Memorandum Date: March 5, 1993 To: Senator Dole From: Alec Vachon Re: Request to Co-Sponsor a Concurrent Resolution on Equitable Mental Health Care Benefits (End of Letterhead) Senator Shelby has asked if you would sign on as an original co-sponsor to the attached concurrent resolution. It calls for mental health care benefits to be provided equitably with physical care benefits in any health care reform package. The resolution's 23 "Whereas" clauses appear to be factually accurate, and the six resolution clauses express good intentions about access to mental health care, quality of care, consumer choice, etc., without any specifics that might be controversial. You were one of the two original co-sponsors (together with Senator Simon) of a very similar resolution introduced by Senator Shelby last year, which died without enactment at the end of the session. Final tally of last year's co-sponsors was 18 Democrats and 8 Republicans. Senator Simon has agreed to be an original co-sponsor again this year; Senator Shelby does not intend to ask any other Senators to be original co-sponsors. WILL YOU CO-SPONSOR THIS RESOLUTION? YES X NO cc: G. Schnacke, D. Stanley 103d CONGRESS 1st SESSION S. CON. RES. (End of Title) IN THE SENATE OF THE UNITED STATES Mr. SHELBY submitted the following concurrent resolution; which was: CONCURRENT RESOLUTION Expressing the sense of Congress that equitable mental health care benefits must be included in any health care reform legislation passed by Congress. Whereas mental illness and substance abuse disorders are prevalent throughout our society; Whereas approximately 19 percent of the adult population in the United States have a diagnosable mental illness or a substance abuse disorder within any 6-month period; Whereas mental illness and substance abuse disorders can strike at any point during a person's lifetime; Whereas 20 percent of Americans under the age of 18, or approximately 7,500,000 children and adolescents, have some type of mental illness or emotional disorder; Whereas 4/5 of children in need of mental health care do not receive services, resulting in significant costs to society as these children become adults; Whereas approximately 1/3 of homeless people have a mental illness and approximately 40 percent of homeless people have a substance abuse disorder; Whereas there are more Americans with a serious mental illness in prisons and street shelters than in hospitals; Whereas the incidence of mental illness and mental health problems is very costly both to the individual with a mental disorder and to society as a whole; Whereas mental illness and substance abuse disorders are devastating to the lives of those afflicted, as there exists a direct and close relationship between mental health and overall well-being; Whereas American businesses lose over $100,000,000,000 per year due to lost productivity of employees because of substance abuse and mental illness; Whereas annual direct costs of treatment for mental illness and substance abuse disorders are estimated at $68,000,000,000 and annual indirect costs due to lost productivity, lost employment, vehicular accidents, criminal activity, and social welfare programs are estimated to be approximately $250,000,000,000; Whereas significant progress has been made within the last 10 years in research into the causes and treatments of mental illnesses, and many such illnesses are now treatable; Whereas 70 percent of clinically depressed patients can be specifically treated by psychotherapy, and 80 percent or more of clinically depressed patients can be successfully treated by combined psychotherapy and psychopharmacologic treatments; Whereas pharmacologic intervention for schizophrenia and bipolar disorders, coupled with appropriate rehabilitative services, can dramatically reduce the rehospitalization rate for those afflicted with these disorders, improving the ability of such individuals to live productively in the community; Whereas the success rate for the treatment of panic disorders is between 70 percent and 90 percent; Whereas significant numbers of persons with mental illness in the United States find it difficult, if not impossible, to secure needed health care; Whereas only approximately 30 percent of those in need of mental health services actually receive them; Whereas mental health care is treated differently from care for other health conditions in both public and private financing systems; Whereas 99 percent of insured individuals and their families have private health coverage for some inpatient mental health treatment, but only 21 percent have coverage for other illnesses, and only 2 percent have coverage for outpatient care that is equivalent to their coverage for other illnesses; Whereas many private insurance programs continue to discriminate against individuals with mental illness or substance abuse disorders under public insurance programs, such programs continue to discriminate against these individuals, as evidenced by the fact that the Medicare program has a 50 percent copayment requirement for mental health care services but only a 20 percent copayment requirement for all other services; and Whereas businesses, consumers, and Federal and State governments are already paying for mental health care for the uninsured and underinsured in an inefficient and inequitable manner, resulting in much unnecessary pain and suffering for those afflicted with mental disorders as well for their families. Now, therefore, be it Resolved by the Senate (the House of Representatives concurring). That is the sense of Congress that any legislation enacted to reform the health care delivery system of the United States must ensure that every person has access to coverage for medically and psychologically necessary treatments for mental disorders that is equitable to the coverage provided for treatments for physical illnesses, and should contain the following provisions: (1) Provisions providing for coverage of a broad array of mental health and rehabilitation services for individuals of all ages. (2) Provisions guaranteeing that mental health services will be available based on medical or psychological necessity, including provisions prohibiting discrimination through the imposition of arbitrary barriers to mental health services. (3) Provisions to ensure that services are based on individual need and informed choice, with consumer participation in treatment decisions. (4) Provision providing financial protection for individuals and their families with mental health needs to prevent these individuals and families from spending a disproportionate share of their income and resources to obtain services. (5) Financing policies that guide service delivery to the lowest cost settings consistent with appropriate care, including provisions ensuring that any managed care techniques used limit financial conflicts of interest and promote real efficiencies while protecting the patient's right to quality care, access to necessary care, and confidentiality. (6) Provisions to ensure that mental health services will be coordinated effectively with existing systems and programs of medical, income, residential, and social support at the Federal, State, and local levels. Richard Shelby Alabama Committee on Armed Services Committee on Banking, Housing, and Urban Affairs Special Committee on Aging 313 Hart Building Washington, D.C. 20510 (202) 224-5744 State Offices: 1800 Fifth Avenue North 327 Federal Building Birmingham, AL 35203 (205) 731-1354 Madison County Airport 218-217 Skycenter Complex Huntsville, AL 35806 (205) 772-0460 113 St. Joseph Street 438 U.S. Courthouse Mobile, AL 36602 (205) 694-4164 15 Lee Street B2BA U.S. Courthouse Montgomery, AL 36104 (205) 832-7303 1118 Greensboro Avenue Room 240 U.S. Courthouse Tuscaloosa, AL 38401 (205) 759-5047 UNITED STATES SENATE Washington, D.C. 20510 FACSIMILE COVER SHEET (End of Letterhead) To: Alexander Vachon Agency/Company/Department: Dole Fax #: From: Stewart Hall Date: Time: Total Pages to be Transmitted (including this page): 6 Comments: