Public Policy Update

As the 108th Congress begins its first session, the Public Policy Office (PPO) faces major challenges in achieving APA's public interest policy goals. Wartime spending, homeland security, a sustained economic slump and severe budget deficits will make it difficult to attain even level funding for vital domestic programs, particularly those serving vulnerable populations. Your help is urgently needed to direct congressional attention to important health and education programs, which are at risk for termination if statutory authority is not extended.

In addition, lawmakers on Capitol Hill are likely to consider issues that will generate a great deal of debate and controversy, including affirmative action, reproductive rights and the relationship between church and state. Your federally elected officials will make many key decisions this year based on what you--their constituents--tell them. Therefore, you are an integral part of APA's efforts to ensure that psychological expertise is heard on Capitol Hill.

Programs still awaiting reauthorization

A number of federal programs, including unemployment insurance, welfare reform and special education, were due to be reauthorized by Sept. 30 of last year but carried over into this Congress.

  • Unemployment benefits need further extension. Although President Bush signed a narrow extension into law on Jan. 8, a longer-term solution is needed to aid the 2.5 million unemployed people benefited by this program. Unemployment inevitably leads to higher numbers of Americans without health insurance because more than 40 percent of those losing or changing jobs become uninsured. It has been recently reported that two-thirds of the states are cutting Medicaid benefits, increasing copayments and restricting eligibility.

The National Governors Association estimated that one million to two million low-income people would lose insurance coverage as a result of the cutbacks. This is of particular concern to APA, since Medicaid is the largest funder of mental health services in the country. The unemployed and the uninsured remain a top priority for PPO, and we will be working to keep them on the congressional agenda.

  • Welfare needs additional reform. The Temporary Assistance to Needy Families (TANF) program--created by the 1996 welfare-reform legislation, the Personal Responsibility and Work Opportunity Reconciliation Act--is still operating on borrowed time through short-term extensions. Although welfare caseloads have declined dramatically due to recent reform measures and a strong economy, the U.S. General Accounting Office reported that TANF recipients with mental or physical impairments (who constitute 44 percent of current caseloads), or those caring for children with such impairments, were found to be half as likely to leave the program as other recipients.

It is expected that a version of the welfare-reform bill that passed the U.S. House of Representatives last year and included very strict work requirements--often a more substantial hardship for the recipients with mental and physical impairments (or those with children with such impairments)--will be reintroduced in the 108th Congress. PPO will continue to advocate for comprehensive services for those TANF recipients who face multiple barriers to self-sufficiency, particularly mental health, substance abuse and domestic violence problems. In so doing, we will also strive to forge stronger linkages with vocational rehabilitation services provided under the Rehabilitation Act--also due for reauthorization this year--to enhance the transition to work for these TANF recipients.

  • Special education also left behind. Another hold-over from last year for reauthorization is the Individuals with Disabilities Education Act (IDEA). This federal legislation outlines the requirements for educating children with disabilities, such as procedures for identifying disabilities and for developing individualized educational plans, including mental health and other related services. Although certain parts of IDEA expired last year, neither the House nor Senate introduced reauthorizing legislation. Among the key issues to be debated this year include whether children with disabilities can be expelled from school for disciplinary infractions related to their disability and the use of discrepancies between IQ and achievement test scores to determine if a child has a learning disability. PPO will continue to bring psychological research to bear on these significant issues.

Programs due for reauthorization this year

  • An early start for Head Start? On a related front, Head Start, a comprehensive social development program for children ages 0-5, is scheduled to be reauthorized this year. It consists of Early Head Start for ages 0-3 and regular Head Start for preschool-age children. During the last reauthorization in 1998, Congress stressed school readiness by emphasizing pre-literacy and pre-numeracy skills.

Over the last year, there has been much discussion about the possibility of moving Head Start from the Department of Health and Human Services to the Department of Education. Such a move is opposed by those who fear the social development aspects of the program would be undermined. Related debates will center on how the program can promote literacy and school-readiness skills without forsaking its other features. PPO will work hard to ensure that both the social and academic needsof young children are considered during the reauthorization debate.

  • Another look at the Substance Abuse and Mental Health Services Administration (SAMHSA). Authorization for this federal agency also expires on Sept. 30. SAMHSA is undergoing significant changes under its new administrator, Charles G. Curie, with an increased emphasis on accountability, capacity and effectiveness. One new initiative would replace the Community Mental Health Services and Substance Abuse Prevention and Treatment Block Grants to the states with two new Performance Partnership Grant programs. SAMHSA is also developing more initiatives for children, including programs for co-occurring substance abuse and mental disorders.

The reauthorization process may codify some of these changes. With the anticipated issuance of the final report of the President's New Freedom Commission on Mental Health at the end of April, it is hoped that the recommendations will provide an impetus for legislative changes in the mental health delivery system that will benefit both children and adults. PPO has been working closely with SAMHSA and congressional staff and will continue to do so throughout the reauthorization process.

Controversy looms on social issues

  • Anti-discrimination measures warrant attention. APA will continue to support equal opportunity and the civil and constitutional rights of minority populations and others at risk for discrimination. Accordingly, PPO is pressing once again for passage of antidiscrimination legislation blocked for a number of years by various factions in Congress.

Most notably, these bills include hate-crime legislation--such as the Local Law Enforcement Enhancement Act--which in part would extend legal protections on the basis of gender, disability status and sexual orientation, and the Employment Non-Discrimination Act, which would provide basic workplace protection from discrimination based on a person's sexual orientation.

On a related front, the Bush administration has challenged the University of Michigan affirmative action policy at the undergraduate and graduate levels in the U.S. Supreme Court cases of Gratz and Hamacher v. Bollinger et al. and Grutter v. Bollinger et al., respectively. APA has filed an amicus brief in support of the policy.

  • Reproductive rights in the balance. On the 30th anniversary of Roe v. Wade, the U.S. Supreme Court decision that recognized a constitutional right to abortion, opponents of reproductive rights are preparing a major push for new abortion restrictions in the 108th Congress. Many congressional opponents of abortion have adopted a step-by-step approach by introducing legislation to prohibit late-term abortions, to limit adolescent access to reproductive health care and to allow hospitals and other health-care providers to refuse to perform abortions without losing their federal funds.

Also of concern, there is growing congressional support for abstinence-only sex education that does not discuss other ways to prevent pregnancy and sexually transmitted diseases. PPO will strive to ensure that the debate over reproductive rights and sex education takes into account APA policy positions and relevant psychological research.

Legislative priorities of the new Congress and call for action

The top legislative priorities of the congressional leadership include tax cuts, domestic and national security, prescription drug coverage for the elderly, reducing racial health disparities, and financing the President's education plan that passed last year. Although APA's public interest policy goals will not always match those of the congressional leadership, we will nonetheless continue to advocate on behalf of vulnerable populations and for programs that serve them.

Our strategic plan includes working with our friends in Congress, cultivating new allies and finding common ground with our opponents, in addition to working with our coalition partners. Yet, the most important tool in our advocacy strategy is you--our APA Members. We hope that you will join us in advocating on behalf of psychology in the year ahead. Your public interest policy staff can be reached at ppo@apa.org.

This report was compiled by APA's Public Policy Office.