Public Policy Update: June 18, 2009
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June 18, 2009
Work Group on Meaningful Use Sends Recommendations for Definition to Health IT Policy Committee
Senate HELP Committee Reviews Healthcare Reform; CBO Provides Partial Scoring of Legislation
SAMHSA’s Core Consensus Principles for Health Reform Presented at Meeting
Women Veteran’s Health Care Improvement Act Approved by House Committee
Senate Judiciary Committee Holds Hearing on National Criminal Justice Commission Act
Resources from the National Council
National Council and Other Advocates Host Briefing on Chronic Disease Management for Alcohol and Drug Problems
On June 11, 2009, the National Council, Faces and Voices of Recovery, Therapeutic Communities of America, and the National Association of State Alcohol and Drug Abuse Directors Inc. (NASADAD) hosted a Congressional briefing highlighting the cost savings derived from providing comprehensive treatment services and supports to individuals with addiction disorders.
David L. Rosenbloom, PhD of the National Center on Addiction and Substance Abuse (CASA) highlighted CASA’s latest report, Shoveling Up II: The Impact of Substance Abuse on Federal, State, and Local Budgets, which found that federal, state, and local governments spend $467.7 billion as a result of untreated substance abuse and addiction or 10.7% of their entire budgets for the year.
Panelists included:
- Michael L. Dennis, PhD Senior Research Psychologist at Chestnut Health Systems & National Council member
- Michael Botticelli, Director of the Bureau of Substance Abuse Services for Massachussetts
- Gale Saler, Regional Director of Guadenzia, Inc.
- Beverly J. Haberle, Project Director for Pennsylvania Recovery Organization – Achieving Community Together (PRO-ACT)
Dennis supported CASA’s findings by illustrating several physical, emotional, and financial outcomes for untreated patients with substance abuse and addiction problems. He recommended a system of Recovery Management Checkups that would include quarterly monitoring meetings post-treatment, as well as motivational interviews for those patients that may need to return to treatment. Meanwhile, Botticelli noted the important role that the Substance Abuse Prevention and Treatment (SAPT) Block Grant plays in providing comprehensive services and supports and stressed how imperative it is to support an increase in contributions to the grant as outcomes data shows it has helped people remain alcohol and drug free, obtain or regain employment, stay out of the criminal justice system, and find stable housing.
All speakers’ comments emphasized the importance of investing in prevention and early intervention, treatment and disease management, and expanded research, all of which are expected to save the federal, state, and local governments billions of dollars. Panelist presentations and further information about these organizations can be found online.
The National Council would like to thank the Congressional Addiction, Treatment, and Recovery Caucus for their continued support and dedication to substance abuse and addiction advocacy and initiatives.
This article was authored by Anupriya Grover, Policy Intern at the National Council.
Attention National Council Hill Day Attendees: Complete Online Evaluation of Hill Day and Provide Follow-up Information to Congressional Offices
Since June 10, 2009, when almost 380 Hill Day participants went to the Hill to advocate on behalf of people with mental health and substance use illnesses, the National Council has been receiving feedback from participants. If you have not yet filled out the online evaluation please fill it out today.
The National Council staff continues to work in following up with Congressional offices request for information. Please contact the Christina Hammond if you need any help in providing additional information that a Member of Congress or his/her staff may have requested. Also, if you have not yet sent a note of appreciate to the offices that you visited; we would encourage you to do so. Be sure to include a summary of your discussion and asks, a thank you for the time the individual spent with you, any follow materials they requested and request to be kept informed on the issues you discussed. You can find the contact information for your elected officials on the National Council’s webpage.
Medicaid Services Restoration Act Introduced in Senate; Clarifies Scope of Rehab and Case Management Services
The Medicaid Services Restoration Act of 2009 (S 1217) was introduced in the Senate on June 9, 2009, by Senators Debbie Stabenow (D-MI), Mark Begich (D-AK) and Blanche L. Lincoln (D-AR). The bill clarifies the definition of rehabilitation to include services for the restoration, attainment, and maintenance of functioning. Additionally, S 1217 expressly authorizes states to use "reasonable and efficient" payment methodologies for the provision of rehabilitation and case management services - including the bundling of daily rates. The bill also creates a new optional service category in Medicaid for Therapeutic Foster Care services. The National Council supports this legislation and would like to thank Senators Stabenow, Begich and Lincoln for their leadership on this important issue.
