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Federal Action Alert: Grassroots Action Needed To Allow Block Grants To Effectively Serve Persons With Co-Occuring Disorders

Congress And Governors Need To Hear From NAMI Members

Chris Marshall
For Immediate Release
2 Apr 99
National studies commissioned by the federal government estimate that 10 million Americans have co-occurring mental and addictive disorders. Disagreements between the mental-illness and addictive-disorders communities over shared responsibility for persons with these co-occurring illnesses has become an obstacle to the legislative reauthorization of the Substance Abuse and Mental Health Services Administration (SAMHSA), the federal-government agency charged with administering services programs for these two populations.

Staff members of the Senate Committee on Health, Education, Labor, and Pensions (HELP) are drafting legislation to reauthorize the Substance Abuse and Mental Health Services Administration (SAMHSA). NAMI, the National Mental Health Association, the Bazelon Center for Mental Health Law, and others have been advocating that both the Mental Health Block Grant and the Substance Abuse Block Grant effectively and equitably finance integrated treatment programs for persons with co-occurring mental and addictive disorders. Because of opposition by the substance abuse community, in many ways supported by SAMHSA’s staff, Senate HELP staff have not allowed such effective and equitable financing.


1. Contact your governor and request that he or she ask members of the United States Congress to expressly allow both block grants to financially support integrated-treatment programs in SAMHSA reauthorization. A list of governors and their telephone numbers is provided at the end of this alert.

2. Contact your members of the United States Congress and encourage them to expressly allow both block grants to support integrated-treatment programs in SAMHSA reauthorization. All members of Congress can be reached by calling the Capitol Switchboard at 202-224-3121. Fax, email and mail addresses can be accessed through the policy page on the NAMI website at and click on Write to Congress.

3. As the immediate debate is before the Senate HELP Committee, their roster is listed below. These contacts are urgently needed.

James Jeffords, Chairman (R-VT), Edward Kennedy, Ranking Member (D-MA), Judd Gregg (R-NH), Christopher Dodd (D-CT), William Frist (R-TN), Tom Harkin (D-IA), Mike Dewine (R-OH), Barbara Mikulski (D-MD), Mike Enzi (R-WY), Jeff Bingaman (D-NM), Tim Hutchinson (R-AK), Paul Wellstone (D-MN), Susan Collins (R-ME), Patty Murray (D-WA), Sam Brownback (R-KS), Jack Reed (D-RI), Charles Hagel (R-NE), Jeff Sessions (R-AL).


At issue is a proposal by the mental illness community that SAMHSA’s two block grants (mental health and substance abuse) effectively and equitably co-finance integrated-treatment programs for persons with co-occurring disorders. This is known as "blended funding." Integrated treatment means mental illness and addictive disorders services and interventions are delivered simultaneously at the same treatment site, ideally with cross-trained staff. What is not considered integrated treatment is sequential treatment (treat one disorder first, then the other) or parallel treatment (in which two different treatment providers at separate locations use separate treatment plans to treat each condition separately but at the same time).

The addictive-disorders community argues against state discretion to combine mental-health and substance-abuse block grant funds expressly for integrated treatment because of waiting lists for other priority populations such as people with AIDS who are substance abusers and pregnant women who are substance abusers. This community further argues that integrated treatment programs can be jointly financed now so long as each and every requirement contained in both block grants, including reporting and auditing requirements, is fully met. Integrated-treatment providers argue that the requirement that every penny of the substance abuse block grant be exclusively spent on addiction services and that every penny of the mental health block grant be exclusively spent on mental health services are obstacles because such exact and strict reporting adherence does not allow financing of cross-trained staff and integrated non-clinical support services.

As an alternative to giving states discretion to combine block-grant funds expressly for integrated treatment, the addictive-disorders community advocates a new federal government discretionary and competitive grant program to demonstrate how integrated-treatment programs can work and a two-year study of the issue. The mental-illness community believes it is unrealistic in 1999 to expect the federal government to establish a brand-new grant program (whose funds will likely go only to exemplary programs) and that such a program would delay resolution of the core issue: should not both block grants financially support integrated treatment for persons with co-occurring disorders?


