Legislative and
Advocacy Update

November 2020
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.
Federation in Action
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.

H.R. 7689, the Improving Data Collection for Adverse Childhood Experiences Act
This bill would give CDC funding to build upon the previous ACEs literature in important ways such as:  
  • Inclusion of a diverse, nationally representative sample
  • Examining the strength of the relationship between ACEs and negative health outcomes
  • Examining the intensity and frequency of ACEs and the relative strength of particular risk and protective factors 
  • Exploring the effect of social, economic, and community conditions 

The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act
As part of MHLG we urged the Senate Committee on Health, Education, Labor and Pensions to consider that The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 8283/S.4421) would increase access to health care during the national public health emergency by allowing health care practitioners with a valid practitioners’ license to provide services, including telehealth services, in all states for the duration of the public health emergency

H.R. 4996, the Helping MOMS Act - in essence expands Medicaid coverage for postpartum moms beyond 60 days after childbirth. One (1) in 5 mothers will experience a maternal mental health condition. This relates to the mental health community as maternal mental health conditions emerge during pregnancy and 12 months following childbirth, so not having health coverage beyond two months after childbirth puts our mama’s at risk of not having mental health coverage when they seek treatment. The Federation signed on in support of this legislation.
Legislative Updates
President Trump Signs 988 into Law 
Adapted from NASMHPD

President Trump signed the National Suicide Hotline Designation Act of 2020 (S. 2661) legislation into law on October 17. The bipartisan Act creates a new three-digit dialing code - 988 - for mental health and suicidal crisis. The current National Suicide Prevention Lifeline 10-digit number (1-800- 273-TALK) will be replaced by 988 as an easy-to-remember
three digit number for suicide prevention and mental health support services.

The National Suicide Prevention Lifeline is composed of about 170 local crisis call centers across the nation. This national network ensures that calls to the Lifeline are routed to the closest local crisis call center in hopes of providing the best localized services to callers. The Federal Communications Commission (FCC) designated 988 as the new crisis hotline number on July 16. The newly enacted law reinforces the FCC ruling, requiring that all telephone carriers implement the new 988 number by July 16, 2022. 
H.R. 5572
During the first week of October, the House of Representatives passed the bipartisan bill, H.R. 5572, the Family Support Services for Addiction Act. The legislation would create a $25 million grant program over five years to help national and local nonprofit organizations provide services for families impacted by addiction.  
The Community-Based Response Act creates a new Community-Based Emergency and Non-Emergency Response Grant Program through the Department of Health and Human Services to establish programs to provide an additional option beyond law enforcement for community-based emergency response. The bill will promote an additional option for a community-based response in emergency situations, allowing for  the dispatch of professionals trained in mental and behavioral health or crisis response instead of law enforcement.
This legislation was signed mid-October by President Trump. The bill includes a section on expanding telehealth capabilities and the provision of telehealth services to veterans through the Department of Veterans Affairs by awarding grants to organizations that represent or serve veterans, nonprofit organizations, private businesses, and other interested parties. 
News You Can Use
Telehealth Services in Medicaid
 and Medicare
On October 14, CMS expanded the list of telehealth services that Medicare Fee-for-Service will pay for during the COVID-19 Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care. CMS added 11 new services to the Medicare telehealth services list since the publication of the May 1 COVID-19 Interim Final Rule.

Department of Justice Announces More Than $341 Million in Grants to Combat America’s Addiction Crisis

The Department of Justice announced on October 16th, grant awards totaling more than $341 million to help fight America's addiction crisis. Office of Justice Programs (OJP) Principal Deputy Assistant Attorney General Katharine T. Sullivan discussed this year's grant awards during a roundtable discussion of mental health and addiction issues led by Second Lady Karen Pence.
The Department of Justice’s Office of Justice Programs (OJP) has announced $261 million in awards to support mentoring services for youth and protect children from abuse, exploitation, and sex trafficking. OJJDP awarded nearly $85 million to national, state, and local organizations to provide mentoring to youth who are at risk of juvenile delinquency, victimization, and juvenile justice system involvement. This includes support of OJJDP’s National Mentoring Resource Center, which provides training and resources to help mentoring programs nationwide.

