What to Expect for Behavioral Health in 2020
From funding for Certified Community Behavioral Health Clinics to state Medicaid waivers, 2020 is sure to be a whirlwind for behavioral health and for the health care system at large. While Congress remains split down party lines with Democratic control of the House and Republican control of the Senate, time will tell if any large changes will happen during this election year. Here is a preview of what is likely ahead in health policy in the first year of the new decade.
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Department of State Issues Public Charge Rule
Earlier this month, the Department of State (DOS) issued an interim final rule that mirrors changes to expand the definition of a “public charge,” promulgated by the Department of Homeland Security. Some immigrants are subject to a test when entering the U.S. to determine if they will become a “public charge,” or someone who is likely to become dependent on the government in the future, which weighs against their immigration eligibility. The DOS rule, which has not yet taken effect, would apply to non-U.S. citizens who go through consular processing in their home country before entering the U.S.
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Executive Order Seeks to Limit Agency Guidance
Last week, President Trump signed an executive order designed to limit the effect of federal agency guidance. Historically, agencies have issued guidance to the public on how to best comply with a law or regulation, and, for many agencies, guidance documents have taken the place of policymaking. Issuing guidance can often be a much faster process than the possible years of waiting for federal regulation to be approved. The executive order makes all current and future guidance documents nonbinding, “both in law and in practice.”
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Legal Challenges Halt Implementation of DHS Public Charge Rule
Federal judges in New York, California, and Washington state have issued temporary injunctions against the Department of Homeland Security’s (DHS) public charge rule. The rule, which was set to take effect on October 15 but is now on hold, would greatly expand the definition of “public charge” when considering some immigrants’ applications to enter or become permanent residents of the United States. The National Council has long opposed the proposed updates to public charge determinations as they would result in significant harm to the health and welfare of migrant families.
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White House Bars Uninsured Immigrants from Entry to US
President Trump last week released a proclamation suspending entry for some immigrants who cannot prove that they will have health coverage or the means to pay for it without assistance within 30 days of their arrival. Under the proclamation, immigrants who “will financially burden the U.S. healthcare system” by remaining uninsured or relying on public health programs such as Medicaid or government-subsidized coverage will be denied a visa. The National Council remains strongly opposed to policies such as this that prevent individuals from receiving health care and assistance to which they are legally entitled.
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Presidential Candidates Offer Thoughts on Mental Health in America
Mental Health for US, of which the National Council is a founding coalition member, released survey responses from top presidential candidates on how they would improve mental health and addiction care in America, if elected. Candidates polling at one percent or higher nationally were sent an 11-question survey covering topics including suicide prevention, criminal justice reform, access to care, and addiction. Responses were received from U.S. Senator Cory Booker, Mayor Pete Buttigieg, U.S. Senator Kamala Harris, U.S. Senator Amy Klobuchar, U.S. Senator Bernie Sanders, and U.S. Senator Elizabeth Warren.
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House Passes Funding Extension for CCBHC Demonstration
On Tuesday, the House voted to pass the “Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 (H.R. 3253),” which would extend funding for certain Medicaid programs. Under the provision, funding for the eight-state Certified Community Behavioral Health Clinic (CCBHC) demonstration program would be extended for another two and a half years until December 21, 2021. There was overwhelming bipartisan support of H.R. 3253, passing with a vote of 371-46. The bill must now go to the Senate for a vote before the CCBHC demonstration program expires on June 30th, 2019.
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National Council Member Testifies in Support of Extending CCBHCs
On Tuesday, Mary-Catherine Bohan of Rutgers University Behavioral Health Care (UBHC), a National Council member and Certified Community Behavioral Health Clinic, testified before the House Energy and Commerce Subcommittee on Health in support of the Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767). The legislation would extend the Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration program in its original eight states for two years and expand the program to 11 other states that applied but were not originally selected. The CCBHC program is set to expire on June 30th, 2019 if Congress does not act.
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NatCon19 Showcases Behavioral Health Policy Landscape
This past week, over 6,000 attendees gathered in Nashville, TN for NatCon19, behavioral health’s premier conference. From inspiring fireside chats and keynotes to line dancing, NatCon19 had it all and provided the latest insights into policy challenges, solutions and guidance for behavioral health advocates. The consensus among health care leaders, government officials and innovative experts is that Medicaid waivers, state plan amendments, parity, and telehealth policy will continue to dominate the 2019 policy landscape for mental health and addiction treatment. NatCon19 attendees can access all presentation slides here with their badge number.
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What to Watch in Health Care in 2019
The 116th Congress began on Thursday amid a government funding lapse that has shut down roughly 25 percent of the federal government. Democrats are set to lead the House chamber for the first time since 2010, while Republicans remain in control in the Senate. While legislation may be move less quickly in the new divided Congress, lawmakers will still face a number of “must-pass” bills that include health care priorities. Additionally, the Trump Administration will continue to shape the health care landscape with Medicaid waivers and potential payment reforms. Here is a preview of what’s ahead in health policy in 2019.
