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Ambassadors Brief: December 2014

In This Issue:

FROM CHUCK’S CHAIR

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Dear National Council Ambassadors,

While re-reading How the Grinch Stole Christmas recently, I was reminded of a Hill Day 2014 attendee’s comment that her Representative had never supported behavioral health issues, never would, and she wasn’t sure if it’s worth it to keep trying. As Dr. Seuss might say, it seemed like this Rep’s heart was just two sizes too small.

I can certainly understand the feeling. But if there’s one thing I’ve learned from my years on the Hill, it’s that today’s opponent (or indifferent bystander) is tomorrow’s friend. Political pressures can change on a dime, creating new imperatives to action where none existed before – if we lay the right groundwork to take advantage of the opportunity.

That’s what being a National Council Ambassador is all about: laying the groundwork for sometimes-surprising allies (like the Grinch and the Whos down in Whoville) to come together. This holiday season, I’d like to send a special thank you to YOU, our superstar advocates, for all that you do. Even when the going seems tough, it’s always worth it to keep trying.

Happy holidays,

Chuck Ingoglia
Senior Vice President, Public Policy & Practice Improvement


UPCOMING ACTIVITIES

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Ambassadors Network Quarterly Call

When: January 21, 3:00 PM EDT
Where:  Register online here.

Get an insider’s look at what to expect from the new Congress, our forecast of the challenges and opportunities facing our legislative priorities, and more.

NatCon15

When: April 20-22, 2015
Where: Orlando, Florida

This year, the Conference will include special programming designed specifically for National Council Ambassadors (stay tuned for more details). Learn more about the conference and register here.


Ambassador Spotlight

 

amanda-gillmanCongratulations to this month’s outstanding Ambassador, Amanda Gilman!

Where: Natick, Massachusetts

What: As Senior Director at the Association for Behavioral Healthcare, Amanda’s on the front lines of advocacy – and she always brings her friends. Any time she sees an opportunity for action, Amanda blasts an email to her network, asking them to join in. Here’s just one example of the power of sharing: last week, Amanda helped more than double the number of Mass. constituents who asked Senators Warren and Markey to support a letter urging CMS to expand access to residential substance use treatment.

How you can do this too: The sky’s the limit. Forward the Ambassador’s Brief to your colleagues with a suggestion they join our network. Post our latest action alert to Facebook or Twitter. Recruit a group of friends to come to Hill Day with you. Or get creative! Like always, you can contact us to get sample emails, social media posts, and more ideas for sharing.

 


DISPATCH FROM CAPITOL HILL

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There’s a New Sheriff in Town…

And his name is Senator Mitch McConnell. The Kentucky Republican will become Senate Majority Leader in January, ousting 8-year incumbent Harry Reid (D-NV) in the wake of the Democrats’ losses in the midterm elections. If you think you don’t care about the changing of the guard because you’re not from Kentucky or Nevada, you should think again. Here’s why. (Spoiler alert: it also affects the prospects for our mental health and addictions priorities.)

Senator McConnell has been vocal about his desire to push a strong Republican agenda, and with big majorities in both chambers of Congress, the stage is set for he and House Speaker John Boehner (R-OH) to succeed. However, Republican leaders must still deal with President Obama’s veto pen, and Senate rules require 60 votes to do just about anything (Republicans currently hold 54 seats in the new Senate). So getting big things – or maybe even small things – done will still be difficult for incoming Majority Leader McConnell.

Nonetheless, the Senate Majority Leader has a number of powerful, behind-the-scenes tools as his command, all of which could be used for the good – or detriment – of mental health and addictions:

Setting the agenda. It will be Senator McConnell who decides which bills will come before the Senate, and which will not. For example, current Majority Leader Harry Reid refused to bring any of the 54 House-passed Obamacare repeal bills to the Senate floor; we would expect Senator McConnell will move quickly to give Senators a chance to vote on such a bill. Even the best bipartisan bills usually don’t move forward based on their own merits – like the Excellence in Mental Health Act earlier this year, they move when packaged with a legislative “vehicle” that’s sure to win a majority vote. And it’s the Senate Majority Leader who ultimately decides which bills get the green light.

Whipping votes and adding sweeteners. The Senate Majority Leader and his leadership team are in charge of persuading the rank-and-file members that they should vote the party line. This is more difficult on some votes than others, when Senators in a swing district or facing a hot-button issue at home feel the pressure to defect. Because of his agenda-setting powers, the Senate Majority Leader has the ability to package bills together in such a way as to make the end result more palatable for his caucus. As just one example, we saw this in action in 2008 when a Democratic-led Congress attached the bank bailout bill (known as TARP) to the mental health and addictions parity bill as a way to generate more support among its members.

Will McConnell use his leadership power to promote mental health and addictions? These issues have not been among McConnell’s top priorities in the past, but Majority Leaders make many of their decisions based on a national-level view of what will help or hurt their party in the next elections. If behavioral health is high on the public’s radar or a top priority for his rank-and-file members, McConnell may feel the pressure to move legislation on mental health or addictions issues. This highlights the importance of broad grassroots action to continue putting pressure on Congress to take action on behavioral health!

