NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS

Legislation

Panaramic photo of the US Capitol building

NASMHPD's key initiative is advocating to government leaders to improve behavioral health services by promoting access to high-quality services and reforming our nation's healthcare delivery system. Our public policy staff ensures that we advocate for key federal legislation and regulations.

Criminal Justice

House Energy and Commerce Oversight and Investigations Subcommittee Holds Forum on Mental Illness and Violence on March 5, 2013.

Mentally Ill Offender Treatment and Crime Reduction Act of 2004 (MIOTCRA), P.L. 108-732, 118 STATS 2327-2336, passed unanimously by Congress and signed by President George W. Bush on October 30, 2004. MIOTCRA provides grant funding to states/territories, local jurisdictions and organizations to facilitate programs that provide collaboration among criminal justice and behavioral health systems to ensure access to treatment and services for adults or juveniles with a mental illness or co-occurring addiction disorders who are in the criminal justice systems. The grants have funded a variety of best practices programs, such as mental health courts and crisis intervention teams.  

In February 2012, President Obama's FY13 budget proposed that drug and mental health courts programs be combined into a $57 million drug, mental health, and problem solving courts initiative. This proposal would eliminate many of the programs funded under MIOTCRA. In collaboration with the Council of State Government and other partnering organizations, NASMHPD advocated to Congress to oppose Obama's budget proposal and pass the Commerce, Justice, Science and Related Agencies Appropriations Act (H.R. 5326/S. 2323), which provides a total of $1.5 billion in funding. Specifically, $9 million is appropriated to MIOTCRA.
Sponsor: Rep. Frank Wolf (R-VA); Sen. Barbara Mikulksi (D-MD)
Status: House approved the bill (May 10, 2012). On April 19, 2012, the Senate version of the bill was placed on the Senate Legislative Calendar No. 360.  

Financing

On March 22, 2012, NASMHPD and NASADAD jointly sponsored a Congressional briefing on the impact of the state budget crisis and treatment gap on the public mental health and addiction treatment systems across the United States.  During the briefing, a panel of mental health and addiction experts described the impact of state budget cuts on the behavioral health system and impact on persons recovering from mental health and addiction disorders and other community sectors, such as law enforcement, emergency departments, and the healthcare delivery system. Briefing Overview (PDF, 1.4 MB)

On February 16, 2011, NASMHMD hosted a special Senate briefing on the economy's impact on lower income populations who are being served by the public mental health system. A survey by the NASMHPD Research Institute found that from FY09 to FY11, states were forced to cut behavioral health funding by $2.2 billion even though demands for behavioral health and crisis services increased by almost 60%.  An expert panel gave their testimonies on how the budget cuts have impacted their organizations and access to mental health services. Opening Remarks (PDF, 34 KB), Power Point presentation (PDF, 587 KB)

Healthcare Reform
The Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act (P.L. 111-152)￑commonly referred to as the Affordable Care Act (ACA) were signed into law by President Barack Obama on March 23, 2010.  The Affordable Care Act transforms the nation's healthcare system by safeguarding that individuals have access to affordable and high-quality healthcare. Several states and organizations have filed to appeal certain regulations of ACA with two of the four appellate courts upholding the Act. In spring of 2012, the Supreme Court heard six hours of oral arguments and it's anticipated they will issue a decision on the constitutionality of the law by the end of the summer.  
Housing

Past Commissioner of Alabama, Zelia Baugh, testified before the Health, Education, Labor and Pensions Subcommittee on the Olmstead Enforcement Update: Using the ADA to Promote Community Integration held June 21, 2012.

Frank Melville Supportive Housing Investment Act of 2010 (S. 1481) was introduced July 21, 2009 and signed by President Barack Obama on January 4, 2011. The bill amends the Cranston-Gonzalez National Affordable Housing Act by improving supportive housing options for persons with disabilities and mental illness.

Due to the requirements in the Budget Control Act of 2011, President Obama's FY13 budget request for affordable housing programs was a combination of cuts or maintenance-level funding. In partnership with key housing coalitions and the Consortium for Citizens with Disabilities, NASMHPD advocated for increased FY13 funding than what was allocated in FY12 and proposed by the Obama Administration.  On May 13, 2012, the U.S. Department of Housing and Urban Development (HUD) awarded $85 million toward the project-based rental assistance (PRA) demonstration to meet the severe housing crisis needs of persons with disabilities and serious mental illness. The funding is anticipated to support over 3,000 new supportive housing units.

