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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
and
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.
Communications
Michael Hogan, Chair
and
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:
2002
July 17-19
August 7-8
September 11-12
October 2-3
November 13-14
December 4-5
2003
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
and
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.
Chair
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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