Certified Community Behavioral Health Clinics Tackle Mental Health, Substance Use Crises with Expanded Access to Care |
CCBHCs provide mental health care services, including 24/7 crisis services, to anyone regardless of income or insurance. The National Council for Wellbeing created CCBHCs with members and policy makers over a decade ago and has surveyed clinics since they were first established in 2017. This report comes a week after the Biden-Harris Administration announced new funding through the Bipartisan Safer Communities Act to expand CCBHCs nationwide.
The report found that about 2 million people are being served across the country by all 450 active CCBHCs and grantees from the new funding. This is a sharp increase from 2021, when 224 CCBHCs were serving about 1.5 million people. Clinics that reported an increase in their caseload are serving on average 900 more people per clinic than before CCBHC implementation, which is a 23% increase. Since implementation, clinics surveyed are serving a total of nearly 180,000 new clients.
CCBHCs are making life-saving services easily accessible, as 98% offer access to 24/7 crisis lines, 97% to mobile crisis response, and 94% to crisis stabilization services. Also, the report found that the 229 clinics that responded hired 6,220 new staff members after becoming a CCBHC, with the average clinic hiring 27 new members. Across all 450 active CCBHCs, The National Council for Wellbeing estimates that over 11,000 new staff members have been hired.
Note that Minnesota was one of the pilot states and we have 13 CCBHCs in the state. Learn who is a CCBHC in Minnesota here.
From the National Council
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Drivers in Decline: A Shortage of Volunteers Complicates Access to Care in Rural America |
The number of volunteer drivers for medical transportation programs has been declining, according to transportation advocates. Experts say the drop is due to volunteers reaching an age where they can no longer drive or finding the associated costs too high. These programs, like Faith in Action in Red Wing, reimburse drivers at the charitable rate of 14 cents per mile, not nearly enough to cover gas and wear and tear costs. The Internal Revenue Service (IRS) hasn’t increased the charitable since 1997.
United Community Action Partnership in southwestern Minnesota had for years been reimbursing volunteer drivers at the business rate of 58.5 cents per mile, but when they learned the IRS could count reimbursement exceeding the charitable rate as taxable income, many drivers left. Those who remained often found the 58.5 cents per mile reimbursement too low to cover surging gas prices over the summer, and although the IRS increased the business rate reimbursement to 62.5 cents in June, some drivers had to stop volunteering due to financial constraints.
Rep. Pete Stauber (8) introduced H.R. 7432, which would increase the mileage rate for the charitable use of an automobile (14 cents per mile) to the standard business mileage rate (58.5 cents per mile in 2022). It is co-sponsored by Rep. Angie Craig (2) and Rep. Dean Phillips (3).
Rep. Angie Craig (2) introduced H.R. 8265 and it is co-sponsored by Rep. Pete Stauber, (8), Rep. Dean Phillips (3) and Rep. Betty McCollum (4). This bill increases the rate of the tax deduction for the charitable use of a passenger automobile to equal the standard business rate (i.e., 58.5 cents per mile in the first half of 2022, then 62.5 cents per mile for the rest of that year) for taxable years beginning after 2021 and before 2024. It then provides for a permanent 24 cents per mile rate, adjusted annually for inflation, for taxable years beginning after 2023.
Another challenge volunteer drivers face is differentiating themselves from drivers-for-hire who work at places like Uber, as insurers could require them to spend more on insurance meant for ride-hailing drivers. Last year, Minnesota passed legislation distinguishing volunteer drivers from drivers-for-hire, becoming only the third state to do so.
Volunteer driver organizations have adjusted to declining volunteers in different ways. In southeastern Minnesota, the nonprofit Semcac has had to limit users to two nonmedical trips per month and partner with certain insurance providers to help fill the gap. The average driver age for Semcac is estimated at 80 years old. Faith in Action in Red Wing is planning a new strategy to address their similar average driver age by recruiting stay-at-home parents as drivers. From KHN. |
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News from the State Level |
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The issue of children boarding in the ERs continued to be discussed in the media this week. There was a story on MPR, where it was noted that NAMI Minnesota will be bringing forth legislation to change the definition of neglect so that families who cannot take their child home from the ER are not put into the child protection system. Thanks to Traci LaLiberte, Executive Director of the Center for Advanced Studies in Child Welfare.
A letter from NAMI Minnesota's executive director was published in today's Star Tribune in response to the article about the boy boarding in the ER.
A recent Kaiser Family Foundation article looked at medical debt "A recent KFF poll designed to measure the many ways people borrow to pay medical bills found that about 100 million Americans have some kind of health care debt, and 20% of those owe money for mental health services." They also reported on families spending down to obtain Medicaid. Luckily in MN we have "TEFRA" or the Katie Beckett Waiver so families don't have to spend down - but it does take months to obtain it. |
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The Star Tribune continued a series on juvenile justice last week with a new piece titled “ Nowhere to Go for Most Troubled Youth”. This is the third article in the Juvenile Injustice series, and it features the history and current state of youth detention and community-based programs in Minnesota. Placements in institutional and detention facilities have dropped drastically for the last 20 years due to findings that youth were not being rehabilitated and a series of scandals around 2016. Yet community-based programs to rehabilitate youth have not been built to meet the needs of youth who are convicted in the juvenile system. Mental health treatment is nearly always a factor for children in the juvenile system and as our children’s mental health system is currently struggling to serve kids who are not in the justice system, placements for kids with violent charges and complex needs present equally difficult challenges.
