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Legislative and
Advocacy
February 2021 Updates
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The National Federation of Families 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.
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The National Federation of Families 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. As part of our work with MHLG Committee and its members, the Federation of Families has supported the following actions:
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Barriers to Suicide Act - Congressman Beyer reintroduced the Barriers to Suicide Act. This vital piece of legislation will create grants for state and local governments to fund nets and barriers on bridges to prevent deaths by suicide.
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Mental Health Access Improvement Act (H.R. 432) Re-Introduced Representatives Thompson (D-CA) and Katko (R-NY) recently re-introduced a bill that would allow marriage and family therapists (MFTs) and licensed mental health counselors to directly bill Medicare for their services.
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Medicaid Reentry Act Reintroduced Sens. Baldwin (D-WI) and Braun (R-IN) and Reps. Tonko (D-NY) and Turner (R-OH) reintroduced the Medicaid Reentry Act, which would allow Medicaid to cover health care related services provided to incarcerated individuals up to 30 days before their release from jail or prison. This legislation is an important step toward improving access to critically needed mental health and substance use services for one of the nation’s most vulnerable populations.
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The TREAT Act Reintroduced Led by Sens. Murphy (D-CT) and Blunt (R-MO) and Reps. Dingell (D-MI) and Latta (R-OH). The legislation would increase access to health care services during the national COVID-19 public health emergency by allowing practitioners with valid licenses to provide services, including telehealth services, in all states for the duration of the public health emergency.
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Mental Health Services for Students Act (H.R. 721) Reps. Napolitano and Katko re-introduced the Mental Health Services for Students Act, legislation MHLG previously supported. The legislative text is nearly identical to the version of the Mental Health Services for Students Act passed unanimously by the US House of Representatives on 9/29/20 in the 116th Congress. Only one change was made to increase funding from $130,000,000 to $200,000,000.
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The Federation joined other MHLG Members in signing on to the Unified Visio for Transforming Mental Health and Substance Use Care. In early 2020, as COVID began to spread across the United States, the leaders of the nation’s leading mental health, addiction and well-being advocacy groups and professional organizations began meeting weekly to generate proposals for how to powerfully address the new wave of need. With their combined expertise working on the fault lines of substance use, suicide and severe mental illness towards well-being and resilience, they created a Unified Vision for Transforming Mental Health and Substance Use Care, that offers actionable pathways for success. And, for the first time, there is strong agreement among stakeholders about what must be done.
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Call for a White House Office of Children and Youth
The Federation along with 350 organizations and leaders, have called upon the incoming Biden-Harris Administration to establish a White House Office on Children and Youth and a federal Children’s Cabinet. Children are the future of our nation. Our economic and civic strength and prosperity rely on today’s investment in children and youth. At this critical inflection point for our nation’s future, we need to re-imagine our systems for optimal health, well-being and development for all children and youth.
Read a summary of the proposals to elevate an agenda for children and youth.
See the organizations and leaders that support cohesive, national leadership for children and youth.
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Keep Our Promise to America’s Children and Teachers (PACT) Act -
U.S. Sen. Chris Van Hollen, D-Md., introduced legislation which would fully fund two federal education mandates that help students with special needs and high poverty schools. For years states have complained that Congress passed laws requiring school districts to provide additional services to some students — often the most expensive to educate — but has not provided the full funding for them.
Supporting Foster Youth and Families through the Pandemic Act - HR 7947-
Introduced by Rep. Danny Davis and Rep. Jackie Walorski provides critical relief to
- Grandfamiliies/kinship families
- Young people in or aging out of foster care
- Vulnerable families and children at risk of entering foster care
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Telehealth Provisions in the Consolidated Appropriations Act, 2021 (HR 133
The combined relief-spending bill (HR 133) passed by Congress in late December 2020 included several telehealth-related provisions. Chief among them are the addition of a new Medicare payment designation, new flexibilities for rural hospitals, and significant funding for broadband access efforts. Several other notable telehealth-related provisions were tucked into the bill and CCHP has developed a factsheet summarizing what you need to know.
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COVID Legislative Updates |
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The key elements of President Biden’s proposal for children include:
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$170 billion for K-12 education and higher ed.
- $4 billion for SAMHSA
- Expand emergency paid leave.
- Provide an additional $1400 stimulus payment per person in addition to the $600 previously allocated. (Note that this gives the same amount for children as adults, unlike the first stimulus payment.)
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Extend the emergency unemployment programs through September 2021 and increase the weekly supplement from $300 to $400.
- Extend the eviction and foreclosure moratorium until September 30, and add $30 billion in eviction prevention and utility shut off funding, as well as $5 billion in housing for the homeless.
