We want to begin by acknowledging the tremendous bi-partisan support for mental health that has emerged during the past several years, culminating in the passage of significant mental health systems improvements in the 21st Century Cures Act.
We believe that these mental health provisions, coupled with the broad parity provisions - including support for pre-existing condition coverage and inclusion of behavioral health services as essential benefits - that are also now law, laid an important foundation for the improvement of mental health and substance use services in America.
However - as the scores of Congressional sponsors and supporters of mental health legislation have said - there is still much work to do for both front-end and back-end services. The following are Mental Health America of Eastern Carolina's statement regarding policy maintenance and development:
As we build on the solid foundation of the 21st Century Cures Act, we favor:
* Saving billions of dollars by ending the unnecessary and wasteful incarceration of nonviolent offenders with mental illnesses and substance use disorders;
* Expanding the use of certified peer specialists on both clinical care and social support teams as well as in reintegration and diversion practices in criminal justice, because this will save dollars, expand the workforce, improve deep-end health services integration, and promote recovery;
* Appropriating the dollars for new innovative and evidence-based programs that are authorized in the Act; and
* Prevention, screening, early identification, and early intervention services, including those that help integrate health and educational services for children – to promote success in school, reduce suspension and expulsion, and create successful pathways to adulthood – and help integrate health, housing, and employment supports for adults – to promote productivity and reduce dependence on government programs.
As the private health care financing and insurance systems are changed, we favor:
* Maintaining behavioral health benefits at parity with other benefits, and recognizing that that mental health is essential to the overall health and well-being of individuals; Maintaining guaranteed, continuous, and affordable insurance coverage for people with pre-existing and chronic conditions;
* Closing the existing gap in coverage for those living below poverty in non-Medicaid expansion states, because this adversely affects people with serious behavioral health conditions;
* Maintaining the established right of each state to set consumer protection and regulatory standards that exceed those established by the federal government; and
* Conforming 42 CFR Pt. 2 to HIPAA, thereby putting the individual in control of all his/her own health data because 42 CFR Pt. 2 is an expensive impediment to health and behavioral health integration – because you can’t treat a whole person with half a record.
No matter what the structure for Medicaid is in the future, we favor:
* Not shifting costs to the states understanding that Medicaid, the single largest payer for mental health services, is the backbone of the public mental health system on which seniors and people with disabilities heavily rely;
* Protecting expansions in states that have expanded Medicaid;
* Permitting states to expand Medicaid if they wish; and
* Increasing flexibility within the Medicaid program to cover earlier interventions and non-medical services, such as supported housing and supported employment.
We are animated by the evidence that our behavioral health system is most effective when it promotes prevention for all, early identification and intervention for those at risk, integrated care, services and supports for those who need them, with recovery as the goal. Historically, behavioral illnesses are the only conditions we have waited until Stage 4 to treat, and then often inappropriately through incarceration. We believe that to change the trajectories of lives, we must be willing also to intervene before stage 4, just as we do with every other chronic health condition.
Policy Statement Regarding the Healthcare Policy Revision, Repeal, and Replacement
Focused on Mental Health Systems, the Afforable Care Act, and, Medicaid
Approved by Board of Directors: March 10, 2017
Mental Health America of Eastern Carolina is a 501(c)3 non-profit organization based in Greenville, NC. The organization is dedicated to supporting healthier and happier lives of those affected by mental health and substance use in Eastern Carolina, through promoting wellness through prevention, advocacy, and education by partnering to improve accessibility, effectiveness, and integration of systems. For more information about MHAEC, please visit: www.MHAEC.org