hospital CMHC, Buffalo, N.Y.

Orange County MHC,1 Goshen, N.Y

Wilson Green Mental Health Center,' Wilson, N.C..
Carl Albert CMHC, McAlester, Okla.

Holy Spirit Hospital CMHC, Camp Hill, Pa.
Hamot CMHC, Erie, Pa-----

[blocks in formation]

ATTACHMENT 1-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..
Bell County MH/MR Center,' Belton, Tex_.
Harris County MH/MRC, Houston, Tex__.

712, 963

786, 947

119, 983

Southwest Mental Health Center, Columbus, Ohio‒‒‒‒‒

625, 475


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..
Massachusetts MHC, Boston, Mass-

438, 755

Columbia Area Mental Health Center, Columbia, S.C..

382, 683

404, 025

Dallas County MH/MR Center, Dallas, Tex--
Open Harbor, Inc., Boston, Mass--

785, 051

59, 000

Tufts Mental Health Center,' Boston, Mass_.

Cambridge-Somerville MH/RC,1 Cambridge, Mass---
Emerson Hospital, Concord, Mass----


[All poverty areas]

Alabama Catchment Area M-16C, Mobile, Ala__.

Community MH/MR Center, Lawrenceburg, Ind_

MH Association of North Central Massachusetts, Fitchburg, Mass..
Cape Ann Children & Family Center, Gloucester, Mass..
CMHC Area 43, Hudson County, Newark, N.J__
Riverview Hospital, Red Bank, N.J___

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


36, 472

47, 404

East Los Angeles Health Task Force, Los Angeles, Calif.
Sunset, Richmond Oceanview, San Francisco, Calif...

Board of Co. Commissioners Multnomah Co., Portland, Oreg‒‒‒‒‒



Ozark Guidance Center, Box 515, Springdale, Ark__

Tucson East CMHC, 36 North Tucson Blvd., Tucson, Ariz
San Jose CMHC, 77 North 15th St., San Jose, Calif.
Westside CMHC, 2201 Sutter St., San Francisco, Calif.
Bayview CMHC, 101 Grove St., San Francisco, Calif__

Central City CMHC. 4272 South Broadway, Los Angeles, Calif.
Sacramento Co., MH Services (North), 2315 Stockton Blvd., Sacra-
mento Calif..

Resthaven Psychiatric Hospital, CMHC, 765 West College St., Los
Angeles, Calif_.

$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..
Peoples Clinic, Santa Ana, Calif.

179, 636

Comp. Mental Health Services, of East Central Indiana, Inc., Muncie,

199, 757

Silver Spring Takoma Park, 7600 Carroll Ave., Takoma, Md_
Regional MH Complex, P.O. Box 43, Starkville, Miss_

303, 399

Pine Belt Reg. MH & Retardation Complex, Suite 406, Carter Bldg.,
P.O. Box 161, Hattiesburg, Miss___

St. Francis Hosp. CMHC, Gordenville & Mount Auburn Rd., Cape
Girardeau, Mo‒‒‒‒‒

Southeast Jackson Co. CMHC, Lees Summitt, Mo....

1 Indicates poverty.

ATTACHMENT 2-Continued

CUT OFF BY HEW-continued

Thousand Hills CMHC. Kirksville, Mo----

Lutheran Mental Health Center, 415 South 25th Ave., Omaha, Nebr.
(Mervin Riepe, Administrator)---

Lincoln-Lancaster MHC, 1107 Lincoln Benefit Life Bldg., Lincoln,

North Platte Psychiatric Clinic (Great Plains Mental Health Center),
221 South Jeffers St.. North Platte, Nebr...

St. Joseph's Hospital CMHC, 2305 South 10th St., Omaha, Nebr.
Mid-Nebraska CMHC, 916 Baumann Dr., Grand Island, Nebr.
Southern Nevada CMHC, Las Vegas, Nev..

Washoe Co. Center, Nev..

So. Comp. CMHC, Nevada___

Community Ctr. for MH Inc., 2 Park Ave., Dumont, N.J.
Gloucester Co. MHC, Psychiatric Clinic for Gloucester Co., Tatum St.,
Woodbury, N.J..

$894, 771

1, 563, 517

Mercy Hospital of Watertown, 218 Stone St., Watertown, N.Y...
Marymount Hospital MHC, 12300 McCracken Rd., Cleveland, Ohio____
Child & Adult MHC, 1009 Realty Bldg., Youngstown, Ohio..
Southwest CMHC, Columbus, Ohio---

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.__
Hall-Mercer CMHC, 8th and Locust Sts., Philadelphia, Pa..

Child Guidance Center, West Philadelphia Consortium, 1700 Bain-
bridge St., Philadelphia, Pa...

City-County Clinic, P.O. Box 669, Johnston, Pa...

Divine Providence CMHC, 1100 Grampian Blvd., Williamsport, Pa---
Episcopal Hospital, CMHC, Front St., and Lehigh Ave., Philadelphia,

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...
Central Pennsylvania CMH/MRC, Day Care Center, Pennsylvania___
Cambria County CMHC, Johnstown, Pa------

MH/MR Center for Hidalgo County, P.O. Drawer 1108, 1425 South
9th Edinsburg, Tex----

Bear River Mental Health Center, County Courthouse, Bringham
City, Utah_____

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___
MH Service of Roanoke Valley, Carlton Terrace Bldg., Suite 500, 920
South Jefferson St., Roanoke, Va-----

533, 115

Department of MH & Hospital, P.O. Box 40, Salvada, Va..
Fairfax South City, 4080 Chain Bridge Road, Fairfax, Va-

N. Panhandle CMHC, 2000 Eoss St., Wheeling, W. Va..

Allegany County Health Department, Willow Brook Rd., P.O. Box 690, Cumberland, Md__.

[graphic][subsumed][merged small][subsumed][subsumed][merged small][merged small]

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
1972 and for the first quarter of 1973. Between now and July 1, many states
and localities will be making final decisions on the use of these funds during
the coming fiscal year (1973). It is important for centers to make strong
efforts to tap these resources since:

Many states and localities will have surpluses during this fiscal
year as a result of unexpected general revenue sharing federal dollars;
•Programs funded this year under revenue sharing will probably find it
easier to obtain similar funding in the future (general revenue sharing
funds are now authorized for five years).


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).

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