Integration

Senate Help Committee Holds Major Hearing on Mental Health Issues: Parity Issues, Integration, Importance of Peer Specialists Spotlighted during the Session on January 23, 2013.

Positive Aging Act (S. 525) is designed to improve integration between behavioral health care and primary care for older adults. In addition, the Community Mental Health Block Grant requires states to: identify outreach to older adults, individuals who are homeless, and individuals living in rural communities; and how community-based behavioral health services plan to provide services to these targeted populations.

Sponsor: Sen. Susan Collins (R-ME)
Status: Referred to the Committee on Health, Education, Labor and Pensions

Behavioral Health Information Technology Act of 2011 (S. 539), introduced on March 10, 2011, would expand the eligibility for health information technology (HIT) assistance through the HITECH Act to include behavioral health professionals and facilities (i.e., community mental health centers, psychiatric hospitals). The goal of the bill is to improve integration of behavioral health and primary care through the adoption of HIT.

Sponsor: Sen. Sheldon Whitehouse (D-RI)
Status: Referred to the Senate Finance Committee
Parity

Senate Help Committee Holds Major Hearing on Mental Health Issues: Parity Issues, Integration, Importance of Peer Specialists Spotlighted during the Session on January 23, 2013.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 (P.L. 110-343) was signed into law on October 3, 2008 by President George W. Bush. The legislation requires health insurance plans to cover both mental and physical health equally. Under the law, individuals seeking treatment for mental health and substance use disorders must receive the same coverage comparable to other medical and surgical procedures covered under the plan. MHPAEA does not require health plans to cover mental health and substance use disorder benefits.

School and Campus Mental Health

Mental Health Awareness and Improvement Act of 2013 (S. 689) was passed on April 10, 2013 by the Senate Health, Education, Labor, and Pensions (HELP) Committee. The bill primarily focuses on services for children and young adults by reauthorizing and improving existing programs administered by the departments of Education and Human Services. The first section focuses on educational programs that promotes awareness, prevention, and early identification of mental health conditions. Specifically, the legislation modifies the use of certain funds under the Elementary and Secondary Education Act of 1965 to include the promotion of school-based mental health programs and other behavioral interventions to improve the learning environments in schools.

The second portion of the bill primarily covers health programs and was modeled after the Mental Health First Aid Act (S. 153, HR 274) to include: training school staff, emergency services personnel and others to recognize the signs and symptoms of mental illness, connecting services and resources for community members with a mental health condition, and safely de-escalating a crisis situation involving someone with a mental illness.

Additional Provisons Include:

  • Garrett Lee Smith Memorial Act Reauthorization: updates the use of funds to allow for the education of students, families, faculties, and staff to increase awareness and training in the field of suicide prevention.
  • Children's Recovery from Trauma: reauthorizes the National Child Traumatic Stress Initiative (NCTSI); encourages the collaboration between NCTSI and Health and Human Services to disseminate evidence-based and trauma-informed interventions, treatments and resources.
  • Assessing Barriers to Behavioral Health Integration: requires the GAO to assess the federal requirements impacting access the behavioral health treatment related to integration with primary care, administrative and regulatory issues, quality measurements, and data sharing.
  • Examining Mental Health Care for Children: requires the GAO to report on the use of mental health services for children and adolescents, including access to care, assessment tools used for children, and the administration of psychotropic medications on children and adolescents.
  • Evidence-Based Practices for Older Adults: encourages the Secretary to disseminate information and provide technical assistance on evidence-based practices for mental health and substance use disorders in older adults.

Sponsor: Sen. Tom Harkin (D-IA)
Status: Placed on Senate Legislative Calendar under General Order
Please see thomas.gov for more information about S. 689, S. 153 & HR. 274

Senate Passes “The Mental Health Awareness and Improvement Act"

House Energy and Commerce Oversight and Investigations Subcommittee Holds Forum on Mental Illness and Violence on March 5, 2013.

