January, 2010

IN THIS ISSUE:
Our Priorities; Health Reform Update; Condolence Policy on Soldier Suicides

A New Year—Forward: Our Priorities

As the New Year begins, House and Senate leaders are starting work on merging their respective health care reform bills into a final product. Both plans expand coverage and improve access to mental health and substance use disorder treatment services and we are pushing to ensure a merged bill retains those key provisions. An article on the plans is below. We will be updating you on legislation’s progress in the weeks ahead. Look for future action alerts regarding opportunities to weigh in and join our advocacy efforts.

We will also be working on a number of priority areas in the months ahead to improve services and expand access to care:

• Parity Implementation—With the federal mental health parity law now fully effective, we are working to increase awareness of its requirements, responding to requests on the impact on state laws, pushing for regulations that reflect Congressional intent, and monitoring compliance by health plans.

• Health Care Reform Implementation—Anticipating that health reform will become law, we will be joining with advocates around the country to influence implementation activities by the federal administration and state governments, pushing for federal regulations that broadly define the mental health and substance use disorder benefit to include a comprehensive array of services, and ensuring effective implementation of a ground-breaking Medicaid expansion.

• Comparative Effectiveness Research—We are building on our efforts to ensure a strong consumer role in the setting of priorities, oversight, development and dissemination of findings.

• Prevention—Incorporating mental health and substance use disorder into federal prevention initiatives is an important priority. We also will be promoting and supporting legislation to encourage prevention activities at schools, such as positive behavioral supports.  And we will be working on a project aimed at encouraging States to improve access to preventive services through their Medicaid programs

• SAMHSA Reauthorization and Appropriations—The President’s budget will be released in February. We will continue to support essential funding for mental health programs in the appropriations process and anticipate Congress may turn to SAMHSA reauthorization in the near future.

• Medicare Part D—We are working to maintain strong coverage of mental health medications.

• Medicaid—With many states facing tight budgets, we are deploying resources to prevent or limit expected cuts to Medicaid, including restrictions on access to medications.

Health Reform Update: Letter Sent to House, Senate Leaders

The Senate passed a comprehensive health care reform bill, entitled the “Patient Protection and Affordable Care Act,” (H.R. 3590) on December 24th by a vote of 60 to 39 with all the Democrats supporting the bill and all Republicans opposed (Senator Jim Bunning (R-KY) did not vote). The House had previously passed their “Affordable Health Care for America Act” (H.R. 3962) on November 7th by a vote of 220 to 215 with only one Republican supporting the bill (Rep. Joseph Cao (R-LA).  It is not expected that a formal conference committee will be convened. Instead, Democratic leaders in the House and Senate–including Senate Majority Leader Harry Reid (D-NV) and Senators Max Baucus (D-MT), Christopher Dodd (D-CT), and Tom Harkin (D-IA) along with House Speaker Nancy Pelosi (D-CA), Majority Leader Steny Hoyer (D-MD), and Representatives George Miller (D-CA), Henry Waxman (D-CA), and Charles Rangel (D-NY) and their aides—are currently working to resolve differences between the two bills. The Democrats have set a goal of passing a final bill before the President’s State of the Union address which will be some time in late January or early February. 

There are many important provisions in both bills that would significantly improve the availability and quality of mental health and substance use services.  Both bills would impose mental health and substance use parity requirements on health care plans offered through the new health insurance exchanges to uninsured individuals and people who work for small businesses. In addition, these health plans would be required to offer mental health and substance use services as core benefits.  There are provisions to improve care coordination and integration of behavioral health and other specialty or general health services. A number of initiatives are included in both bills to improve access to preventive services and community-wide prevention initiatives. The bills also include a number of proposals to address mental health and substance use workforce shortages. 

Mental Health America is working with our partners in the mental health and substance use communities to ensure that the strongest possible provisions are included in the final bill. A letter we sent to House and Senate leaders outlining our views on the differences between the bills on key provisions affecting individuals with mental health and substance use conditions can be accessed here (PDF). We have also been working with other advocacy groups to develop group letters on a number of these issues.

House Jobs Bill Extends Increase in Medicaid Funding Through June 2011

A jobs bill passed by the House of Representatives last month includes a $23.5 billion increase in federal funding for state Medicaid programs through June 2011. The approval extends a provision in the stimulus bill (the American Recovery and Reinvestment Act) that increased the federal medical assistance percentage through 2010 for states that maintain their Medicaid eligibility standards. The higher federal match provides an incentive for states to commit resources to their Medicaid programs and helps ensure services for Medicaid beneficiaries. In addition, the jobs bill includes $12.3 billion to extend the 65 percent COBRA health insurance subsidy to 15 months for individuals who lose their jobs through June 30, 2010. The Senate has not yet introduced its version of the legislation.

Spending Bill Signed Into Law; Increases For Key Mental Health Programs

President Obama signed an omnibus spending bill in December that more than doubles the Administration’s funding request for mental health services and supports at the Substance Abuse and Mental Health Services Administration (SAMHSA)—from $17 million to $36 million. The $36 million increase pushed funding for the Center for Mental Health Services past a $1 billion for the first time. You can read more on the legislation in the December Advocacy in Action. Your hard work—responding to our alerts, setting up District/State visits and participating in Capitol Hill day—and leadership from Congress resulted in significant funding increases to help meet the critical needs of millions of individuals with, or at risk of, mental health conditions.

Action Items

• Mental Health America Calls for Overturning of Policy on Condolence Letters To Families of Soldiers Who Complete Suicide — Petition Circulated
  
  Mental Health America is calling on President Obama to reverse a long-standing, unwritten policy of not sending Presidential letters of condolence to the families of service members who have completed suicide. A resolution approved unanimously by the Executive Committee of the Board of Directors said: “We believe the lack of acknowledgment and condolence from the President can leave these families with an emotional vacuum and a feeling that somehow their sacrifices may not have been as great as others who died while in the military.” Whether a soldier died in combat or because of suicide, nothing diminishes the personal sacrifices each family endured on our country’s behalf. Overturning this policy and sending letters to families will help eliminate stigma and shame associated with suicide.
  
  We are also circulating a petition through our Facebook page. Please sign the petiion and forward to a friend: http://apps.facebook.com/causes/petitions/374. If you are not on Facebook, go to http://www.change.org/actions/view/a_letter_for_every_life_lost.
  
  
  
• Dr. David Shern, president and CEO of Mental Health America, was interviewed on C-SPAN’s American Journal program regarding mental health parity legislation and health reform. You can view the segment here.
  
  
  
• Mental Health America is calling for education efforts to ensure the public is aware of the benefits of the federal mental health parity law. Read more here.

About the Advocacy Network
Mental Health America’s Advocacy Network is a powerful voice for change that is made up of thousands of individuals nationwide who take an active role in protecting America’s mental health through legislative advocacy. Together, we speak out and make our voice heard on equal access to care, federal funding, treatment and prevention.