Legislative
and
Advocacy
Update

June 2019
The Federation is involved at the national level in monitoring
legislation, advocacy and funding opportunities and identifying resources that could aid your work as the voice for families.
Legislation
Legislative Actions
Congress returned from their “spring break” and had a very
busy month of action leading up to the Memorial Day recess.
The Federation actively represents you as part of the  Mental Health Liaison Group  (MHLG) .  The MHLG is a forum for collaboration among the leading national mental health and addiction-focused organizations. Together, we provide policymakers with information and support in advancing our shared policy priorities. The MHLG hosts congressional staff briefings to share information on trends and best practices in the field, provides annual recommendations on mental health and addiction funding in the federal appropriations bills, writes letters to Congress outlining our position on important legislation or offering suggestions for improving proposed policies and more. The current statement issues for MHLG are found here.

Mental Health Parity
  • The Mental Health Parity Compliance Act, was introduced June 7th by Reps. Porter and Bilirakis. The legislation fosters transparency and accountability, to ensure that health plans are complying with the Federal parity law and that those confronting mental illness have equal access and coverage of needed mental health and behavioral health services. We joined members of the MLHG in issuing a letter of support for this Act.

  • Murphy/Cassidy Bill S 1737 - We join MHLG organizations in strongly supporting the Mental Health Parity Compliance Act of 2019. The legislation fosters transparency and accountability, to ensure that health plans complying with the Federal parity law and that those confronting mental illness have equal access and coverage of needed mental health and behavioral health services.

  • American Psychological Association, American Society of Addiction Medicine, and The Kennedy Forum in support of the Parity Enforcement Act (H.R. 2848), sponsored by Congressman Norcross, and Rep. Fitzpatrick (R-PA). This bipartisan bill would give USDOL this critical authority and complements other recent parity bills, which would increase transparency on treatment limitations, by giving USDOL a “stick” when violations are found. Providing USDOL this authority was a recommendation of President Trump’s Opioid Commission (#35) and President Obama’s Parity Task Force.
  • One Pager on the Parity Enforcement Act


  • We encouraged HELP (Health, Education, Labor and Pensions Committee) Chairman Alexander and Ranking Member Murray to include the Mental Health Parity Compliance Act in the bipartisan proposal they are developing to lower health care costs. Read the letter to Committee
  • The HELP Committee is a key committee. They will be making recommendations on a cost package soon. We encourage you to follow the work and hearings of this committee here.

Maternal Health
  • We joined with 65 other national advocates in encouraging Chairman Blunt and Ranking Member Murray on the Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies to request that they include report language within the Fiscal Year (FY) 2020 LHHS appropriations bill to conduct an interagency report at the US Department of Health and Human Services (HHS) on the role each agency plays in addressing gaps in maternal mental health for new and expectant mothers. 

Pre-Existing Conditions
  • We joined American Psychological Association, NAMI, the Eating Disorders Coalition and the Residential Eating Disorders Consortium in a letter supporting the Protecting Pre-Existing Conditions and Making Health Care Affordable Act of 2019, introduced by Reps. Pallone, Neal and Scott.  
  • The bill, introduced by Reps. Frank Pallone, Richard Neal, and Bobby Scott (chairs of the three committees with jurisdiction over major health care programs), would "substantially improve financial assistance for people purchasing coverage through the Affordable Care Act (ACA) marketplaces, strengthen protections for people with pre-existing health conditions.”
  • Read the summary of the bill and its effects
  • Coalition Health Care Task Force Co-Chairs Statement on ACA Bill Introduction

Services for Students
  • With MHLG we expressed strong support for Senator Tina Smith's Mental Health Services for Students Act of 2019 (S 1122) The Bill will provide federal support to assist local communities and schools with health providers who can effectively support our nation’s youth in dealing with trauma and violence by increasing funding through Project AWARE and strengthening school-based resources for students.
  • More about the Mental Health Services for Students Act

Nutrition
  • We joined the Eating Disorders Coalition and others in asking that language be included in the Live Well Act (HR2625) to include eating disorders prevention within local school wellness policies.
The National De-Escalation of Violence and Community Safety Training Act of 2019
Adapted from National Council

T he National De-Escalation of Violence and Community Safety Training Act of 2019 (H.R. 2457), introduced by Rep. Gwen Moore (D-WI) would equip communities with the skills and knowledge to de-escalate crisis situations involving individuals living with mental illness or substance use disorders. The bill would also reauthorize Mental Health First Aid training grants through 2025.
House Appropriators
Pass FY 20 Health Spending
Adapted from National Council

The House Appropriations Committee approved its Labor-HHS budget for Fiscal Year 2020 funding key federal health, education and labor programs for the year ahead. The Substance Abuse and Mental Health Services Administration (SAMHSA) saw increases of $115 million to its programming which includes level funding for several key programs as well as new funding for the Community Mental Health Services Block Grant and substance use disorder workforce initiatives. It now heads to the full House.

