The 2010-2011 resolution is: Be it resolved: the United States Federal Government should substantially reform the provision

of mental health services to the chronically mentally ill.

Court Cases Government Actions

 SAMHSA  Other government Definitions State vs. government Groups

2-9 10-18
10-17 18 19

Court cases Supreme Court mental health

Buck v. Bell April 22, 1927 --- Decided: May 2, 1927
1. The Virginia statute providing for the sexual sterilization of inmates of institutions supported by the State who shall be found to be afflicted with an hereditary form of insanity or imbecility, is within the power of the State under the Fourteenth Amendment. P. 207. 2. Failure to extend the provision to persons outside the institutions named does not render it obnoxious to the Equal Protection Clause. P. 208. ERROR to a judgment of the Supreme Court of Appeals of the State of Virginia which affirmed a judgment ordering [p201] the Superintendent of the State Colony of Epileptics and Feeble Minded to perform the operation of salpingectomy on Carrie Buck, the plaintiff in error.

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0274_0200_ZS.html

Skinner v. Oklahoma ex rel. Williamson

May 6, 1942 --- Decided: June 1, 1942

1. A statute of Oklahoma provides for the sterilization, by vasectomy or salpingectomy, of "habitual criminals" -- an habitual criminal being defined therein as any person who, having been convicted two or more times, in Oklahoma or in any other State, of "felonies involving moral turpitude," is thereafter convicted and sentenced to imprisonment in Oklahoma for such a crime. Expressly excepted from the terms of the statute are certain offenses, including embezzlement. As applied to one who was convicted once of stealing chickens and twice of robbery, held that the statute violated the equal protection clause of the Fourteenth Amendment. P. 537. 2. The State Supreme Court having sustained the Act, as applied to the petitioner here, without reference to a severability clause, the question whether that clause would be so applied as to remove the particular constitutional objection is one which may appropriately be left for adjudication by the state court. http://www.law.cornell.edu/supct/html/historics/USSC_CR_0316_0 535_ZS.html

Pennhurst State School and Hospital v. Halderman

Decided: April 20, 1981

December 8, 1980 ---

The Developmentally Disabled Assistance and Bill of Rights Act (Act) established a federal-state grant program whereby the Federal Government provides financial assistance to participating States to aid them in creating programs to care for and treat the developmentally disabled. The Act is voluntary, and the States are given the choice of complying with the conditions set forth in the Act or forgoing the benefits of federal funding. The "bill of rights" provision of the Act, 42 U.S.C. 6010(1) and(2), states that mentally retarded persons "have a right to appropriate treatment, services, and habilitation" in "the setting that is least restrictive of . . . personal liberty." Pennsylvania, a participating State, owns and operates Pennhurst State School and Hospital, a facility for the care and treatment of the mentally retarded. Respondent [p2] Halderman, a retarded resident of Pennhurst, brought a class action in Federal District Court on behalf of herself and all other Pennhurst residents against Pennhurst and various officials responsible for its operation. It was alleged, inter alia, that conditions at Pennhurst were unsanitary, inhumane, and dangerous, and that such conditions denied the class members various specified constitutional and statutory rights, including rights under the Act, and, in addition to seeking injunctive and monetary relief, it was urged that Pennhurst be closed and that "community living arrangements" be established for its residents. The District Court found that certain of the claimed rights were violated, and granted the relief sought. The Court of Appeals substantially affirmed, but avoided the constitutional claims and instead held that 6010 created substantive rights in favor of the mentally retarded, that mentally retarded persons have an implied cause of action to enforce those rights, and that the conditions at Pennhurst violated those rights. The court further found that Congress enacted the Act pursuant to both 5 of the Fourteenth Amendment and the spending power. Held: Section 6010 does not create in favor of the mentally retarded any substantive rights to "appropriate treatment" in the "least restrictive" environment. Pp. 11-32. (a) The case for inferring congressional intent to create, pursuant to Congress' enacting power under 5 of the Fourteenth Amendment, enforceable rights and obligations is at its weakest where, as here, the rights asserted imposed affirmative obligations on the States to fund certain services, since it may be assumed that Congress will not implicitly attempt to impose massive financial obligations on the States. Unlike legislation enacted under 5, however, legislation enacted pursuant to the spending power is much in the nature of a contract; in return for federal funds, the States agree to comply with federally imposed conditions. The legitimacy of Congress' power to legislate under the spending power thus rests on whether the State voluntarily and knowingly accepts the terms of the "contract," but if Congress intends to impose a condition on the grant of federal moneys, it must do so unambiguously. Pp. 15-18. (b) Applying the above principles to these cases, this Court finds nothing in the Act or its legislative history to suggest that Congress intended to require the States to assume the high cost of providing "appropriate treatment" in the "least restrictive" environment to