Senate HELP Committee Unanimously Approves Measure to Promote Awareness, Early Identification of Mental Health Problems among Children and Young Adults

Achievement through Prevention Act (S. 541) was proposed on March 10, 2011 to amend the Elementary and Secondary Education Act of 1965 (ESEA) to promote positive behavioral interventions and supports (PBIS) and early intervention services (EIS) for school personnel. The legislation focuses on improving coordination and services outlined under the Individuals with Disabilities Education Act (IDEA).

Sponsor: Sen. Michael Bennet (D-CO)
Status: Introduced to the Senate Health, Education, Labor and Pensions Committee

Keeping All Students Safe Act (H.R. 1381/S. 2020) was introduced on April 6, 2011 (House) and on December 16, 2011 (Senate). The Act protects students from hazardous seclusion and restraint practices in schools by prohibiting its use unless a student poses imminent risk to him/herself. The legislation prohibits seclusion in locked and unattended rooms, promotes training for school personnel to reduce the use of restraints (e.g., positive behavior interventions and supports (PBIS), and requires parents/guardians to be notified after a student has been restrained or secluded).

Sponsor: Rep. George Miller (D-CA); Sen. Thomas Harkin (D-IA)
Status: Referred to the House Education and the Workforce Subcommittee on Early Childhood, Elementary and Secondary Education; and Senate Health, Education, Labor and Pensions Committee

Mental Health in Schools Act of 2011 (H.R. 751) was introduced to amend the Public Health Service Act to revise and extend projects relating to children and violence that would provide access to school or community-based comprehensive mental health programs.  Awarded grantees must demonstrate that the program includes training for school personnel, family members and guardians of children with behavioral health conditions, and concerned community members; and how grantees will sustain the program after the funding terminates.   

Sponsor: Rep. Grace Napolitano (D-CA)
Status: Referred to Subcommittee on Health on February 28, 2011

Mental Health on Campus Improvement Act (H.R. 1833) is legislation that provides grant opportunities to higher education institutions for behavioral health services and outreach on college campuses. The funding would assist campuses in expanding their behavioral health services by developing comprehensive services and providing mental health training.  

Sponsor: Rep. Janice D. Schakowskly (D-IL)
Status: Introduced on May 11, 2011 to the House Energy and Commerce Committee and referred to the Subcommittee on Higher Education and Workforce Training

Successful, Safe and Healthy Students Act (S. 919) was introduced on May 9, 2011 to assist states' educational systems in initiating programs and services that foster positive learning in public schools to promote students' physical and mental health and well-being and to provide a safe learning haven measured by: promotion of physical activity, education, fitness and nutrition; promotion of mental health; prevention of violence (e.g., bullying), harassment and substance abuse; and promotion of safe and supportive schools and communities.

Sponsor: Sen. Thomas "Tom" Harkin (D-IA)
Status: Introduced to the Senate Health, Education, Labor and Pensions Committee
Suicide Prevention

Garrett Lee Smith Memorial Act Reauthorization of 2011 (S. 740) renews and expands provisions under the current Act by increasing funding to the Suicide Prevention Resource Center, expanding suicide prevention programs to all populations, and revising campus suicide prevention programs at higher education institutions that focus on services for students with mental health and addiction disorders. In addition, it requires future grantees to enhance suicide prevention services and develop best practices strategies for the suicide prevention field.

Sponsor: Sen. John "Jack" Reed (D-RI)
Status: Introduced on April 6, 2011 to the Senate Health, Education, Labor and Pensions Committee
Veterans

President Obama Issues Executive Order on Meeting the Behavioral Health Needs of Veterans, Service Members and Families on August 31, 2012.

Caregivers and Veterans Omnibus Health Services Act of 2010 (S. 1963) was introduced on October 28, 2009 and signed into law (P.L.111-163) on May 5, 2010. Provisions include: support for caregivers of veterans, such as training, counseling, supportive services and living stipends; expansion of services for women veterans; improvement of services to rural veterans by recruiting and retaining high quality healthcare providers, providing travel reimbursement to veterans receiving treatment at VA facilities, and expanding the VA's telehealth program; improvement of mental health care by providing readjustment counseling and a study on veteran suicides; and improving and increasing services for homeless veterans.   

Sponsor: Sen. Daniel Akaka (D-HI)