There was level funding from FY2019 vs FY2020 for: Substance Abuse Prevention and Treatment Block Grants, Promoting the Integration of Primary and Behavioral Health Care, PIPBHC Technical Assistance and Training Center, Mental Health First Aid, State Opioid Response Grants and Certified Community Behavioral Health Clinic Expansion Grants.

There was an increase in funding from FY2019 to FY2020 for the following:
SAMHSA +$115 million, National Institutes of Health +$2 billion, Community Mental Health Services Block Grant +$35 Million and the Loan Repayment Program for Substance Use Disorder Treatment Professionals +$25 million.
RISE (Resilience Investment, Support and Expansion) from Trauma Legislation

Senators Durbin and Capito plan to introduce the Rise from Trauma Act to enhance support for children, families and communities that experience trauma and toxic stress. See the attached bill, section by section. The bill has a parity provision included as it links to IDEA Parts B and C and early intervention services. The RISE from Trauma Act expands upon these efforts with a focus on enhancing community programming and workforce development to broaden the reach of trauma-informed services.   
Bipartisan Legislations to Reduce Shortage of Mental Health Professionals

On May 1st, U.S. Reps. John Katko and Grace Napolitano reintroduced bipartisan legislation to increase the number of mental healthcare professionals throughout the United States. H.R. 2431, The Mental Health Professionals Workforce Shortage Loan Repayment Act of 2019, aims to increase the number of mental healthcare professionals practicing in underserved communities by authorizing a loan repayment program for those who work in an area with a lack of accessible care.

T he Mental Health Professionals Workforce Shortage Loan Repayment Act, would address the workforce shortage of mental health professionals by creating a loan repayment program. The bill proposes creating this program such that individuals who agree to serve as a mental health professional in an area with a shortage of that workforce can enter into an agreement in which the federal government will repay part of the principal of and interest on eligible accrued loans. 

"This legislation incentivizes mental healthcare professionals to practice in underserved communities, improving access to treatment and improving the quality of care. I am grateful to once again collaborate with my Co-Chair Congresswoman Napolitano in introducing this critical legislation.” said Rep. Katko. “There is a national shortage of trained mental health professionals, and we must do all we can to address it,” Rep. Napolitano said.
CARE Act
T he House and Senate re-introduced a bill that would invest $100 billion in federal funds over ten years to better address the opioid overdose epidemic. The Comprehensive Addiction Resources Emergency (CARE) Act (S. 1365/H.R. 2569) includes provisions to strengthen standards for recovery residences, establish new grant programs to help individuals living with addictions find or maintain employment, and incentivize states to cover the full range of addiction services in their Medicaid programs.
For More Details about National Issues
For more details about the latest in National Legislation and Advocacy, watch our April update video and visit our National Legislative and Advocacy webpage .
Advocacy Alert
Poverty Line Proposal Would Cut Medicaid and Medicare Benefits Over Time  
Adapted from The Center on Budget and Policy Priorities and
The Coalition on Human Needs  

The Trump administration issued a request for comments on a proposal to change the way the federal poverty line is adjusted for inflation. The change would have significant and lasting impacts on families who are already struggling to overcome barriers to financial security. Programs use the poverty line to determine eligibility and benefits.
Over time, this proposal would lower the federal poverty line, which already underestimates the number of struggling families in the United States. It would also limit eligibility for critical programs that support children and families.

The administration is requesting comments on the proposal until June 21. It is quite important that diverse comments are part of the public record.

Coalition on Human Needs has created a range of portals and comment guides to facilitate sending effective comments to OMB on this proposed change:
In the News
Parity
As Parity legislation takes front stage nationally, the states are also passing legislation in the promotion and assurance of mental health parity. To date the following states have enacted their own state parity legislation:
Parity Track examines the current state of Parity implementation across the country through in-depth analysis of current legislation and regulatory actions by state.

You can look up your state by:
  • Legislation
  • Regulations
  • Statute
  • Resources
Opioid Lawsuit Heads to Trial
Adapted from The National Council Capital Connector  

The  first trial against a pharmaceutical opioid manufacturer started in Oklahoma in what could be a precedent-setting case for similar lawsuits across the country. In the multibillion-dollar lawsuit against Johnson & Johnson, lawyers for the state argued that the company knew about the addictive nature of opioids, but misled doctors by downplaying the risks of the drugs. While this is the first opioid case to head to trial, several opioid manufacturers have already agreed to settlements with states. In response, the  Addiction Solutions Campaign developed this resource guide   outlining strategies for investing opioid settlement funds in effective solutions addressing the opioid crisis.  
Enhancing Your Advocacy
2018 Congressional Scorecard
Children need Champions and Defenders who are willing to focus on, support, raise their voices, and attach their name to legislation that would improve the lives of our nation’s children and actively oppose legislation that would harm kids. 
In an attempt to recognize those lawmakers in the second session of the 115th Congress who worked to improve the lives of our nation’s children through public policy change, First Focus released its 2018 Scorecard.

