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The Indiana General Assembly Adjourns Sine Die  

But, our work is just beginning....

 

The 2013 Indiana General Assembly completed its work, but left many issues unresolved.  The backdrop of the 2013 Session included a new Governor, new administrative appointees, and an unprecedented number of new legislators.  With that environment, the legislative process often-times defaults to study committees as tools for both information sharing and consensus building.  This Session seemed to set a record in that regard.  Senate President Pro Tempore David Long was quoted as saying he thought that they must have created 2,500 study committees.  While he was intentionally exaggerating to some degree, there were critical issues sent to study committee for future consideration in the 2014 Session.  This leaves Mental Health America of Indiana with much to do over the intervening summer months in preparation for the 2014 Session of the General Assembly.  Relevant study committees are noted in italics.

 

Below is a legislative status report on issues prioritized by Mental Health America of Indiana:

 

Affordable Care Act

The 2013 Indiana General Assembly was expected to provide for legislation enabling the implementation of the Affordable Care Act.  This was (and is) a top priority of mental health and addiction advocates--as ACA, if implemented appropriately, could provide coverage for mental health and addiction services at parity to most everyone in the state.  While legislators did debate (and argue) over how best to implement the ACA, the only language that passed dealt with the Exchanges and Navigators (HEA 1328).  What may turn out to be the most important piece of legislation this Session, is legislation that was passed in the 2011 Session of the Indiana General Assembly.  SEA 461 (Miller/Simpson, Brown/Brown) provides at least the legislative framework for ACA implementation in Indiana.  The remaining unresolved--but critical-- piece revolves around the Expansion population.  As it stands now, the Governor's Office/FSSA has applied for a Medicaid Waiver to use the Healthy Indiana Plan model to provide for the Expansion population.  Mental Health America of Indiana provided both legislative testimony and administrative comments supporting the utilization of HIP, without a cap on enrollment and annual or lifetime limits.  The Administration is awaiting a response from HHS as to whether it will be permissible to use HIP as an expansion vehicle.  It is expected that the Administration will be in negotiation with HHS as to the parameters of the Expansion.  The Health Finance Commission with oversee the ACA implementation.  Mental Health America of Indiana will work with the Commission and the Administration toward providing universal access for mental health and addiction services in Indiana.

 

Budget

Of course, this was a Budget year and passing the biennial budget was the only constitutionally required act that the Indiana General Assembly had to perform.  That goal was accomplished with HEA 1001.  Notably, a funding reserve was set aside for ACA implementation.  In the area of Mental Health and Addiction, the House added a small increase to the Governor's proposed budget in funding for SMI and Addiction, though the Senate removed the increase.  In the final budget, the funding for SMI was increased from $94,302,551 to $95,102,551 in each year of the biennium.  Similarly, CMHC Tobacco Settlement funds were increased from $7,000,000 to $7,200,000 per year.  The Substance Abuse line item was increased from $4,855,902 to $5,355,820, with $500,000 dedicated for a drug rehabilitation program in Jefferson County.  For the first time, $2,000,000 was added in the second year of the biennium for Forensic Diversion.  At various points, current addiction funding dedicated from gaming was at risk of being redirected to other areas, but such did not remain in the final bill.  The budget was a priority of the Indiana Council of Community Health Centers with strong support from MHAI.

 

$500,000 in each year of the biennium was added for Guardianship to be used to provide matching funds to counties that implement in courts with probate jurisdiction a volunteer advocate program for seniors and incapacitated adults.  The funds are also to develop and maintain an adult guardianship registry to serve as a data repository for adult guardianship cases and adult guardians appointed by the courts.  This appropriation was a priority of a Guardianship Stakeholders Group of which MHAI is a member.

 

Unfortunately, the Budget only provided for $5,000,000 for tobacco prevention and cessation programs, a reduction from $8M needed to sustain the current funding--and just a fraction of the $78.8M recommended by the CDC for a comprehensive tobacco control program.  While legislators avoided steeper cuts than had originally been proposed, this funding continues to be cut each budget cycle, despite the state receiving more than $125M every year from the Master Settlement Agreement.   This was a priority of the Tobacco Free Coalition of which MHAI is a member.

 

Immediate Detention

HEA 1130 adds "gravely disabled" to the immediate detention statute, making it consistent with the emergency detention and temporary commitment statutes.  This was a priority of NAMI Indiana and supported by MHAI.  This bill was recommended by the Indiana Commission on Mental Health and Addiction and has been signed by the Governor.

 

Antibullying

HEA 1423 requires the development of guidelines to establish bullying prevention programs, policies and reporting requirements.  The legislation provides training and education requirements as well as procedures for support services.  This bill was a significant achievement on the part of children and human service advocates, including BullySafeIndiana, MCCOY and others.

