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President Bush's (July 2004) Forced U.S. "Mental Health Screening" & Psychiatric Drugging Program
for ALL Americans has GOT TO BE STOPPED NOW !
*** The Federal PPRA Act of 1998 ***
New Freedom Commission on Mental Health
State Implementation Activities
Note 1: Information in this report is derived from questionnaire analysis, commissioners’ reports, and technical assistance
reports.
Note 2: “SMHA” refers to the relevant state mental health association; “MH” refers to mental health or the relevant state
department of mental health; “SA” refers to substance abuse or the relevant state department of substance abuse.
Note 3: The “Goals” column refers to the goals of the President’s New Freedom Commission on Mental Health (“NFC”)
currently being addressed.
Note 4: “TA” refers to whether that state has received any technical assistance provided under Targeted Technical
Assistance or another SAMHSA-funded initiative.
State Activity
Key
dates
Who’s
involved?
Goals
TA
Alaska
Divisions of MH and SA are merging to create a division of
behavioral health, a process underway before the NFC
report was released. Implementation activities in Alaska
will therefore impact both MH and SA; recovery and
resiliency are receiving the most attention. Department’s
treatment and recovery section is taking the lead regarding
prevention and early intervention, increasing protective
factors, and reducing risk factors.
SMHA
No
Arizona
Development of statewide suicide prevention plan;
Working with Medicaid providers to more closely
collaborate on mental health physical health issues;
Inclusion of consumers and family members in several
statewide MH initiatives including in the development of
new statewide assessment tool; Enhancement of Child and
Family Team process; Development of performance-based
annual review process; Implementation of comprehensive
state MH plan; Office of Human Rights addressing the
protection and enhancement of people with mental illness;
Trainings on advance directives; Implementation of various
services regarding a written cultural competency plan and
telemedicine; Addressing co-occurring issues statewide;
Enhancement of several Best Practices; Development of
report on implementation of integrated electronic health
record and personal health information systems.
SMHA;
Medicaid
providers; Regional
Behavioral Health
Authorities
All No
Arkansas
5.8 million in new funding for locally customized acute
care services; Prior authorization project implemented
where dollars follow consumer into community; MH & SA
departments merged/receipt of new COSIG grants with
ACT team involvement; Currently funding dollars to target
toward EBP implementation; Successful reduction of
seclusion and restraint.
SMHA
No
California
CIMH has developed a work plan for NFC implementation;
Conducted a meeting with constituents to prioritize
recommendations on which action may be taken;
Recommendations are being considered in the context of no
new money, therefore restructuring and reeducation are the
likely focus.
SMHA;
CIMH
No
Colorado
Development of specific action plans; Development of
three-year MH block grant plan; Use of MH Block Grant
plan as primary planning document for public MH system;
Elimination of disparities in MH services primarily through
EBP focus; Continued Development of SAMHSA System
SMHA;
Planning
and Advisory
Council
2; 3; 4;
5
No
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of Care grant used for early intervention efforts for
children; Development of staff training on EBPs; Provision
of TA to community-based providers; Support of
innovative and evidence-based practices; Implementation
assigned to a pre-existing strategic planning committee,
which provides some distance from the central
administration with a charge to investigate how to
incorporate recommendations in existing plan resulting in
prioritization of all goals except Goal Six.
Connecticut
Report used to ignite initiatives such as updating its 2000
Blue Ribbon Commission Report; Office of the Governor
invited Dr. Hogan to speak on implementation of the NFC
goals to group of stakeholders including legislators.
SMHA;
Office
of
the Governor;
Judicial and
Executive branches
No
Delaware
Report used to (1) support and validate preexisting
activities, initiatives and reorganization and (2) assist with
state strategic planning efforts.
SMHA
No
District of
Columbia
Requirement of individualized plans for each person
receiving services through MHRS; Development of system
of recovery; Created a comprehensive MH plan; legislating
and staffing Office of Consumer Affairs; Developed
Cultural Competence Plan for 2003-2005 including
Training Institute; Development of a youth and families
system of care; Developed comprehensive approach to co-
occurring disorders; Implementing supported employment
program; Implementing programs in all 6 EBP areas;
Development of comprehensive information system.
SMHA;
MH
Rehabilitation
Services; Addiction
Prevention and
Recovery Admin.;
DC school system;
Johnson and
Johnson; public
community-based
MH system; St.
Elizabeth’s Hosp.