This series comes during a highly charged election season with public safety as a hot-button topic. Statistics on crime have been used to make both arguments that crime is on the rise during the pandemic and that historically, violent crime continues to trend downward in the U.S. Regardless of the trends, the Star Tribune piece highlights that we have known what works for youth for many years, but the state has failed to build it. The article also tells the story of several youth, some of whom were successful in recovering from their system involvement and others who became entangled in the adult criminal legal system. The stories also underscore the wholistic needs of children and families who have experienced trauma and other barriers like systemic racism and difficulty meeting basic needs.
It will be important in the upcoming session for mental health advocates to prioritize building our children’s mental health system. NAMI Minnesota will be working with the Mental Health Legislative Network to ensure that essential services like Psychiatric Residential Treatment Facilities (PRTFs) are accessible, covered by insurance, and able to specialize. There is no one issue that can keep youth out of the juvenile system, but as has been said, we do know what works – safe and stable housing, engagement in school, access to healthcare, meaningful relationships with adults and peers, and interrupting harms like racism and punitive discipline practices.
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We are looking for people willing to share their story with reporters and legislators related to having difficulty obtaining the right level of care. This includes experiencing "phantom" networks where the information in your health plan's network directory is incorrect (no longer take the insurance, not taking new patients), or being discharged too soon and appropriate community services are not available, or being boarded in the ER while waiting for a bed. If you are willing to share your story email us at namihelps@namimn.org
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News from the Federal Level |
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State Medicaid Officials Expect to See Enrollment Declines, Slower Total Medicaid Spending Growth and Rising State Costs in FY 2023 |
Most state Medicaid agencies expect Medicaid enrollment to decline after the COVID-19 Public Health Emergency ends, which many think will happen in Fiscal Year 2023. A new state Medicaid budget survey by the Kaiser Family Foundation found that state Medicaid directors expect Medicaid enrollment growth to slow from 11.2 percent in FY 2021 to 8.4 percent in FY 2022, then decline by .4 percent in FY 2023.
Agencies also expect lower enrollment to lead to slower total Medicaid spending growth in FY 2023, even though the loss of pandemic-era federal funding will likely increase state funding to rebalance the spending mix. While total Medicaid spending growth is expected to decrease from 12.5 percent in FY 2022 to 4.2 percent in FY 2023, state Medicaid funding growth is expected to increase from 9.9 percent in FY 2022 to 16.3 percent in FY 2023.
Many states also reported making progress on health care priorities that have gained a renewed focus during the pandemic. Two thirds of states have used at least one strategy to increase equity in data completeness. States reported more benefit expansions than reductions, particularly in behavioral health, and more rate increases than restrictions for providers. Most have adopted or plan to adopt permanent telehealth expansions for Medicaid, though some are thinking about adding restrictions.
The Public Health Emergency was recently extended for the 11th time since the onset of COVID-19. The next extension deadline is January 11th, and the Biden-Harris Administration has told states they will give 60-days-notice before ending the Public Health Emergency.
From KFF
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Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds |
The 24 th annual Employer Health Benefits Survey by the Kaiser Family Foundation has found that mental health is a top priority for most employers. Almost half of large employers said that the number of employees using mental health services has been increasing throughout the pandemic. However, nearly a third of that group said their health care plan didn’t cover enough mental health providers for employees to receive the care they need.
About 4 in 5 of the over 2000 employers surveyed said that their health care plan covered enough primary care services, but only 44% said the same about mental health care. Among employers with 50 or more workers, 17% have seen an increase in the number of workers requesting leave for mental health reasons.
In a positive sign, 90% of all employers surveyed said that they offered a health care plan that covers telehealth. Also, 81% of large employers said they have an employee mental health service assistance program, 44% said they offered mental health self-care apps, and 27% said they have added mental health care providers to their health care plan’s network this year.
The survey also found that this year’s health care plan premiums are little changed from last year’s, as the average premium for a family plan rose slightly from $22,221 to $22,463, with employees paying $6,106 of that cost. But KFF President and CEO Drew Altman says that next year’s premiums could rise more dramatically given the U.S. is still experiencing the highest inflation rates in four decades.
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National NAMI Releases Report on Crisis Services |
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The National NAMI office recently released a report on crisis services. For this report, NAMI surveyed people who have experienced a mental health crisis or loved ones who supported someone in a crisis from 12 demographic groups. Focus group discussions concentrated on understanding barriers to crisis services, as well as perceptions and expectations related to 988.
The report highlights best practices for creating a high-quality crisis response system including:
• Crisis response training
• Cultural competency of service providers
• Language accessibility
Behavioral Health News recently wrote about 988. Check it out here.