- Extend the SNAP 15% increase through September and add $3 billion for WIC
- Create a $25 billion child care stabilization fund, add $15 billion in CCDBG funding, and a one year child care tax credit increase that also makes it 50% refundable.
- Expanding the Child Tax Credit for the year and making it fully refundable.
- Subsidize COBRA costs and expand the health insurance premium credit.
- A minimum wage increase to $15/hour.
- Additional federal funding for Medicaid home and community-based services (HCBS) (see more detail below)
- Extension and expansion of paid leave tax credit
- Expansion of Earned Income Tax Credit for childless adults
- $130 billion for education to assist states to safely reopen schools repairing ventilation systems, purchasing personal protective equipment, and other important safety measures
This is a Reconciliation. So what does that mean?
Reconciliation is a budget “fast track” process that makes it easier to pass spending and tax bills, but with strict limits on what they can include. The first step is that Congress must pass a Budget Resolution, which is not a law, but sets out the rules for the year’s budget decisions. Historically, spending reconciliation bills have only included mandatory spending not discretionary spending (that is, annual appropriations). This would allow Congress to enact changes like the ones proposed to SNAP and other entitlement programs, but not make changes to things like education funding that are appropriated annually. A reconciliation bill can only include provisions that affect the federal budget. Thus there is a strong possibility that the minimum wage provision will be stricken from the bill under a Senate rule called the Byrd rule.
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Marketplace Special Enrollment Period for COVID-19 Public Health Emergency |
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In accordance with the Executive Order issued by President Biden, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced a Special Enrollment Period (SEP) for individuals and families for Marketplace coverage in response to the COVID-19 Public Health Emergency, which has left millions of Americans facing uncertainty and exceptional circumstances while millions of Americans have experienced new health problems during the pandemic.
The Special Enrollment Period (SEP) for the Health Insurance Marketplace® will officially be available to consumers in the 36 states that use the HealthCare.gov platform on Monday, February 15, and will continue through Saturday, May 15.
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States to Get Enhanced Medicaid
Funding Through 2021
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The Biden Administration intends to keep the national Public Health Emergency (PHE) in place through “at least” 2021.That has important implications for states. Last year’s Families First Coronavirus Relief Act gives states a 6.2 percentage-point increase in their federal share of Medicaid spending as long as the PHE is in place, which helps them cover higher costs related to COVID-19 and prevent damaging budget cuts.
The Biden Administration also committed to giving states 60 days’ notice before ending the PHE.
The Acting Secretary for the U.S. Department of Health & Human Services (HHS) indicated in a recent letter to state Governors that the Department intends to extend the declaration of a Public Health Emergency (PHE) through at least the end of 2021. In addition, the Acting Secretary indicated in the letter that the Department will provide states a 60-day notice prior to the termination of the PHE declaration. In the Acting Secretary’s own words, this shift is intended to bring “predictability and stability” to states and their public health programs, many of which have tied expiration of their telehealth expansions to the federal PHE declaration. For more information, view the full letter from the Acting Health & Human Services Secretary.
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Family First Prevention Act |
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The Family First Prevention Services Act has generated significant reforms to the child welfare system and several key provisions allow states to use Title IV-E funds, which is the largest federal funding source for child welfare activities for certain evidence-based prevention services to reduce unnecessary out-of-home placements for children and youth. Since the provision went into effect in October 2019, states have been at various stages of implementing allowable congregate settings that are eligible to claim Title IV-E foster care maintenance payments under FFPSA. Nearly all states have either implemented or are working to implement QRTPs, with many states launching and/or refining their program models in the coming months of this year.
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Family First Prevention Services Act: Implementing the Provisions that Support Kinship Families Checklist.
This user friendly tool is designed to address the federal requirements of the Family First Act and describe the necessary steps for effective implementation of the kinship provisions.
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Webinar Series: Strengthening Services for Youth by Using Evidence and Partnership
This new webinar series is designed for child- and family-serving system leaders and other stakeholders to meet the requirements of the Family First Prevention Services Act. This series is an opportunity to develop a service array that best meets the needs of youth and families using evidence-based programs (EBPs). Join to discuss strategies and tools for identifying and addressing gaps in an existing service array; assessing the fit of EBPs to fill gaps; and leveraging and aligning an EBP array with existing financial resources. Watch the recording of the first session and register now for the upcoming sessions!
Next date: Mar. 11, 2-3:30 p.m. ET
Hosted by the Institute for Innovation and Implementation.