In addition, OJJDP and the Office for Victims of Crime awarded more than $176 million in grant funding to help find missing children, investigate and prosecute child exploitation cases, serve abused and neglected children, and assist victims of human trafficking. Grants also address youth addiction, including the opioid epidemic.
COVID-19 Information for SAMHSA Discretionary Grant Recipients
SAMHSA is allowing flexibility for grant recipients affected by the loss of operational capacity and increased costs due to the COVID-19 crisis. Grant recipients have the flexibility to re-budget (e.g. 25% or less of the current budget or $250,000, whichever is less) as long as the activities are allowable under the Funding Opportunity Announcement (FOA), within the scope of your grant application, and in line with the statutory requirement of the award. Grant recipients must keep documentation of all costs and SAMHSA may request this documentation during the grant period.

If the re-budgeting of funds is more than 25% of the current budget or $250,000 whichever is less you MUST submit a COVID-19 post award amendment through eRA Commons.

If your organization incurs costs related to the cancellation of events, travel, or other activities necessary and reasonable for the performance of the award due to the COVID-19 pandemic, you may charge these costs to your award. If you have contracts with providers or other vendors, you must adhere to terms of the contract’s cancellation clause(s), as appropriate. Grant recipients should not assume additional funds will be available should the charging of cancellation or other fees result in a shortage of funds to eventually carry out the event or travel. Grant recipients are required to maintain appropriate records and cost documentation to substantiate the charging of any cancellation or other fees related to interruption of operations or services.
National Care Coordination Standards for Children and Youth with Special Health
Care Needs
Adapted from National Academy for Safe Health Policy (NASHP)

The National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN) outline the core, system-level components of high-quality care coordination for CYSHCN. These standards are designed to help state officials and other stakeholders develop and strengthen high-quality care coordination for children with the goal of identifying and assessing the need for care coordination, engaging families in the care coordination process, building a strong and supportive care coordination workforce, and developing team-based communication processes to better serve children and families.
Joint Economic Committee Releases New Report on Coronavirus and Mental Health
The U.S. Congress Joint Economic Committee - led by Vice Chair Don Beyer (D-VA) - released a new report on how America's failure to contain the coronavirus is taking a toll on Americans’ mental health.

The report found that thirty-seven percent of American adults reported symptoms of anxiety and/or depressive disorder - triple the percentage reported in 2019 - according to a large recent survey by the U.S. Census Bureau. The increase was especially high among Latinos, who have the highest rates of any racial group, as well as Blacks, young people and essential workers.

The likely causes of this high rate are the public health crisis and the resulting recession. Sixty-five percent of Americans surveyed report that they fear that they or their loved ones will contract the coronavirus and 70% surveyed report that they fear that the coronavirus will negatively impact their household income. Meanwhile, the substantial economic pressures that Americans are facing have yet to subside: 22 million jobs disappeared this spring, more than 12 million workers remain unemployed and another 5 million have given up and left the labor force. One-third of adult Americans surveyed report having trouble paying usual household expenses.
IRS Issues Final Rules for ABLE Accounts
Adapted From Disability Scoop

The Internal Revenue Service issued final regulations this month spelling out details about how ABLE accounts should operate. The accounts, which were established by the 2014 ABLE (Achieving a Better Life Experience) Act, allow individuals with disabilities to accrue up to $100,000 without risking eligibility for Social Security and other government benefits. Medicaid can be retained no matter how much money is saved in the accounts.

Annual deposits to ABLE accounts are capped at the value of the gift tax exclusion for any given year, currently $15,000 annually. However, under the final rules, people with disabilities who are employed can deposit their earnings in ABLE accounts, above and beyond the existing contribution cap for the year. These individuals can save whatever money they earn in their ABLE account up to the value of the poverty line in the state where they live.

ABLE accounts are open to people with disabilities that onset prior to age 26. Money saved in the accounts can be used for education, housing, transportation, employment training and support, assistive technology, personal support services and other “qualified disability expenses.” Currently, 42 states and Washington, D.C. have active ABLE programs, many of which are open to people with disabilities nationwide, according to the ABLE National Resource Center.
Blueprint for Change
In the fall of 2019, the Maternal Child Health Bureau began working with a small group of experts and families to reexamine systems of care for CYSHCN and to identify priorities and opportunities that can advance those systems and improve outcomes. The result is a draft called A Blueprint for Change: Guiding Principles for Advancing the System of Services for Children and Youth with Special Health Care Needs (CYSHCN) and Families (Blueprint). This Blueprint can inform programs and policy at the community, state, and federal levels.

