PUBLIC POLICY

 

April 23, 2009   Legislation to End Medicare’s Two-Year Waiting Period Introduced in Congress

Methadone Treatment and Protection Act Introduced in Senate

CLASS Act Introduced in Congress; Would Provide Supplemental Long-Term Services for Individuals with Disabilities

Federal Trade Commission Ruling: Health Agencies Must Implement Red Flags Rule by May 1

Healthcare Reform Discussed by President and SAMHSA

National Criminal Justice Commission Proposed in Senate

CMS Provides Guidelines for Children’s Health Insurance Plan Reauthorization Act

National Council Sends Letter to Senators in Support of Juvenile Justice and Delinquency Prevention Act

Register Now for Hill Day!

Recently Released Resources from the National Council

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Legislation to End Medicare’s Two-Year Waiting Period Introduced in Congress

On March 25, the Ending the Medicare Disability Waiting Period Act of 2009 (S 700 and HR 1708) was introduced by Senator Jeff Bingaman (D-NM) and Representative Gene Green (D-TX).  This legislation would phase out the waiting period gradually, so it would be completely removed by January 1, 2014.  As it currently stands, individuals with disabilities often forgo needed health services as they wait to be eligible for Medicare, putting their health at risk.  During the two year waiting period, 24% of people eligible to receive Medicare due to a disability have no health insurance and 40% are without health insurance at some point during the two years.  The National Council signed onto a letter in support of eliminating the waiting period along with dozens of other organizations.  Stay tuned to the Public Policy Update to learn the latest news about ending the two year waiting period.

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Methadone Treatment and Protection Act Introduced in Senate   Senators John D. Rockefeller (D-WV) and Bob Corker (R-TN) introduced the Methadone Treatment and Protection Act of 2009 (S 754) on March 31 to increase the federal oversight of methadone treatment.  S 754 would award grants to States and non-profits to increase the education of both health care providers and consumers about the dangers of opioid abuse, including methadone abuse.  S 754 would require practitioners who are registered to prescribe or otherwise dispense methadone or other opioids to complete a 16-hour training requirement once every 3-years.  In addition, S 754 would require opioid treatment programs that close for business on any weekday or weekend day, including a Federal or State holiday, to make acceptable arrangements for each patient who is restricted, by Federal regulation or guideline or by the determination of the program medical director, from having a take home dose of a controlled substance related to the treatment involved, to receive a dose of that substance under appropriate supervision during the closure.  The introduction of this legislation comes after the release of a Government Accountability Office (GAO) report which indicated a potential relationship between the rise in methadone-related deaths and the increased usage of methadone for pain management.   Currently, the National Council is analyzing the effect the legislation would have on community behavioral health organizations that provide methadone as part of an opioid treatment program.  Stay tuned to find out more about the actions the National Council is taking in regards to S 754.

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CLASS Act Introduced in Congress; Would Provide Supplemental Long-Term Services for Individuals with Disabilities

On March 25, Senator Edward Kennedy (D-MA) and Representatives Frank Pallone (D-NJ) and John Dingell (D-MI) re-introduced the Community Living Assistance Services and Supports (CLASS) Act (S. 697 and HR 1721) in the Senate and House. This bill was first introduced in 2007 in the Senate where it was referred to committee.  The legislation would create a new national insurance program for adults seeking access to long-term services and supports if they became functionally disabled, while providing them the opportunity to continue to live, work and participate in their communities.  CLASS Insurance is not intended to replace private insurance, Social Security Insurance or Old, Age, Survivors and Disability Insurance.  It is intended to help pay for additional needs for people who are disabled and are living in the community.  The CLASS program will be paid for through a voluntary payroll withholding and placed in a “National Independence Fund.”  To be eligible to receive the benefits an individual must be at least 18 years old and contributed to the fund for at least 5 years.  To learn more go to https://www.passtheclassact.org/.

