Previous Legislative Priorities
2020 Legislative Priorities
Fifty percent of all lifetime mental illnesses show symptoms before the age of 14. To improve the mental wellbeing of residents, all communities need to lessen the severity of mental health challenges and support people's ability to maintain wellness. Evidence-based prevention and early-intervention techniques can reduce both the incidence of mental health conditions and the duration associated with them. A comprehensive public-health approach to mental health requires a focus on preventive services, as well as including programs and services that provide treatment and support for people who have become ill. The legislation below supports this approach:
- H.R 4626 Social Emotional Learning for Families of 2019 Act
- S.824 / H.R 1767 Excellence in Mental Health and Addiction Treatment Expansion Act
- S. 1770 RISE from Trauma Act
- S.1642 / H.R.2958 Increasing Access to Mental Health in Schools Act
- S.1122 / H.R 1109 Mental Health Services for Students Act of 2019
- H.R 1395 Youth Mental Health Services Act of 2019
- H.R 1920 Medicaid Bump Act
- S.2499 / H.R 4381 Elementary and Secondary School Counseling Act
- S.1737 / H.R 3165 Mental Health Parity Compliance Act
- H.R 4025 Mental Health in Schools Excellence Program Act of 2019
- H.R 4525 Student Support Act
- H.R 4835 Supporting Trauma-Informed Education Practices Act
- H.R 5006 Expanding Access to Inpatient Mental Health Act
One in five Americans faces a mental health challenge each year. Stigma is toxic to their mental health because it creates an environment of shame, fear and silence that prevents many people from seeking help and treatment they need. The perception of mental illness won't change unless our communities act to change it. To reduce mental illness-related stigma, we need to feel comfortable having conversations about it. The legislation below supports this approach:
There are widespread shortages of mental health professionals in the United States. Such shortages are aggravated by inequitable distribution of mental health professionals across geographic areas and challenges with insurance coverage and compensation that increase difficulties for the provider. In order to reach the millions of Americans with mental illness, we need to vastly increase the number of mental health providers and equal access to these providers, with a emphasis on recruiting and retaining these providers. The legislation below supports this approach:
Suicide is a significant public health epidemic in communities across America. Over 47,000 people died by suicide in the United States in 2017 and it is now the 10th leading cause of death overall. Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicide is complicated and tragic. Much more can be done to help people sooner and prevent these tragedies from occurring. The legislation below supports this approach:
- H.R 4564 Suicide Prevention Lifeline Improvement Act
- S.2661 / H.R 4194 National Suicide Hotline Designation Act of 2019
- H.R 1646 HERO Act of 2019
- H.R 3778 Cady Housh and Gemesha Thomas Student Suicide Prevention Act of 2019
- H.R 4309 Barriers to Suicide Act of 2019
- S. 3006 / H.R 4861 Effective Suicide Screening and Assessment in the Emergency Department Act
From 1999 to 2017, more than 702,000 people have died from a drug overdose. In 2017, more than 70,000 people died from drug overdoses, making it a leading cause of injury-related death in the United States. Of those deaths, almost 68% involved a prescription or illicit opioid. The nation's addiction epidemic will not end without increased access to comprehensive, multidisciplinary care for pain, as well as enhanced access to high quality, evidence-based treatment for substance use disorders. The legislation below supports this approach:
2019 Legislative Priorities
The Excellence Act would extend the Certified Community Behavioral Health Center demonstration, which provides for an additional year, while expanding the demonstration to 11 additional states across the country.
The CARE Act is modeled directly on the bipartisan Ryan White Comprehensive AIDS Resources Emergency Act, which was enacted nearly 30 years ago to support federal investments and local decision-making to tackle the HIV/AIDS epidemic. The CARE Act would provide $100 billion in federal funding over ten years. Of that $2.7 billion per year would directly go to the hardest hit counties and cities, including $1.43 billion to counties and cities with the highest levels of overdoses, and $1 billion through competitive grants.
The legislation would authorize $200 million over four years. It would expand the scope of the Project AWARE State Educational Agency Grant Program carried out by the Secretary of Health and Human Services, in order to provide access to more comprehensive school-based mental health services and supports.
This legislation would provide a higher federal matching rate for increased expenditures under Medicaid for mental health and behavioral health services.
The State Targeted Opioid Response grants need to be re-authorized by October 1st, 2019, which gives us an opportunity to amend the structure of the grants to include direct funding political subdivisions of states (counties and cities).
2018 Legislative Priorities
Current federal laws and programs have supported access to health care regardless of income. This past year has shaken the core principles of our health care infrastructure creating a problem for all cities across the country.
- Defend and strengthen insurance coverage and associated regulatory protections for those enrolled through the Affordable Care Act
- Enforce legally mandated parity in mental and physical insurance coverage
- Maintain Medicaid funding levels and defend against any changes that create barriers to care, such as work requirements and/or cost sharing
- Maintain funding for federally qualified health centers that treat the uninsured
Despite the costs of untreated mental illness on people's health and economic productivity, our current healthcare delivery and financing systems do not prioritize mental health services and access. Cities provide an ideal opportunity to incubate best and promising practices to promote mental wellness and address longstanding treatment gaps.
- Incentivize collaborative care – where mental health conditions and substance use disorders are treated together in a primary care setting through changes to Medicaid/Medicare reimbursement
- Fund pilot programs to increase access to mental health services, such as telemedicine to provide access to mental health in underserved communities; and mental health services in schools
- Develop a long-term strategy to create a diverse behavioral health workforce
- Advocate Congress appropriate robust funding for the Community Mental Health Block Grant and Programs of National and Regional Significance, as well as other programs created as part of the 21st Century Cures Act
For the second year in a row the Centers for Disease Control (CDC) announced a drop in life expectancy largely due to the untenable increase in drug abuse stemming from the opioid crisis. This is a national emergency and this crisis hits home most immediately at the local level, requiring the advocacy and intervention of municipal leaders.
- Reduce risks/harms to active users: rapid screenings in shelters, supportive housing and jails
- Increase enrollment in effective treatment by expanding access to Medication Assisted Treatment (MAT), including buprenorphine and reducing limitations for prescribers
- Expand affordable availability of naloxone in highest risk populations
- Directly fund local communities of greatest need, allowing cities and counties on the frontlines to innovate and act. The Trump Administration should take additional steps to combat this epidemic by declaring it a National Emergency
- Reduce barriers to buprenorphine by eliminating all training requirements related to buprenorphine prescribing and eliminating all patient caps that restrict the number of patients prescribers can treat with buprenorphine because there are no limits on the drugs that doctors can prescribe for pain, so there should not be limits on what can be prescribed to treat addiction
- Appropriate at least an additional $25 billion in federal aid to expand access to treatment, strengthen prescription drug monitoring programs, and accelerate research on opioid misuse