Advocacy Alert: April 2020 Advocacy Update for BHAP Members

April 15, 2020

Greetings, BHAP!

On behalf of Slingshot Solutions, thank you for your membership in BHAP and your commitment to advocacy that will shape the future of behavioral health. As your advocate in Washington, D.C., it is my responsibility to keep you informed when it comes to policy developments, and to represent your interests before the federal government. We do this by working with Congress, the White House and executive agencies, and other interest groups and coalitions.

Andrew Kessler
Principal
Slingshot Solutions LLC

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Monthly Advocacy Call Reminder

A reminder that BHAP holds a monthly advocacy call with Andrew monthly to discuss the items below and answer any questions you may have about current or upcoming legislation — both federal and state — affecting the behavioral health industry.

The next call is scheduled for April 28, 2020, at 10 am Pacific (see when that is in your time zone). You will receive a reminder email a week prior and the day before with call in information. This is for BHAP members only!

It is no surprise that the events of the last month concerning COVID 19 have of course dominated the policy landscape. Hence, most of this report will focus on the legislation aimed at battling COVID-19, and how it may benefit BHAP members and the providers we work on behalf of. In the most recent bill signed into law, the CARES Act — often referred to as “Phase 3” — has some areas of interest to our providers.

SAMHSA will receive $425 million as a result of this legislation. $50 million will be set aside for suicide prevention activity. $15 million will be allocated to Indian health services. $100 million will be set aside for emergency response grants, which will be distributed to states, if they choose to apply for them. Each state will determine in its own priorities in their respective applications. Finally, $250 million will be allocated directly to treatment providers, if their grant applications are accepted. It is not entirely clear what providers will be eligible, as the funds will be held in an account that is set aside for providers that qualify as community behavioral health centers. (1) However, it is not entirely clear at the moment if one must qualify as a CCBHC to apply for funds, or if that is simply the account where the money will be “parked.”

Also of interest to our providers are loans to small businesses. Both private and non-profit establishments will be able to apply for these loans, so long as they do not have over 500 employees. These loans will go towards programs such as paycheck protection. Overall, $377 billion will be available to rescue small businesses, including forgivable loans to small businesses and nonprofits to maintain their workforce and help pay for other expenses like rent, mortgage, and utilities. $260 billion has been approved for increased unemployment insurance that waives waiting periods and covers part-time, self-employed, and gig economy workers.

While we often highlight what was included in legislation, we rarely take the time to mention what was excluded. However, we want to inform you of efforts we undertook to defeat language from an earlier draft that would have been quite harmful to SUD providers if it remained. The loans mentioned in the paragraph above, in the first draft of the legislation, were restricted from distribution to non-profits that received Medicaid reimbursement. Working with a coalition of other behavioral health providers, we worked to get this language removed.

Also, the COVID-19 Telehealth Program will provide $200 million in funding, appropriated by Congress as part of the CARES Act, to help health care providers — including eligible community mental health and substance use treatment providers — fund technology and equipment to bolster service delivery via telehealth. The program will provide immediate support by fully funding telecommunications services, information services and devices necessary to deliver connected care services to patients at their homes or mobile locations. The program will last until the funds have been expended or the pandemic ends.

Our current work is on “Phase 4,” the next bill to be drafted in response to the pandemic. We are making a serious effort to protect BH providers in the current legislation being drafted. BHAP has signed onto a document that sets forth the priorities of the behavioral health community in conjunction with several other national organizations. Our request was ambitious — $38.5 billion to enable our behavioral health system to cope with the difficulties that have arisen from the pandemic.

The National Council for Behavioral Health, with whom we collaborate often, estimates that community behavioral health organizations revenue could fall 50% over the next year — or approximately $38.5 billion (hence the size of our request). It is our intent that funds could be used for expenses / lost revenue attributable to COVID-19.

Of this $38.5 billion, we recommended that $5.6 billion to the SAMHSA emergency fund to provide crisis / grief counseling and other behavioral health needs for health care workers, first responders, grocery store workers, and others front-line workers affected by the virus. During past disasters, mental health resources were deployed to help those who were impacted on an emergency basis.

We also would like to see SAMHSA provide emergency grants to organizations to expand mental health and addiction virtual peer supports, aid nonprofit organizations that primarily serving people with behavioral health needs and receive state/county funding that are at risk of cutting back / ending services, and provide behavioral health screenings, particularly for the uninsured, and utilize a universal de-identified database of population behavioral health needs based on screening results. Other programs would include $1.2 billion to DOJ for jail diversion programs to lessen crowding in corrections facilities, and the strain on state and local budgets; $800 million to HRSA for emergency workforce development, including but not limited to immediately increasing slots and paying for training for psychologists, social workers, licensed health professionals, and certified peer specialists.

We will keep you posted on the progress of “Phase 4” and other important developments as we can!

1) CCBHCs must provide: crisis mental health services; screening, assessment and diagnosis; patient-centered treatment planning; outpatient mental health and substance use services; primary care screening and monitoring;* targeted case management;* psychiatric rehabilitation services:* peer support, counseling and family support services; and services for veterans.* (*May be provided directly by CCBHC or through contract with Designated Collaborating Organization.) (back to article)

Questions? Concerns?

As always, we want your input. If you can’t attend our monthly updates, please contact us with any questions or concerns you have about our advocacy efforts.

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