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Federal Trade Commission Ruling: Health Agencies Must Implement Red Flags Rule by May 1

The Federal Trade Commission (FTC) has ruled that healthcare providers fall under the definition of creditors and must implement the Red Flags Rule by May 1, 2009.  The Red Flags Rule requires organizations to implement a written Identity Theft Prevention Program designed to detect the warning signs – or “red flags” – of identity theft in their day-to-day operations, take steps to prevent the crime, and mitigate the damage it inflicts.  The American Medical Association (AMA) requested a waiver for health agencies since they already follow HIPPA standards and additional requirements were unnecessary and burdensome.  The FTC ruled that health agencies must implement the red flags rule as they are considered a creditor due to their billing process.  Some of the obligations imposed by the Red Flag Regulations may be addressed by procedures that healthcare providers have adopted for dealing with patient information.  Generally, the Red Flags Rule requires the board of directors of a healthcare provider to develop and implement a program to protect and monitor patient information for identity theft.  A guide to the Red Flags Rule and implementing the regulations can be found online.

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Healthcare Reform Discussed by President and SAMHSA

President Obama has recently reaffirmed his desire to tackle healthcare reform this year by officially creating the White House Office of Health Reform by Executive Order.  The Order also calls for the creation of a Health and Human Services (HHS) Office of Health Reform.  The two offices will work together to coordinate President Obama’s healthcare policies.  Nancy-Ann DeParle who worked in the Clinton administration’s health office will lead the White House Office of Health Reform; no announcement has been made about who will lead the HHS office.

The President is not the only one interested in healthcare reform.  The Substance Abuse and Mental Health Services Administration (SAMHSA) has dedicated a new section of its website (www.samhsa.gov/healthreform) to the exchange of ideas on healthcare reform for people affected by mental health and substance use disorders.  To participate in the healthcare reform discussion, simply go to SAMHSA’s website and submit your ideas.

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National Criminal Justice Commission Proposed in Senate

The National Criminal Justice Commission Act of 2009, introduced by Sen. Jim Webb on March 26, (S 714) was referred to the Committee on the Judiciary.  The legislation would create the National Criminal Justice Commission to look at both federal and state criminal justice costs, practices and policies.  More specifically the Commission is expected to study, report and make findings on U.S. drug policies and its effectiveness, the system of reintegration for exoffenders, and, according to the bill text, “improve and streamline the treatment of mental illness, both in our society and in the criminal justice system…”  The National Council will continue to monitor the progress of this legislation; stay tuned to the Public Policy Update and the Criminal Justice page of the National Council’s website for updates.

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CMS Provides Guidelines for Children’s Health Insurance Plan Reauthorization Act

The Centers for Medicare & Medicaid Services (CMS) recently released a State Health Officials Letter on implementing the Children’s Health Insurance Plan Reauthorization Act of 2009 (CHIPRA).  Under CHIPRA, States will be able to strengthen their existing SCHIP and Medicaid programs and provide coverage to additional low-income, uninsured children and pregnant women. The letter provides a general overview of the key provisions in the new law, with the understanding that technical issues will be addressed in the coming weeks and months.   CMS will issue a series of State Health Official and State Medicaid Director letters over the next few months to provide more detailed guidance on CHIPRA provisions. Additionally, CMS will be having regularly scheduled conference calls with States to listen to questions and implementation concerns related to the new law. If you have any questions regarding CHIPRA, please e-mail them to [email protected] .  The National Council will continue to follow the implementation process of CHIPRA; to keep abreast of the latest information continue to read the Public Policy Update and the Technical Assistance Update.   For more information regarding CHIPRA read the National Council’s fact sheet.