NAMI and other mental illness advocates are merely asking that states be allowed to blend block grant funds for integrated treatment, that states should report how they have spent block grant funds for integrated treatment, and that SAMHSA’s reporting requirements will not prevent such blending of funds. The exact language we are seeking would amend Section 1955 of the Act and reads as follows:

"A State receiving amounts under section 1911 or 1921 may use a portion of such amounts to fund integrated treatment services for individuals who have co-occurring serious mental illness and addictive disorders. The Secretary shall obtain appropriate program data on integrated treatment programs. In administering this section, the Secretary shall ensure that federal reporting requirements do not unduly hinder States in their ability to combine or commingle funds from section 1911 and 1921 in order to provide an integrated program of services to individuals with co-occurring disorders."

The 50 Governors
Alabama Don Siegelman (D) 205-242-7100
Alaska Tony Knowles (D) 907-465-3500
Arizona Jane Dee Hull (R ) 602-542-4331
Arkansas Mike Huckabee (R ) 501-682-2345
California Gray Davis (D) 916-445-2841
Colorado Bill Owens (R ) 303-866-2471
Connecticut John G. Rowland (R ) 203-566-4840
Delaware Thomas R. Carper (D) 302-739-4101
Florida Jeb Bush (R ) 904-488-4441
Georgia Roy Barnes (D) 404-656-1776
Hawaii Benjamin J. Cayetano (D) 808-586-0034
Idaho Dirk Kempthorne (R ) 208-334-2100
Illinois George Ryan (R ) 217-782-6830
Indiana Frank L. O’Bannon (D) 317-232-4567
Iowa Tom Vilsack (D) 515-281-5211
Kansas Bill Graves (R ) 913-296-3232
Kentucky Paul E. Patton (D) 502-564-2611
Louisiana Mike Foster (R ) 504-342-7015
Maine Angus King (R ) 207-287-3531
Maryland Parris N. Glendening (D) 410-974-3901
Massachusetts Argeo Paul Cellucci (R ) 617-727-3600
Michigan John Engler (R ) 517-373-3400
Minnesota Jesse Ventura (Reform) 612-296-3391
Mississippi Kirk Fordice (R ) 601-359-3150
Missouri Mel Carnahan (D) 573-751-3222
Montana Marc Raciciot (R ) 406-444-3111
Nebraska Mike Johanns (R ) 402-471-2244
Nevada Kenny Guinn (R ) 702-687-5670
New Hampshire Jeanne Shaheen (D) 603-271-2121
New Jersey Christine Todd Whitman (R ) 609-292-6000
New Mexico Gary E. Johnson (R ) 505-827-3000
New York George E. Pataki (R ) 518-474-8390
North Carolina James B. Hunt (D) 919-733-4240
North Dakota Edward T. Schafer (R ) 701-328-2200
Ohio Bob Taft (R ) 614-644-0813
Oklahoma Frank Keating (R ) 405-521-2342
Oregon John Kitzhaber (D) 503-378-3111
Pennsylvania Tom Ridge (R ) 717-787-2500
Rhode Island Lincoln C. Almond (R ) 401-277-2080
South Carolina Jim Hodges (D) 803-734-9818
South Dakota William J. Janklow (R ) 605-773-3212
Tennessee Don Sundquist (R ) 615-741-2001
Texas George W. Bush (R ) 512-463-2000
Utah Michael O. Leavitt (R ) 801-538-1000
Vermont Howard Dean (D) 802-828-3333
Virginia James S. Gilmore III (R ) 804-786-2211
Washington Gary Locke (D) 206-753-6780
West Virginia Cecil H. Underwood (R ) 304-558-2000
Wisconsin Tommy G. Thompson (R ) 608-266-1212
Wyoming Jim Geringer (R ) 307-777-7434