May 9, 1973
Page 14913
By Mr. MUSKIE
S. 1768. A bill to establish a Commission on Mental Health and Illness of the Elderly, and for other purposes. Referred to the Committee on Labor and Public Welfare.
COMMISSION ON MENTAL HEALTH AND ILLNESS OF THE ELDERLY ACT
Mr. MUSKIE. Mr. President, I introduce for appropriate reference the Commission on Mental Health and Illness of the Elderly Act.
For far too long, mental health has been the stepchild of the health care field. And this is especially so in the case of mental illness and the elderly. The bill I introduce today represents an important first step to help correct this situation.
Geriatric patients now occupy one of every five beds in our Nation's mental hospitals. And from 15 to 25 percent of elderly persons living in their own homes have some degree of mental impairment.
Yet our public policy is confused and contradictory when it comes to mental health of the elderly. Many elderly are "warehoused" in institutions when they could be returned to the community if proper services were available. Others are dumped into communities without adequate facilities and resources to assist them. Still others remain in their homes and apartments, cut off from the help they need.
The mental health problems of older Americans are made worse by misconceived negative attitudes. In a recent letter to me from Lee Muth, chairman, Representatives of State Mental Health Programs for the Aged, National Association of State Mental Health Program Directors, this point was forcefully stated:
The mental and emotional well-being of the aged has been particularly neglected probably because "senility" is so often believed to be an inevitable and irreversible consequence of aging.
Too often there is a stereotype of the elderly mental patient who cannot be helped. As a result, the patient gets a cursory diagnosis, which is simply that treatment will not work.
Fortunately, there is solid evidence to dispel this myth. A November 1971 report of the Senate Special Committee on Aging, prepared at the direction of Senator CHURCH and myself, documents the fact that mental health problems of the elderly can often be substantially alleviated.
One survey of 49 psychiatric hospitals showed 75 percent of all elderly mental patients improved enough to go home within 2 months.
My bill provides the framework to make certain that this type of help would be more generally available. It would create a commission, appointed by the President, by and with the advice and consent of the Senate, which would formulate a unified national policy for the mental health of the elderly. The nine-member Commission would include at least one representative from the fields of psychiatry, psychology, social science, social work, and nursing.
This legislation provides for more than just another study. The main task of the Commission would be to develop a national policy in the field of mental health and the elderly. But it would also be charged with these duties–
Assessing future requirements for mental health facilities, manpower, research, and training to meet mental health care needs of the elderly;
Submitting an annual report to the President for transmittal to the Congress, describing major developments in the field of mental health and the elderly, identifying priority issues, and proposing recommendations for solving problems ;
Evaluating present mental health programs to determine whether such programs are responsive to the needs of the elderly ;
Developing priorities for programs designed to increase knowledge about various aspects of mental illness among older Americans; and
Cooperating with the executive and legislative branches to implement the policy proposals of the 1971 White House Conference on Aging.
The Commission established in this bill would be assisted by an Advisory Council on Mental Health and Illness of the Elderly, to be composed of nine members appointed by the President. This council would advise the Commission on policy matters relating to mental health and illness of the elderly.
Mr. President, as chairman of the Subcommittee on Health of the Elderly, I recently opened hearings on "Barriers to Health Care for Older Americans." Nowhere are barriers more apparent than in the area of mental health. The Commission that I propose in this bill would work toward tearing down these barriers.
This Nation can no longer afford to turn its back on the serious mental health problems of the elderly. My proposal gets us started on a national policy in this area and on solutions to these problems.
And I do not propose to keep this Commission in existence forever. Under my bill, the Commission would last for a period not to exceed 5 years and would terminate 60 days after the submission of its final report.
What we need is a concentrated attack on these problems and a strong commitment to their solution. My Commission would meet these objectives.
Mr. President, I ask unanimous consent that the text of this bill be printed at this point in the RECORD.
There being no objection, the bill was ordered to be printed in the RECORD, as follows
S. 1768
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Commission on Mental Health and Illness of the Elderly Act".
ESTABLISHMENT OF COMMISSION
SEC. 2. There is hereby established a temporary commission to be known as the Commission on Mental Health and Illness of the Elderly (hereinafter called the "Commission"). Such Commission shall exist for a period not to exceed five years.
DUTIES OF THE COMMISSION
SEC. 3. It shall be the duty of the Commission to–
(1) develop a national policy for the proper maintenance of mental health for aged and aging persons and the care and treatment of mental illness for such persons;
(2) undertake studies to assess future needs for mental health facilities, manpower, research, and training to meet the mental health care needs of aged and aging persons;
(3) submit to the President for transmittal to Congress an annual report describing major developments concerning the treatment and care of elderly persons suffering from mental illness, identifying priority issues, and proposing recommendations for solving these problems;
(4) recognizing that proper physical health and proper mental health are inseparable, evaluate present mental health programs to determine whether such programs are responsive to the needs of aged and aging persons;
(5) develop priorities for programs designed to increase knowledge about various aspects of mental illness among aged and aging persons; and
(6) cooperate with the executive and legislative branches for the purpose of implementing the policy proposals recommended at the 1971 White House Conference on Aging.