2.1; 2.2;
2.3; 2.4;
2.5; 3.5;
4.1; 4.2;
4.3; 5.1;
5.2; 5.3;
6.2
No
Florida
Creation and detailed Implementation of five SMHA
recommendations aligned with NFC Goals: (1) Improve
shared stewardship, (2) Ensure the safety, well-being and
self-sufficiency of consumers, (3) Realign and refocus the
workforce, (4) Provide effective and enhanced prevention
services, (5) Strengthen accountability. Implemented:
PACT Teams, Suicide prevention project, Co-occurring
initiated, Therapeutic Foster Care, Medication Algorithm
Project, and NAMI Pt. education project. Significantly
downsized state hospitals. Statewide adoption of seclusion
and restraint reduction activities.
SMHA All
No
Georgia
Staff training on person-centered planning to ensure
individualized plan of care for consumers; Emphasis on
recovery through peer support; Introduced staff training and
capacity development initiative to increase services to
consumers with co-occurring disorders; Identification of
gaps in services and Development of strategies to expand
EBPs; Community support teams and ACT teams in place
for all regions; 11 peer centers that are social & vocational
oriented; measurement of community integration with
symptom management; Provider contracts mandate service
availability; First state to combine MH & SA block grant
dollars to create two co-occurring peer centers
.
SMHA 5;
specific
-ally to
advance
EBPs
No
Guam
Launching a strategic planning process that includes the
NFC report as a focus with broad stakeholder involvement
in context of overall redesign of the territory’s government.
SMHA
No
Hawaii
MH Director has written a proposal to the governor for a
major initiative based NFC recommendations; Governor
was elected with MH as part of platform; State is operating
under a court order to develop a community plan in which
SMHA is attempting to crosswalk that plan with the NFC
SMHA;
Office
of
the Governor
No
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report, resulting in two foci: (1) How can a comprehensive
state plan be developed? And (2) What can be done about
criminalization? Outcomes of process are uncertain
pending Governor’s response to proposal. Report has
prompted a general look at opportunities for linkage.
Idaho
No formal initiative has yet developed due to NFC report,
however it is being used to strengthen existing initiatives.
Reorganization is underway, resulting in: Integrated service
teams and Examination of standards of practice for ACT.
“Healthy Connections” Medicaid gatekeepers are being
better trained in MH. Planning council is using the NFC
report as the focus for an upcoming legislative breakfast.
SMHA;
Medicaid
Officials; MH
Planning Council;
Legislature
No
Illinois
Legislation established a Children’s MH Partnership and
directed the Governor to appoint a 25 member task force to
look at the re-organizing the Children’s MH System. A
preliminary report is due to the Governor by 9/2004, and
the final report is due 6/2005. Created a new organizational
chart with three deputy directors (one clinical operations
and two program directors – child and forensic) to help
identify them as a serve line – manage DSC – MH is now
positioned in a way to look at things differently. This was
used as an opportunity to bring the NFC report as a
resource to stimulate and solicit community input.
Participated in Children’s MH Policy Academy.
SMHA;
Legislature;
Secretary of Health
and Human
Services
No
Indiana
Went to key agencies and asked questions about root causes
and how partnering might help, especially on children’s
issues. Participated in a Policy Academy on Early
Screening Assessment & Treatment with Child Welfare
with different options; Development of effective children’s
systems of care; Implementation of screening, assessment,
and effective treatment for children in the child welfare
system with MH and SA needs; Development of results-
based funding initiative for supportive employment services
in communities; Formation of Cultural Competency
Committee within SMHA; Development of co-occurring
disorders strategies; Implementation of Illness Management
and Recovery (IMR) in one-third of state CMHCs;
Development of trainings on WRAP.
SMHA;
state
Office of
Consumer and
Family Affairs;
state task forces
community-based
issues; state Office
of Vocational
Rehabilitation;
state Department of
Corrections
2.1; 4.1;
4.3; 2.2;
2.3; 2.5;
3.1; 4.3;
5.3
No
Kansas
Implementation of NFC report joint initiative by Targeted
TA group collaboration with Jane Adams and a newly
established Mental Coalition of Kansas MH stakeholders;
Implementation of new braided contract with SA and
juvenile justice that uses MH centers (3 funding streams) to
do collaborative work; Working with public health and
bioterrorism.
ongoing SMHA
To
be
determi
ned
Yes
Kentucky
Numerous initiatives underway that track recommendations
of the President’s Commission:
Suicide Prevention Planning Group has developed
a prevention plan to be implemented through
collaboration with stakeholder agencies.
