Bazelon Center Mental Health Policy Reporter

Welcome to the Bazelon Center Mental Health Policy Reporter. Available exclusively online and to our email subscribers, the Reporter supplements the Bazelon Center's Action Alerts by providing a periodic bulletin on significant policy developments that affect people with mental illnesses.

Volume VII, No. 8, December 17, 2008

Spotlight on America’s Health

Healthcare, mental health included, is high on the policy agenda

In this issue:

• Health Care Reform in the Offing
• Health and Education Regulations
• On the Horizon

Newsbytes

• Adolescent Health Services Report
• Unclaimed Children
• Healthy People 2020

As the end of the year approaches, advocates can expect a new Administration and Congress to place healthcare high on the priority list. With economic strains affecting many sectors of society and wide recognition that the economic health of the nation is fundamentally connected to the health of its citizens, reform has grown ever more urgent.

The Bazelon Center is poised to take on the new year’s opportunities with optimism about the future health of our nation. We invite you to work with us to further meaningful reforms for children and adults with mental health disorders. In this compressed issue of the Mental Health Policy Reporter, you’ll find links to a number of new resources with policy data and recommendations.

 Happy Holidays!

Health Care Reform 

•  Change.Gov offers opportunity for public input

President-elect Obama’s internet office, Change.Gov, provides various opportunities for public input on issues of concern as well as ways to stay informed about the latest news and announcements. The website offers a welcome opportunity to raise the profile of mental health issues and the need to integrate mental health within healthcare. We encourage you to add your comments to help inform and guide the new Administration. You can do so at http://change.gov/agenda/health_care_agenda/

• Healthcare reform issue briefs stress integration of mental health

The Bazelon Center has prepared a series of seven issue briefs on critical areas affecting the integration of mental health services in healthcare reform. Each contains federal policy recommendations.  The issue briefs include a discussion on primary care, medical homes, public programs, public health, and quality assurance. Feel free to use these ideas and recommendations in policy communications to your elected or appointed officials, including your comments on Change.Gov. All of the briefs can be downloaded, printed and disseminated at http://www.bazelon.org/issues/healthreform/

• Key Senators commit to healthcare reform

The chairs of the two Senate committees with jurisdiction over health care reform, Health, Education, Labor and Pensions Committee Chairman Edward Kennedy (D-MA) and Finance Committee Chairman Max Baucus (D-MT), have already signaled that healthcare reform will be a priority for them. Senator Kennedy plans on having reform legislation drafted by Inauguration Day (January 20), with staff engaging in discussions with diverse stakeholder groups. Senator Baucus released on November 12th a white paper outlining his vision for policy in on areas of coverage, costs and quality. Titled A Call to Action: Health Reform 2009, Senator Baucus’ paper is available at http://finance.senate.gov/healthreform2009/home.html

Senator Jay Rockefeller (D-WV) has also expressed his commitment to comprehensive healthcare reform. In a statement released in mid November, he said, “I have been working on health care policy for more than 25 years, and I have never been more hopeful about the prospects for reform—nor more convinced about the overwhelming need for reform—than I am now.” As chairman of the Finance Subcommittee on Health Care, Senator Rockefeller is also a leader on the State Children’s Health Insurance Program (SCHIP) and has stated he sees SCHIP reauthorization as a step that would send an important message that healthcare is a top priority. Senators Tom Harkin (D-IA) and Christopher Dodd (D-CT), members of the Senate Health, Education, Labor and Pensions Committee, have expressed sentiments on prevention and early intervention as needed approaches to healthcare reform. 

In addition, Senate Budget Committee Chairman Kent Conrad (D-ND) and Senator Sheldon Whitehouse (D-RI) have asked the Government Accountability Office (GAO) to study best practices to reduce healthcare costs and improve quality. Specifically, they requested that GAO conduct a study that includes: 1) identification of best practices utilized by states, integrated delivery systems or other countries to reduce costs and improve quality; and 2) an examination of the extent to which these best practices can be applied on a system-wide basis in the U.S. To access the letter see http://conrad.senate.gov/pressroom/record.cfm?id=305285

Health and Education Regulations

• Final FERPA rules released

The final regulations implementing the Family Educational Rights and Privacy Act (FERPA) were published in the Federal Register on December 9. The regulations made a number of significant changes and clarifications relating to health or safety emergencies to help educational agencies and institutions meet the challenges of safeguarding education records. The Bazelon Center provided comments to the notice of proposed rulemaking and will share our analysis of the changes in the final rule on our website in the near future. The regulations can be accessed at http://

• Medicaid benchmark plans and co-payment final rules released

The final regulations on Medicaid state flexibility on benchmark plans and Medicaid’s cost-sharing provisions, implementing section 6044 and section 6041-6043 of the Deficit Reduction Act (DRA), were released on December 3 and November 25, respectively. They can be accessed at http://edocket.access.gpo.gov/2008/E8-28330.htm and http://www.bazelon.org/pdf/FERPArules12-9-08.pdf

The final rules on benchmark plan flexibility are effective February 2, 2009 and the cost-sharing flexibility rules are effective 60 days after the date of publication (November 25, 2008).

See the Bazelon Center’s summary of the DRA provisions in our Policy Reporter of March 2006, at http://www.bazelon.org/newsroom/reporter/2006/3-21-06-reporter.html, and our report on state implementation at http://www.bazelon.org/newsroom/2008/3-08DRA.htm

On the Horizon

• Medicaid  increase and SCHIP

Congressional Democrats seem to be moving closer to including short-term reauthorization of the State Children’s Health Insurance Program, along with a temporary increase in federal Medicaid spending, in an economic stimulus package that aims to boost the economy. They hope to pass a package early in January to put it on incoming President Obama’s desk for quick approval. Early reauthorization of SCHIP would give Congress more time to work on comprehensive healthcare reform legislation. 

• Moratorium on Medicaid rules will expire

The moratorium on the Medicaid regulations (rehabilitation option; case management and targeted case management regulation; school-based transportation services, etc) is set to expire on April 1, 2009.  The moratorium was included in the supplemental appropriations act  (P.L. 110-252) approved last July.  A diverse group of stakeholder advocacy groups was successful in obtaining this delay. The same groups are advocating for the new Administration to rescind the harmful Medicaid rules.

Newsbytes

• Adolescent Health Report

The National Research Council and the Institute of Medicine of the National Academies has released a report entitled Adolescent Health Services: Missing Opportunities. The report explores the state of adolescent health services and how the system is failing youth. The report can be read and purchased at: http://www.iom.edu/CMS/12552/35625/60680.aspx

• Children's Mental Health Services

A new report, Unclaimed Children Revisited: The Status of Children’s Mental Health in the United States, studies how child mental health policies across the United States respond to the needs of youth who have or are at risk of having mental health conditions and their families. It can be accessed at http://www.nccp.org/publications/pdf/text_853.pdf

• Healthy People 2020

An advisory committee of the U.S. Department of Health and Human Services has released its findings and recommendations. Healthy People 2020 envisions a national health agenda that communicates a vision and strategy for improving the health of the nation’s population and achieving health equity. You can learn more by visiting http://www.healthypeople.gov/hp2020/advisory/PhaseI/summary.htm

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