Public Policy Update: December 22, 2011
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December 22, 2011
Editor’s Note: At the National Council, we try to keep on top of the latest technology and tools for disseminating information and educating the public about behavioral health. So, we’re pleased to announce that the PPU is now on Twitter! Each Thursday, we’ll be tweeting our top stories using the handle @nationalcouncil. We’ll also include sample tweets in each PPU to make it easy for you to share all the latest behavioral health policy news with your social networks.
Overcoming a political impasse, Congress late last week approved the remaining nine bills that make up the 2012 budget. The “megabus,” as the 9-bill package was dubbed, includes several notable funding increases for behavioral health programs, a major victory given the massive reductions to behavioral health that were included in the budget proposal by the House of Representatives. Overall, the Substance Abuse and Mental Health Services Administration saw a $27 million cut, for a total of $3.5 billion in funding for the agency. This total amount is still subject to a 0.189% decrease that was included in the megabus bill. Details on how this cut will be applied are forthcoming.
Within the SAMHSA budget, several key programs received funding increases:
- Mental Health Block Grant: $460.6 million (+$41 million vs. FY 2011)
- Substance Abuse Prevention and Treatment Block Grant: $1.8 billion (+21 million vs. FY 2011)
- Primary Care and Behavioral Health Integration (PBHCI): $30.8 million for SAMHSA portion (+$3 million vs. FY 2011; this figure does not include the additional Prevention and Public Health Fund money that may be allocated to the program)
- Primary Care and Behavioral Health Integration Technical Assistance: $2 million (this is a new line item in the budget; funding previously came from the PBHCI line item)
- Project LAUNCH: $34.7 million (+10 million vs. FY 2011)
- National Child Traumatic Stress Network: $45.8 million (+$5 million vs. FY 2011)
Within the Center for Mental Health Services, the following programs were level funded from 2011: Children’s mental health services ($117 million); Projects for Assistance in Transition from Homelessness ($64.9 million); Jail Diversion ($6.2 million); and Homelessness Prevention ($30.8 million). Youth violence prevention received a $54.3 million cut, from $77.5 in 2011 to $23.2 million in 2012.The Co-occurring State Incentive Grant, which received $2.2 million in 2011, was eliminated, as was the Community Resilience and Recovery Initiative.
Within the Center for Substance Abuse Treatment, the agreement includes: $28.2 million for Screening, Brief Intervention, Referral, and Treatment (level vs. FY 2011); $98.5 million for Access to Recovery level vs. FY 2011), and $67.6 million for criminal justice activities (+$2.5 million vs. FY 2011).
Click here for more details about specific program funding levels (the section for SAMHSA begins on p. 39).
Let it Snow! Linda Rosenberg and Chuck Ingoglia Discuss the Future of Behavioral Health Funding in New Blog Feature
In the words of the famous holiday song, “the weather outside is frightful” – and particularly so as we look at the funding climate for healthcare services in the years ahead. What do proposed spending cuts in 2013 and beyond mean for behavioral health? In a new feature on our blog, join Linda Rosenberg and Chuck Ingoglia of the National Council as they discuss Medicaid, the current political environment, and the future of funding for the mental health and addictions safety net.
Chuck Ingoglia, Vice President, Public Policy: Let’s start by talking about what we have achieved this year in terms of protecting Medicaid and behavioral health funding.
Linda Rosenberg, President & CEO: You know it’s funny, in a way, Chuck. I think that what we may have achieved is something that didn’t happen, which was the Supercommittee didn’t come to a decision. Maybe that was a win in some ways for people with serious mental illnesses and addictions and the organizations that serve them – that their coming to a deal would have been more dangerous than their not coming to a deal.
Chuck: Absolutely, Linda. I think we can take Congress not reaching a conclusion as a victory. Many people mobilized within the disability community, within the provider community, and within our membership to send the message to the Supercommittee that Medicaid is too important right now to cut, and I do think that was a victory.
Linda: But Chuck, do you think that we just delayed the inevitable? Healthcare will remain a banner issue both through the elections and afterward, when Congress gets back to looking at healthcare and Medicaid. What strategy do we need to articulate then? (Click here to keep reading.)
Share this story on social media: Let it Snow! Linda Rosenberg, Chuck Ingoglia discuss the political future of behavioral health funding http://wp.me/p11mrA-wC @nationalcouncil
Medicare payment rates will drop by 27% in January if Congress fails to take action on a bill to stave off the automatically scheduled cuts.
The 27% cut is this year’s scheduled cut under the Sustainable Growth Rate (SGR) formula, which requires Congress to adjust Medicare payment rates each year to align payment with a predetermined rate of growth in the program. In practice, this has meant that Medicare payments would take an ever-increasing yearly cut – but each year, Congress has passed legislation postponing those cuts.
