A national survey of more than 2,000 adults conducted by The Harris Poll and the National Council for Mental Wellbeing found that 43% of adults who said they needed substance use or mental health care in the past year did not receive it. Barriers to care included cost-related issues (no insurance, out-of-pocket costs), the inability to find a conveniently located provider and the inability to get an appointment immediately when needed. Even the majority of those who did receive care reported difficulties in getting it. Nearly three in five believe it is easier and faster to get behavioral health care if you pay out-of-pocket versus using insurance. The survey found 71% would be more likely to get care if they could receive it through their primary care provider, and 67% think it is harder to find a mental health care provider than a physical health care provider.
Lawmakers are facing increased pressure to pass a comprehensive behavioral health package but are unlikely to make an initial goal of advancing legislation before the implementation of the 988 national hotline in July. The House Energy and Commerce Committee recently advanced its package reauthorizing grant programs set to expire with the fiscal year, but no date for a floor vote has been set. The Senate Health, Education, Labor and Pensions Committee, which also has jurisdiction on the programs, has not yet scheduled a markup. The Senate Finance Committee released a discussion draft of the telehealth portion of its package. The House Ways and Means Committee also expressed interest in a Medicare-focused bill but is in earlier stages. The most likely path would be to form a package encompassing all committees’ efforts similar to the SUPPORT Act in 2018. It would likely be attached to the omnibus, but neither chamber has released appropriations bills for FY 2023 yet, making July a tough sell.
Source: With July approaching, mental health bill seems far off (Roll Call)
Agencies across the Department of Health and Human Services (HHS) issued a joint letter to states, tribes and jurisdictions encouraging them to prioritize and maximize their efforts to strengthen children’s mental health and wellbeing. The letter outlines HHS’s plans to support and facilitate state-level coordination across federal funding streams to advance and expand mental health services for children. The letter highlights opportunities to strengthen the health care system’s capacity to meet mental health needs, connect more people to care and create a continuum of support to address mental health comprehensively and equitably by coordinating across federal programs. Leaders from the agencies also held a roundtable discussion to hear from representatives of organizations providing behavioral health services on their experiences getting their patients/clients connected to the care they need. Feedback will help inform HHS’s future work and identify collaboration opportunities to strengthen the mental health and crisis care systems.
Source: HHS Leaders Urge States to Maximize Efforts to Support Children’s Mental Health (Department of Health and Human Services); Readout: HHS Leaders Host Roundtable on Maximizing Federal Resources to Strengthen Children’s Mental Health (Department of Health and Human Services)
A bipartisan group of senators on the Finance Committee working on mental health policy released a discussion draft of telehealth provisions. Congress made access to mental health services through telehealth in Medicare permanent in 2020, but seniors had to have visited the same provider in person within the previous six months. That requirement has not gone into effect because of pandemic emergency regulations, and this proposal would eliminate that requirement. The draft plan also includes preserving some audio-only mental health coverage in Medicare, requiring insurance plans to post public information about beneficiaries’ rights to access telehealth, giving states more flexibility to use CHIP funding for school-based mental health services and requiring reports on telehealth usage.
The White House released a fact sheet for Mental Health Awareness Month highlighting actions the administration is taking to strengthen system capacity, connect more people to care and create a continuum of support. This includes promoting the mental wellbeing of the health workforce, piloting new approaches to training behavioral health paraprofessionals, strengthening the crisis care and suicide prevention infrastructure and building the capacity of long-term care facilities to deliver behavioral health care. Actions also include addressing the caregiving crisis, advancing behavioral health care for the Asian American/Native Hawaiian/Pacific Islander community, lowering barriers to care among service members, ensuring access to mental health support in schools/colleges/universities, strengthening the government’s role as a model employer for behavioral health and training social/human services professionals in basic mental health skills. In addition, the administration’s goals include training tribal law enforcement in mental health, enhancing school-based supports in Native communities, spurring innovation in recovery support models, improving veterans’ financial security, enforcing workplace rights and establishing a federal mental health research action plan.
Teva and Allergan reached a $161.5 million opioid settlement with West Virginia. The agreement is the largest state-negotiated settlement in West Virginia history. It consists of $134 million in cash plus the contribution of drugs used to treat opioid overdoses. The settlement ended a trial that had been proceeding for two months in Kanawha County Circuit Court. Teva will pay $83 million in cash and provide a 10-year supply of Narcan (valued at $27 million), and Allergan will pay $51.2 million. The settlement guarantees the state an additional payout if Teva and Allergan reach larger-than-expected nationwide settlements (more than $7.2 billion).
Source: Teva, Allergan reach $161.5 mln opioid settlement with West Virginia (Reuters)
Rhode Island Governor Dan McKee signed into law the Rhode Island Cannabis Act, legalizing and regulating recreational adult-use cannabis in the state. The law includes automatic expungement of prior civil or criminal marijuana possession charges. Possession and home-growing is now legal for adults 21 and over, and in-store sales may begin as soon as December 1. The legislation includes social equity provisions. Rhode Island is the 19th state to legalize cannabis.
Source: Governor McKee Signs Legislation Legalizing and Safely Regulating Recreational Cannabis in Rhode Island (Governor Dan McKee)
The Children’s Hospital of Philadelphia PolicyLab released a white paper on innovative strategies implemented by states and municipalities in support of comprehensive behavioral health services in schools. It discusses and provides state examples of best practices for school-based behavioral health services, leveraging Medicaid for school-based behavioral health services, funding preventive school-based behavioral health services for all enrolled children regardless of insurance status, supporting access to services for uninsured and underinsured students, increasing staffing in schools to support behavioral health and standardizing and evaluating school-based interventions.
There are steps that federal agencies have the authority to implement without additional legislation to expand access and reduce barriers to methadone. These include extending take-home flexibilities for methadone; modifying current regulations governing prescribing, dispensing and treatment with methadone (such as limits preventing most physicians from prescribing and pharmacies from dispensing methadone, mandatory toxicology screenings, non-evidence-based criteria for take-home doses and arbitrary scheduling doses); using authority over public programs to monitor and check coverage barriers imposed by insurers (such as prior authorization, utilization review and narrow networks); using existing federal authorities to incentivize states to expand access to methadone; and increasing enforcement of the Americans with Disabilities Act to protect the rights of individuals receiving methadone.
Source: An Expedited Regulatory Strategy For Expanding Access To Methadone Treatment For Opioid Use Disorder (Health Affairs)
To expand access to methadone, the Substance Abuse and Mental Health Services Administration (SAMHSA) should make the COVID-19 flexibilities on take-home doses permanent and issue guidance clarifying that methadone treatment does not always need to be paired with urine drug screening and behavioral counseling. SAMHSA and the Drug Enforcement Administration should explore issuing a waiver that would allow health care providers to prescribe methadone outside of the opioid treatment program (OTP) setting, similar to the X-waiver for buprenorphine. The Opioid Treatment Access Act would allow pharmacy-based dispensing and office-based prescribing of methadone outside of OTPs by physicians board-certified in addiction psychiatry or addiction medicine, end registration requirements for mobile methadone vans and increase take-home flexibilities. Congress should amend it to expand prescribing privileges beyond addiction providers and further expand take-home flexibilities.
Source: To Save Lives From Opioid Overdose Deaths, Bring Methadone Into Mainstream Medicine (Health Affairs)