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President's New Freedom
Commission on Mental Health


June 18-19, 2002
Meeting Minutes

Ritz Carlton at Pentagon City
Arlington, Virginia

Chair Michael Hogan convened the first meeting of the President's New Freedom Commission on Mental Health at 9:30 a.m. on June 18, 2002 at the Ritz-Carlton Pentagon City, 1250 South Hayes Street, Arlington, Virginia. In accordance with the provisions of Public Law 92-463, the meeting was open to the public on June 18 from 9:30 a.m. to 12:00 p.m. and from 1:30 p.m. to 4:45 p.m. On June 19, it was open from 8:05 a.m. to 12:05 p.m., when the meeting adjourned.

Commission Members Present:

Michael F. Hogan, Chair
Jane Adams
Rodolfo Arredondo, Jr.
Daniel B. Fisher
Anil G. Godbole
Henry T. Harbin
Larke N. Huang
Norwood W. Knight-Richardson
Ginger Lerner-Wren
Stephen W. Mayberg
Robert N. Postlethwait
Waltraud E. Prechter
Nancy C. Speck
Randolph J. Townsend
Deanna F. Yates

Ex Officio Representatives Present:

Charlie Curie, Substance Abuse and Mental Health Services Administration
Wayne Fenton, National Institute of Mental Health
Larry Lehmann, Department of Veterans Affairs
Richard Nakamura, National Institute of Mental Health
Robert Pasternak, Department of Education

Staff Members Present:

Claire Heffernan, Executive Director
Stanley Eichenauer, Deputy Executive Director
James Finley, Senior Policy Analyst
Dawn Foti, Health Policy Analyst
Patty Ditoto, Administrative Assistant
Kevin Hennessy, Senior Advisor

Presenters present for a portion of the meeting were:

Howard Goldman, University of Maryland School of Medicine
Philo Hall, Executive Office of the President
Kenneth Moritsugu, Public Health Service
Karen Wagner, Substance Abuse and Mental Health Services Administration
Mark Weber, Substance Abuse and Mental Health Services Administration

June 18, 2002

Agenda Overview and Introductions

Dr. Hogan convened the meeting at 9:30 a.m. and welcomed Commission members and observers to the "awesome task that lay ahead." After providing a brief overview of some of the planning work that occurred prior to the meeting, Dr. Hogan noted that much of the first meeting would concern organizational issues, including putting a schedule together for the life of the Commission. He also stated that each Commission meeting would provide an opportunity for public comment. Dr. Hogan asked members to introduce themselves and provide their priorities for the Commission's work. Dr. Hogan concluded with a description of the meeting agenda.

Review of President's Executive Order

Philo Hall
Executive Office of the President

Dr. Hogan introduced Mr. Philo Hall, Associate Director for Health, Domestic Policy Council, Executive Office of the President. Mr. Hall reviewed the White House process behind the Executive Order that created the Commission. The Executive Order recognizes that numerous levels of Federal, State and local governments currently oversee mental health policies, programs and the network of public and private providers. The Commission's goal is to develop concrete recommendations to ensure the mental health system serves the needs of consumers and their families, delivers the best care to patients, and that each individual's capacity for community integration is maximized. The Executive Order grants the Commission wide latitude in the kinds of proposals it can recommend, including changes in legislation, public or private provision of services, and changes from any level of government.

Mr. Hall highlighted several key policy objectives of the Commission's work including identifying community level models of care that help to maximize the use of existing resources. Mr. Hall concluded that President Bush recognizes that he has asked the Commission to accomplish a challenging but important task.

Commission members engaged in a question and answer period with Mr. Hall. A number of questions concerned boundaries on the Commission's responsibilities. Members asked for White House support of their efforts to increase ex-officio participation from Federal agency leaders and Mr. Hall indicated he would help.

Organizing and Conducting the Commission's Work

Overview of Federal Advisory Committee Act (FACA)
Claire Heffernan, Executive Director
Karen Wagner, Branch Chief
Office of Counsel
Substance Abuse and Mental Health Services Administration

Ms. Heffernan introduced Karen Wagner, who summarized key components of the Federal Advisory Committee Act (FACA). The Act controls the circumstances under which the President can utilize non-Federal advisory groups to obtain advice or recommendations. FACA establishes many conditions for the work of the Commission, including requiring open meetings and public notice requirements for meetings. Some of the limited circumstances under which a meeting could be closed were described along with the rules for the operation of subcommittees. Lastly, a designated Federal official must attend all Commission meetings; in this case, Claire Heffernan is serving this function. Members then engaged in a question and answer period.

Michael Hogan, Chair
Stanley Eichenauer, Deputy Executive Director

Dr. Hogan stated that the purpose of this discussion was to decide how the Commission would obtain public comment on its deliberations. One of the major communication tools will be a website. Mr. Eichenauer displayed the website and described its purpose and content. The description began with the proposed home page and proceeded to the Chair's welcome message, background on the Commission, links to key founding documents, a roster and contact information on each of the Commission members, a calendar of upcoming meetings, activities of the Commission, and approved minutes of the Commission. The site will be used to solicit public comments and more items yet to be identified are expected to be added. Commissioners asked questions about specific website content and made several recommendations for additions or changes.

Review of Background Materials

Dr. Hogan summarized highlights from a briefing book prepared for the Commission. A full list of all briefing materials would be posted on the website and all of the materials are publicly available. Dr. Hogan briefly described papers he thought particularly noteworthy, pointing out they are not intended to be comprehensive, and that some additions have been identified. Commissioners recommended a variety of additions to the book and Dr. Hogan asked them to share their information with the staff.