their mentally retarded citizens. There is virtually no support for the Court of Appeals' conclusion that Congress created rights and obligations pursuant to its power to enforce the Fourteenth Amendment. The Act nowhere states that that is its purpose, but, to the contrary, the [p3] Act's language and structure demonstrate that it is a mere federal-state funding statute. Section 6010, when read in the context of other more specific provisions of the Act, does no more than express a congressional preference for certain kinds of treatment. Far from requiring the States to fund newly declared individual rights, the Act has a systematic focus, seeking to improve care to individuals by encouraging better state planning, coordination, and demonstration projects. Pp. 18-22. (c) There is no merit to the contention that Congress, acting pursuant to its spending power, conditioned the grant of federal funds on the State's agreeing to underwrite the obligations the Court of Appeals read into 6010. As noted, the "findings" of 6010, when viewed in the context of the more specific provisions of the Act, represent general statements of federal policy, not newly created legal duties. Moreover, the "plain language" of 6010, as well as the administrative interpretation of the provision, also refutes such contention. Section 6010, in contrast to other provisions of the Act that clearly impose conditions, in no way suggests that the grant of federal funds is "conditioned" on a State's funding the rights described therein. Pp. 22-24. (d) The rule of statutory construction that Congress must express clearly its intent to impose conditions on the grant of federal funds, so that the States can knowingly decide whether or not to accept those funds, applies with greatest force where, as here, a State's potential obligations under the Act are largely indeterminate. The crucial inquiry here is not whether a State would knowingly undertake the obligation to provide "appropriate treatment" in the "least restrictive" setting, but whether Congress spoke so clearly that it can fairly be said that the State could make an informed choice. In this case, Congress fell well short of providing clear notice to the States that, by accepting funds under the Act, they would be obligated to comply with 6010. Pp. 24-25. (e) A comparison of the general language of 6010 with the conditions Congress explicitly imposed on the States under the Act demonstrates that Congress did not intend to place either absolute or conditional obligations on the States under 6010. Pp. 25-27. (f) Questions not addressed by the Court of Appeals -- as to whether individual mentally retarded persons may bring suit to compel compliance with those conditions that are contained in the Act, the federal constitutional claims, and claims under another federal statute -- and issues as to whether state law imposed an obligation on Pennsylvania to provide treatment, are remanded for consideration or reconsideration, respectively, in light of the instant decision.

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0451_0001_ZS.html

Youngberg v. Romeo

January 11, 1982 --- Decided: June 18, 1982

Respondent, who is mentally retarded, was involuntarily committed to a Pennsylvania state institution. Subsequently, after becoming concerned about injuries which respondent had suffered at the institution, his mother filed an action as his next friend in Federal District Court for damages under 42 U.S.C. 1983 against petitioner institution officials. She claimed that respondent had constitutional rights to safe conditions of confinement, freedom from bodily restraint, and training or "habilitation" and that petitioners knew, or should have known, about his injuries, but failed to take appropriate preventive procedures, thus violating his rights under the Eighth and Fourteenth Amendments. In the ensuing jury trial, the District Court instructed the jury on the assumption that the Eighth Amendment was the proper standard of liability, and a verdict was returned for petitioners, on which judgment was entered. The Court of Appeals reversed and remanded for a new trial, holding that the Fourteenth, rather than the Eighth, Amendment provided the proper constitutional basis for the asserted rights. Held: Respondent has constitutionally protected liberty interests under the Due Process Clause of the Fourteenth Amendment to reasonably safe conditions of confinement, freedom from unreasonable bodily restraints, and such minimally adequate training as reasonably may be required by these interests. Whether respondent's constitutional rights have been violated must be determined by balancing these liberty interests against the relevant state interests. The proper standard for determining whether the State has adequately protected such rights is whether professional judgment, in fact, was exercised. And in determining what is "reasonable," courts must show deference to the judgment exercised by a qualified professional, whose decision is presumptively valid.

