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NAMI Minnesota Legislative Update October 11, 2020Special Session This Week, Chance for Bonding BillThe Legislature will return for another special session this week on Monday, October 12. The first order of business will be a vote on Governor Walz's decision to extend the public health emergency for another month. As in previous sessions, the Senate is expected to oppose the extension and the House will take no action, thereby continuing the public health emergency for another month.The good news is that leadership in the House and Senate are going to try and pass a bonding bill. The bill language is drafted and a HYPERLINK "" \t "_blank" spreadsheet has been posted. Key provisions in the bonding bill include funding for regional mental health crisis centers, funding for a playground for the CABHS program in Willmar, Native American Community Clinic in Mpls, 38th Street Cultural Wellness Center, $16 million for public housing rehabilitation, and $100 million in housing infrastructure bonds. The bill explicitly mentions a crisis center for Duluth.The regional crisis centers language is from 2018 when the bonding bill appropriated $28.1 million for what they are calling “behavioral health crisis facilities.” The funding is for buying land and building facilities (bricks and mortar) – the actual cost of building them, up to $5 million per project. Only a publicly owned hospital, city, county or housing and redevelopment authority can apply and must be working with the mental health authority or a regional consortium of organizations that serve people with a mental illness or substance use disorder. ?The facilities must provide mental health or substance use disorder services. Proposals are to be submitted to the Department of Human Services (DHS) and must: ·??????Demonstrate a need for the program; ·??????Provide a detailed service plan regarding the mental health care that will be provided including staffing requirements; ·??????Provide an estimated cost of operating the program; ·??????Confirm the financial sustainability of the facility including third party payments from private insurance and Medical Assistance; ·??????Demonstrate an ability and willingness to build on existing resources within the community; ·??????Agree to regular evaluations by the Department of Human Services on the quality and financial sustainability of the program. Passing a bonding bill requires a supermajority vote with three fifths of members, so bonding is typically an area where the DFL minority in the Senate and the GOP minority in the House are able to exercise more influence.Previously, the House GOP minority has been the biggest barrier to passing a bonding bill because of their opposition to the public health emergency due to the COVID-19 pandemic. It appears that the House GOP minority has backed off this stance. However, minority leader Daudt HYPERLINK "" \t "_blank" has stated that there must be spending off-sets to cover the costs of the debt service for the bonds. The House GOP minority has also expressed interest in a tax bill as well.It is very important that the bonding bill includes $100 million in Housing Infrastructure Bonds (HIB) to develop new affordable housing projects for people with very low incomes, as well as $16 million in General Obligation (GO) bonds to refurbish existing public housing units. This is the legislature's last, best chance to pass a bonding bill this year, so it is very important for NAMI members to HYPERLINK "" \t "_blank" contact your state legislators and urge them to pass a bonding bill. Here's what you have to say:My name is ____________ and I am a NAMI Minnesota member living in __________.(Briefly share your story)?I am reaching out to urge you to pass a bonding bill this month. I support the Homes for All Coalition and the $100 million for housing infrastructure bonds. Thank you for your support of NAMI Minnesota and people with mental illnesses.Every Legislator in the State House and Senate needs to hear from NAMI members, but it is especially important for you to contact your state representatives if they are a Republican. These folks need to hear loud and clear just how important it is to pass a bonding bill this week. Thank you for your support for affordable housing and for contacting your legislators.Lt. Governor Holds Press Conference to Announce Mental Health FundingOn Thursday, October 8, Lieutenant Governor Peggy Flanagan and Department of Human Services (DHS) Commissioner Jodi Harpstead visited St. David’s Center to highlight the Walz-Flanagan Administration’s commitment to prioritizing mental health for children and families, during Mental Illness Awareness Week. They spoke about the $3 million investment in CARES Act funding for mental health services for children and families amid the COVID-19 pandemic.? Also speaking at the event was Stephani Combey from St David's who talked about what providers are doing to meet the needs and the barriers they face. The Andersen family shared the story of their son who needed mental health treatment and their experience as teachers seeing the mental health needs of students.Sue Abderholden, NAMI Minnesota's executive director, also spoke. She stated the NAMI, AspireMN and the MN Association of Community Mental Health Providers had worked together with DHS, the Governor's office and the Children's Cabinet to present the $3 million request. She spoke to the negative impact of the pandemic and Mr. Floyd's killing on the mental health of children, and while as adults we have "tools in our toolbox" children do not and we need to do everything possible to help them through this difficult time. She also spoke to the difficulty that children have with telehealth and that typically therapy is more "hands on" with children so