Future Meeting Schedule and Planning

Dr. Hogan suggested that the Commission meet each month. The Commission agreed and tentatively established the following dates for its future meetings:

July 17-19
August 7-8
September 11-12
October 2-3
November 13-14
December 4-5

January 8-9
February 5-6
March 5-7
April 2-3

Dr. Hogan led a discussion of future hearing plans, including possible meeting locations. He proposed that July's meeting primarily focus on hearing from outside groups and expert witnesses. Dr. Harbin concurred it was important to hear from national groups. Dr. Adams stated a preference to break into subcommittees at the July meeting to discuss key issues before the Commission.

Dr. Hogan then led a discussion of ground rules for how the Commission engages in soliciting or receiving input from people who want to bring it information. Mr. Postlethwait stated that he wished to develop a process by the next meeting to establish the major objectives of the Commission. Judge Lerner-Wren identified a need to structure how the Commission processes information and to develop a work plan at this meeting. Dr. Fisher recommended Commission consideration and resolution of the work plan activity before finalizing future meeting plans. Dr. Godbole stated his desire to develop a work plan at this meeting that lays out the goals for each month. After further deliberation of meeting and work plan options, members agreed to continue discussion the following day.

Dr. Hogan recessed the Commission at 4:45 p.m. until 8:00 a.m. June 19.

June 19, 2002

Dr. Stephen Mayberg, filling in for Dr. Hogan who was called briefly to other business, reconvened the Commission at 8:05 a.m. Dr. Mayberg expressed appreciation for the Commissioners' accomplishments of the first day and introduced Dr. Kenneth Moritsugu.

Surgeon General's Report on Mental Health Summary Report, Implications for the Commission

Kenneth Moritsugu, M.D. Acting Surgeon General
Department of Health and Human Services
Howard Goldman, M. D., Senior Scientific Editor
Surgeon General's Report
Department of Psychiatry, University of Maryland School of Medicine

Dr. Moritsugu introduced Dr. Howard Goldman. Dr. Moritsugu stated that the Surgeon General's report and supplemental reports are not new information or new science, but rather, "…they represent a compilation and evaluation of the best science and evidence available at the time …for the American people to help them achieve health for themselves as individuals and for us as a nation." Dr. Goldman stated, "...the main point of the report was to demonstrate how mental health is fundamental to health." Dr. Goldman reviewed the eight chapters of the report, which follow the cycle of human life. Each chapter contains simple recommendations for the public based on a review of the literature and science. Dr. Goldman then turned the presentation over to Dr. Moritsugu who described several supplemental reports the Surgeon General's Office released following the main report. The speakers concluded with a question and answer period with Commission members.

Commission Workplan

Dr. Hogan resumed the Chair and returned to the discussion of how the Commission should organize its work. Dr. Mayberg stated there were three separate groups who developed proposals for Commission deliberations. One worked on a plan for the Commission's interim report, due October 29, another on critical policy issues before the Commission and one worked on themes for expert papers the Commission may wish to consider.

Mr. Postlethwait commented on the importance of organizing the Commission to complete its interim report. He identified three critical elements for the interim report called for in the Executive Order. The small group developed a grid to conceptualize various components of the interim report, which he briefly described. Commission members deliberated on the approach without taking final action.

Dr. Mayberg summarized the second group's recommendations on how the Commission could address major themes in the final report using a three-dimensional matrix approach. Major dimensions include people centered concerns, system of service issues, and specific themes or problem areas including: children, adults, older adults, culture and diversity issues, co-occurring disorders, physical health, stigma and stereotypes, financing, integration of services, access to care, and a research agenda. Each subcommittee on a topic would address all appropriate dimensions of a particular problem area. Commission members discussed the approach and recommended modifications including adding adolescents and young adult population issues, criminal justice issues, and recovery and consumer centered service issues.

Dr. Godbole reported on the third group that developed recommended themes for potential issue papers to be developed by subcommittees. The group proposed that one to three experts work with a subcommittee on assigned issue areas to review the science and literature and then develop recommendations for Commission deliberation. Potential topic areas include evidence-based practice; financing at the Federal, State, and private levels; recovery and rehabilitation; public and provider education and stigma measures; and children and adolescents at risk. There was considerable discussion, but no action or decision was made. Commission members also discussed the role and function of subcommittees and agreed to form issue groups at the July hearing.

Public Comment

Dr. Hogan introduced the period for public comment. He announced procedures for the speakers including limiting comments to three minutes each. Members of the public who spoke were: Robert Johnson, Chris Koyanagi, Lawrence Plumlee, Judi Chamberlin, Justin Shilliday, Joseph Rogers, Paul Seifert, Ron Thompson, Linda Adre, John Avery, Barbara Huff, John Piacitelli, Laurie Ahern, Marsha Martin, Bob Lieberman, Brandon Durst, Valerie Porr, and Richard Birkel.

Adjournment and Next Meeting Announcement

Dr. Hogan thanked all the presenters and announced that the next meeting will be in Washington, DC on July 17-19, 2002. The meeting adjourned at 12:05 p.m.

I hereby certify that, to the best of my knowledge, the foregoing minutes are accurate and complete.

Claire Heffernan
Executive Director
President's New Freedom Commission on Mental Health

Michael Hogan, Ph.D.
President's New Freedom Commission on Mental Health

These minutes were considered and approved by the Commission at its July 19, 2002 meeting and any corrections or notations incorporated into the text.

Last Modified 07/22/02

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