July 23, 2009

Impact of National Council Member Advocacy: Definition of Federally Qualified Behavioral Healthcare Centers Included in House Energy and Commerce Committee Healthcare Reform Bill

Healthcare Reform Proposals Continue to Progress in House & Senate Committees

HHS FY2010 Budget Bill Approved by House Appropriations Committee Includes $14 Million for Primary and Behavioral Healthcare Integration Grants; Goes to Floor for Debate

CHIPRA Grant Solicitation for Outreach and Enrollment 

Resources from the National Council 

Impact of National Council Member Advocacy: Definition of Federally Qualified Behavioral Healthcare Centers Included in House Energy and Commerce Committee Healthcare Reform Bill

On July 20, 2009, the House Energy and Commerce Committee voted to include an amendment containing the definition of a Federally Qualified Behavioral Health Center (FQBHC) in the  Affordable Health Choices Act. This amendment was introduced by Rep. Frank Pallone (D-NJ) on behalf of Reps. Eliot Engel (D-NY) and Doris Matsui (D-CA).  Once the Energy and Commerce Committee has approved its version of healthcare reform it will be combined and reconciled with the Ways & Means and Education and Labor Committees’ versions of reform.

The definition of FQBHCs is an important first step toward strengthening the safety net that struggles to meet the significant and growing unmet need for comprehensive healthcare services for persons with mental illnesses and addiction disorders. You can learn more about the FQBHC proposal on the National Council's website.

"Creation of FQBHCs places mental health and addictions treatment providers on equal footing with the rest of healthcare, paving the way for our nation to make good on its commitment to persons with serious mental illnesses and addiction disorders — to provide the right care, at the right time, in their communities. We are immensely grateful to Representatives Engel and Matsui for this first step," said Linda Rosenberg, President and CEO of the National Council.

The National Council would like to extend our gratitude to Reps. Engel and Matsui for their leadership on this vital issue and would also like to thank all of our members who advocated in support of this definition as part of Hill Day and other communications with your Members of Congress. As health care reform discussions continue in Congress, stay tuned for further opportunities to support the FQBHC definition.  Please see next story for more information on healthcare reform.

Healthcare Reform Proposals Continue to Progress in House & Senate Committees

During the past week, Congressional committees with jurisdiction over health care reform continued to debate the Affordable Health Choices Act, while advocates continue to wait for the Senate Finance Committee's version of healthcare reform.  The following is a summary of committee action and any mental health and/or addiction measures of interest.

Senate Health, Education, Labor and Pensions Committee: The Affordable Health Choices Act was approved by the Committee on July 15, 2009.  Provisions of interest include:

• Habilitative and rehabilitative services and devices in the minimum insurance packages offered on the exchange
• Ban of pre-existing condition exclusions
• End of annual and lifetime insurance caps with a limit on out-of-pocket expenses
• Community Living Assistance Supports and Services (CLASS) Act, which would provide long term services and supports to the chronically ill. The National Council, as a member of the Consortium for Citizens with Disabilities (CCD), sent a thank you letter to Senator Edward M. Kennedy (D-MA) for his efforts in support of health care reform. 

Education and Labor Committee:  The Affordable Health Choices Act was approved by the Committee on July 17, 2009.  Provisions of interest include:

• mental health and substance use screenings, including the SBIRT, are included as a mandatory reimbursable preventative service

Ways & Means Committee:  The Affordable Health Choices Act was approved by the Committee on July 17, 2009, and the CBO indicated the legislation would be budget neutral.  Provisions of interest include:

• $465 billion saved by limiting the spending growth of Medicaid and Medicare
• $544 billion earned by placing a surtax on the adjusted gross income of upper-income taxpayers, with a top rate of 5.4 percent for individuals making $800,000 a year and married couples making $1 million; the surtax would affect the top 1.2 percent of taxpayers

Energy and Commerce Committee:  The Energy and Commerce Committee continues to debate healthcare reform legislation.  Provisions of interest include:

• On July 20, 2009, Rep. Frank Pallone’s (D-NJ) amendment which would define Federally Qualified Behavioral Health Centers (FQBHCs) was accepted.  For more information on the FQBHC designation see the FQBHC story in this issue. 
• The CLASS Act which would provide long term services and supports to the chronically ill was included as part of the Pallone Amendment.