House Appropriations Committee Approves Department of Justice Budget for FY2010; Includes Increased Funding for MIOTCRA
The House Appropriations Committee approved the FY2010 budget for the Department of Justice (DOJ) (HR2847). The bill includes $30 million for state prison substance abuse treatment programs - an increase of $20 million over FY2009 - in an effort to improve residential substance abuse treatment programs in correctional facilities, and establish and maintain community-based aftercare services for probationers and parolees. The bill also includes $12 million for the Mentally Ill Offender Act - an increase of $2 million from FY2009. The Mentally Ill Offender Act helps states design and implement programs, such as mental health courts, that improve the response of the criminal justice system to offenders with a mental illness. The Appropriations Committee chose not to combine the drug courts and the activities of the Mentally Ill Offender Act as was suggested by the Obama Administrations FY2010 budget. The bill would provide an additional $45 million for drug courts, which provide alternatives to prosecution and incarceration of individuals with substance use problems. It also includes Second Chance Act funding of $114 million. For the latest information on the FY2010 budget visit the National Council’s Federal Budget Webpage. Also see the National Council’s Appropriations Fact Sheet.
Work Group on Meaningful Use Sends Recommendations for Definition to Health IT Policy Committee
The Meaningful Use Work Group was created and tasked by David Blumenthal, M.D., Chair of the Health Information Technology Policy Committee, to recommend a definition of “meaningful use” as is shall apply to electronic health record (EHR). The Work Group sent recommendations for the definition of “meaningful use” to the Health IT Policy Committee. The American Recovery and Reinvestment Act authorizes the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive for physician and hospital providers who are successful in becoming “meaningful users” of an EHR. These incentive payments begin in 2011 and will gradually decrease until 2015 where CMS will begin charging a penalty under Medicare.
The Work Group provided a meaningful use matrix based on priorities developed by the National Quality Forum in 2008 including: patient engagement, reduction of racial disparities, improved safety, increased efficiency, coordination of care, and improved population health. An additional area related to privacy and security was added to emphasize the importance of preserving patient protections and ensuring patient trust in the use of electronic health records. The matrix represents a set of objectives and care processes that the workgroup believes should inform the ultimate definition of meaningful use. Comments on the meaningful use matrix can be submitted to the Office of National Coordinator for Health Information Technology (ONC) by 5:00 pm est on June 26, 2009 at MeaningfulUse@hhs.gov.
For more information read the Work Group's Preamble.
Senate HELP Committee Reviews Healthcare Reform; CBO Provides Partial Scoring of Legislation
The Senate Health, Education, Labor and Pensions (HELP) Committee began to review the Affordable Health Choices Act on June 17, 2009. The legislation was introduced by Senator Christopher Dodd (D- CT) on behalf of Chairman Edward Kennedy (D-MA) on June 9, 2009. The draft legislation contains several important features including:
- individual mandate to purchase health insurance
- federal government subsidies for individuals and families to purchase insurance with an income level between 150-500% of the federal poverty level (FPL)
- health insurance exchanges or gateways created at the state level with support from the federal government
- definitions of benefit packages offered on the exchange would include essential healthcare benefits including mental health and substance abuse services and rehabilitative and habilitative services
- Community Living Assistance Supports and Services (CLASS) Act to help ensure individuals are able to function as independently as possible within their homes, families, and their communities
- prohibitions on insurers denying coverage due to a “Medical condition (including both physical and mental illnesses)” pg 13 lines 7-8
- coverage of dependent children who are less than 27 year of age
Most notably, the legislation did not contain a tax on health insurance benefits provided by employers, an employer mandate or a “public plan” option. However, there has been some indication by the HELP Committee that they are still considering a “public plan” option as well as indications by the Senate Finance Committee that their version of healthcare reform will include such an option.
On Monday, June 15, the Congressional Budget Office (CBO) sent a letter to Sen. Kennedy with an initial and partial scoring of the Affordable Health Choices Act, which concluded the bill would expand health insurance coverage to 16 million Americans and cost $1 trillion over the next ten years. A recent Kaiser Family Foundation poll indicated Americans’ dedication to overhauling the healthcare system although there is growing concern over how to pay for reform. The National Council recently signed onto a letter in support of raising the alcohol excise tax to help pay for healthcare reform. Write your Members of Congress today in support of raising the alcohol excise tax to pay for healthcare reform.
SAMHSA’s Core Consensus Principles for Health Reform Presented at Meeting
On Monday, June 8, 2009, the Department of Health and Human Services Substance Abuse & Mental Health Services Administration (SAMHSA) held a meeting to discuss “Ensuring U.S. Health Reform Includes Prevention and Treatment of Mental and Substance Use Disorders – A Framework for Discussion: Core Consensus Principles”.
SAMHSA synthesized the recommendations of over sixty mental health and addiction organizations, including the National Council, to develop a document containing nine principles for any health reform proposal. Acknowledging the ambitious timetable set by Congress, speakers stressed the need to determine where mental health fits in with overall health reform.