Screening for mental health needs begin in county
jails as part of a 2002 funding initiative, as do jail
staff training and collaboration between jails and
mental health programs.
Kentucky has received a SAMHSA Education and
Training grant to promote the use of medication
algorithms, including use of a web-based system
for tracking medication usage.
SMHA;
MH
Planning Council;
Statutorily
Authorized
Planning Body
“HB843
Commission”
1.1;
No
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The HB 843 Commission charged with creation of
an integrated state plan for treatment and support
for individuals with mental illnesses, substance
addictions, and co-occurring disorders
“Anti-Stigma Work Group”
Professional Staffing Work Group to make
recommendations for recruitment of professional
staff
Consumer-driven advocacy effort to pass Advance
Psychiatric Directive legislation in the 2003
General Assembly.
Current state regulations require individualized
Plans of Care for consumers of community mental
health services.
Individualized outcomes for children with SED are
tracked through the IMPACT Evaluation System.
Individualized adult outcomes will be tracked as
part of a federal information systems improvement
project.
The Kentucky Consumer Advocacy Network (KY
CAN) will be conducting peer reviews of Regional
MH/MR Boards to measure system’s orientation
towards recovery, its quality, and its effectiveness.
Early Childhood Mental Health Initiative places
consultant in each of Kentucky’s 14 MH regions.
Louisiana
Active conversion of current initiatives to follow NFC
recommendations. Re-established ACT teams;
Implementing treatment algorithm with monitoring
protocols; Receipt of COSIG grants; Establishment of
statewide telecommunications education system; Began
several early childhood initiatives under the “children’s
cabinet” in the Office of the Governor.
SMHA;
Office
of
the Governor
No
Maryland
Report is in background of activities and justifies SMHA
plans. Involvement in national EBP project used for
development of practice implementation on broader scale;
Promotion of knowledge and utilization of EBPs;
Development of: (1) recovery oriented activities (held
annual conference on recovery last year), (2) relationships
with various constituencies including providers, (3)
comprehensive plan and early childhood intervention, and
(4) school-based MH services in several schools.
SMHA;
Childhood
MH Steering
Committee;
University of
Maryland;
Dartmouth College
Virtuall
y All
No
Massachusetts
Development of new 3-year state MH plan which will focus
on relationship between mental and physical health, anti-
stigma activities as one of eight pilot sites in SAMHSA’s
Elimination of Barriers Initiatives, the development,
refinement, and utilization of technology to provide
efficient and effective care. Recently reorganized state
Executive Office of Health and Human Services and moved
Medicaid Behavioral Health Care Programs to the
Department of MH; Raised public MH awareness of state
agencies (ex. the school-based toolkit).
SMHA;
Executive
Office of Health
and Human
Services
2.4; 2;
1.2; 1.1;
6.1; 6.2
No
Michigan
The Dept. of Community Health has been moving toward
integrating key elements of a recovery orientation in its
public MH programs. State law provides all consumers an
entitlement to person-centered services; state has modified
its contractual expectations of community MH programs
and launched a comprehensive training program statewide
to promote adoption of person-centered planning. Last
SMHA 2.1;
2.2;
Yes
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year, the Dept. requested targeted TA around its new efforts
to install consumer-directed services for adults with serious
mental illnesses. Governor has formed an advisory
commission to evaluate the state’s MH system and make
recommendations for improving the public MH system.
Montana
Operating under a statutory mandate to produce a plan for
regional MH authorities through regional advisory groups
that include many consumers; issues receiving most
attention are co-occurring disorders and Medicaid redesign.
SMHA
No
Nebraska
Mental health is part of team governor and others plan to
focus on housing – hoping to get a re-codification of mental
health statutes – part of plan involves closing state facilities.
SMHA
No
Nevada
Development of legislative package; Legislative
Commission meetings; Development of model report.
2003-
2004
Senate; SMHA
Yes
New Hampshire
Report used to validate and support preexisting activities
and initiatives, especially for evidence-based practices;
Assist with state strategic planning efforts.
SMHA
No
New Jersey
Report is the tapestry used by SMHA to validate activities
and initiatives. Activities underway to align children’s
services and federal funding more effectively.
SMHA 2.3
No
New Mexico
Redesign of the system is underway independent of NFC;
Creation of purchasing collaborative with use of NFC Goals
and recommendations as guidelines for the process; An
example of a specific area of implementation is a move
towards electronic charting in all four regions; the process
is expected to take 18 – 24 months.