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National Council Sends Letter to Senators in Support of Juvenile Justice and Delinquency Prevention Act

Senator Patrick Leahy (D-VT) introduced the Juvenile Justice and Delinquency Prevention Act of 2009 (JJDPA or S 678) on March 24; it was then referred to committee.  In support of this legislation, the National Council sent a letter of support to Senators on the Judiciary Committee.  The National Council supports S 678 because it strengthens and updates critical components of the Juvenile Justice Delinquency and Prevention Act (JJDPA), which has been protecting youth across the nation for over 30 years.  Additionally, S 678 makes meaningful improvements that expand several of the core protections and other areas contained in the bill, including strengthening emphasis on the need for mental health and substance abuse services for young people in the juvenile justice system.   The National Council would encourage all of our members to write their Senators and urge them to support S 678.  To find contact information for you Senator please go to the National Council’s website  and enter your zip code.  Language for your letter can be taken from the National Council’s letter when writing your Senator.

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Register Now for Hill Day!   2009 is a critical year for Behavioral Healthcare.  We look forward to having you join us on June 9 & 10 for the National Council’s Fifth Annual Hill Day—register now!

Hill Day is designed to provide participants with in-depth information on key issues.   June 9, 2009  •8:30-4:00 Public Policy Committee Meeting: Join the National Council’s Public Policy Committee as we receive briefings on the National Council’s Hill Day priorities from Capitol Hill Staff and public policy experts. •4:30-6:00 Small Group Coaching: Available upon request. The small group coaching with D.C. insiders will help you make the most of your appointment and ensure you leave a lasting positive impression with your representatives in Congress and their staff. •6:00-7:00 Welcome Reception: A great opportunity to meet the National Council Staff and network with others who have come to Washington, D.C. to advocate for community mental health and addiction services.

June 10, 2009  •8:00-10:00 Breakfast Briefing: Join your fellow behavioral healthcare leaders for a little nourishment and last minute encouragement before you make your Hill visits. •10:00-4:00 Meetings with Members of Congress: This time is set aside for you to go to your pre-scheduled appointments with members of Congress. Make sure you have appointments with every Representative whose district you provide services in. You may have 4 or more appointments! • 5:00-7:30 Capitol Hill Reception: Join the National Council in honoring Congressional champions of mental health and addictions services. This is your opportunity to thank Members of Congress that have supported issues important to the National Council and its membership.

Get inspired – One Person Can Make a Difference!

Make your Hill Day 2009 hotel reservations today!   Most Hill Day 2009 events will take place at the Washington Court Hotel, located on Capitol Hill. Make your reservations at:  •Washington Court Hotel by phone: 202-628-2100 •Liaison Capitol Hill by phone: 202-434-0110   Be sure to ask for the National Council for Community Behavioral Healthcare room block to get our special group rate of $269 per night for hotel reservation made by May 15.

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Recently Released Resources from the National Council

The National Council’s website is frequently updated with issue briefs, letters, and other materials of interest to members. Please take notice of these recent updates:

The National Council has put together a multitude of information and helpful documents for people applying for the Primary and Behavioral Health Care Integration RFA from SAMHSA.  Members can access the materials via our Members Only section of the website.   The National Council released three fact sheets on the American Recovery and Reimbursement Act: Medicaid, Health Informtaiton Technology, and Other Key Provisions.   The National Council released a chart comparing the Omnibus Budget Bill introduced in the House with the FY08 budget and the FY09 budget released by former President Bush.

The National Council recently released a summary of the SCHIP Bill.

The National Council recently signed on to a letter supporting an increase in the Federal Alcohol Excise Tax.

The National Council recently released a fact sheet on the Final Rule for the Federal Cost Sharing Rules. The rule gives states broader authority to charge premiums and higher co-payments for Medicaid.

The National Council recently created a power point presentation on the Mental Health Parity and Addiction Equity Act of 2008. The presentation covers the 1996 Parity Law, the history of the 2008 Act and the main points of the Act.