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0457_0307_ZS.html

City of Cleburne, Texas v. Cleburne Living Center, Inc.

Decided: July 1, 1985

March 18, 1985 ---

Respondent Cleburne Living Center, Inc. (CLC), which anticipated leasing a certain building for the operation of a group home for the mentally retarded, was informed by petitioner city that a special use permit would be required, the city having concluded that the proposed group home should be classified as a "hospital for the feebleminded" under the zoning ordinance covering the area in which the proposed home would be located. Accordingly, CLC applied for a special use permit, but the City Council, after a public hearing, denied the permit. CLC and others (also respondents here) then filed suit against the city and a number of its officials, alleging that the zoning ordinance, on its face and as applied, violated the

equal protection rights of CLC and its potential residents. The District Court held the ordinance and its application constitutional. The Court of Appeals reversed, holding that mental retardation is a "quasi-suspect" classification; that, under the applicable "heightened scrutiny" equal protection test, the ordinance was facially invalid because it did not substantially further an important governmental purpose; and that the ordinance was also invalid as applied. Held: 1. The Court of Appeals erred in holding mental retardation a quasisuspect classification calling for a more exacting standard of judicial review than is normally accorded economic and social legislation. Pp. 439-447. (a) Where individuals in a group affected by a statute have distinguishing characteristics relevant to interests a State has the authority to implement, the Equal Protection Clause requires only that the classification drawn by the statute be rationally related to a legitimate state interest. When social or economic legislation is at issue, the Equal Protection Clause allows the States wide latitude. Pp. 439-442. (b) Mentally retarded persons, who have a reduced ability to cope with and function in the everyday world, are thus different from other persons, and the States' interest in dealing with and providing for them [p433] is plainly a legitimate one. The distinctive legislative response, both national and state, to the plight of those who are mentally retarded demonstrates not only that they have unique problems, but also that the lawmakers have been addressing their difficulties in a manner that belies a continuing antipathy or prejudice and a corresponding need for more intrusive oversight by the judiciary than is afforded under the normal equal protection standard. Moreover, the legislative response, which could hardly have occurred and survived without public support, negates any claim that the mentally retarded are politically powerless in the sense that they have no ability to attract the attention of the lawmakers. The equal protection standard requiring that legislation be rationally related to a legitimate governmental purpose affords government the latitude necessary both to pursue policies designed to assist the retarded in realizing their full potential, and to freely and efficiently engage in activities that burden the retarded in what is essentially an incidental manner. Pp. 442-447. 2. Requiring a special use permit for the proposed group home here deprives respondents of the equal protection of the laws, and thus it is unnecessary to decide whether the ordinance's permit requirement is facially invalid where the mentally retarded are involved. Although the mentally retarded, as a group, are different from those who occupy other facilities -- such as boarding houses and hospitals -- that are permitted in the zoning area in question without a special permit, such difference is irrelevant unless the proposed group home would threaten the city's legitimate interests

in a way that the permitted uses would not. The record does not reveal any rational basis for believing that the proposed group home would pose any special threat to the city's legitimate interests. Requiring the permit in this case appears to rest on an irrational prejudice against the mentally retarded, including those who would occupy the proposed group home and who would live under the closely supervised and highly regulated conditions expressly provided for by state and federal law. Pp

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0473_0432_ZS.html Ford v. Wainwright

April 22, 1986 --- Decided: June 26, 1986

In 1974, petitioner was convicted of murder in a Florida state court and sentenced to death. There is no suggestion that he was incompetent at the time of the offense, at trial, or at sentencing. But subsequently he began to manifest changes in behavior, indicating a mental disorder. This led to extensive separate examinations by two psychiatrists at his counsel's request, one of whom concluded that petitioner was not competent to suffer execution. Counsel then invoked a Florida statute governing the determination of a condemned prisoner's competency. Following the statutory procedures, the Governor appointed three psychiatrists, who together interviewed petitioner for 30 minutes in the presence of eight other people, including petitioner's counsel, the State's attorneys, and correctional officials. The Governor's order directed that the attorneys should not participate in the examination in any adversarial manner. Each psychiatrist filed a separate report with the Governor, to whom the statute delegates the final decision. The reports reached conflicting diagnoses, but were in accord on the question of petitioner's competency. Petitioner's counsel then attempted to submit to the Governor other written materials, including the reports of the two psychiatrists who had previously examined petitioner, but the Governor's office refused to inform counsel whether the submission would be considered. The Governor subsequently signed a death warrant without explanation or statement. After unsuccessfully seeking a hearing in state court to determine anew petitioner's competency, his counsel filed a habeas corpus proceeding in Federal District Court, seeking an evidentiary hearing, but the court denied the petition without a hearing, and the Court of Appeals affirmed. Held: The judgment is reversed, and the case is remanded. JUSTICE MARSHALL delivered the opinion of the Court with respect to Parts I and II, concluding that the Eighth Amendment prohibits the State from inflicting the death penalty upon a prisoner who is insane. The reasons at common law for not condoning the execution of the insane -- that such an execution has questionable retributive value, presents no example to others, and thus has no deterrence value, and [p400] simply offends humanity -- have no less logical, moral, and practical force at present. Whether the aim is to protect the condemned from fear and pain without comfort of