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Mental Health Parity Compliance Gets a
Boost in 2021 Spending Act
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Consolidated Appropriations Act, 2021 requires group health plans and issuers that cover mental health/substance use disorder (MH/SUD) and medical/surgical (M/S) benefits to prepare a comparative analysis of any nonquantitative treatment limits (NQTLs) that apply. Beginning Feb. 10, plans must supply this analysis and other information if requested by federal regulators (the Department of Labor (DOL) for ERISA plans). The 2021 CAA adds two new requirements to health plans’ existing MHPAEA obligations: a comparative analysis and the duty to disclosure this analysis and related information to DOL on request.
What parity information must plans provide on request?
Under the new law, plans must make available to the DOL the following information:
- Terms — the specific plan and coverage terms on NQTLs for MH/SUD and M/S benefits and a description of these benefits, including which of the six parity classifications contains the benefit (i.e. inpatient in network, outpatient in network, pharmacy, etc.)
- Factors — the factors used to determine that the NQTLs should apply to the benefits
- Evidentiary standards — the evidentiary standards and any other sources on which the plan relied to back up the factors used to design the NQTL and justify its application to a benefit (see chart below for examples)
- Comparative analysis — a separate analysis of each NQTL for benefits in each classification “demonstrating that the processes, strategies, evidentiary standards and other factors used to apply the NQTLs” to MH/SUD benefits (in written terms and plan operations) are “comparable to and applied no more stringently” than those used to apply NQTLs to M/S benefits
- Findings and conclusions — the results of the comparative analysis giving the plan’s or issuer’s specific findings on what is and is not in compliance with the parity law,
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2021 Telehealth Policy Updates |
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The Center for Connected Health’s newest video on telehealth policy, updated with everything you need to know for 2021. This includes temporary COVID-19 policies, as well as a breakdown of the policies that have been made permanent through the 2021 physician fee schedule (PFS) and The Consolidated Appropriates Act of 2021 (HR 133) that passed in December. The video also includes some updates on state policy and 2021 legislative trends CCHP is already flagging on the federal and state levels. Check out the video and slide deck for a complete 2021 policy update.
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Tom Coderre is the Acting Assistant Secretary for Mental Health and Substance Use. With decades of public, private, and non-profit service, Mr. Coderre is the first person in recovery to lead SAMHSA. Mr. Coderre’s career has been significantly influenced by his personal journey and a philosophy that acknowledges the essential role peer recovery support services play in helping people with mental and substance use disorders rebuild their lives.
February 16th, the U.S. Department of Health and Human Services announced the following Biden-Harris Administration appointments.
Administration for Children and Families
- Larry Handerhan, Chief of Staff and Senior Advisor
- Jose Garibay Medrano, Special Assistant for the Office of Refugee Resettlement
- Lanikque Howard, Director of the Office of Community Services and Senior Advisor on Asset Building
- Jenifer Smyers, Chief of Staff for the Office of Refugee Resettlement
Centers for Medicare and Medicaid Services
- Arielle Woronoff, Director of the Office of Legislation
Substance Abuse and Mental Health Services Administration
- Sonia Chessen, Chief of Staff
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Medicaid Work Requirement |
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The Biden Administration is taking steps to rescind Trump Administration guidance that allowed states to implement Medicaid work requirements through Section 1115 waivers. This follows Biden’s recent executive order that instructed federal agencies to review regulations that could reduce Medicaid coverage. While there are no states with Medicaid work requirements in effect, last week the Centers for Medicare & Medicaid Services (CMS) wrote to certain states, including Arkansas, indicating it is now deciding whether to withdraw states’ approved work requirement waivers. CMS also sent additional notices to states rescinding the Trump Administration’s Jan. 4, 2021 letters that would have required additional procedures for 1115 waivers to be suspended or terminated. This chart details the status of states’ efforts to implement Medicaid work requirements.
The Supreme Court announced it would hear oral arguments on March 29 concerning the validity of the Trump administration’s Medicaid work requirement waivers. President Biden recently signed an Executive Order directing HHS to review the work requirement waivers. Additionally, the Centers for Medicare and Medicaid Services (CMS) is still reviewing 1115 demonstration protections put in place by former Administrator Seema Verma.
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Partnership to End Addiction's
Advocacy Toolkit
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So you’re interested in advocacy, but where do you begin? This toolkit on Advocacy from the Partnership to End Addiction is where you start.
The Toolkit includes:
- What advocacy is and why it’s so powerful
- The winning formula of data + stories
- Tips for building relationships and effectively communicating with members of Congress
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Important advocacy needs in the addiction field
- Guidance for getting involved and making change at any level of government (local, state, or federal)
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Advocacy Resources from the Partnership for America's Children |
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The Partnership for America's Children have put together some great resources to help you advocate for Children in this session.