telehealth doesn't work. The need for funding to pay for the protections needed to hold in-person treatment is great and this funding will help. Again, NAMI Minnesota thanks the Governor and his cabinet for his commitment to this issue. We also learned that DHS was successful in obtaining $4 million from SAMHSA for school-linked mental health providers to respond to this disaster. Find out who represents you HYPERLINK "" \t "_blank" Click hereNews from the State LevelFairview to Close St. Joe's and Bethesda HospitalsNAMI Minnesota is deeply concerned with the changes being proposed by Fairview Health Services. The loss of 18 inpatient psychiatric beds at Fairview Southdale Hospital is not offset by opening an intensive mental health ER. While mental health ERs can triage and stabilize some people, there are far too many people already languishing in Emergency Departments who need inpatient psychiatric care – and this number continues to grow. If people are in need of hospital level of care, they need to be able to access it. We are also concerned with the loss of an ER at St. Joseph's and the strain that will put on Regions and United Hospitals. ?It is clear that the 100 inpatient psychiatric beds at St. Joseph’s Hospital will be closed in about one year. The loss of these beds will be devastating to the metro area and will greatly decrease access to inpatient psychiatric care across the state. Fairview has stated that they are looking for partners to build a new free-standing psychiatric hospital. It’s important to note that the federal Medicaid law includes an “Institution for Mental Disease (IMD)” clause that prevents Medicaid funding being used in any facility with more than 16 beds where over half of the patients are being treated for a mental illness or substance use disorder. Without Medicaid funding, the hospital cannot be built.?“NAMI Minnesota is not placated by promises to build a new free standing psychiatric hospital – knowing that federal Medicaid law would prevent payments to care provided in a psychiatric only hospital and that there is little possibility of changing the law in the near future due to the enormous fiscal note,” said Sue Abderholden, NAMI Minnesota’s executive director. “Additionally, at a time when advocates, providers and health care systems are pushing for integrated care – between health and mental health – why would we support a psychiatric only hospital?”??Many psychiatrists report that the percentage of people in an inpatient psychiatric unit with serious medical comorbidities who require ongoing specialty medical consultation and management is steadily increasing.?While Fairview has stated that it’s the largest mental health provider in the Midwest, this is not a reason to decrease access to mental health treatment at a time when the pandemic has increased the need for mental health care.?It doesn’t matter how big a provider you are, closing beds decreases access. NAMI Minnesota urges community members to speak up against these closures.?Upcoming Training on Federal Housing AdvocacyAre you worried about the lack of affordable housing in Minnesota? We are too. Here's your chance to step up and advocate at the federal level.Join advocacy experts from HYPERLINK "" \t "_blank" Opportunity Starts at Home for a lunch and learn on how to effectively engage your congressional delegation to bring housing funding to Minnesota. HYPERLINK "" \t "_blank" Register to?join us on Zoom 12:00 - 1:00pm on October 20 HYPERLINK "" \t "_blank" ? News from Federal LevelTrump Administration Signs Executive Order on Mental HealthThis week, President Trump issued an HYPERLINK "" \t "_blank" executive order addressing mental health and substance use concerns resulting from the COVID-19 pandemic. The order establishes a Coronavirus Mental Health Working Group focusing on the mental health needs of vulnerable populations affected by the pandemic. The working group will evaluate current strategies for assessing the mental health needs of those populations and will submit an implementation plan by November 19, 2020. The executive order also directs agency heads to encourage current mental health, medical, and related grantees to implement mental health and suicide prevention policies, and to award grants to community organizations to enhance mental health and suicide prevention services. (National Council)Trump Administration Extends Public Health EmergencySecretary Azar has formally extended the Federal Public Health Emergency for COVID-19 beyond October 23rd through January 22, 2021. This is an important step that continues certain Medicare and Medicaid provisions - including important waivers - as well as other important telehealth and funding flexibilities. You can read the HYPERLINK "" \t "_blank" full statement here.More Provider Relief Funds AvailableThe application portal for the Department of Health and Human Services’ (HHS) new Phase 3 Provider Relief funding HYPERLINK "" \t "_blank" is now open, and the deadline to apply is Friday, November 6. To expedite the calculation and distribution of payments, HHS encourages providers/organizations to apply as soon as possible. HYPERLINK "" \t "_blank" Download instructions, HYPERLINK "" \t "_blank" review an FAQ, and check out our updated HYPERLINK "" \t "_blank" "Rules of the Road" infographic to help guide you through the application process. One key thing to note – if you are a behavioral health provider/organization, you may be eligible to apply even if you were deemed ineligible for previous distributions. HYPERLINK "" \t "_blank" Learn more about how to apply. From the National CouncilFederal Judge Rules Incarcerated People Can Receive CARES Act Stimulus FundsOn September 24th a U.S. District Court Judge in Northern California issued an order requiring the Department of Treasury and