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Charles Ingoglia, MSW

President and CEO of the National Council for Behavioral Health

Unprecedented Times Bring Rapid Change, and Signs of Hope

March 20, 2020 | leadership | Comments
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Where to begin. These are unprecedented times. We are all working to quickly adapt to the new reality. And while this health crisis is unsettling, I also see promising signs of hope.

Now more than ever, people are supporting each other, taking care of our communities and supporting the professionals that take care of us. The behavioral health field has always embodied strength and resilience, and that is certainly true right now.

The National Council’s primary mission is to ensure the behavioral health field has the support and resources necessary to meet the needs of our communities.  To that end, we are working overtime to make federal and state policymakers aware of the urgent needs facing community behavioral health organizations … and to ensure that our members can benefit from the rapid policy changes taking place at the federal and state level.

I think Congress has passed more legislation in the past week than they did in the past year, with more to come.  But here is a quick recap of recent policy changes, beginning with those that relate to telehealth.

  • Medicaid Telehealth: CMS made clear to states that they already have flexibility to utilize telehealth services, including audio-only services, in their Medicaid programs. No federal approval is needed for state Medicaid programs to reimburse providers for telehealth services in the same manner or at the same rate that states pay for face-to-face services. Note: States themselves, not CMS, are responsible for making these options, including audio-only telephonic services, available to providers.
  • Medicare Telehealth: Retroactive to March 6, Medicare will temporarily pay clinicians to provide telehealth services for beneficiaries across the country. A range of providers, including clinical psychologists and licensed clinical social workers, will be able to offer Medicare-covered telehealth services to enrollees based in any health care facility, including physicians’ offices, nursing homes, as well as from enrollees’ homes.
  • Telehealth and Prescriptions of Controlled Substances: The DEA has announced temporary relief of the Ryan Haight Act for the duration of the public health emergency. Registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation as long as required conditions are met.
  • HIPAA: The Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) announced that it will waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies, including FaceTime or Skype, when used in good faith.
  • 42 CFR Part 2: SAMHSA issued guidance related to the sharing of SUD health records throughout the public health emergency, making clear that information may be re-disclosed for treatment purposes as needed, and with required documentation. SAMHSA emphasizes that, under the medical emergency exception, providers make their own determinations whether a bona fide medical emergency exists for purposes of providing needed treatment to patients.

I encourage you to check out Best Practices for Telehealth During COVID-19 Public Health Emergency for more information.

We know that increased utilization of telehealth options alone cannot solve all of the challenges facing the nation. Other forms of financial support will also be critical and several changes are taking place in this realm.

  • Federal Medical Assistance Percentage (FMAP): The federal government’s share of Medicaid payments has been increased by 6.2 percentage points. This increased assistance comes with the requirement that state Medicaid programs cover COVID-19-related treatment, vaccines, and therapeutics at no cost to enrollees as well as states not making eligibility standards more restrictive or increasing any cost sharing for enrollees.
  • Protective Equipment: Community based residential facilities play a critical role and they need resources to maintain their ability to operate safely. Specifically, the National Council has submitted a request to Congress for $250 million to provide personal protective equipment (PPE) to BH organizations.  And we are working with state public health authorities to make sure they are aware of the needs of residential providers.
  • Marriage and Family Therapists: The National Council is advocating for changes in Medicare rules that would, finally, recognize marriage and family therapists and thus expand the pool of professional eligible for payment at this critical time. This is something we have long sought and do not know if we will be successful, but we are trying.

We recognize that not everything Congress and the Administration is doing right now is perfect.  We will continue to work with policymakers to ensure the needs of behavioral health providers are being met.   And we ask you to let us know if you are encountering additional regulatory challenges that we can help address.

Everyone has lots of questions that go beyond policy matters and we are working to answer them – check out our COVID-19 Q&A resource here and check back regularly, as the update it. And we have a full list of resources on our website, which is being updated regularly.

These are incredibly challenging times. But I know that our members and the behavioral health field at large is one of the most dedicated, nimble and resilient group of individuals I have ever met. We are all working together to get through this and, I believe, we will look back on this and see that our field was an essential element of the crisis response and national healing that will, eventually, take place.

For now, know that the National Council is here for you. We will continue to provide updates and, in the meantime, please know how humbled I am by the extraordinary work each and every one of you is doing right now. Thank you for what you do every day. Thank you for taking care of your community and please, please … don’t forget to take care of yourself.