understanding, or to protect the dignity of society itself from the barbarity of exacting mindless vengeance, the restriction finds enforcement in the Eighth Amendment. Pp. 405-410. JUSTICE MARSHALL, joined by JUSTICE BRENNAN, JUSTICE BLACKMUN, and JUSTICE STEVENS, concluded in Parts III, IV, and V, that Florida's statutory procedures for determining a condemned prisoner's sanity provide inadequate assurance of accuracy to satisfy the requirement of Townsend v. Sain, 372 U.S. 293, and that, having been denied a factfinding procedure "adequate to afford a full and fair hearing" on the critical issue, as required by 28 U.S.C. 2254(d)(2), petitioner is entitled to a de novo evidentiary hearing in the District Court on the question of his competence to be executed. Pp. 410-418. (a) No state court has issued any determination to which the presumption of correctness under 2254(d) could attach, and indeed no state court played any role in the rejection of petitioner's claim of insanity. P. 410. (b) The first defect in Florida's procedures is the failure to include the prisoner in the truth-seeking process. Any procedure that precludes the prisoner or his counsel from presenting material relevant to his sanity or bars consideration of that material by the factfinder is necessarily inadequate. A related flaw in the procedures is the denial of any opportunity to challenge or impeach the state-appointed psychiatrists' opinions, thus creating a significant possibility that the ultimate decision made in reliance on those experts will be distorted. And perhaps the most striking defect in the procedures is the placement of the ultimate decision wholly within the Executive Branch. The Governor, who appoints the experts and ultimately decides whether the State will be able to carry out the death sentence, and whose subordinates have been responsible for initiating every stage of the prosecution, cannot be said to have the neutrality that is necessary for reliability in the factfinding proceedings. Pp. 413-416. JUSTICE POWELL concluded that the test for whether a prisoner is insane for Eighth Amendment purposes is whether the prisoner is aware of his impending execution and of the reason for it. He further concluded that petitioner's claim falls within this definition, and that, because petitioner's claim was not adjudicated fairly within the meaning of due process or of 28 U.S.C. 2254(d), petitioner is entitled to have his claim adjudicated on remand by the District Court. Finally, he concluded that the States could satisfy due process by providing an impartial officer or board that can receive evidence and argument from the prisoner's counsel, including expert psychiatric evidence. Beyond these [p401] requirements, the States retain substantial discretion to create appropriate procedures.

http://www.law.cornell.edu/supct/html/historics/USSC_CR_0477_0399_ZS.html

Government Actions Basic information

The Federal Government provides numerous resources for the prevention and treatment of mental health problems, including SAMHSA's Center for Mental Health Services (CMHS), which awards grants to States and localities for a range of treatment and support services. Additional information about CMHS grants can be found at http://www.mentalhealth.samhsa.gov/funding. SAMHSA and its partners across the Federal Government have released the Federal Action Agenda for Mental Health System Transformation, which describes the first steps Government Agencies are taking to bring about a fundamental improvement of the mental health care system in America. For more details, visit http://www.samhsa.gov/Federalactionagenda/NFC_HIGHLIGHTS.aspx Additional information about Government mental health services and programs is available on the following web sites: (1) www.samhsa.gov, (2) www.dhhs.gov, (3) www.surgeongeneral.gov.

