Dear Advocates,

We invite you to follow along as we navigate this year's new and exciting legislative session. If you are interested in learning more about our policy agenda, please be sure to review our Public Policy Statements HERE.

Mental Health America of Indiana advocates for effective legislation that will improve the behavioral health sector in Indiana. Below are KEY behavioral health bills heard in committee this week.
Spotlight Bill -
House Bill 1468:
988 Crisis Response - (Rep. Steve Davission)

The number of Indiana residents on the brink of crisis whom are living with serious suicide related thoughts and/or exhibiting suicide related behaviors is escalating to unprecedented levels. Individuals in Indiana looking for mental health and substance use related help has sky- rocketed, especially for youth, and there is an insufficient workforce to meet that need.

The pandemic has exacerbated Hoosier’s mental health and substance use related issues to a crisis of epic proportions.

Each of us have friends, neighbors, coworkers, children, all who have been in distress - yet our current behavioral health crisis response system is not effective.

Indiana does not have a system designed to specifically meet the needs of behavioral health crisis other than Emergency Departments, first responders, and law enforcement agencies, most of which typically begin with a call to a 911. Unfortunately, all of these entities currently have an overtaxed bandwidth. In addition, Indiana has an insufficient number of psychiatric beds, which over the past year, on multiple occasions, has been exacerbated by the COVID-19 pandemic.

When things go right with our current crisis system flow, there are typically two points of entry. One typically starts with a call to 911 and engaging law enforcement who transport individuals in crisis to Emergency Departments. The other begins with an individual seeking an Emergency Department without the help of law enforcement. After an individual arrives in the Emergency Department, only a small percentage of cases will have access to inpatient services. A large majority of cases are referred to outpatient mental health services with a significant wait time or the inability to meet the needs of the individual.

This is the best-case scenario. Too often services are declined and individuals are referred back to insufficient community supports, or result in incarceration or relocation.

Often, these outcomes lead to homelessness, unemployment, increased trauma, and ultimately suicide. While our current crisis system is not designed to effectively respond to individuals experiencing a behavioral health crisis, our state is spending an exorbitant amount of money each year to provide an ineffective response.

The framework of House Bill 1468 would create a structure for a behavioral health crisis response, using a community-based partnership between law enforcement, first responders, hospitals, mental health and substance use professionals, and other community based entities. The point of entry involves the utilization of call centers, mobile crisis outreach services, sub-acute stabilization centers, peers, and treatment providers. This would reduce the need for acute care and hospital Emergency Department visits, substantially decreasing the burden of traditional responders and significantly cutting the costs of care that is not even appropriate for this service need.

To read more about House Bill 1468, please read below:

House Bill 1468: VARIOUS HEALTH MATTERS - Specifies that the division of mental health and addiction (division) has primary oversight over suicide prevention and crisis services activities and coordination and designation of the 9-8-8 crisis hotline centers. Sets forth requirements to be designated as a 9-8-8 crisis hotline center. Establishes the statewide 9-8-8 trust fund. Delays the requirement that a prescription for a controlled substance be in an electronic format until January 1, 2022. Adds pharmacists as a prescriber for purposes of the telemedicine laws. Removes the requirement that a prescription for a patient who is receiving services through telemedicine be based on a previous in person examination or as part of an established treatment plan.
House Committee recommends passage, as amended Yeas: 12; Nays: 0 
House Bills:
House Bill 1127:
MENTAL HEALTH AND ADDICTION FORENSIC TREATMENTS  - Removes a provision that allows a: (1) delinquent child's; or (2) person's; Medicaid participation to be terminated following a two year suspension due to certain adjudications or incarceration. Adds competency restoration services to the list of treatment and wraparound recovery services made available to certain persons in the criminal justice system. Adds competency restoration services to the list of services that qualify a person for mental health and addiction forensic treatment services. Adds: (1) recovery community organizations; and (2) recovery residences; certified by the division of mental health and addiction (division) or its designee to the list of organizations eligible for certain funds and grants from the division. Requires demographic data concerning race and ethnicity to be included in certain demographic research performed by the division. Establishes the long term recovery group for Southwest Indiana program and the long term recovery group for Southwest Indiana fund.
House Committee recommends passage, as amended Yeas: 20; Nays: 0