The National Council recently released a resource guide, “Veterans on the Road Home”, which equips you to reach out and to effectively serve Iraq and Afghanistan veterans and their families. The book describes the physical, mental, economic, and social effects of the wars in Iraq and Afghanistan. It presents detailed case studies of treatment organizations and associations with special expertise in and commitment to serving veterans and their families.

At the end of October, the National Council released a series of fact sheets on the Deficit Reduction Act of 2005:

-Overview of the DRA

-Expanded Medicaid Coverage Under the DRA

-Medicaid Services for Children Under the DRA

-State Implementation of the DRA   Meaningful Employment for Individuals with Mental Illness, a backgrounder from the National Council, provides information on the current employment status of individuals with mental illness, opportunities for career development, and federal initiatives to improve the chances of individuals with mental illness obtaining and keeping jobs.

The National Council recently released a fact sheet on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 which provides a detailed explanation of the impact of this bill.

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April 2, 2009

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National Council Held Hill Briefing on America’s Public Mental Health Crisis

New SAMHSA Grants Support Primary Care Needs for People with Serious Mental Illnesses

FY2010 Budget Resolutions Advance in Both the House and Senate

MOTHERS Act Passed by House

Veterans’ Bills Pass the House on Monday

Register Now for Hill Day!

Recently Released Resources from the National Council

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National Council Held Hill Briefing on America’s Public Mental Health Crisis   On March 31, the National Council, in conjunction with Senator Debbie Stabenow, hosted a Congressional briefing on the public mental health crisis facing communities nationwide.  In her opening remarks, National Council President & CEO Linda Rosenberg highlighted the healthcare needs of individuals with mental illnesses and addictions, especially in light of evidence showing  that people with serious mental illness on average die 25 years sooner than other Americans. Rosenberg highlighted three National Council priorities including a $35 million increase for the integrated care mental health/primary care program, a $100 million increase in for the Community Mental Health Services Block Grant, and $250 million Medicaid demonstration that would support healthcare homes for people with serious mental illness.   Five additional panelists offered a front line perspective on how increasing demand and decreasing funds are reducing access to care.  Cindy Kaestner, from the Abbe Center for Community Mental Health in Cedar Rapid, IA described the impact of the recent floods on her Center’s community.  Kaestner stated that efforts to recover from the floods, and reduced  revenue due to the economic down turn combined with a 14 percent increase in demand for services has created a perfect storm.  Kaestner emphasized that additional resources are necessary to provide services for individuals with mental health and substance use disorders.   Jeff Capobianco from Wastenaw Community Mental Health Organization in Ypsilanti, Michigan discussed the importance of his organization’s effort to integrate primary and mental healthcare facilities.  Helen Royal and Karen Wyatt from Summit Community Care Clinic in Frisco, CO discussed their experiences with integrating primary and mental healthcare in Colorado.  Capobianco, Royal and Wyatt all expressed their support for a patient-centered healthcare system such as the one created by integrated primary mental health and called for a federal investment in integrated, person centered care.   Malkia Maisha Newman spoke of her personal story as a consumer of mental health services and the importance of the life-saving services that community mental health centers provide to individuals with serious mental illness.  Malkia discussed the role that treatment played in her life, the value of peer services in her recovery, and her current job as a community educator to fight the stigma associated with mental illness.   There was wide representation in the audience – consumer advocates, national mental health, addiction, and physical health advocates, and several Congressional staffers. The National Council would like to thank Senator Debbie Stabenow (D-MI), who hosted the briefing, for her continued support of several mental healthcare initiatives.

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New SAMHSA Grants Support Primary Care Needs for People with Serious Mental Illnesses

The Substance Abuse and Mental Health Services Administration has announced new FY 2009 grants to support Primary and Behavioral Health Care Integration (PBHCI). The program is aimed at improving the physical health status of people with serious mental illnesses (SMI) by supporting communities to coordinate and integrate primary care services into publicly funded community mental health and other community-based behavioral health settings.

