House Appropriations Committee Fiscal Year 2007 Labor-Health
and Human Services (HHS)-Education Appropriations Bill
On June 13, the House Appropriations Committee approved its
version of the Fiscal Year 2007 Labor-Health and Human Services
(HHS)-Education Appropriations bill. The Committee report
accompanying that bill includes language, proposed by AAGP,
concerning several programs affecting the mental health of
older adults. Although report language is not binding, federal
agencies give careful consideration to such language as it
indicates programs or initiatives that are particularly important
to appropriators.
Committee Report Language
National Institute of Mental Health:
Mental Health For Older Americans: The Committee is aware
that demographics will demand a greatly increased focus on
mental disorders in older persons and commends NIMH for recently
recognizing the need to place higher priority on the mental
health needs of that population. The Committee encourages
the Institute to follow through on the 2004 recommendations
promulgated by the NIMH Aging Research Workgroup and the restructuring
of the Adult and Geriatric Treatment and Preventive Intervention
Research Branch. However, the Committee believes it is critical
that studies related to the elderly keep pace with the rapid
growth of this cohort. Despite the recent internal reorganization
to focus intervention efforts on the aging population, the
Committee encourages NIMH to continue to emphasize research
on adults over age 65 to reflect the growth in numbers of
this population, particularly in light of the public health
consequences of an inadequate knowledge base about late-life
mental illness. A correlating issue is the need for greater
numbers of investigators focused on late-life mental health
research. Therefore, the Committee encourages NIMH to expand
research in this area, including issues relating to neurodegenerative
disorders and to provide adequate resources to advance the
geriatric mental health research agenda. The Committee encourages
NIMH to continue its commitment to research on late-life mental
illness as a means to act as a catalyst for investigators
to focus on this critical area of research.
Substance Abuse and Mental Health Services Administration:
The mental health needs of our Nation's seniors are largely
ignored within our mental health system. While many older
Americans experience depression, dementia, anxiety and substance
abuse disorders, far too often these conditions are not recognized
or treated. Outreach to elderly persons conducted in places
frequented by seniors, such as senior centers, meal sites,
primary care settings and other locations, is needed. The
elderly treatment and outreach program is the only federally
funded services program dedicated specifically to the mental
health care of older adults. It is for this reason that within
the funds provided, the Committee recommends that no less
than the level allocated in fiscal year 2006 be allocated
for the older adults program.
Mental Health Block Grant: The Community Mental Health Services
Block Grant Program distributes funds to 59 eligible states
and territories through a formula based upon specified economic
and demographic factors. Applications must include an annual
plan for providing comprehensive community mental health services
to adults with a serious mental illness and children with
a serious emotional disturbance. Because the mental health
needs of our Nation's elderly population are often not met
by existing programs and because the need for such services
is dramatically and rapidly increasing, the Committee recommends
that SAMHSA require that states' plans include specific provisions
for mental health services for older adults.
Agency for Healthcare Research and Quality:
The Committee is concerned about the prevalence of undiagnosed
and untreated mental illness among older Americans. Affective
disorders, including depression, anxiety, dementia, and substance
abuse and dependence, are often misdiagnosed or not recognized
at all by primary and specialty care physicians in their elderly
patients. Research has shown that the treatment of mental
illness can improve health outcomes for those with other chronic
diseases. While effective treatments for these conditions
are available, there is an urgent need to translate advancements
from biomedical and behavioral research to clinical practice.
The Committee urges AHRQ to support evidence-based research
projects focused on the diagnosis and treatment of mental
illnesses in the geriatric population, and to disseminate
evidence-based reports to physicians and other health care
professionals.
Title VII Geriatrics Professions Programs
AAGP had requested (both in writing and in oral testimony)
that funding for the Title VII geriatrics health professions
programs be restored. All funding for that program had been
eliminated in the FY 2006 appropriations, and AAGP had advocated
that full funding--$31.5 million--be allocated for FY 2007
in order to restore funding to FY 2005 levels.
The Committee report states the following:
The Committee provides $31,548,000 for geriatric programs,
which is the same as the fiscal year 2005 funding level. Funding
for these programs was not included in either the fiscal year
2006 appropriation or the fiscal year 2007 budget request.
The geriatric programs are comprised of three activities:
(1) geriatric education centers; (2) the geriatric training
program for physicians, dentists, and behavioral and mental
health professionals; and (3) Geriatric Academic Career Awards.
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