Their review of the 115th Congress offers a complete list of the 120 Champions and Defenders of Children. These lawmakers introduced bills to safeguard children’s programs, supported beneficial measures and voted against those that would harm children. The Scorecard also lists the key votes and bills for children during the 115th Congress.
The Policy Experts at First Focus have rated the current bills in the
116th Congress.
Do they help kids or harm kids? u
News from the States
Most of the states legislative sessions have ended, which means we have  a lot of news about what has been done this session .

For more details on state Sessions,
Legislative Summaries and Bill Trackers
visit the  From the States section of our website or watch the adjacent video. o.
California
From the Capital Connector

California is set to expand Medicaid to some undocumented immigrants. State legislators have agreed to a budget deal that would expand Medicaid to roughly 90,000 undocumented immigrants up to the age of 26, which would make California the first state in the nation to provide public insurance for this population. Governor Newsom is expected to sign the budget deal in the coming weeks. 
Connecticut

Connecticut's Care4Kids program, which provides child care subsidies for low-income, working families, received a moderate increase of approximately $5 million in funding and a $14 million carry over from surplus funds from the previous year. 
Florida

The state is considering changes to rules surrounding who can provide Medicaid behavioral-health services. The changes could increase access to mental-health providers in settings such as schools. 
Iowa

School teachers and staff across the state of Iowa are now beginning training to address children's mental health needs within their school buildings. Governor Reynolds set aside $2.1 million of the $950 million state education budget for children's mental health training and support in schools. The money will help Iowa's Area Education Agencies who will oversee training for schools across the state. 
Kansas

Kansas failed to pass its Medicaid Expansion Plan. The proposal, which would have provided coverage for an estimated 86,000 uninsured, low-income adults, failed to move forward in the state legislature following unsuccessful negotiations between the state’s Republican-led Senate and Democratic Governor, Laura Kelly. Earlier this week the Senate fell one vote short of advancing the bill to be debated on the chamber’s floor.
Kentucky
   From the Kentucky Youth Advocates

Through efforts led by Senator Wise and Representative Carney, members of the School Safety Working Group, and a variety of diverse stakeholders, the complex issue of school safety and security was thoughtfully approached, resulting in an equally comprehensive and well-thought-out array of solutio ns.
Mississippi
US DOJ vs. State of Mississippi

Last week was the opening of the trial that is a result of the lawsuit the U.S. Department of Justice filed in 2016 against the state of Mississippi for violating Olmstead.
NFFCMH State Chapter, Families as Allies, will have staff members attending the trial, and we will be reposting their updates on the Legislative Facebook page. The trial is expected to last 6 weeks.
New Hampshire

Workers at the Division for Children, Youth and Families have some of the highest average workloads in the country. This week, a bill hoped by lawmakers to address that, became law. Senate Bill 6, a measure to dramatically increase the staffing at the agency, adds funding for 77 new positions over two years.
Oregon

Senate Bill 1008 passed the Oregon House by a 40-to-18 vote, Lawmakers approved a series of significant changes to Oregon’s juvenile justice system that mark the end of a decades-old practice of automatically sending youth accused of serious crimes to adult court.
Tennessee
Tennessee to Seek Block Grant for Medicaid

The Tennessee legislature passed a bill that would make it the first state in the nation to transform its Medicaid program into a single lump sum block grant. The legislation was passed after continued promises from the Trump Administration to provide states with greater flexibility in running their state Medicaid programs. The bill now heads to Governor Bill Lee’s desks for his review and approval. 
Staying Connected
New Legislation and Advocacy Pages
  • Learn how to keep up with news and updates
  • Finding your legislator, state Medicaid Director and state Mental Health Commissioner
  • Tips on committees
  • Live streams of the House and Senate
  • Information on highlighted National legislation
  • Information on highlighted legislation from the states
  • State tabs where, for each state, you will find:
  • The General Assembly page
  • How to find your state legislator
  • Link to state legislative advocacy organization
  • Links to the live stream sessions from the state
  • Tips on how to advocate
Facebook Page
Following our dedicated Legislative and Advocacy News and Resources Facebook page is a great way to keep up with what is going on in all the states and to share what is happening in yours.
Alerting us to what is happening on the state level will aid not only those in your state but others nationally as ideas spread. As you become aware of state or national legislative alerts, funding and advocacy opportunities or resources that could be used to build funding requests, please let us know by emailing mcovington@ffcmh.org .