Actions SAMHSA does

Principle A Focus on the Outcomes of Mental Health Care, Including Employment, Self-Care, Interpersonal Relationships, and Community Participation
Action Items

y y y y y

y y y

Initiate a National Public Education Campaign. Launch the National Action Alliance for Suicide Prevention. Educate the Public about Men and Depression. Respond to refugees' mental health needs. Develop prototype individualized plans of care that promote resilience and recovery. Provide technical assistance on resilience and recovery. Promote the use of customized employment strategies. Promote the transition of youth with serious emotional disturbances from school to postsecondary opportunities and/or employment. Develop an employer initiative to increase the

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y y

y y

recruitment, employment, advancement, and retention of people with psychiatric disabilities. Assist youth with serious emotional disturbances involved with the juvenile justice system to transition into employment. Promote the employment of people with mental illnesses who are chronically homeless. Establish a DOL Work Group to promote quality employment of adults with serious mental illnesses and youth with serious emotional disturbances. Provide treatment and vocational rehabilitation that supports employment for people with mental disorders. Conduct outreach to homeless individuals with mental disorders. Initiate a national effort focused on meeting the mental health needs of young children as part of overall health care. Create a comprehensive action agenda for implementing throughout the Veterans Health Administration all relevant recommendations of the President's New Freedom Commission on Mental Health. Launch a user-friendly, consumer-oriented web site. Promote ADA compliance, support and work to eliminate unnecessary institutionalization, and help eliminate discrimination.

Principle B Focus on Community-Level Models of Care That Coordinate Multiple Mental Health and Human Service Providers and Private and Public Payers
Action Items

y y y y y

Include issues critical to mental health in health care reform. Launch the Federal Executive Steering Committee on Mental Health. Build on and expand criminal and juvenile justice and mental health collaborations. Support the Interagency Autism Coordinating Committee. Review standards and set guidelines for culturally competent care. 11

y y y

y y

y y

Create a National Strategic Workforce Development Plan to reduce mental health disparities. Initiate a project to examine cultural competence in behavioral health care education and training programs. Advance efforts to integrate mental health and primary care services for racial and ethnic minorities. Participate in HHS "Close the Gap Initiative." Develop a National Rural Mental Health Plan. Promote strategies to appropriately serve children at-risk for mental health problems in high risk service systems. Develop a demonstration project for children in foster care. Foster joint responsibility and implementation strategies for children, youth, adults, and older adults with co-occurring disorders. Focus on children in the juvenile justice and child welfare settings. Include mental health in Community Health Center consumer assessment tools.

Principle C Maximize Existing Resources by Increasing Cost Effectiveness and Reducing Unnecessary and Burdensome Regulatory Barriers
Action Items

y y y y y y y y y

Educate employers and benefits managers on the practicability of paying for mental health care. Evaluate and report the impact of mental health parity. Initiate Medicaid Demonstration Projects. Convene Directors of State Mental Health, State Medicaid, and Regional Medicare Programs. Help parents avoid relinquishing custody and obtain mental health services for their children. Support the Ticket to Work Program. Address reimbursement in primary care. Develop a strategy to implement innovative technology in the mental health field. Explore creation of a Capital Investment Fund for Technology.

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Principle D Use Mental Health Research Findings to Influence the Delivery of Services
Action Items

y y y y y y y y y y y y y y

Accelerate research to reduce the burden of mental illnesses. Foster a research partnership. Expand the "Science-to-Services" agenda. Conduct research to understand co-occurring disorders. Harness research to improve care. Support research to develop new medications. Expand the National Registry of Evidence-based Programs and Practices to include mental health. Develop new toolkits on specific evidence-based mental health practices. Develop the knowledge base in understudied areas. Conduct research to reduce mental health disparities. Review the literature and develop new studies on mental illness/general health. Conduct mental health services research in diverse populations and settings. Test new treatments for co-occurring disorders in community settings. Disseminate findings of the Juvenile Justice and Mental Health Project.