ORGANIZATION OF THE COMMISSION
SEC. 4. (a) The Commission shall be composed of nine members to be appointed by the President, by and with the advice and consent of the Senate. The Commission shall include at least one member from each of the fields of psychology, psychiatry, social science, social work, and nursing. Each person so appointed shall, as a result of his training, experience, and attainment, be exceptionally qualified to formulate and appraise programs and activities related to aging.
(b) The President shall designate one of the members of the Commission to serve as Chairman and one to serve as Vice Chairman. Vacancies shall be filled in the same manner in which the original appointments were made. Any vacancy in the Commission shall not affect its powers, and five members of the Commission shall constitute a quorum.
POWERS OF THE COMMISSION
SEC. 5. To carry out the purposes of this Act, the Commission shall have the authority to–
(1) prescribe such rules and regulations as it deems necessary governing the manner of its operations and its organization personnel;
(2) obtain from any department, agency, or instrumentality of the United States, with the consent of the head thereof, such facilities, services, supplies, advice, and information as the Commission may determine to be required by it to carry out its duties;
(3) acquire by lease, loan, or gift, and to hold and dispose of by sale, lease, or loan. real and personal property of all kinds of necessary for, or resulting from, the exercise of authority under this Act;
(4) enter into contracts or other arrangements, or modifications thereof, with State and local governments, and institutions and individuals in the United States, to conduct programs the Commission deems necessary to carry out the purposes of this Act, and such contracts or other arrangements, or modifications thereof, may be entered into without legal consideration, without performance or other bonds, and without regard to section 3709 of the Revised Statutes;
(5) make advance, progress, and other payments which the Commission deems necessary under this Act without regard to the provisions of section 3648 of the Revised Statutes;
(6) receive money and other property donated, bequeathed, or devised to the Commission, without condition or restriction other than that it be used for the purposes of the Commission;
(7) accept and utilize the services of voluntary and uncompensated personnel and reimburse them for travel expenses, including per diem, as authorized by section 5703 of title 5, United States Code;
(8) employ such officers and employees as may be necessary to carry out its functions under this Act; and
(9) obtain services of consultants in accordance with the provisions of section 3109 of title 5, United States Code, at rates for individuals not to exceed $100 per day for each day they are engaged in the performance of their duties to the Commission.
COMPENSATION OF COMMISSION MEMBERS
SEC. 6. (a) Section 5313 of title 5, United States Code, is amended by adding at the end thereof the following new paragraph:
"(22) Chairman, Commission on Mental Health and Illness of the Elderly.".
(b) Section 5315 of title 5, United States Code, is amended by adding at the end thereof the following new paragraph:
"(95) Members, Commission on Mental Health and Illness of the Elderly (8).".
ADVISORY COUNCIL
SEC. 7. (a) There is hereby established an Advisory Council on Mental Health and Illness of the Elderly (hereinafter referred to as the "Council") to be composed of nine members appointed by the President for terms of two years without regard to the provisions of title 5, United States Code.
(b) The Council shall elect its own Chairman and Vice Chairman and shall meet at the call of the Chairman, but not less than four times a year. Members shall be appointed for two-year terms, except that of the members first appointed, five shall be appointed for a term of one year and four shall be appointed for a term of two years as designated by the President at the time of appointment. Any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall serve only for the remainder of such term. Members shall be eligible for reappointment and may serve after the expiration of their terms until their successors have taken office. A vacancy in the Council shall not affect its activities, and five members thereof shall constitute a quorum.
(c) The Commission shall make available to the Council such staff, information, and other assistance as it may require to carry out its activities.
FUNCTIONS OF THE COUNCIL
SEC. 8. The Council shall advise the Commissioner on policy matters relating to mental health and illness.
COMPENSATION OF COUNCIL MEMBERS
SEC. 9. Each member of the Council appointed pursuant to section 7 shall receive $50 a day, including travel time, for each day he is engaged in the actual performance of his duties as a member of the Council. Each such member shall also be reimbursed for travel, subsistence, and other necessary expenses incurred in the performance of his duties.
TERMINATION
SEC. 10. The Commission shall cease to exist sixty days after the submission of its final report.
AUTHORIZING OF APPROPRIATIONS
SEC. 11. There are authorized to be appropriated such sums as may be necessary to carry out the purposes of this Act.