National Alliance on Mental Illness
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Action Needed to Preserve Medicaid Funding for ACT Programs

In response to the tragedy unfolding in the Gulf States following the destruction wrought by Hurricane Katrina, NAMI has created a resource center on our Web site and established a fund to aid victims of the hurricane with serious mental illnesses and their families.  To find information and to learn more about how you can help, visit

September 2, 2005

On September 6, Congress returns from its month-long summer recess and will begin work on a massive budget measure that includes a requirement to limit future Medicaid spending by $10 billion over the next 5 years. Among the proposals under consideration is a significant restriction on the ability of state Medicaid programs to support intensive case management for children and adults with severe mental illness. In recent years, many states have begun using available options under Medicaid (targeted case management and rehabilitation) to finance intensive case management as part of assertive community treatment (ACT) programs.

Despite the fact that a Medicaid Reform Commission rejected this proposal, it is still expected to receive serious consideration in Congress. As early as next week, both the Senate Finance Committee and the House Energy & Commerce Committee will consider a proposal initiated by the Bush Administration to modify the definitions of both targeted case management and rehabilitation to exclude ACT programs that are run by public mental health agencies and CMHCs.

Action Required

Advocates are strongly encouraged to forward the attached letter to members of Congress urging them to:

  • oppose restrictions to the definition of rehabilitation and case management services recommended by the Bush Administration,
  • oppose increases in co-payments for non-preferred prescription drugs covered under Medicaid, and
  • oppose efforts to restrict access to medications to treat mental illness through prior authorization, step therapy and mandatory therapeutic substitution requirements implemented as part of state supplemental rebate programs.

Because of current delays related to screening of all U.S. mail going into congressional offices, it is highly recommended that advocates forward letters to their state's congressional delegation by using fax machines and e-mails (please identify your home address in all e-mail messages). Given the urgency, advocates are also urged to contact congressional offices by phone.

Enter your zip code below to access a sample letter on this issue and a list of your representatives to contact now.  If you do not see the box for entering your zip code, click here.

At a August 18 hearing, NAMI offered testimony to the HHS Medicaid Reform Commission, outlining concerns about higher beneficiary co-payments, rehabilitation and case management services, restricted access to medications, the IMD exclusion and other issues. Click here to view the NAMI testimony.

Click here to view background information on actions taken by the HHS Medicaid Commission on August 18 and current Medicaid issues now before Congress.

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