Principle E Ensure Innovation, Flexibility, and Accountability at All Levels of Government and Respect the Constitutional Role of the States and Indian Tribes
Action Items

y y y y y y y y

Award State Mental Health Transformation Grants. Provide technical assistance to help develop comprehensive State Mental Health Plans. Award Child and Adolescent State Infrastructure Grants. Track State mental health system transformation activities. Establish a foundation for the Samaritan Initiative. Establish the Re-Entry Initiative for ex-prisoners with psychiatric disabilities. Award Seclusion and Restraint State Incentive Grants. Develop statewide systems of care for children with

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y y y

mental disorders. Provide technical assistance to States on systems of care for children with serious emotional disturbances and their parents and other family members. Convene State leadership to develop Statewide plans to serve children with serious emotional disturbances. Expand the Partnerships for Youth Transition Grant Program. Provide technical assistance on Early and Periodic Screening, Diagnosis, and Treatment (EPSDT). Facilitate linkages between DOL/SSA's joint Disability Program Navigator Initiative, SAMHSA, and related State and local mental health systems. Disseminate information on mental health issues through DOL grant and program initiatives.

State and local

Federal agencies can act as leaders and as facilitators, promoting shared responsibility for change at the Federal, State, and local levels, and in the private sector, in such areas as public education, research, service system capacity, and technology development. States, however, will be the very center of gravity for system transformation; many have already begun this critical work. Their leadership in planning, financing, service delivery, and evaluation of consumer and family-driven services will significantly advance the transformation agenda. Finally, an emphasis on individual recovery and resilience will transform not only service delivery systems, but also hearts, minds, and lives for future generations.

Executive Order 13263

22337

Federal Register Vol. 67, No. 86 Friday, May 3, 2002

Presidential Documents

Title 3-

Executive Order 13263 of April 29, 2002

The President

President's New Freedom Commission on Mental Health By the authority vested in me as President by the Constitution and the laws

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of the United States of America, and to improve America's mental health service delivery system for individuals with serious mental illness and children with serious emotional disturbances, it is hereby ordered as follows: Section 1. Establishment. There is hereby established the President's New Freedom Commission on Mental Health (Commission). Sec. 2. Membership. (a) The Commission's membership shall be composed of: (i) Not more than fifteen members appointed by the President, including providers, payers, administrators, and consumers of mental health services and family members of consumers; and (ii) Not more than seven ex officio members, four of whom shall be designated by the Secretary of Health and Human Services, and the remain-ing three of whom shall be designated-one each-by the Secretaries of the Departments of Labor, Education, and Veterans Affairs. (b) The President shall designate a Chair from among the fifteen members of the Commission appointed by the President. Sec. 3. Mission. The mission of the Commission shall be to conduct a comprehensive study of the United States mental health service delivery system, including public and private sector providers, and to advise the President on methods of improving the system. The Commission's goal shall be to recommend improvements to enable adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate fully in their communities. In carrying out its mission, the Commission shall, at a minimum: (a) Review the current quality and effectiveness of public and private providers and Federal, State, and local government involvement in the deliv-ery of services to individuals with serious mental illnesses and children with serious emotional disturbances, and identify unmet needs and barriers to services. (b) Identify innovative mental health treatments, services, and technologies that are demonstrably effective and can be widely replicated in different settings. (c) Formulate policy options that could be implemented by public and private providers, and Federal, State, and local governments to integrate the use of effective treatments and services, improve coordination among service providers, and improve community integration for adults with serious mental illnesses and children with serious emotional disturbances. Sec. 4. Principles. In conducting its mission, the Commission shall adhere to the following principles: (a) The Commission shall focus on the desired outcomes of mental health care, which are to attain each individual's maximum level of employment, self-care, interpersonal relationships, and community participation; (b) The Commission shall focus on community-level models of care that efficiently coordinate the multiple health and human service providers and public and private payers involved in mental health treatment and delivery of services; Federal Register / Vol. 67, No. 86 / Friday, May 3, 2002/ Presidential Documents