Now, a 2-month “SGR fix” has been attached to legislation that would extend the current payroll tax holiday and unemployment compensation benefits until February 28. On Saturday, the Senate passed this legislation with overwhelming bipartisan support on a vote of 89-10. However, House Republicans balked at the deal, arguing that the Senate should work with them to resolve the differences between the Senate bill and a different version passed by the House earlier this month. The House version, which passed on a largely party-line vote, included several unrelated “policy riders,” such as the construction of an oil pipeline and a pay freeze for federal employees.
With both the House and the Senate scheduled to be in recess until mid-January, it is unclear whether legislators will be able to avert the Medicare cut before it goes into effect. Both the House and the Senate held strong to their positions this week, with the House insisting that the Senate return to Washington for conference committee negotiations, and the Senate urging the House to pass the bipartisan deal and continue negotiations on a longer-term extension after the new year. However, as political pressure to reach a deal mounts, Congress may return to Washington early to work out another deal.
HHS Announces Guidance on Essential Health Benefits; National Council Analysis Available on MentalHealthcareReform.org
On December 16, the Department of Health and Human Services released its initial guidance on how states and insurance plans should implement the essential health benefits provisions of health reform. The HHS information bulletin is the latest step in an ongoing process of determining what type of coverage will be available to consumers in Medicaid benchmark plans and the state health insurance exchanges when health reform is fully rolled out in 2014.
The National Council has published on our blog an analysis of how this guidance impacts behavioral health. A summary is below, and the full analysis can be read on MentalHealthcareReform.org.
Rather than designing one standard benefit package for all health plans in the nation to follow, HHS has opted to leave states with broad discretion in defining essential benefits in their state. The recent information bulletin proposes to allow states four options for selecting a “benchmark” plan whose covered benefits would be the basis of the EHB package in that state. This approach is an indication that the Obama Administration plans to allow states a fair amount of flexibility in carrying out the new insurance requirements of the ACA. How behavioral health will fare during this process may vary on a state-by-state basis and will depend in large part on how each state decides to approach the issue.
Of particular importance to National Council members, the bulletin confirms that mental health and addictions services must be offered at parity with medical/surgical benefits. If the plan that is selected as the state’s benchmark plan does not currently include these services at parity, modifications must be made to the benchmark plan. Parity applies to individual plans as well as small group plans – a provision that was inserted into the law as an amendment by Senator Debbie Stabenow during the health reform debate.
HHS is accepting public comments on this information bulletin through January 31, 2012. Click for our detailed analysis of the bulletin and instructions on how to comment.
Hearts, Minds, Congress: Win the attention of Congress and a new Kindle in our Hill Day Slogan Contest, Launching Dec. 28!
Have you ever seen a slogan for an organization or a tagline for an advertisement that you just couldn’t get out of your head? We have – and we want to make Hill Day 2012 just as memorable for our attendees and the Members of Congress that they meet with on June 25-26, 2012! Help us convey the importance of behavioral health to Congress by sending us your best idea for a slogan – and get a chance to win an Amazon Kindle in the process.
Here’s how it works: from Dec. 28-Jan 13, visit our Facebook contest page and submit your best idea for a Hill Day slogan. Need inspiration? Here are some slogans we love (but don’t feel limited by these examples – we want your most creative and inspiring ideas!):
- “Make the first five count” Easter Seals
- “Speak now for kids” National Association of Children’s Hospitals
- “The official sponsor of birthdays” American Cancer Association
National Council staff will select the winning slogan, and the winner will receive an Amazon Kindle with wi-fi and a 6-inch e-ink display. And of course, you’ll also get the pride of having your slogan printed on our Hill Day materials, splashed on the Hill Day website, and spoken in the halls of Congress on Hill Day. Put your creative thinking cap on, and stay tuned for the official launch of the contest on Dec. 28!
To say thank you to our members for your hard work and advocacy over the last year fighting to keep behavioral health funding intact, the National Council has created this special holiday song for you! Written and performed by two members of our Public Policy team, this song asks Congress not to cut funding for SAMHSA – to the tune of “I Have a Little Dreidel.”
Like this song? Let your friends like it too by sharing it on your social media sites:
Facebook: Loving this happy holidays video to the tune of "I Have a Little Dreidel" from @TheNationalCouncil. Nothing like asking Congress to preserve behavioral health funding and ringing in the holidays at the same time! http://wp.me/p11mrA-w4
Tweet: Happy Holidays, Happy Behavioral Health! Policy and advocacy rolled into one sing-along video from @nationalcouncil http://wp.me/p11mrA-w4
