After twice failing to muster the 60 votes needed to pass a bill that included a 6-month extension of enhanced federal assistance for Medicaid, the Senate is now considering a scaled-back version of the legislation. On Wednesday, Senate leadership offered a revised package of amendments to the bill, H.R. 4213. The new package would continue the federal assistance for an additional six months, but would phase the level of assistance down over that period of time. 

 

The Federal Medical Assistance Percentage (FMAP), which is the portion of each state’s Medicaid program paid for by the federal government, is currently increased by 6.2 percentage points for all states, with additional aid for states experiencing very high unemployment. This enhanced aid is set to expire on Dec. 31, 2010. Under the new proposal, the increase in FMAP rates would be lowered to 3.2 percentage points from Jan.-Mar. 2011, and to 1.2 percentage points from Apr.-June 2011. This move, along with other spending reductions in the bill, is designed to lower the total cost so as to win over opponents and reach the 60 votes needed for passage. If the Senate moves quickly to a vote on the bill, House consideration of the measure could come as soon as Friday.

 

 

 

On Monday, the U.S. District Court for the District of Columbia dismissed a lawsuit filed by a coalition of insurance groups seeking to block the implementation of the Wellstone-Domenici Mental Health Parity and Addictions Equity Act. The lawsuit had challenged the interim final rules for the enforcement of the parity law issued by the Departments of Labor, Treasury, and Health and Human Services on the grounds that they violated the public notice and comment requirements of the Administrative Procedure Act. The rules are slated to go into effect on July 1.

 

In its decision to dismiss the case, the Court wrote that the Departments had not violated the Administrative Procedure Act when they issued the interim final rules. As evidence that the Departments were justified in acting swiftly to promulgate the rules, the Court cited two letters from Congress signed by 26 Senators and 73 Representatives respectively, that highlighted the need for “specific and timely direction from the agencies to ensure that our citizens receive the mental health and substance use disorder services for which [Congress] fought.” The National Council would like to thank our members who responded to our Action Alerts urging your legislators to sign on to these letters.

 

 

 

Earlier this month, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a draft position paper, describing a modern addictions and mental health system. This document is designed to foster discussion among the Department of Health and Human Services and other federal agencies on how best to integrate mental and substance use disorders into the health reform implementation agenda and also provide guidance to state agencies that are presently making decisions about services available to these populations. 

 

The draft position paper states, “The vision for a good and modern mental health and addiction system is grounded in a public health model that addresses the determinants of health, system and service coordination, health promotion, prevention, screening and early intervention, treatment, and recovery support to promote social integration and optimal health and productivity.  The goal of a “good” and “modern” system of care is to provide a full range of high quality services to meet the range of age, gender, cultural and other circumstances presented with a reasonable waiting period for access to services.”

 

The National Council commends SAMHSA for the initiative and foresight it has exhibited in the creation of its position paper and provided several recommendations that would help to highlight the evidence/effectiveness of individual interventions on individuals with mental illness and/or addictions. Additionally, the National Council suggested that it would be helpful to indicate that some of these interventions that have been developed and utilized for persons with serious mental illness may have application to other populations, such as persons with chronic diabetes (e.g. Intensive case management or ACT).

 

Lastly, the National Council states that the proposal to establish federally qualified behavioral health centers (FQBHCs) would support SAMHSA’s vision of a modern addictions and mental health system in several key ways by establishing uniform service requirements that mirror almost exactly the continuum that SAMHSA has proposed. 

 

You can read the National Council’s comments, in their entirety, online. Stay tuned to the Public Policy Update for a more updated version of SAMHSA’s position paper on a modern addictions and mental health system in the near future. 

 

 

 

If you are looking for tools and training to help empower clients to successfully manage their mental and physical health, then look no further. The National Council is proud to make available a limited number of FREE half and full day trainings in Team Solutions and Solutions for Wellness. These well-known tools have been recently updated and are enhancing clinical programs across the country. If you would like to include a Team Solutions/Solutions for Wellness training in your upcoming regional training, annual conference, or other educational events, contact Laura Galbreath (lauraG@thenationalcouncil.org, 202-684-7457, ext 231) quickly; summer and fall training slots are booking up quickly. 

 

 

 

This year at Hill Day, 500 National Council members will converge in Washington, D.C. to talk to their elected officials about policy issues that impact the behavioral health community. Topics will include behavioral health information technology, federally qualified behavioral health centers, the mental health and substance abuse block grants, and an extension of federal assistance for Medicaid. Visit our Hill Day website to learn more about the issues and read our fact sheets on each topic.