MCHB invites you to review the draft Blueprint and provide input on how we can integrate this work at the community, state and federal levels in four key areas:  
  • Health Equity
  • Access to Services and Supports
  • Family/Child Well-being and Quality of Life
  • Financing of Services

Please submit comments to CYSHCN@hrsa.gov and reference "CYSHCN Blueprint RFI" in the subject line by Monday, November 30, 2020 by 11:59 p.m. Eastern Time.
Enhancing Your Advocacy
Post Election Symposium
The Alliance for Health Policy's Post Election Symposium is taking place November 17-18, 2020. This unique event will gather both policy and public health experts in a series of engaging conversations designed to inform audiences about how the results of the upcoming election could shape health policy in 2021 and beyond.
Topics to be covered include:
  • Lasting impacts of the COVID-19 pandemic
  • Perennial health care priorities
  • Strategies to address persistent health disparities and inequities
  • Insight into what’s ahead for health policy in the administration, Congress, federal courts, and the states
Sessions are free and open to the public; we encourage audiences of all backgrounds to attend. Registration opens soon!
Mental Health America Releases its Annual State of Mental Health in America Report
For the 7th year in a row, Mental Health America (MHA) released its annual State of Mental Health in America Report, which ranks all 50 states and the District of Columbia based on fifteen mental health and access measures for both adults and youth (ages 12-17). 

This year’s report includes a spotlight on the impact of COVID-19 on mental health, using information collected from over 1.5 million people who completed the MHA Screening from January to September 2020.
Bazelon Center Updates Voting Rights Guides, Highlighting Voter Rights for People with Disabilities

The Judge David L. Bazelon Center for Mental Health Law, a national legal advocacy organization advancing the rights of people with mental disabilities, has issued an updated version of its guide for voters with psychiatric or intellectual disabilities. The guide is issued jointly with the Autistic Self Advocacy Network, the National Disability Rights Network, and the law firms of Akin Gump Strauss Hauer & Feld LLP and Schulte Roth & Zabel LLP.
Where to Find Legislative Information
These new resources, developed by the Federation, list state and national resources to help you stay informed about the latest news, legislation and opportunities for advocacy.
In the States
Our Advocacy Toolkit has been revised to better give you the tools you need
to be the most effective advocate you can be.
News from the States
Alabama Arise releases its 2021 policy roadmap to a better Alabama. Learn more about their issue priorities for the coming year.

Dept. of Child Safety announces settlement agreement in class action lawsuit

The United States District Court granted preliminary approval of a settlement agreement that would resolve a class action lawsuit filed against the Arizona Department of Child Safety in 2015 by Children's Rights, Inc. This is according to a press release issued Oct. 14. The agreement will benefit the state by avoiding costly, ongoing court oversight of its child welfare system, and will allow DCS to focus all of its attention and resources on further improving services for children and families.

Invest in Education Initiative (Proposition 208)
The Invest in Education Initiative (Proposition 208) would boost the state’s K-12 school funding by $827 million to $940 million every year, through a 3.5 percent income tax surcharge on income over $250,000 for individuals and $500,000 for joint filers.

Senate Bill 855

Gov. Gavin Newsom signed into law Senate Bill 855.
This landmark piece of legislation will help close a critical gap in the way mental health care is covered by insurers, one that often forces families to pay out of pocket for lifesaving care.
Many health plans determine coverage based on “medical necessity.” The problem is that they define “medical necessity” using their own internally developed criteria that often aren’t consistent with nationally recognized standards of care. Starting in January 2021, the new law will require commercial health insurers to adopt uniform standards of care developed by nonprofit clinical associations and pay for medically necessary treatment of any mental health or substance use disorder listed in the current edition of the Diagnostic and Statistical Manual of Mental Disorders.

Proposition EE

EE will provide access to universal free preschool for all Colorado kids. Research shows that kids who have access to preschool are less likely to have a significant reading deficiency in kindergarten, half as likely to be held back through 3rd grade, and more likely to graduate on time. The measure raises revenue by closing a tax loophole that will also decrease teen vaping. Learn more here.