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NatCon19: The Best in Behavioral Health
On March 25-27th, behavioral health’s premier conference, NatCon19, will kick off in Nashville, TN. NatCon19 is where the best in behavioral health gather to learn from industry experts, take in world-class entertainment, keep up on the most innovative products, and make new connections. Policy and advocacy are always a special focus at NatCon. This year, our NatCon19 Policy Track will help you gain understanding of the latest policy challenges and solutions and guidance on how you can influence policy to better support clinics and patients.
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National Council Survey Shows Providers’ Policy Priorities
In a few short weeks, Members of the 116th Congress will begin work on Capitol Hill. A new Congress equals new opportunities to improve the lives of individuals and families impacted mental illness and substance use disorders. To help prepare for the new Congress, the National Council’s Policy and Advocacy team recently surveyed National Council members to gather input on federal policy priorities for 2019 and beyond. Read more a for a summary of the results
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House Panel Examines 21st Century Cures Mental Health Initiatives
Implementation of the 21st Century Cures Act’s mental health provisions was the topic of a Congressional hearing last week. Lawmakers sought updates on the Administration’s progress in strengthening the behavioral health workforce and mental health parity enforcement. Dr. Elinore McCance-Katz, head of the Substance Abuse and Mental Health Services Administration (SAMHSA), testified to her agency’s progress in addressing these initiatives as well as other pressing mental health and addiction issues.
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Trump Administration Proposes Consolidating Public Assistance Programs
Last week, the White House released a proposal to make sweeping changes to the Executive Branch of the government, reorganizing agencies such as the Department of Health and Human Services (HHS), the National Institute of Health (NIH) and the Food and Drug Administration (FDA), among others. Among the more notable proposed changes is to consolidate certain public assistance programs under HHS and rebrand the agency as the Department of Health and Public Welfare. Congress’s approval will be needed to make most of the large-scale changes, which poses a significant challenge to the plan’s enactment.
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Federal Social Impact Partnership May Yield Social Savings
A little-known provision in the recent budget deal included new federal funding for social impact bonds (or pay-for-success contracts) that are meant to spur innovation and lower government spending. Social impact bonds are financing program contracts where privately funded initiatives receive government spending only if the program achieves its targeted outcomes. Social impact bonds are used in behavioral health care to improve clinical outcomes, yield savings and share risk in financing new approaches to treatment.
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Nominee for HHS Secretary Testifies Before Senate HELP Committee
On Wednesday, the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing on the nomination of Alex Azar to serve as Secretary of the Department of Health and Human Services (HHS). Azar expressed his priorities if confirmed as Secretary, which include tackling the opioid epidemic, and was met with mixed feelings from committee members. Azar will sit for another hearing in front of the Senate Finance Committee, which will vote on advancing his nomination for a final confirmation vote on the Senate floor.
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House Passes Tax Reform, Senate Version Adds Health Care Provision
This week, the House of Representatives approved its version of tax reform legislation by a vote of 227-205. This House proposal is vastly different than the version the Senate is currently working on. On Tuesday, the Senate inserted a provision to repeal the Affordable Care Act’s individual health insurance mandate as a part of its proposal. The provision would zero out the penalty individuals face for not purchasing insurance beginning in 2019.
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Bill Introduced to Expand Charitable Giving Deductions
Representative Mark Walker (R-NC), has introduced the Universal Charitable Giving Act of 2017 (H.R. 3988) in the House, which would allow taxpayers who do not itemize their tax returns to write off a portion of their charitable contributions. This could help provide incentives for individuals to increase their charitable giving. However, if passed, this provision would likely be a part of President Trump’s larger tax reform package – a package that has raised concerns from numerous charitable organizations.
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Bipartisan Task Force Launched to Address Suicide Prevention
Representatives John Katko (R-NY) and Don Beyer (D-VA) announced last week the formation of a new bipartisan House Suicide Prevention Task Force, a new subset of the Congressional Mental Health Caucus. The task force will work to create bipartisan solutions to help curb and combat the high rate of suicide in America. The National Council thanks these leaders for their service and commitment to this important cause.
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Industry Experts: President Trump’s Tax Plan Could Hurt Nonprofits
Last week, the White House and the U.S. House released the broad outlines of an upcoming effort to dramatically overhaul the U.S. tax code, amounting to a massive tax cut for both individuals and corporations. Nonprofit industry experts warn that both proposals could result in a big hit to bottom line for nonprofit organizations by changing to the amount of money taxpayers can write off and increasing the standard deduction. A timeline on when either package may be considered in Congress remains unclear and most analysts predict the proposals are a starting point for negotiations, not a final package.
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