Other important powers of being in the majority. Republicans will also chair each of the Senate Committees and Subcommittees next year. Republicans will determine which bills are debated in Committee and who gets to testify during legislative and oversight hearings. When a bill is debated in committee, it will be the Republican chair’s “mark” – his or her version of the bill – that will serve as the starting point for debate.

What this means for us – and for you. No matter the shifts in power between Democrats and Republicans, the National Council’s advocacy strategy stays the same: improving Americans’ access to behavioral health services has never been a partisan issue, and we are committed to building a broad base of mental health and addiction champions across party lines.

What the shift in power means for National Council Ambassadors is that some of your legislators may have a more powerful role in Congress next year than they have had before. It’s especially important to cultivate relationships with committee and subcommittee chairs, as well as the majority and minority leadership, since they are the key lawmakers who set the agenda. If you’re represented by someone who hasn’t always supported our issues – or who has been lukewarm to them in the past – that’s an opportunity to build a new relationship of support! Here at the National Council, we work under the principle that anyone who’s not already a friend is a potential new friend. Next year, we’ll be working side by side with you to strengthen old friendships in Congress and build new ones.


STATE OF PLAY

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Excellence in Mental Health Act. The Centers for Medicare and Medicaid Services is now accepting comments on how it should formulate guidance to states on establishing a Prospective Payment System (PPS) under the Excellence Act. The National Council will be submitting comments and will make our comments available to members as a template.

2015 Appropriations. House and Senate negotiators this week released the draft of a bill to keep most government agencies funded through September 2015. The “cromnibus,” as it is known, keeps most mental health and substance use funding flat at 2014 levels, including $15 million for Mental Health First Aid trainings around the country and $50 million for Primary-Behavioral Health Care Integration grants. The $1.1 trillion bill also maintains nearly level funding for the Mental Health Block Grant at $482 million (a $1 million cut vs. 2014) and level funding for the Substance Abuse Prevention and Treatment Block Grant at $1.82 billion.

Mental Health First Aid. Notably, the 2015 “cromnibus” appropriations bill revises the training audiences for which the $15 million in Mental Health First Aid funding may be used. 2014 funding was available only for local and state school districts; in 2015, this audience will be expanded to include list. The National Council supports this expansion of training audiences and will continue advocating to increase the total amount of the appropriation to accommodate new audiences.

Comprehensive Addiction and Recovery Act. New cosponsors continue to join this bipartisan legislation, most recently Senators Diane Feinstein (D-CA) and Chuck Schumer (D-NY). Though the bill will not move forward this year, increasing the number of cosponsors will help the bill get off to a strong start when it is reintroduced in the next Congress. Thank you to our 650 advocates who sent 1300 messages to the Senate asking for their support! Sign up for National Council Action Alerts to hear about future opportunities to speak up for this bill.


ADVICE AND COUNSEL

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Has this ever happened to you?

SETTING:  Office of Senator Clayton Slocum in Washington, DC

SENATOR SLOCUM:  Thanks so much for coming in today.  It’s great to see you.

CONSTITUENT:  Thank you Senator.  We’re here representing behavioral health providers in Middletown and we’d…

SENATOR:  Did you know my mother is from Middletown? She was born there, met my father in Slackjaw and then settled in Boonington. That’s where I grew up. Did you know that?

CONSTITUENT: Umm.. No Senator, I did not. But since you are so familiar with Middletown, you know the importance of access to high quality mental health and substance use services to our community.  We’re here to talk with you today about…

SENATOR: I’m sorry. (Turns to aide.) Brad, when are we next scheduled to be in Middletown?

BRAD: I’m not sure, Senator.  I’ll look into it.

SENATOR:  You do that, Brad. And let these fine folks know when we’ll be back in my mom’s hometown.  Hey, let’s get a picture before I need to get back to that dang hearing. Thank you so much for coming in to see me. Brad will be sure to let you know about our next visit.

Frustrating, isn’t it? You’ve met with your Senator but it isn’t clear whether you’ve accomplished anything.

But this meeting wasn’t a total loss.

First, even though you didn’t get to talk about the substance of the issues you were there to discuss, the Senator knows you were there and that you care about mental health and substance use services.  He knows as well that you traveled to Washington to meet with him, so these issues must be important to you. That makes your issues important to him.

Second, now you know Brad. Brad serves on the staff for Senator Slocum and, if he is in the meeting, he likely has responsibility for behavioral health issues in the Senator’s office.  Build on that relationship.  Become a resource for Brad on behavioral health issues; correspond with him; invite him to visit your facility next time he is back home.

Finally, next time you visit Washington, ask for a meeting with Brad. He will take the time to talk about the issues, to hear your concerns and respond to your ask. And, if appropriate, ask if you might get a picture with the Senator.


BRIEFLY NOTED

briefly-noted-webHere are a few thought-provoking articles and resources that we’ve come across recently.  Happy reading!

In-Person Meetings with Constituents Most Effective – According to an exhaustive survey by the Congressional Management Association, visits by constituents to meet with legislators and/or staff in Washington or back home are the most effective way to get your legislators’ attention and perhaps win them over to your side. But, you knew that already. Read more here.

Health Care Issues in the 114th Congress – Immediately following the election, The Commonwealth Fund and CQ Roll Call put together a quick summary of the opportunities and challenges in health policy heading into January. See it here.