The Trump administration has given Georgia the green light to partially expand Medicaid without federal support, and to impose work requirements on Medicaid beneficiaries.
The plan announced by Gov. Brian Kemp (R) October 15th stops short of the full-scale Medicaid expansion supported by Democrats, which would cover thousands more low-income adults regardless of their employment status.
Kemp’s plan, called "Pathways to Coverage," would cover adults who meet the work requirements and who earn no more than 100 percent of the federal poverty level - $12,760 a year for an individual.

2020 Illinois Children's Mental Health Partnership's
Annual Report

Under the Children's Mental Health Act of 2003, the Partnership submits an annual report to the Governor on the state of children's mental health in Illinois. The report provides guidance for efforts to improve the lives of children and families throughout the state throughout the next year.
New handbook offers help to the many grandparents and others offering 'kinship' care for kids:

Lawmakers Express Concern Over COVID-19's Impact on Child Abuse Cases
Lawmakers on the Child Welfare Oversight and Advisory Committee expressed concern over reported incidences of child abuse and child abuse court cases. According to Kentucky Court of Justice data, in March 2019, 2,191 dependency, neglect and abuse cases were filed in Kentucky courts and 2,002 were filed in April 2019. In March 2020 and April 2020, 1,476 and 903 cases were filed, respectively. Marcus Vanover, a family court judge in Lincoln, Pulaski and Rockcastle Counties, shared with lawmakers that although COVID-19 safety protocols have changed how court operates, courts did not close.

New coordinator for mental health accessibility appointed

A special assistant attorney general in Mississippi has been appointed to a new role in state government as the coordinator of mental health accessibility. William Rosamond will evaluate the quality of mental health care to possibly change services offered in some counties. Rosamond will conduct a comprehensive analysis of the state’s mental health system and determine if certain mental health services in the state are inadequate. He has broad powers to potentially reshape the landscape of Mississippi’s mental health services.

Learn more at US News and the Daily Journal.

Initiative 428

Payday lenders prey on vulnerable Nebraska families,
taking advantage of them by charging interest rates that average 404% annual interest - and in some cases go as high as 461%. Marketed as a short-term fix, the terms are designed to trap borrowers in a cycle of loans that cause long-term debt. Unlike most loans, payday lenders do not verify that borrowers will be able to repay their loan on time, because they stand to make more profit when those borrowers must reborrow again and again. Learn more.
New York

NYC launches pilot to expand use of parent advocates in foster care.

New York City's Administration for Children's Services is launching a pilot program to expand the use of parent advocates who have experience dealing with the foster care system and can support and mentor parents whose children are currently in foster care. The "Parents Supporting Parents" initiative will be launched at two nonprofits, Graham Windham and Rising Ground.
North Carolina

Child Advocacy Network Post-Election Meeting 

The final Child Advocacy Network meeting of 2020 will be held November 20th. They will be discussing what the election results mean for kids and asking for input on NC Child's legislative agenda for 2021. Register here.

Governor DeWine signs HB8 into law

House Bill 8, sponsored by Representatives Susan Manchester and Tavia Galonski, modernizes foster care training by offering greater flexibility to respond to foster caregiver needs, as well as helping to better recruit and retain foster parents.

From Texas Tribune

Texas budget cuts to children's therapy programs flouted special education guidelines

Texas has failed to ensure that children with developmental delays have early access to speech and occupational therapy and other services, according to a letter ​written this week by U.S. education officials who say the state is not complying with federal special education guidelines.
The Texas Health and Human Services Commission has three months to draw up a plan to ensure that a program that pays for infants and toddlers to receive such early intervention therapies is reaching all eligible Texans, federal officials wrote. Failure to do so could cost the state federal funding. After years of budget cuts in Texas caused nonprofit therapy providers to drop out of the program, U.S. Department of Education officials found Texas to be in “significant noncompliance” with education guidelines on early intervention services. Read the article.

The website, hosted by the Wisconsin Department of Children and Families, outlines the state's efforts to implement the Family First Prevention Services Act. Resources include background, action teams and Quality Residential Treatment Program legislation.
Stay Informed
Facebook Page
Following our dedicated Legislative and Advocacy News and Resources Facebook page is the BEST WAY to keep up with what is going on in all the states and nationally real time.
Legislation and Advocacy Pages
  • Where to find legislative information nationally and in your state
  • Learn how to keep up with news and updates
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  • Information on highlighted legislation from the states
  • State tabs where, for each state, you will find:
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  • 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.