the IRS to stop withholding CARES Act stimulus funds from any citizen on the sole basis of their incarcerated status. The IRS has also extended the original deadlines to file, paper claims must be postmarked by October 30th, 2020 and online claims may be filed until November 21, 2020. Several organizations are supplying more information and instructions on people can file, check out this HYPERLINK "" \t "_blank" FAQ from the law firm that brought the litigation in California, HYPERLINK "" \t "_blank" Prison Policy Initiative, and HYPERLINK "" \t "_blank" Black and Pink, and. For the time being, the IRS is not allowing family or friends to sign claim forms for incarcerated people, even with documented power of attorney. Advocates are pushing this issue, but in the meantime, claims must be signed and filed by the person themselves.New Information from the Kaiser Family FoundationAnnual family premiums for employer-sponsored health insurance rose 4% to average $21,342 this year, according to the? HYPERLINK "" \t "_blank" 2020 benchmark KFF Employer Health Benefits Survey. On average, workers this year are contributing $5,588 toward the cost of family coverage, with employers paying the rest. This year 83% of covered workers have a deductible in their plan, similar to last year and up from 70% a decade ago. The average single deductible stands at $1,644 for workers who have one, similar to last year’s $1,655 average but up sharply from the $917 average of a decade ago. These two trends result in a 111% increase in the burden of deductibles across all covered workers.The survey finds a large majority (83%) of offering employers say they are satisfied with the overall choice of providers available through their insurance plans, though significantly fewer (67%) say the same about their mental health and substance abuse networks.About one in five (19%) describe their mental health networks as somewhat or very narrow, potentially leaving workers with limited options at a time when worry and stress related to the pandemic is affecting many working Americans.“The coronavirus pandemic has increased the need for access to mental and behavioral health services, for which the provider networks are often more narrow than for other services,” said Gary Claxton, a KFF senior vice president and director of the Health Care Marketplace Project, the lead author of the study and Health Affairs article. “Some plans have been able to increase access by supporting telehealth, though it’s unclear whether such options will become a permanent feature.”Another HYPERLINK "" \t "_blank" report from KFF finds that mental illnesses may soon be the most common pre-existing condition. Before the ACA, the definition of a pre-existing condition in the individual insurance market was largely up to insurers to decide. There were some conditions that would almost always be declinable, meaning insurers wouldn’t offer coverage unless they were required to. Examples of declinable conditions include heart failure, recent cancers, and diabetes, to name a few. Other conditions, like depression, might have led to a denial in some cases or an offer with higher premiums and/or exclusions in other cases. For example, according to a pre-ACA Humana underwriting manual, a person suffering from major depression that involved a hospitalization would be denied coverage, whereas a person with depression receiving counseling and no medication would be charged a 10-20% higher premium. For other insurers, recent use of? HYPERLINK "" \t "_blank" some medications?that treat mental illness, like Abilify, Lithium, and Clozapine, was another reason to deny individuals coverage before the ACA. If a person, perhaps because of stigma, failed to report a mental illness or medication during their application process, an insurer discovering this could later rescind the individual’s coverage. Some people suffering from symptoms of anxiety or depression during the pandemic may not meet the criteria for a diagnosis, or have yet to receive a diagnosis or treatment. Regardless of whether a diagnosis was pre-existing, though, many individual market plans? HYPERLINK "" \t "_blank" did not cover?mental health care and substance abuse disorder services or medications for any enrollees, prior to the ACA’s requirement to cover Essential Health Benefits like mental health care. Providers are?encouraged to offer routine screening for depression for adults and adolescents, which could help many receive needed treatment, but may also leave them with a diagnosis on their medical record. With the ACA prohibiting insurers from discriminating against those with pre-existing conditions, people experiencing new symptoms of mental illness and other conditions no longer have to fear what an underwriter may discover in their medical records. That is, assuming the ACA’s broad protections for people with pre-existing conditions remain law.Excerpted From KFF articleUpdates from NAMI MinnesotaNAMI Legislative CommitteeMeetings are held on the second Tuesday of every month at 6 PM. To be added to the email list, contact HYPERLINK "mailto:ssmith@" \t "_blank" Sam Smith. If you missed the complete summary of the 2020 Legislative Sessions, click HYPERLINK "" \t "_blank" here HYPERLINK "" \t "_blank" . NAMI Minnesota | 1919 University Ave. W., Ste. 400 | St. Paul, MN 55104 HYPERLINK "mailto:namihelps@" \t "_blank" namihelps@ | HYPERLINK "" \t "_blank" htttp:// 651-645-2948 | 1-888-NAMI-HELPS HYPERLINK "" \t "_blank" ? HYPERLINK "" \t "_blank" ? HYPERLINK "" \t "_blank" ? HYPERLINK "" \t "_blank" ABOUT NAMI HYPERLINK "" \t "_blank" GET INVOLVED HYPERLINK "" \t "_blank" EDUCATION HYPERLINK "" \t "_blank" SUPPORT HYPERLINK "" \t "_blank" CONTACT USCopyright ? 2020. All Rights Reserved. ................
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