November 12, 2009

House Votes to Approve Health Care Reform Legislation; Includes Key Mental Health & Substance Use Services Provisions

ACTION NEEDED: Urge Your Senator to Support the Frank Melville Housing Investment Act for Individuals with Disabilities

Survey Finds Barriers to Veterans and Mental Health; Veterans Mental Health Act Still Not Implemented

CMS Releases Guidance on Implementing Mental Health Parity for CHIP & Medicaid Plans

H1N1: HHS Secretary Authorizes Reimbursement for Providers
 

House Votes to Approve Health Care Reform Legislation; Includes Key Mental Health & Substance Use Services Provisions

On Saturday, Nov. 7, the House voted 220-215 to approve its version of healthcare reform legislation.  The vote was predominantly along party lines, although 39 Democrats voted against the bill, and 1 Republican voted in favor of it.  The House healthcare reform bill includes many provisions supporting mental health and substance use treatment, including an expansion of Medicaid eligibility up to 150% of FPL (includes childless adults), an extension of the federal Medicaid aid from the American Recovery and Reinvestment Act until June 2011, and requirements that all health plans offer mental health and substance use treatment benefits.

The momentum for healthcare reform has now shifted to the Senate, where the Congressional Budget Office is still in the process of analyzing the cost of the Senate bill.  The language of the bill has not yet been released to the public.  Once the CBO assigns the bill a score, it will then move to the Senate floor for debate and a vote, where 60 votes are needed to block a filibuster.  If the Senate approves its bill, a conference committee will be appointed to reconcile the House and Senate versions.  The House and Senate leadership have said they hope to complete the process by the end of 2009, but might have to push their final votes into early 2010 if negotiations take longer than expected.


ACTION NEEDED: Urge Your Senator to Support the Frank Melville Housing Investment Act for Individuals with Disabilities

The Senate Banking Committee is considering the Frank Melville Supportive Housing Investment Act of 2009 (S. 1481), a bill that would expand the Section 811 Supportive Housing for Persons with Disabilities Program, a critical federal program that assists the lowest income people with serious and long-term disabilities, including those with mental illnesses and addictions, to live independently in the community by providing integrated affordable rental housing linked with voluntary services and supports.

While the Committee's Chairman, Senator Dodd, has expressed support for S. 1418, we need the support of as many Senators on this Committee as possible to ensure that it passes during Committee vote.  If you live in one of the following states, contact your senator and tell him/her to sign on as a co-sponsor of S. 1418! (AL, CO, CT, FL, HI, ID, IN, KY, LA, MT, NE, NJ, NY, OH, OR, RI, SD, SC, TN, TX, UT, VA, WI)

The National Council strongly supports the intent of S. 1418 and has signed on to a coalition support letter.  Thank you to members that have already responded to this alert.


Survey Finds Barriers to Veterans and Mental Health; Veterans Mental Health Act Still Not Implemented

While the Veterans Mental Health Act was signed into law more than a year ago, a new survey by the National Council for Community Behavioral Healthcare (National Council) finds that veterans still face significant barriers to accessing mental health and substance use treatment. The Act requires the US Department of Veterans Affairs (VA) to partner with community behavioral health centers to increase capacity and expand mental health services to include marriage and family counseling.

The survey of National Council members nationwide shows some of the most serious roadblocks that prevent veterans from getting treatment include:

• Access to Care: Almost two-thirds of respondents said veterans and their families experience long delays to get initial appointments for people in crisis and excessive waits in between appointments.
• Long Distances: Veterans often must travel long distances to the VA or a military base. Travel times can be as long as five hours in rural areas. Others do not have access to a vehicle or public transportation, or may be unable to drive or take public transportation because of physical and mental limitations.
• Stigma: Many veterans are concerned that seeking treatment from the VA or military will be noted in their personnel records, negatively impact their careers, and label them as "weak" or "crazy."
• Lack of Family Involvement: Though the Act specifically includes marriage and family counseling, few family members are involved in treatment. Respondents suggested these services are either not being provided or have not been widely promoted.

National Council members, community-based mental health and addictions treatment organizations, are filling these service gaps by providing a range of treatment and support services for veterans, service members and their families. The survey finds that 90 percent of respondents currently provide mental health and substance use services to veterans, reservists and National Guard. Respondents serve an average of more than 70 veterans, service members and their families a month. Two-thirds of responding organizations have veterans on staff and some provide peer-to-peer support for veterans and service members.

Respondents cited the consequences of not meeting the needs of veterans, service members and their families. For example, Indiana received 69 calls from returning de-activated soldiers that involved suicide attempts during the first six months of 2009. Six of those returning service members ultimately died. Respondents in other states reported problems of domestic violence, divorce, homelessness, unemployment, and criminal justice system involvement.

More information and a survey report is available by contacting the National Council at 202.684.3728.


CMS Releases Guidance on Implementing Mental Health Parity for CHIP & Medicaid Plans

The Centers for Medicare and Medicaid Services has issued a letter to state health officials providing guidance on the implementation of the mental health parity requirements in the Children's Health Insurance Program Reauthorization Act of 2009.  Among other requirements, the letter specifies that CHIP plans must fully comply with the Wellstone-Domenici Parity Act, and Medicaid programs must comply only if the state contracts with managed care or prepaid health plans.  The full letter is available online.


H1N1: HHS Secretary Authorizes Reimbursement for Providers

Recently, Secretary of Health and Human Services Kathleen Sebelius invoked her waiver authority under Section 1135 of the Social Security Act.  This allows for the waiver or modification of certain Medicare, Medicaid, and Children's Health Insurance Program (CHIP) requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and that providers who provide such services in good faith can be reimbursed and exempted from sanctions (absent any determination of fraud or abuse). Once an 1135 Waiver is authorized, health care providers can submit requests to operate under that authority or for other relief that may be possible outside this waiver authority to either the State Survey Agency or CMS Regional Office.  For further information, visit CMS' H1N1 webpage.