December 17, 2009

Action Needed: Tell Us About Challenges You Expect to Face in 2010

Congress Sends Omnibus Appropriations Bill to President Obama

Secretary Sebelius Delivers Remarks on Integration of Mental and Physical Health Services at National Council Member Organization

Jobs for Main Street Act Approved by House; Includes Extension of ARRA FMAP Increase

National Council Releases Results from Member Survey on Children’s Services

Senate Nears Final Deal on Healthcare Reform

Senate Passes Veterans’ Health Bill

PA Welfare Secretary Takes Post at HUD

Bill to Treat Depression and Bipolar Disorders Introduced in House

Reminder: Complete Brief Capital Needs Survey by Dec. 25

Action Needed: Tell Us About Challenges You Expect to Face in 2010

Mental Health Weekly, the field’s most highly read and regarded periodical, is seeking input from the provider community for its special 2010 Preview issue releasing Jan 4, 2010. This is your chance to be heard by policymakers, administrators, funders, and colleagues. Email your comments, in 200 words or less, to MeenaD@thenationalcouncil.org by Mon., Dec. 21. We will collect all member responses and forward them to Mental Health Weekly.

Your comments should speak to what the most pressing challenges are that you expect to face in 2010 and how you plan to address them. The National Council suggests that you try to address three points in your comments:

1. The challenges posed by continuing state and local budget cuts and the need for block grant increases to compensate the dwindling resources.
2. The need for federal status and reimbursement models to equip community mental health providers with adequate capacity to meet the significant increase in demand expected with the implementation of healthcare reform and parity
3. The critical need to strengthen HIT infrastructure and a call to policymakers to include mental health and addictions services providers in the increased HIT funding being made available under recent federal legislation. 

We look forward to receiving your comments by Dec. 21. Please include your name, title, organization, and contact info with your comments.


Congress Sends Omnibus Appropriations Bill to President Obama

Both the House and the Senate have approved an omnibus appropriations bill that includes funding for Labor-HHS-Education and Commerce-Justice-Science.  The spending bill must now be signed into law by President Obama.  The bill includes several important spending increases for mental health and addictions services, including:

• $14 million for SAMHSA’s co-location grant program, double the FY 2009 allocation of $7 million
• $1.8 billion for the Substance Abuse Prevention and Treatment Block Grant, a $20 million increase vs. FY 2009 levels
• $121 million for children’s mental health services, a $13 million increase vs. FY 2009
• $65 million in grants to states for homelessness, a $5 million increase vs. FY 2009
• $12 million for the Mentally Ill Offender Treatment Crime Reduction Act, a $2 million increase
• $100 million for Second Chance Act Recovery programming, four times the FY 2009 allocation of $25 million

Funding for the Mental Health Block Grant remained flat at $421 million.  The National Council has updated our Fiscal Year 2010 Budget Chart with the newest funding levels from the omnibus bill. We are grateful to all of the National Council members who have supported these budget increases at Hill Day and in other interactions with their members of Congress.


HHS Secretary Sebelius Delivers Remarks on Integration of Mental and Physical Health Services at National Council Member Organization

Secretary of Health and Human Services Kathleen Sebelius on Wednesday delivered remarks at Sheppard-Pratt Health System in Maryland.  Much of her speech was in support of integrated care programs such as the SAMHSA co-location grant that received a 100% increase in funding in the recently passed omnibus spending bill:

“We know that these integrated care models can be especially effective when they combine behavioral and physical health conditions.  That’s because mental illnesses and substance use disorders usually go hand in hand with other physical conditions.  We know that the sicker you are, the more likely you are to be depressed: forty percent of older patients with advanced heart failure have major depression.  And we also know that when physical and mental health problems come together, they usually make each other worse.  For example, the cost of treating a patient a medical problem and comorbid psychiatric condition is twice as high as the cost for a patient with the medical condition alone.

“We already have several successful examples of how to provide this kind of integrated care.  Health care systems like Cherokee Health, Intermountain Health, and the Veterans Administration have all successfully included mental health into their primary care systems.  Now the challenge is to spread these models, especially to smaller practices that may not have the same experience dealing with mental health and substance abuse problems. 

“And we also need to make integration work the other way.  We know that barely half of public mental health centers have the capacity to provide medical treatment for physical health problems either onsite or through referral.  We need to do better, and SAMHSA is currently administering a grant program designed to figure out how we can incorporate primary care services into these community behavioral health centers.”

The full text of Secretary Sebelius’ remarks will be available online at http://www.hhs.gov/secretary/speeches/index.html


Jobs for Main Street Act Approved by House; Includes Extension of ARRA FMAP Increase

The House this week voted to approve its jobs creation legislation, the Jobs for Main Street Act of 2010.  The bill contains $75 billion in investments in infrastructure, public service jobs, and emergency relief.  Two provisions in the bill are of particular interest to behavioral health providers: a six-month extension of the increase in the Federal Medical Assistance Percentage (FMAP) enacted under the American Recovery and Reinvestment Act, and a provision to freeze Department of Health and Human Services (HHS) poverty guidelines at 2009 levels in order to prevent a reduction in eligibility for public programs, including Medicaid.  A summary of all the spending provisions in the bill is available online.  The National Council has signed on to a letter in support of the FMAP extension.