This document provides reauthorization deadlines for programs that affect children. It also lists programs that have already expired.
This document lists all of the committees that have jurisdiction over programs affecting children.
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Alabama
Governor Ivey’s detailed budget proposal was released and there were significant asks for the Department of Early Childhood Education for Pre-K and Home Visiting, increases for Mental Health initiatives, the inclusion of the Healthy Food Financing Initiative again, a new request for $1.5M for the Department of Public Health for a Data Analytics Division, and increased funding for both DHR and the Department of Mental Health which we were very appreciative of, given the circumstances so many states are facing.
VOICES is already tracking nearly 40 bills that directly impact Alabama’s children. These range from a bill that would make kindergarten mandatory for all 5-year-olds to a bill that would require the Department of Education to provide expanded mental health support to children, to a bill that defines different types of foster family homes.
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Arizona
2022 budget proposal
Governor Ducey released his fiscal year 2022 budget proposal.
The Governor’s budget does include some important investments, like:
- $18 million to fund the continuation of the childcare waitlist and for a new pilot program that provides child care to children of parents pursuing education and nursing degrees;
- $92.7 million in supplemental funding for the stabilization of child care centers and to further support providers during the pandemic;
- $10 million to renew and bolster the Rural Broadband Grant Program.
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California
2020-21 California County Scorecard of Children’s Well-Being
AB 32 – Requires the State Department of Health Care Services to indefinitely continue the telehealth flexibilities in place during the COVID-19 pandemic state of emergency. The bill would require the department, by January 2022, to convene an advisory group with specified membership to provide input to the department on the development of a revised Medi-Cal telehealth policy that promotes specified principles.
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Georgia
Bills to follow
Senator Clint Dixon’s leadership in pushing meaningful legislation to combat human trafficking. SB 33 and SB 34 are important reforms to support survivors, both received bipartisan support in the Senate and will move on to the House.
- SB 33 by Senator Clint Dixon will create a new pathway for human trafficking survivors to file suit for civil damages against their traffickers and others who knowingly profited off of their victimization.
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SB 34 by Senator Clint Dixon, will create an exception to Georgia’s current name change statute to protect the privacy and safety of human trafficking survivors who wish to change their names.
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Hawaii
These 12 priorities reflect the input of 40+ community organizations and advocates. Click here to check it out - you can find bill numbers and download a PDF version as well.
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Kentucky
The Blueprint for Kentucky’s Children is a coalition of non-profit, public, and private organizations that stands on three pillars: thriving communities launch strong families, strong families
launch successful kids, and successful kids launch a prosperous future for Kentucky.
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Senate Bill 10 - The bill would establish a commission on race and access to opportunity that is tasked with providing research driven policy proposals and required to publish an annual report.
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House Bill 212 - This bill would require the child and maternal fatality annual report to do a demographic analysis by race, income, and geography and require the annual report be sent to the Interim Joint Committee on Health, Welfare, and Family Services.
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Senate Bill 23 - This bill would require the Legislative Research Commission to identify any bill, amendment, or committee substitute that may result in a health disparity impact and require the Cabinet for Health and Family Services to carry out a health disparity review, if necessary, within 30 days.
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House Bill 283, supports women’s mental health postpartum. This bill would require Medicaid to cover behavioral health services for eligible pregnant women for 12 months postpartum.
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Senate Bill 42 - This bill would require that training programs in suicide assessment, treatment, and management include cultural diversity for certain professionals.
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House Bill 140 -This bill would require the Cabinet for Health and Family Services to establish minimum standards for telehealth, reestablish the requirement for the Cabinet for Health and Family Services and managed care organizations to study the impact of telehealth on the state’s health care delivery system, require reimbursement rates for telehealth to be equivalent to reimbursement rates for the same service provided in person, and more.
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Senate Bill 55 - This bill would prohibit copayments or cost sharing to be paid by any medical assistance recipients, prohibit copayments be charged in the Kentucky Children’s Health Insurance Program (KCHIP), and prohibit deductible, copayments, and coinsurance requirements for Medicaid telehealth services.
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House Bill 86 - This bill would limit use of solitary confinement for juveniles and require reporting of data on its use.
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Senate Bill 77 - This bill would require greater representation of persons of color on superintendent screening committees in school districts in which students of color make up 50 percent or more of the student population.
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Michigan
Michigan's Children launches monthly lunch and learns focusing on Policy and Advocacy. Previous month's presentations are also available for you to view.