22338

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(c) The Commission shall focus on those policies that maximize the utility of existing resources by increasing cost effectiveness and reducing unneces-sary and burdensome regulatory barriers; (d) The Commission shall consider how mental health research findings can be used most effectively to influence the delivery of services; and (e) The Commission shall follow the principles of Federalism, and ensure that its recommendations promote innovation, flexibility, and accountability at all levels of government and respect the constitutional role of the States and Indian tribes. Sec. 5. Administration. (a) The Department of Health and Human Services, to the extent permitted by law, shall provide funding and administrative support for the Commission. (b) To the extent funds are available and as authorized by law for persons serving intermittently in Government service (5 U.S.C. 5701-5707), members of the Commission appointed from among private citizens of the United States may be allowed travel expenses while engaged in the work of the Commission, including per diem in lieu of subsistence. All members of the Commission who are officers or employees of the United States shall serve without compensation in addition to that received for their services as officers or employees of the United States. (c) The Commission shall have a staff headed by an Executive Director, who shall be selected by the President. To the extent permitted by law, office space, analytical support, and additional staff support for the Commis-sion shall be provided by executive branch departments and agencies. (d) Insofar as the Federal Advisory Committee Act, as amended, may apply to the Commission, any functions of the President under that Act, except for those in section 6 of that Act, shall be performed by the Department of Health and Human Services, in accordance with the guidelines that have been issued by the Administrator of General Services. Sec. 6. Reports. The Commission shall submit reports to the President as follows: (a)Interim Report. Within 6 months from the date of this order, an interim report shall describe the extent of unmet needs and barriers to care within the mental health system and provide examples of community-based care models with success in coordination of services and providing desired outcomes. (b)Final Report. The final report will set forth the Commission's recommendations, in accordance with its mission as stated in section 3 of this order. The submission date shall be determined by the Chair in consultation with the President. Sec. 7. Termination. The Commission shall terminate 1 year from the date of this order, unless extended by the President prior to that date.

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THE WHITE HOUSE, April 29, 2002 [FR Doc. 02-11166 Filed 5-2-02; 8:45 am] Billing code 3195-01-P

Website at
http://www.samhsa.gov/Federalactionagenda/NFC_TOC.aspx

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CHMS (The Center for Mental Health Services0

The Center for Mental Health Services (CMHS) is the Federal agency within the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) that leads national efforts to improve prevention and mental health treatment services for all Americans. CMHS pursues its mission by helping States improve and increase the quality and range of treatment, rehabilitation, and support services for people with mental health problems, their families, and communities. http://mentalhealth.samhsa.gov/

National Advisory Mental Health Council (NAMHC)

Advises the Secretary of Health and Human Services; the Director, National Institutes of Health; and the Director, National Institute of Mental Health, on all policies and activities relating to the conduct and support of mental health research, research training, and other programs of the Institute. http://www.nimh.nih.gov/about/advisory-boards-and-groups/index.shtml

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Definitions Should:
1. plan to, intend to, or expect to: I shall go later. 2. will have to, is determined to, or definitely will: You shall do it. He shall do it. 3. (in laws, directives, etc.) must; is or are obliged to: The meetings of the council shall be public. 4. (used interrogatively in questions, often in invitations): Shall we go?

substantially
1. Of, relating to, or having substance; material. 2. True or real; not imaginary. 3. Solidly built; strong. 4. Ample; sustaining: a substantial breakfast. 5. Considerable in importance, value, degree, amount, or extent: won by a substantial margin. 6. Possessing wealth or property; well-to-do. n. 1. An essential. Often used in the plural. 2. A solid thing. Often used in the plural.

Reform
1. To improve by alteration, correction of error, or removal of defects; put into a better form or condition. 2. a. To abolish abuse or malpractice in: reform the government. b. To put an end to (a wrong). See Synonyms at correct. 3. To cause (a person) to give up harmful or immoral practices; persuade to adopt a better way of life. v.intr. To change for the better. n. 1. A change for the better; an improvement. 2. Correction of evils, abuses, or errors. 3. Action to improve social or economic conditions without radical or revolutionary change. adj. 1. Relating to or favoring reform: a reform candidate for mayor. 2. Reform Of or relating to Reform Judaism.

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State vs. government

Exclusive Powers of the National Government Under the Constitution, powers reserved to the national government include: Print money (bills and coins) Declare war Establish an army and navy Enter into treaties with foreign governments Regulate commerce between states and international trade Establish post offices and issue postage Make laws necessary to enforce the Constitution

y y y y y y y

Exclusive Powers of State Governments Powers reserved to state governments include:

y Establish local governments y Issue licenses (driver, hunting, marriage, etc.) y Regulate intrastate (within the state) commerce y Conduct elections y Ratify amendments to the U.S. Constitution y Provide for public health and safety y Exercise powers neither delegated to the national government or prohibited from the states by the U.S. y Constitution (For example, setting legal drinking and smoking ages.)

Powers Shared by National and State Government Shared, or "concurrent" powers include: Setting up courts Creating and collecting taxes Building highways Borrowing money Making and enforcing laws Chartering banks and corporations Spending money for the betterment of the general welfare Taking (condemning) private property with just compensation

y y y y y y y y

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