Legislative and Administrative Changes Needed in Community Mental Health Centers Program

HRD-79-38: Published: May 2, 1979. Publicly Released: Jun 4, 1979.

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A review of the Department of Health, Education, and Welfare (HEW) community mental health centers program discusses problems in monitoring the program as well as problems encountered by HEW, the States, and the individual centers in complying with legislative provisions. Responsibility for administering the program has been delegated to the National Institute of Mental Health (NIMH), under HEW.

Administrative and legislative changes must be made if the goal of a national network of community mental health centers is to be realized in the foreseeable future. The centers visited were experiencing many problems which hampered their effectiveness due, in part, to the limitations on the geographic areas served, the complexity and inflexibility of legislative requirements, and the multitude of funding mechanisms imposed by HEW. State, local, and third-party reimbursements must increase to assure the financial viability of existing centers and the development of new centers. Conversion and financial distress grants have been ineffective as a means for establishing or expanding services on a long-term basis. Administrative changes are needed to improve the efficiency of the grant review, approval, and monitoring process.

Matter for Congressional Consideration

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Matter: Congress should amend the Community Mental Health Centers Act to: allow the Secretary of HEW to waive the requirement for any of the mandated services in certain cases; eliminate the provision for conversion and financial distress grants; restrict consultation and education grants to organizations not receiving staffing or initial operations grants; and allow HEW to award grants for other than a 1-year period. Congress should also explore development of a funding mechanism that would allow communities which are unable to develop full service centers to provide at least for their highest priority needs.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of HEW should: require NIMH to identify communities that cannot apply for Federal community mental health center funding under the current rules due to geographic limitations, work with the States to revise the catchment area designations to allow those communities to apply; examine the possibility of consolidating or standardizing grants and grant periods to reduce administrative burden; require regional offices to follow specified grant application review procedures; improve reporting and monitoring procedures for the construction grant program; prescribe and implement standards for the centers; and work to assure that coordination, screening, and aftercare procedures are established with State and Veterans Administration mental health facilities.

    Agency Affected:

 

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