[Congressional Record Volume 146, Number 136 (Thursday, October 26, 2000)]
[Extensions of Remarks]
[Page E1949]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        MEDICAID INTENSIVE COMMUNITY MENTAL HEALTH TREATMENT ACT

                                 ______
                                 

                           HON. MARCY KAPTUR

                                of ohio

                    in the house of representatives

                       Thursday, October 26, 2000

  Ms. KAPTUR. Mr. Speaker, today I along with my colleague, 
Representative Barbara Cubin, introduced important legislation to 
improve the standard of care for the mentally ill under the Medicaid 
program, the Medicaid Intensive Community Mental Health Treatment Act 
of 2000. This legislation provides each state with the option of 
covering intensive community mental health treatment under the Medicaid 
program. These community health programs are intensive treatments for 
adults and children with a diagnosed and persistent mental illness if 
they meet certain criteria under Medicaid. This bill amends title XIX 
of the Social Security Act to provide states with the option of 
covering intensive community treatment under the Medicaid program.
  With this bill, the states can use 24-hour, 7-day-a-week intensive 
case management programs, psychiatric rehabilitation, discharge 
planning, and other evidence-based approaches such as assertive 
community treatment. These programs have been proven more effective and 
less expensive than inpatient care. The severely mentally ill are not 
receiving the help they need under the current programs covered under 
Medicaid.
  This bill helps states reduce the costs of inpatient care under 
Medicaid. Trials have demonstrated that the use of these services 
substantially reduces the need for inpatient mental illnesses. This 
bill focuses the treatments used to benefit the severely mentally ill 
and thereby reduces the amount spent on inpatient care.
  Current federal financing for community-based metal health care is 
spread across six or more optional Medicaid service categories. There 
exists a patchwork of state and country programs characterized by a 
lack of coordination, inflexible funding streams, and missing service 
components. This bill brings together a number of proven treatments for 
the severally mentally ill. States are given a choice, not a mandate, 
to adopt these improved services.
  The people in our country who suffer from severe and persistent 
mental illnesses are not receiving the care they deserve. Without this 
specialized and intensive treatment it is extremely difficult for them 
to improve their lives. Many of the severely mentally ill are habitual 
inhabitants of the prison system or are homeless. If they have access 
to the specialized intensive care provided by these programs, cyclical 
regression to their illnesses may be avoided. This bill puts the choice 
squarely on the states: they can and should exercise the option to 
provide the quality of care individuals with severe mental illnesses 
deserve.
  This bill does not cover everyone seeking psychiatric therapy. It 
covers only those with severe and persistent mental illnesses who meet 
one of the following criteria: a history of hospitalization or of 
repeated arrests for minor offenses; A history of poor outcomes from 
lesser treatments; who cannot meet their own basic needs; or have a 
history of coexisting substance abuse for at least 12 months.
  The Medicaid Intensive Community Health Treatment Act of 2000 gives 
states a clear choice to improve the lives of their severely mentally 
ill residents.

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