12/18/03-
12/19/03
SMHA 2.3
Yes
New York
Report used to raise public awareness including public
information campaign targeted at stigma and awareness of
other state agencies and governor's office.
SMHA 1.1;
1.2
No
North Carolina
Mandated reform act “looks like” NFC recommendations;
EBPs are embedded in Medicaid plan “Talking” about
recovery statewide.
SMHA
No
North Dakota
Development of plan for goal implementation through the
Mental Health Planning Council
SMHA;
Mental
Health Planning
Council
All No
Ohio
Alignment with 2001 state level commission; Development
of the Balanced ScoreCard with 20+ measures and
Alignment with NFC recommendations; Development of
new state plan; Development of two major interagency
efforts with Governor’s Office: updating the state’s
Olmstead plan (Ohio Access) and updating the
collaborative/interagency approach to children’s services
(Family and Children First)(also focusing on children,
budgeting and long-term care); more involvement of
consumers and families as stakeholders; early stages of
making the NFC recommendations part of the management
scorecard by identifying the number of objectives.
SMHA;
Governor;
state children’s
agency; 2001 Ohio
state level
commission;
consumers and
families
All No
Oklahoma
Expansion and implementation of strategic plan goals to
coincide with NFC Goals; MH Planning Council has set
aside discussion time for implementation of the report’s six
goals which will directly guide the FY05 MH Block Grant
Application; Continuation of public information and anti-
stigma efforts; distribution of suicide prevention and
toolkits to schools; Collaboration with State Department of
Health; Evaluation of behavioral health system and service
integration with Medicaid; Expansion of consumer services;
Collaborative initiatives with criminal justice partners,
including with Department of Corrections to support
SMHA;
Mental
Health Planning
Council;
Department of
Health; Department
of Education; State
System of Care
Committee;
Universities;
Department of
Corrections; Office
All No
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treatment planning for those with mental illnesses who have
been incarcerated and are re-entering the community;
Development of supported housing models; Seclusion and
restraint initiatives (reduction and elimination); System
wide cultural competency training; Promotion of full range
of treatment services in all rural settings; Collaboration with
Department of Health to identify MH and SA as public
health issues with emphasis on public and early education;
Strengthened relationship with Department of Education on
MH Planning Council and state System of Care Committee;
Implementation of jail diversion programs including CIT
and Mental Health Court; Continued promotion, including
university collaboration, on evidence-based practices;
Development of disaster planning; Expansion of children’s
MH services; Promotion of recovery-oriented services;
Update information management and clinical records
systems; Development of ongoing performance
measurement system indicator report; In-depth study from
the Governor and Attorney General’s office of cost
associated with each agency – have a special blue ribbon
task force looking at SA, MH and the cost for the state and
found the fragmentation highlighted in the report;
Partnership council (9 state agency heads to make decisions
for unified plan (universal assessment tool); Held Policy
Academy with Children’s Initiatives and will have a unified
plan for Behavioral Health.
of the Governor;
state Attorney
General
South Carolina
Agency-wide meeting (including consumers, legislators,
and community MH board members) with Dr. Michael
Hogan (NFC overview) and Dr. Larke Huang (children’s
systems of care) - resulting in recommendations to expand
evidence-based practices, continued focus on recovery and
consumer/family involvement; Implementation of statewide
priorities based on local stakeholder input and agency
leadership which are deployed using local action plans;
Development of statewide focus groups with stakeholders
to lay framework for new strategic plan in Spring 2004;
Statewide adoption of recovery framework; Implementation
of Children’s EBPs; $2 million of new funding; Work to
reduce seclusion and restraint; Development of legislative
package; Implementation of NFC recommendations in new
strategic plan.
Spring
2004;
Meeting
12/5/03
Gov. office;
SMHA;
community MH
board members
All Yes
Tennessee
More efficient and effective planning involving consumers
and families; Improvement of inpatient services;
Implementation of recovery-based services; Increase of QI
activities and Request for TA in variety of areas; Housing
initiative with supports including training and employment;
effort to reduce seclusion and restraint; Suicide prevention;
Pursuing medication algorithms.
SMHA;
Consumers
and families
2; 5
No
Texas
Initiated a summit to build consensus on NFC
recommendations, including specific EBP’s: medical
algorithm, disease management, and others; developing a
consensus document and action standards; Benefit Design -
plan to pay only for EBPs – recovery/resilience orientation.