Whitmer Budget Proposal: Key Gains, Missed Opportunities for Kids and Families
Proposed Changes to State Special Education Rules
Michigan Department of Education Office of Special Education is accepting public comment on proposed amendments of 2 special education rules. There will be virtual public hearings on March 16, 17, and 18. Public comments are due by 5pm on March 31.
More information about the proposed rule changes, the public hearings, and submitting comments is available on their website.
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Nebraska
Bills to Watch
The Business and Labor Committee considered LB 290 which would establish a state paid family and medical leave program and
LB 258 would ensure that all workers to have access to a minimum amount of earned sick leave.
The Education Committee heard testimony on several bills related to the Student Discipline Act. LB 673 (Murman) provides behavioral awareness and intervention training for school personnel and provides that teachers and school staff may use “reasonable”
physical intervention to manage the behavior of a student.
The Health and Human Service Committee heard community testimony on expansion of the Bridge to Independence (B2i) program. LB 202 (Pansing Brooks) expands eligibility for the program to allow juvenile-adjudicated youth who have reached age 19 and who were in a court-ordered out-of-home placement to be eligible. LB 262 (Vargas) will allow non-lawfully permanent resident youth, aging out of foster care, to be eligible for the B2i program, including all of its services and supports.
Health and Human Services (HHS) Committee will hold hearings on several bills related to the Supplemental Nutrition Assistance program or SNAP. LB 108 would address what’s known as the “cliff effect” (where a small increase in earnings leads to a much larger loss of income support) by allowing families with higher expenses to deduct them from their food budget. LB 121 would eliminate restrictions on accessing the SNAP program for individuals with drug related convictions who are transitioning back into the community. LB 356 would ensure that families can still access food assistance through SNAP even when they are disqualified from other public programs.
HHS will also consider LB 129, which would establish continuous eligibility for children enrolled in Medicaid by ensuring that they only have to reapply once a year. Friday, HHS will consider LB 516, which would ensure that online work or education is considered comparable in meeting requirement for the Temporary Assistance for Needy Families (TANF) program.
Juvenile Justice
Health and Human Services committee will consider LB 34. Introduced by Sen. Pansing Brooks, LB 34 eliminates life without parole as a sentencing option for youth up to age 21 and removes mandatory minimum sentences for certain felony offenses committed when a child is under the age of 21.
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New Hampshire
HB 602 excludes audio-only telephone from the definition of telemedicine.
It also changes language to state that health plans shall allow for compensation of a distant site and originating site no greater than the total amount allowed for in person services.
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New Jersey
Teen Mental Health First Aid
The New Jersey Pandemic Relief Fund is providing $1.2 million in funding to the National Council to train students and educators in teen Mental Health First Aid, so they have the skills to identify, understand and respond to signs of mental health and substance use issues. This generous funding will allow us to train students at 50 high schools or youth organizations with the goal of reaching 18,750 students.
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New York
New York to Expand Telehealth
Governor Cuomo recently announced his telehealth Proposal to Modernize Regulations and Facilitate Access to Quality Health Care Including Mental Health and Substance Use Disorder Services in Underserved and Rural Communities. Citing how COVID-19 exposed existing health care inequities and how critical telehealth proved to be during the pandemic, the policies will build upon the Governor’s emergency actions to expand flexibilities around its use and the Reimagine New York Commission’s recommendations to transform the health care delivery system.
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North Carolina
co-released by NC Child and the NC Institute of Medicine. Read on to find out how kids are doing on
15 key indicators of health .
The North Carolina Child Health Report Card, published biannually by the North Carolina Institute of Medicine and NC Child, tracks key indicators of child health and well-being in four areas:
- Healthy Births
- Access to Care
- Secure Homes & Neighborhoods, and
- Health Risk Factors
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Oregon
It is endorsed by 115 organizations and urges legislators to center children and youth during this legislative session.
The 2021 Children’s Agenda includes 44 items submitted by 30 partners. Eleven items were elevated as priorities.
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Pennsylvania
Federal stimulus funds for education and housing purposes
SB 109 – which allocated federal stimulus funds for education and housing purposes – was signed into law by Gov. Wolf. It includes $17.5 million for Career and Technical Education Centers from the Governor’s Emergency Education Relief Fund (GEER funds).
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Texas
The Hogg Foundation prepares a new edition of the Mental Health Guide to coincide with each Texas legislative session to help inform mental health and substance use policy analysis, development and decision-making. The intended audience for this guide includes legislators, legislative staff, state agency staff, advocates with lived experience, family advocates, mental health providers and other stakeholders interested in mental health and substance use policy.
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Legislation and Advocacy Pages |
- Where to find legislative information nationally and in your state
- 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
- Links to state legislative advocacy organizations
- Links to live stream sessions from the state
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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.
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