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NAMI Washington 2009 State Legislative Positions

Our positions are guided by the following principles:

• The laws in this state must require that there be fair and just access to medical treatment and related supportive services for individuals with mental illnesses and their families and/or other support networks.
• Early intensive care and treatment - including hospitalization in some cases - has proven to reduce long-term illness and disability. It is the best way for the state to reduce its long-term cost for the mental health system and most importantly, to promote the potential for recovery for as many people as possible. In order to ensure the highest possible quality of service, the state should require programs, treatments and other services to be evidence-based or promising practices.
• Treatment and related assistance needs to be holistic and comprehensive and should include the person’s psychiatric and general physical health, employment potential, housing, social network and mobility. These programs need to work in collaboration with one another and be recovery based.
• Involved family members, friends and others in an individual’s chosen ‘support network’ should have a positive, pro-active role in treatment planning and evaluating treatment effectiveness
• Community mental health organizations, private business and government entities must come together as collaborative partners in the treatment of mental illnesses and the reduction of societal stigma surrounding mental health issues.

2009 Legislative Agenda

TOP PRIORITY ISSUES

Decriminalize mental illness: The 1963 Federal Community Mental Health Services Act stated that persons with mental illness "shall be treated in the least restrictive environment." Washington's Executive, Legislative, Administrative and Judicial branches of government, as well as the general public are calling for a reversal of putting persons with mental illness in jail, with family advocates asking for a decrease in the percentages of persons with mental illness entering the criminal justice system. Thus, NAMI supports legislative proposals that will ameliorate this inhumane practice. Specifically in 2009, NAMI proposes that the legislature enact legislation to support the following initiatives – all relating to the decriminalization of mental illness:

1. Establish Certificates of Restoration of Opportunity – would act to bar the use of criminal records to deny housing, education and employment.
2. Change Medicaid Eligibility for People in Institutions – would remove known barriers to re-entry success for incarcerated/hospitalized individuals, allowing for quicker access to Medicaid supported services upon release.
3. Provide Statewide Crisis Intervention Team (CIT) Training – provide a grant program through the WA. State Criminal Justice Training Commission accessible by all WA. state jurisdictions – to train first responders to be more effective and safe during crisis calls involving persons de-compensating from mental illness, co-occurring disorders and other associated crises. Mental health training should also be provided to all court personnel.
4. Provide a Study Bill re Electronic Medical Records – to examine the feasibility of implementing such a program for all offenders sentenced in Superior, District, Municipal, Mental Health and Drug Diversion Courts, to create a single database containing mental health and chemical dependency information for all involved agencies to have access for legal purposes and continuity of care.
5. Waiver of Fines, Court Costs and Interest for individuals living with a mental illness/chemical dependency – costs which end up accumulating over time to the point where they become impossible to pay, the result being the people being in contempt of court and ending up in jails and prisons.
6. Support automatic restoration of voting rights for felons after they have served their time – recognizing that those suffering with a mental illness who are convicted of a felony before they are receiving treatment later go on to recover; this action allows for quicker restoration of this important citizenship right.

Revise Current Legislation to Allow for Greater Family Member Input to Mental Health Treatment Decisions: Current law excludes considering essential information from family members of those with mental illness, information relevant in making decisions with respect to treatment. In practice under current law, persons with a mental illness needing timely assessment and treatment, even if refusing to volunteer for such treatment, often remain untreated until the illness and related behaviors reach a crisis stage. Current law only recognizes treatment under imminent danger conditions. The wording for this legislation must be revised to allow family input while still allowing for the rights of those living with a mental illness to be considered in the process.

Continuation of NAMI Washington 2009 Top Priority Issues

At a minimum, Maintain the State Share of Mental Health Funding: Experience is showing that many non-Medicaid mental health services (emergency treatment, reimbursement for sliding scale programs, community-based services, etc.) are encountering funding shortfalls, endangering program service delivery. Too many individuals who do not qualify for Medicaid assistance but do not make enough money to adequately cover needed services are falling through the (service) cracks. Recommend an increase of state-only funding for the above non-Medicaid-covered services and for individuals and families not covered under Medicaid in order to achieve parity with those receiving Medicaid funding.

Support Increased Availability of Psychiatric Inpatient Facilities: Inpatient mental health evaluation and treatment is an essential public health and safety function. There is now a critical shortage of both voluntary and involuntary treatment facilities at all levels of service all across Washington State. NAMI supports legislation that will increase numbers of inpatient facilities including increasing reimbursement rates to community hospitals and stopping bed reductions at state hospitals to allow time for community programs such as the Program of Assertive Community Treatment (PACT) to mature sufficiently to assist in at least partially accommodating those reductions. A complete study of the entire inventory of psychiatric hospital beds in Washington State and their availabilities and interrelationships at all levels is needed.

Support Expansion of Supported Employment/Skill Building Programs for those living with Mental Illness: NAMI supports DSHS/MHD/Transformation Grant efforts to increase the use of employment in the recovery process, including employment and skill development at mental health clubhouses.

Preserve Washington State’s General Assistance – Unemployable (GA-U) Program: The Governor’s budget proposal calls for elimination of this state-funded program upon which over 21,000 people statewide depend, including many of those living with a mental illness. Without this support this vulnerable population will have no means to support themselves while they are working on alternative methods to do so, thus ending up on the streets, homeless or in jail or prison.

ADDITIONAL PRIORITIES

Expand Mental Health Services in Rural Areas: Complete mental health services are required no matter the number of individuals or families needing the services or the geographic location needing those services. Rural areas in Washington State are woefully underserved as relates to mental health needs. NAMI supports expansion of the existing pilot program currently serving a few selected Counties in Washington State.

Provide Affordable Housing to Meet the Needs of the Homeless and Those at Risk of Becoming Homeless: NAMI supports maintaining the Housing Trust Fund at least at current funding levels; the Fund is one of the state’s largest, most effective tools for creating affordable homes for very low income families and individuals with mental illness or other disability. We support the recommendations of the state’s affordable housing and homelessness consortiums as well as local, County and State 10 Year Plans to End Homelessness.

Develop a Comprehensive System of Recovery-Based Treatment and Related Services for those with Mental Illness: Treatment and related assistance needs to be holistic and comprehensive, providing not only continuity of care but also support for the individual’s psychiatric and general physical health, employment potential, housing, social network and mobility. These programs need to work in collaboration with one another and must be recovery based. NAMI supports:

• Complete Funding for PACT Teams: NAMI estimates that 8,841 services recipients need PACT services in Washington State, according to its April 2005 analysis of Washington State’s public mental health system “Can Crisis Beget Opportunity”. PACT is an evidence-based practice proven to lessen hospital use and increase employment among participants as well as successfully treat individuals, especially those with co-occurring disorders who are unsuccessful in traditional case management systems. The 2000 State Legislature began PACT development by allocating $4 million to establish up to 8 teams. As an important next investment in this proven program, Washington State should invest the additional monies needed to provide funding for PACT services in the remaining RSN regions.
• Expand Consumer/Advocate Run Mental Health Services: NAMI supports legislation and budget proposals that would ensure that consumer/advocate run services become an important part of the array of services offered and developed by the mental health service system, including Clubhouses. These kinds of programs are absolutely essential to any system of comprehensive, recovery-based treatment for mental illness.

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