National Council Releases Results from Member Survey on Children’s Services

The National Council recently conducted a survey of member organizations to gain new insights into the children’s services they provide.  The survey identified the major issues in populations served, financing structures, and challenges in providing services:

• Populations Served: While a majority of survey respondents provide services across the age spectrum, slightly more than a third of the respondents are primarily child and adolescent providers, delivering 90% or more of their services to children and youth.
• Financing: Medicaid, self-pay, and commercial insurance were the top three payors.  For the majority of respondents, Medicaid accounts for the largest percentage of the children and youth service budgets.
• Challenges: The top challenges listed by providers were lack of funding to cover service costs, misunderstanding of how to pay for parental participation, inadequate coordination with adult services systems, and lack of access to qualified professionals to evaluate and manage medication needs.

The National Council would like to thank our members who participated in the survey.  The full survey results are compiled in this fact sheet.  Additional information is available on the Children and Youth section of our website.


Senate Nears Final Deal on Healthcare Reform

The Senate may be near a final deal on healthcare reform that could allow the bill to come to a vote before Christmas.  While details are sparse, reports indicate that a compromise reached last week that would have allowed Americans age 55-64 to buy in to Medicare has been dropped from the bill due to the strong objections of some centrists in the Democratic caucus.  Other details have not yet been released, and the Congressional Budget Office is in the process of analyzing the bill to determine its cost.  Senate Majority Leader Reid says he plans to move Friday to bring the debate to a close and hold a vote on the bill by Dec. 23 or 24.  Even if the Senate is able to meet this deadline, several hurdles remain, since both chambers of Congress must approve the same version of the bill before it can be sent to President Obama for his signature.  It is unclear at this point what route Congressional leadership will choose to take to reconcile the bills: the House could choose to hold an up-or-down vote on the Senate’s bill, or the House and Senate could appoint a conference committee to work out the differences between the two chambers’ bills. 

Families USA has released a report examining how the Senate healthcare reform bill will affect health coverage. It provides state-specific numbers on how many people will gain coverage under the bill in its current form, including the number of people in each state who will be newly eligible for Medicaid.  The report also provides information on how many people will be uninsured if Congress does not pass healthcare reform.

Stay tuned to the Public Policy Update and the National Council’s healthcare reform update webinar series for the latest information on healthcare reform.  You can also access a side-by-side comparison chart of the House and Senate bills on our website.


Senate Passes Veterans’ Health Bill

The Senate in November voted to approve an omnibus veterans’ health bill, the Caregivers and Veterans Omnibus Health Services Act of 2009 (S. 1963).  Sec. 306 of the legislation directs the Secretary of Veterans’ Affairs to establish a program to provide peer outreach and support services, readjustment counseling, and other mental health services to veterans of the Iraq war and their families. In areas that are not adequately served by other health facilities, the Department must contract with community mental health centers to provide the services. 

S. 1963 was agreed to on a vote of 98-0 and was sent to the House, where it has been referred to the Committee on Veterans’ Affairs and is awaiting a hearing.


PA Welfare Secretary Takes Post at HUD

Estelle Richman, the head of Pennsylvania’s Department of Public Welfare, has announced she is stepping down to take the post of Chief Operating Officer at the U.S. Department of Housing and Urban Development (HUD).  Richman will begin her job at HUD on Jan. 4, 2010.  As Welfare Secretary, Richman oversaw agency efforts that resulted in an increased percentage of foster children finding permanent homes, a drop in the waiting list for mental-retardation services, improved child-support collection programs, and the creation of the state’s first Bureau of Autism.  Prior to her job with the state Public Welfare Department, Richman held several offices in Philadelphia, including Managing Director, Director of Social Services, Commissioner of Public Health, and Deputy Commissioner for Mental Health, Mental Retardation and Substance Abuse Services.


Bill to Treat Depression and Bipolar Disorders Introduced in House

A bipartisan group of Representatives has introduced legislation to establish national centers of excellence for the treatment of depression and bipolar disorders.  The bill, known as the ENHANCED Act (H.R. 4204), also authorizes federal support for the development of evidence-based treatment standards and clinical guidelines for improving the detection of depression and bipolar disorder.  The bill provides further support to individuals with these disorders by establishing resources for professional education and training and the reduction of the stigma associated with mood disorders.

A similar bill  was introduced in the Senate earlier this year. The National Council has written a letter in support of that bill to Senator Stabenow, one of its sponsors.


Reminder: Complete Brief Capital Needs Survey by Dec. 25

In 2007, the Community-Based Mental Health Infrastructure Improvements Act (S. 2183/ HR 4899) was introduced in Congress. This bill would amend the Public Health Service Act to create a new grant program that will explicitly support the construction, expansion, and modernization of facilities used to provide mental health and addiction treatment services. It is our understanding that Congressional support for this bill persists, and an opportunity to reintroduce this bill in 2010 may arise. However, we need your help to support this effort: Please complete a brief online survey by Dec. 25 so we can ensure that this bill is responsive to your infrastructure needs!