 

Protection and Advocacy Services Commission

SEA 203 was the priority of Indiana Protection and Advocacy and provides that an individual with mental illness is eligible for services from IPAS if the individual lives in a community setting.  This amends the statute to conform to existing practice.

  

Controlled Substances

SEA 246 was a priority of the Attorney General's Office.  The Attorney General has created a Prescription Drug Abuse Task Force that includes a Recovery Committee chaired by MHAI CEO, Steve McCaffrey.  As recommended by the Attorney General's Recovery Committee and Task Force, SEA 246 includes language broadening the scope of the Mental Health Medicaid Quality Advisory Committee to include addiction medications.  Additionally, SEA 246 requires the Indiana Commission on Mental Health and Addiction to study issues concerning treatment and recovery from prescription drug use addiction.  Specifically, the commission shall study and make recommendations concerning (1) the use of the Indiana health care professional recruitment and retention fund established by IC16-46-5-8 to provide loan repayment for student loans incurred by addiction professionals (2) Criteria for Medicaid reimbursement for detoxification and rehabilitation services for addiction treatment, and (3) Best practice treatment for pregnant mothers and newborns with prescription pain medication dependencies and addictions.

 

Mental Health Matters

SEA 267 makes numerous technical changes, but was amended to require the Indiana Commission on Mental Health and Addiction to review, discuss revisions, and make recommendations regarding the continued implementation of the children's social, emotional, and behavioral health plan, as developed under IC 20-19-5. The commission shall consider comments and recommendations from governmental agencies and interested parties.  The Division of Mental Health and Addiction Advisory Committee will assist with the plan review.  This effort could make a significant impact on the coordination of children's mental health services in Indiana that were never realized under the original enabling statute.  Language was also added to review the operation of existing mental health crisis intervention teams operating in Indiana and make recommendations

concerning the best practices necessary to encourage the creation and development of mental health crisis intervention.  This is also long overdue.

 

Music Therapists

SEA 273 creates credentialing for Music Therapists administered by the Certification Board for Music Therapists and requires Music Therapists to collaborate with the client's physician, psychologist, or other health or mental health professionals.  The bill also protects the title.

 

Seclusion and Restraint

SEA 345 establishes a commission on seclusion and restraint in schools to adopt rules concerning the use of restraint and seclusion in schools and develop a restraint and seclusion plan.  This was a significant accomplishment and priority of the Autism Society of Indiana and the ARC of Indiana with the strong support of MHAI.

 

Telehealth and Telemedicine

SEA 554 would require the office of Medicaid Policy and Planning to reimburse a community mental health center, home health agency, FQHC, a rural health clinic, and critical access hospital for telemedicine services regardless of distance between the provider and the patient under the Medicaid program.  Further, it requires the Health Finance Commission to study issues concerning telehealth and telemedicine in Medicaid.

 

School Resource Officers

SEA 1 sets forth duties and responsibilities for school resource officers.  Additionally, it establishes the school safety interim study committee, which shall: (1) study how to improve the safety of schools in Indiana; (2) develop best practices for a school resource officer to employ in order to successfully carry out the officer's responsibilities; and (3) study additional topics that the legislative council assigns.

 

Criminal Code Reform

HEA 1006 makes various changes to the criminal code, including changes to the law concerning community corrections, probation, sentencing, probation funding, drug and alcohol program funding. The bill also expands Indiana's four level felony classifications into a six level system.  This will lower most drug possession and selling penalties so that the punishment is more proportionate to the crime.  It also gives judges more flexibility in determining appropriate sentencing.   Importantly, the bill also requires a summer study review of suspendible sentences, criminal justice funding--which includes money for treatment, community corrections and probation--recidivism, and other issues related to sentencing. The statute does not go into effect until July 1, 2014.

 

Sunday Sales

HB 1146 died after a four hour hearing in House Public Policy.  This bill would have allowed alcohol to be sold on Sundays in all outlets that currently are licensed to sell.  The proponents of the bill failed to convince committee members of the need for another day of sales while opponents showed strong grassroots support for keeping alcohol sales to six days a week.  Chairman Bill Davis did not support the bill and would not call for a vote on the measure.  Sunday Sales have been shown in national studies to increase access of alcohol to minors and the bill's defeat was a priority of the Indiana Coalition to Reduce Underage Drinking.

 

Online Server Training

HEA 1262 goes to the Governor for signature following easy passage in both the House and Senate.  This law will allow persons in need of alcohol server training to take on-line courses, which must be certified by the Alcohol and Tobacco Commission and include a testing component.   This was also an ICRUD priority.

 

Social Host

SB 188, which would have increased penalties for adults who provide a location for minors to drink, failed to receive a hearing in committee.

    

The above is only a summary of MHAI priority bills.  If you have additional questions regarding the legislation above or other bills, please feel free to contact the Mental Health America of Indiana office.

Save the Date!
Friday, June 14, 2013
16th Annual Mental Health Symposium  
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