House Bill 1177:
STRATEGIC PLAN ON DEMENTIA  - Requires the state department of health to develop a strategic plan concerning dementia in Indiana. Establishes the Indiana dementia council (council) and sets forth duties of the council. Beginning June 30, 2021, requires the council to submit a report to the governor's office and the general assembly concerning dementia, research on Alzheimer's disease, and the outcomes of implementing the dementia strategic plan.
House Committee recommends passage, as amended Yeas: 12; Nays: 0

What's Going On in Capitol Hill?

Last week, the Energy and Commerce Committee and other House Committees marked up a budget reconciliation bill with several provisions relevant to public health, including mental health and substance use. The bill also included substantial relief to state and local governments.

In the House bill, there are a number of Medicaid changes, including a 12-month extension for full benefits post-delivery for maternal health. It also extends Medicaid eligibility to 30 days prior to release from incarceration and increases the FMAP to 85% for mobile crisis services. In addition to Medicaid, the bill provides additional subsidies for exchange plans to make those more available to low-income families.
Here are some of the other relevant mental health provisions in the bill:
  • $1.75B for the Community Mental Health Block grant and $1.75B for the Prevention and Treatment of Substance Use with a September 30, 2025 end date on the availability of money.
  • $80M for mental and behavioral health training for health care professionals, paraprofessionals, and public safety officers with grants to “plan, develop, operate, or participate” in evidence-informed strategies for reducing and addressing mental health and substance use issues.
  • $20M for an education and awareness campaign for healthcare professionals and first responders.
  • $40M to award grants to health care providers to “establish, enhance, or expand evidence-informed programs or protocols to promote mental & behavioral health among providers.”
  • $30M to award grants to states/local governments, nonprofits and others “to support community-based overdose prevention programs, syringe services programs, and other harm reduction services, to reduce harms of drug misuse exacerbated by COVID-19.” Allowable use of grant funds are “preventing and controlling the spread of infectious disease,” distributing opioid overdose reversal meds, connecting at-risk individuals with counseling/education.
  • $50M for community-based funding for local behavioral health needs. Grants to state and local government and nonprofits to address behavioral health needs worsened by COVID. Use of grant funds include promoting care coordination, training, expanding integrated models of care, addressing surge capacity, providing mental & behavioral health services through telehealth, and supporting/enhancing crisis intervention services.
  • $10M for National Child Traumatic Stress Network for “carrying out” PHS Act section w/r/t high-risk or medically underserved persons who experience violence-related stress.
  • $30M for Project Aware activities in schools.
  • $20M for youth suicide prevention activities.
  • $100M for the HRSA Behavioral Health Workforce Education and Training program, which includes training for professionals and peers.  
There are also significant funds for housing in the budget reconciliation bill that will be helpful to people with mental health and substance use conditions, including $19.05B for emergency rental and utility assistance and $5B in emergency Housing Choice Vouchers with funding for 5 years of renewals, and $5B to state and local governments to finance supportive services, affordable housing and non-congregrate shelter for individuals experiencing homelessness. 
The bill includes $195.3B in direct aid to state and local governments, which can help with looming cuts to state and local mental health budgets in an economic downturn and $130.2B divided evenly between cities and counties (including $65.1B to cities using a modified Community Development Block Grant, $45.57B for municipalities with populations of at least $50K, $19.53B for municipalities with populations of less than $50K and $65.1B to counties based on population).

More than ever, we must stay in touch with you through technology, so please be sure to sign up for our IN.session Newsletter and VoterVoice Action Alerts to stay up to date on important mental health related legislation.

If you would like to review all of the bills Mental Health America of Indiana is following, click HERE for our Action Track report!