Publicly funded community mental health and other community-based behavioral health agencies are eligible to apply. Eleven grants will be awarded. The estimated award is $500,000 annually for four years.  Applications are due Wednesday, May 27, 2009. Download the grant application.   The National Council is encouraging members to apply for this important opportunity and will be developing information and resources to support grant applications.   Save the Date:   At 2:30 PM EST on Monday April 13, the National Council will host a conference call to review important grant application information and to answer your questions. Please contact Laura Galbreath if you have any questions at 202-684-7457, ext 231 or [email protected] .

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FY2010 Budget Resolutions Advance in Both the House and Senate   The House and Senate have each made progress in advancing their respective versions of a FY10 budget resolution this week.  The budget resolution serves as a blueprint for how Congress plans to allocate funding and outlines economic goals. Budget Committees in each chamber approved budget resolutions that will set the fiscal and policy ground rules for spending in FY2010.  The budget proposals in both the House and the Senate are similar and closely mirror the budget proposed by President Obama.  The resolution proposes $58.2 billion in budget authority in FY 2010 for discretionary health programs, and higher levels of spending for these programs in each of the four succeeding years. By FY 2014, funding for these programs under the measure would increase to $65.8 billion, 13% higher than in FY 2010. This function encompasses most health-related programs, including Medicaid, the State Children’s Health Insurance Program, the Food and Drug Administration, the National Institutes of Health, and the Centers for Disease Control and Prevention. Specific allocations to Committees to determine the level of spending for various programs and services will not be decided over the coming months.

There are two main differences in the resolutions offered by the House and the Senate.  The House version includes reconciliation language for healthcare reform while the Senate version does not. Reconciliation language directs committees to report legislation, by a certain date, that changes the mandatory spending programs within their jurisdictions to achieve a certain reduction in spending. Under Senate rules, reconciliation legislation is not subject to a filibuster, which means that passage requires only a simple majority vote, and does not require 60 votes.  The House has also included a reserve fund for healthcare reform that is budget neutral.  According to trade press, the House resolution directs the Energy and Commerce and Ways and Means committees to report, no later than September 29, a bill that would reduce the deficit by $1 billion in FY 2009 through FY 2014.  Although the measure does not specify which provisions of law would be changed, the Budget Committee reportedly intends for the resulting reconciliation measure to be used for a bill that would overhaul the nation’s health care system. The House and the Senate are both expected to vote on their budget resolutions this week.  A conference could come as early as next week to reconcile the differences between the resolutions.

Read Senate Concurrent Resolution 13 and House Concurrent Resolution 85.

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MOTHERS Act Passed by House   The Melanie Blocker Stokes Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act or the MOTHERS Act (HR 20) was passed by the House on March 31.  It was then sent to the Senate and referred to the Committee on Health, Education, Labor and Pensions (HELP).   The MOTHERS Act will fund education and outreach activities to help providers identify women suffering from postpartum depression (PPD), and also creates new grant funding to help assure access to needed care. S 324 the companion bill in the Senate sponsored by Senator Robert Menendez is still in the HELP Committee.

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Veterans’ Bills Pass the House on Monday   The House passed three important bills on March 30 for veterans including HR 1377, HR 1513 and HR 1171.  The three bills were then sent to the Senate and were referred to the Veterans Affairs Committee.  HR 1377 would allow veterans to get reimbursed for emergency care they receive at non-Department of Veterans Affairs (VA) hospitals.  The VA would be required to cover the cost of non-service related care if a third-party insurer does not cover the full cost.  HR 1513 would increase the rate of veterans’ disability compensation, provide additional compensation for dependents and dependency and indemnity compensation for surviving spouses and children.  The increase would be based on the cost of living increase currently provided to people receiving Social Security.  HR 1171 would reauthorize the VA’s homeless veterans’ reintegration programs for job training, counseling, and placement services to expedite the reintegration of homeless veterans into the labor force.  The bill would authorize $300 million dollars over five years.