SMHA
Yes
Utah
A “steering committee” has been created to focus on NFC
recommendations, not just in MH but also SA; Report and
recommendations will be focus of the 2004 annual MH
conference; Overtures have been made to the new
Governor, and creation of a commission in Utah is possible.
SMHA
No
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Virginia
Aligning existing activity with NFC goals. Implementation
of local, regional and state strategic planning to expand
community-based services and access to recovery-oriented
programs; Using strategic planning to strengthen DMH
leadership role; Using recovery implementation model;
Implementing hospital to community based system
initiatives; Development and implementation of consensus
strategies and work plan on EBPs and recovery-oriented
services; Implementation of state Olmstead Task Force
report recommendations; Development of: (1) regional and
state level partnership planning to restructure state public
MH services system to reduce reliance on state facilities
and move more appropriately to the community; (2)
statewide strategic planning focusing on service needs,
system challenges and opportunities, and potential EBPs for
special population groups such as children; (3) SMHA
strategic planning to foster empowerment, peer support, and
recovery-based services; (4) “recovery Roadmap” for a
recovery-oriented system of care through grant program to
collaborate with MH Planning Council and other
stakeholders.
SMHA;
MH
Planning Council;
State Olmstead
Task Force
2.2; 2.5;
4.1; 4.3;
5.2
No
Washington
A department-wide process to update the strategic plan
already underway; Effort to integrate NFC
recommendations into the plan.
SMHA
No
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West Virginia
Existing activities are being aligned with NFC
recommendations. WV University Medical School using
federal grant to expand its existing telemedicine technology
for greater clinical interaction with patients and clinics in
rural and mountainous WV. Technology may later be
linked to the court system in WV for the purpose of
conducting mental hygiene probable cause evaluations and
hearings, and to conduct forensic evaluations.
The Division of Children’s MH, SA and community
stakeholders are developing a three-year MH and SA State
Plan to address access to services, prevention, and meeting
the basic needs (based on a rehabilitation model) of
children with a mental illness or having SA problems
The Divisions of Alcoholism and Drug Abuse and Adult
and Children’s MH are jointly sponsoring a one year
training for practitioners on integrated service delivery; The
Division of Primary Care and BHHF are working towards
formalizing relationships between primary care and
behavioral health providers to decrease stigma associated
with treatment and to provide more consumer friendly
treatment.
WV-APROS, the State chapter of the International
Association of Psycho-Social Rehabilitation Services, WV
State College’s Community & Technical College, the West
Virginia Mental Health Consumers’ Association and BHHF
are working collaboratively to help educate, train and
prepare for certification of psychiatric rehabilitation
practitioners.
State operated facilities installing VistA - a HIPAA
compliant software provided by the Dept. of Veterans
Administration. The WV Department of Health and
Human Resources is developing a master client index
which can be used by the Bureau to link with other data and
registries maintained by the Department such as WIC, other
maternal and child health services, food stamps and other
human services administered by the Department,
immunization, primary care services, etc.
Increased Olmstead compliance via an expanded Olmstead
compliance plan; Suicide prevention to identify, intervene
and treat adolescents and adults in WV at risk of suicide;
The WRAP or Wellness Recovery Action Plan Program;
Released request for proposal for supported employment;
ACT team implemented; The Secretary of DHHR has
initiated an Interagency Council on Homelessness and
Chronic Homelessness replicating a similar effort at the
federal level. A Policy Academy will kick this off next
month.
SMHA;
The
Bureau for
Behavioral Health
and Health
Facilities (BHHF);
DHHR
multiple No
Wisconsin
Using report as support for programs regarding children’s
initiatives including the integration of the foster care system
entered into managed care (added substance abuse, mental
health screening into the contract).
SMHA
No
Wyoming
Summit held to review goals and objectives of NFC report;
Development of multiple stakeholder involvement plan in
SMHA;
Governor/Cabinet
1 (in
particul
No
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NFC recommendations implementation; Implementation of
family to family education; Development of state MH Plan
cross-walked with goals; Development of school-based
programs and focus on early intervention and prevention;
Legislative initiative on access to care through MH parity
and Medicaid waivers; Implementation of more connective
technology within the state; Development of a number of
multiple state stakeholders meetings; Requests for biennial
budget will be planned in light of NFC goals, emphasizing
primary care and child MH waiver.
ar,
within
context
of
primary
care); 2;
6
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