The Core Principles emphasize the need for the following:
- A National Health and Wellness Plan for all Americans
- Universal coverage and compliance with parity laws
- Long-term fiscal sustainability
- Coordination and integration of care for physical, mental, and substance use conditions
- Prevention and early intervention, with a “whole health, person-centered approach” to healthcare
- Implementation of national standards, including evidence-based practices, for clinical and quality outcomes tied to reimbursement and accountability
- Utilization of Health Information Technology for both physical health and mental health, including the adoption of uniform formats for electronic health records
- Development of the mental and substance abuse disorders workforce to raise the level of quality of care available throughout the system
- Maintenance of a safety net of block grants and other resources until new health reform programs are fully implemented and accessible
This article was authored by Hayley Cotter, Policy Intern at the National Council.
Women Veteran’s Health Care Improvement Act Approved by House Committee
The House Veterans’ Affairs House Committee approved the Women Veteran’s Health Care Improvement Act (HR 1211) on June 10, 2009; it has not yet been scheduled for full consideration by the House. The legislation was first introduced on February 26, 2009 by Rep. Stephanie Herseth Sandlin. The legislation would create a new program to offer graduate medical education, training and certification to mental health professionals who provide counseling, care and services for veterans suffering from sexual trauma and post-traumatic stress disorder. The legislation would also authorize $1.5 million in FY 2010 and 2011 for a pilot program to provide child care to veterans who are receiving mental health or other intensive care services at VA facilities. Watch the National Council’s Veterans Webpage to see the latest news on veteran’s behavioral health issues.
Senate Judiciary Committee Holds Hearing on National Criminal Justice Commission Act
The Senate Judiciary Committee held a hearing on the National Criminal Justice Commission Act of 2009 (S 714), which was introduced by Senator Jim Webb (D-WV) on March 26, 2009. The legislation would create a blue-ribbon commission charged with conducting an 18-month, top-to-bottom review of the nation’s entire criminal justice system and offering concrete recommendations for reform. The commission is intended to provide clear standards of prison administration and meaningful avenues of re-entry for those who have served their time.
“The goal of this legislation is nothing less than a complete restructuring of the criminal justice system in the United States,” said Webb at the hearing. “Only an outside commission, properly structured and charged, can bring us complete findings necessary to do so.”
Stay tuned to the Public Policy Update to receive the latest information on S 714.
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:
NEW Fact Sheets from the National Council's Fifth Annual Hill Day June 9-10, 2009
- Summary of National Council’s Advocacy Priorities and Healthcare Reform Agenda
- Fact Sheet: Healthcare Reform and Parity
- Fact Sheet: Federally Qualified Behavioral Health Centers
- Fact Sheet: Co-Sponsor S1136 Mental Illness Chronic Care Improvement Act
- Fact Sheet: HIT Funding Initiatives
- Fact Sheet: Co-sponsor HR1011 Community Mental Health Services Improvement Act
- Fact Sheet: FY2010 Appropriations for mental health and addictions
- Fact Sheet: Support $150 Million Increase in the SAPT Block Grant
- Fact Sheet: Support Increase Funding for Primary Care and Behavioral Health Integration
- Fact Sheet: Mentally Ill Die 25 Years Earlier on Average
NEW Documents from the Public Policy Committee on June 9, 2009
- Primary Care and Behavioral Health Integration
- Full Report: Healthcare Payment Reform and the Behavioral Health Safety Net
- Fact Sheet: Healthcare Payment Reform and the Behavioral Health Safety Net
- National Council Comments to the Senate Finance Committee on Healthcare Reform
- Parity Coalition's Final Comments
- National Council's Parity Comments
NEW Presenations from the Public Policy Committee on June 9, 2009
- National Council Policy Agenda Overview by Linda Rosenberg
- Medicaid Expansion Impact, The Urban Institute
- ARRA and HIT Funding, Kevin Scalia
- Healthcare Payment Reform, Dale Jarvis
- Parity, Alexa Eggleston
- Federal Appropriations Update, Alexa Eggleston
The National Council launched its new Children and Youth page on its website.
The National Council along with other health organizations sent a letter to Senator Baucus on the Finance Committee uring the includion of behavioral health in any HIT funding opportunities. The National Council also supplied a letter template to members to email to key Members of Congress.
The National Council sent a Letter of Support to the Senate Committee on the Judiciary in support of the Juvenile Justice and Delinquency Prevention Reauthorization Act of 2009.
The National Council recently released a new Fact Sheet on the Mental Health Services Block Grant.
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 State Policy - Chris Loftis. Director of Public Policy - Alexa Eggleston. Director of Policy and Advocacy - Laura Galbreath.