For more information on healthcare reform make sure and sign up to participate in the National Council's Healthcare Reform Update Webinars and review the July 22 Healthcare Reform Update Webinar presentation.

HHS FY2010 Budget Bill Approved by House Appropriations Committee Includes $14 Million for Primary and Behavioral Healthcare Integration Grants; Goes to Floor for Debate

The House Appropriations Committee approved the FY2010 budget for the Departments of Labor, Health and Human Services (HHS), and Education on July 17, 2009.  The mental health section of the HHS bill totals $1 billion, which is $22 million more than President Obama’s request and $39 million more than the FY2009 budget.  Included in the bill are:

• $7 million increase to the initiative to integrate the primary and behavioral healthcare for a total allocation of $14 million 
• $17 million increase for Children’s Mental Health Services Program for a total budget request of $125.3 million
• $8.6 million increase for Projects for the Assistance in Transition from Homelessness (PATH) for a total allocation of $68 million

Substance Abuse Treatment Programs of Regional and National Significance would receive an increase of $45.7 million which would raise total funding to $459.7 million.  Included in the bill are:

• $35 million increase for drug courts
• $15 million for ex-offender re-entry programs

Additionally, the bill lifts a ban on federal funds being used for needle exchange programs.  However, the bill does indicate that federal funds cannot be used for a needle exchange program that is located within 1000 feet of facilities such as schools and parks.  The lift of the ban reverses a Bush Administration policy.  The National Council recently signed onto a Letter of Support to lift the ban. 

The National Council would like to thank our members for their tireless advocacy efforts, which were instrumental in the creation of the integration grants last year and the doubling of allocations for FY2010 in the House HHS Budget Bill.

For more information on the FY2010 Appropriations for HHS see the National Council's Budget Chart and the Appropriations Committee's statement.

CHIPRA Grant Solicitation for Outreach and Enrollment

The Department of Health and Human Services (HHS) will award a total of $80 million during two or more award cycles to eligible entities to conduct targeted outreach, resulting in increased enrollment in Medicaid and CHIP of eligible but unenrolled children.  Eligible entities include: a state, a local government, an Indian tribe or tribal consortium, a tribal organization, an urban Indian organization, or an Indian Health Service provider, a Federal health safety net organization, a national, state, local, or community-based public or nonprofit private organization, including organizations that use community health workers or community-based doula programs, a faith-based organization or consortia, an elementary or secondary school, and faith-based and community organizations are eligible to apply. 

Applications from community organizations will require a letter of support from the State agency verifying that community nonprofit has sufficient capabilities to share data with the State and provide technical assistance on enrollment activities to potential enrollees.  Organizations must apply online; all questions regarding the grant can be sent electronically to Mary.Greene@cms.hhs.gov.   The deadline for the first cycle is August 6, 2009.

For more information on the requirements of the grant visit the Centers for Medicare & Medicaid Services website. 

Resources from the National Council

The National Council's website is frequently updated with issue briefs, letters, and other materials of interest to members. Please take notice of these recent
updates:

The National Council sent a Letter of Support to Senator Reed in favor of his amendment to include $50 million in co-location grants in the Affordable Health Choices Act.

The National Council signed onto a Letter of Support in favor of increasing the alcohol excise tax to help pay for healthcare reform.

The National Council signed onto a Letter of Support in favor of the Patient-Centered Outcomes Research Act of 2009.

The National Council submitted comments as part of the CCD on HUDS's Notice of Funding Availability on Section 8 rental assistance.

The Natioanl Council signed onto a letter to support the $11.6 billion funding suggested by the President's bduget for SSA in FY2010.

National Council launched its new Key Contacts Network Webpage for advocates.

National Council and Netsmart Technologies submitted comments  on the definition of "meaningful use."

MAPRx submitted comments on the Medicare Part D Transition Letter: CY 2010

Please contact Chuck Ingoglia, Vice President, Public Policy, with federal policy questions.

The Public Policy Update is a weekly e-newsletter published by the National Council for Community Behavioral Healthcare. Managing Editor - Christina Hammond. Vice President, Public Policy - Chuck Ingoglia. Director of Practice Improvement - Chris Loftis. Director of Public Policy - Alexa Eggleston. Director of Policy and Advocacy - Laura Galbreath.