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Find out who represents you |
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Updates from NAMI Minnesota |
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NAMI Minnesota's State Conference: Charting a New Future |
Join us on Saturday, November 5th, at the Saint Paul RiverCentre for NAMI Minnesota's Annual State Conference. Learn how to reduce mental health disparities and advance health equity from opening keynote speaker Dr. Kisha B. Holden. Then choose 3 out of 18 breakout sessions on a wide variety of current mental health topics. Some breakouts include:
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2022 Legislative Session: Presented by Sue Abderholden, Elliot Butay, and Calvin Melloh of NAMI Minnesota. Learn what happened during the 2022 legislative session and what issues will be before the 2023 legislative session. Learn what you can do to advocate for people living with mental illnesses and their families at the legislature.
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Criminal Justice Reform: Presented by Elliot Butay of NAMI Minnesota, Ryan Flynn of the Ramsey County Attorney’s Office, and KyleeAnn Stevens of the Minnesota Department of Human Services. Learn about new policies and practices, including the impact of the competency restoration bill.
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Mental Health Through a Cultural Lens. Presented by Comfort Dondo of Phumulani: Minnesota African Women Against Violence and Sayali Amarapurkar of AshaUSA
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Optimizing Care for Early Stage Bipolar Disorder. Presented by Piper Meyer-Kalos of the University of Minnesota's Department of Psychiatry & Behavioral Sciences and Kate Miley of M Health Psychiatry Clinic
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The Importance of Employment in Recovery. Presented by Vanessa Gallagher and Kari Olson Lleva of the Minnesota Individual Placement & Support Services State Team
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The Impact of Gender Affirming Care. Presented by Ryan Fouts and Caitlin Baldwin of RECLAIM
In the afternoon, we will recognize the contributions of this year's NAMI award winners during our annual Awards Luncheon and conclude the day with a closing keynote from Breathwork Facilitator Bryan Piatt. If you are a person who lives with a mental illness, a family member or loved one of someone who experiences a mental illness, or a professional who works with people with mental illnesses, this conference is for you!
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Tickets cost $100 for nonmembers and $65 for members. CEU credits cost an additional $20. Full and partial scholarships are available upon request. Contact Christine at publicawareness@namimn.org for more information.
Thank you to our Sponsors who make this event possible! The conference is sponsored in part by United Healthcare, Medica Foundation, Janssen Pharmaceuticals Inc., Optum, the Department of Psychiatry & Behavioral Sciences at the University of Minnesota Medical School, Rogers Behavioral Health, LynLake Centers for Wellbeing, Alkermes, Inc., Beacon Health Options, Accra, Northwood Children's Services, Vail Place, Bremer Bank, Newport Healthcare, the Minneapolis VA, Mental Wellness Campaign for Anoka County, Lutheran Social Service of Minnesota, WRAP Technologies, Woodland Centers, Mental Health Minnesota, North Homes Children & Family Services, Radias Health, Love Disorder , Minnesota Autism Center, Rainbow Health, DBT-PTSD Specialists, Hamm Clinic, Canvas Health, Minnesota Alliance on Problem Gambling, Minnesota Brain Injury Alliance, Myriad Neuroscience/Myriad Genetics, and St. Catherine's University.
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Every candidate elected this year will make decisions that impact mental health in our community. To make mental health a priority, we need to #Vote4MentalHealth this fall. While the decision on who to vote for is yours, you can’t #Vote4MentalHealth if you aren’t registered. Click here to learn more about registering to vote in Minnesota. Watch this short video on the importance of voting. |
Election day is Tuesday, November 8th, 2022, less than a month away. Make your plan to vote before or on election day by mail or in-person.
Voting Early
Voting by Mail
In Minnesota, any registered voter can request to get a ballot by mail. Fill out the mail ballot application and mail or return it in-person to your local election office. Read the instructions carefully on how to mark and return your ballot. You will need a witness when you vote and complete your ballot. The witness can be either a registered Minnesota voter or a notary. Return the ballot and forms right away after you finish. Your ballot will not count if it is received after November 8 th. You can return your ballot by mail or in-person. Find where to return your ballot in-person on Minnesota’s site.
Voting In-Person on Election Day
You can look up where to vote on Minnesota's site. You do not need to show ID to vote in Minnesota if your voter registration is current and active. If you’re voting for the first time in Minnesota, you will have to show ID to vote if you registered by mail and your ID number could not be verified by the state, or if you are registering to vote on Election Day.
Registration
You can register to vote or update your registration here. You will need an email address (use a paper application if you don’t have one), and a Minnesota driver’s license or Minnesota identification card number (if you don’t have one of these, you may use the last four digits of your Social Security number or use a paper application).
Registration Deadlines
· Online: Oct 18 by 11:59 p.m.
Absentee Ballot Deadlines
Voting Deadlines
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NAMI Legislative Committee |
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NAMI Minnesota | 1919 University Ave. W., Ste. 400 | St. Paul, MN 55104
651-645-2948 | 1-888-NAMI-HELPS
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Copyright © 2022. All Rights Reserved. |
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