Regional Policy Council Activities in 2018
Reggie Williams, Paul Gionfriddo, Nebraska Governor Pete Ricketts, Kasey Moyer, and Officer Luke Bonkiewicz in Washington, DC
2018 was quite a year for the Regional Policy Council. There were four RPC national meetings that coincided with national legislative groups: National Governors’ Association (NGA), National Council of State Legislatures (NCSL), American Legislative Exchange (ALEC) and the Conference of State Governments (CSG). Legislative mental health champions were identified and presented awards at each of these meetings. Governor Pete Rickets of Nebraska was honored in Washington, DC in February (NGA), which was preceded by a briefing at the National Press Club entitled Peer Specialists and Police as Partners in Preventing Crises. In Los Angeles (at NCSL) during the meeting Achieving B4Stage4 through Access and Accountability, eight state legislators were given awards and were also presented with a Congressional Proclamation by Congressional Mental Health Caucus Co-Chair Representative Grace Napolitano. In August in New Orleans (ALEC), at the meeting Why the Criminal Justice System is Not a ‘Big Easy’ Solution for Behavioral Health, two legislators received awards, and speakers included current and former legislators and the Tennessee Commissioner for Behavioral Health. The final meeting of 2018 held in Covington, KY (at CSG), Stepping Over Barriers and Building Bridges to Further B4Stage4, had eight additional legislators receiving mental health champion awards. Legislator awards presented in 2018 reflect the following:
- Governor Pete Ricketts of Nebraska
- Five State Senators
- 13 State House Members
- Seven Republicans
- 12 Democrats
Presentations at the RPC meetings were offered by former state legislators, state legislative group spokespersons, industry partners, mental health researchers, and current officials from state and local governments. A sampling of the topics is below:
- Scaling up visionary models for children’s mental health (former CO legislator);
- How to enact state mental health education legislation (MHA of NY State);
- How states may use the California model for combating step therapy (Steinberg Institute);
- Removing barriers to treatment for children and youth (LA Department of Behavioral Health);
- Legislation and state compacts to increase the use of telepsychiatry (Director of state compact);
- State behavioral health and criminal justice reforms in Tennessee (TN Commissioner);
- State justice reinvestment strategies to lower recidivism and save tax dollars (former TX state legislator);
- Private sector industry mental health initiatives (ALEC representative);
- Improving criminal justice outcomes (CSG Justice Center Director);
- Addressing Trauma in Children and Families (WI Director of Children’s Mental Health); and Industry perspective on access barriers (Advocacy and Government affairs director of MHA funder).
Photo: Zima Creason, Asm. Mike Gipson, Richard Van Horn, Christina Miller in Los Angeles California.
But these statistics are only part of the ongoing exchanges between MHA and national legislator groups. There were also initiatives that were undertaken by legislators that were inspired by hearing about fellow legislators at the previous year’s RPC meetings, which included topics ranging from mental health and suicide prevention trainings in schools, text-crisis hotlines, to violence avoidance and gun safety. Additionally, senior representatives from the NCSL, ALEC and CSG offered words of welcome, attended the awards ceremonies, and spoke about awardees. Capping off the reciprocity of the relationships with the national legislative groups, MHA senior staff members were invited to give in-person presentations at NCSL legislator trainings on Peers in Clinical Practice and Mental Health in Maternal/Child/Family Legislation. There were also telephone consultations on mental health provisions in state Medicaid plans, and numerous requests by an ALEC consultant regarding mental health and gun violence, the provision of mental health services in jails and prisons, and the facilitation of a survey conducted of people who work in the bail-bond industry regarding those they serve with mental health conditions, the results of which were presented at the RPC meeting in New Orleans (ALEC).
Attendance numbers for 2018 RPC meetings were as follows:
- 212 attendees at the four RPC meetings
- 101 organizations were represented
- 50 MHA affiliates sent meeting participants
- 26 industry partners and funders were represented
- 19 legislators, five of whom attended all or part of the meetings at which they were honored or were speakers
- Two current high-ranking state Mental Health officials
- One Congresswoman opened a meeting and presented Congressional proclamation
Photo: Congresswoman Grace Napolitano (CA-32) gives remarks in Los Angeles, California.
The RPC also conducted three webinars in 2018 wherein 684 attendees listened as they were presented and hundreds of downloads of the recordings and slides:
- Responding to Medicaid Waivers in the States: March 23, 2018
- 10th Anniversary of the Parity Act and on-going efforts: November 13, 2018
- Safety Not Stigma: Preventing Gun Violence and Suicide: December 12, 2018
The RPC addressed the unprecedented number of legislative proposals to roll back gains made over the previous decades with respect to access to care, inclusive formularies, favorable care management, as well as attempts to impose onerous requirements for pharmacy management, imposing fail-first or step therapy, mandating hours of work, and attempts to limit the rights, preferences and choices of patients and providers. MHA’s national office supported by RPC efforts in the states fought these proposals with calls and visits to legislative offices, letters to state committees of jurisdiction, and through collaboration with advocates and health care recipients telling their stories at State Capitol hearings and Hill Days.
Some of the issues addressed by letters, calls, and at meetings from the RPC in 2018 resulted in legislation or stopped harmful initiatives including:
- Support for parity bills in NY, NJ, CT, CO, IL, TN;
- Support for bills to Restore the Patients’ Voice Act (to allow exceptions to fail-first) in Congress and in the states;
- Letters, visits and meeting attendance opposing the “Gift Ban” for industry discounts on medications by the Philadelphia City Council;
- Opposition to Provider Prevails bills in NY, NE, AK, OK;
- Opposition to bill requiring prior authorization in MO, KS;
- Opposition to work requirements in Medicaid in KY and AR;
- Responses to the Administration regarding Congressional efforts to repeal the Affordable Care Act;
- Responses to the Administration’s regulatory efforts to roll back the protections for full access to medications in Medicare (Six-Protected Classes);
- Comments on State Medicaid Plans regarding formulary restrictions (and some in favor of inclusive formularies), against increased prior authorization for substance use disorder (SUD) treatment and in favor of requiring SUD treatment and requiring coverage for medication assisted treatment (MATS); and
- Letters of support and advocacy regarding the establishment of Mental Health Parity Ombudsman offices in CO and NY.
RPC Representative Ben Harrington and other affiliates listen to criminal justice diversion speaker in New Orleans, Louisiana.
Another signature RPC program is the Back Home Campaign, which coordinates national and state efforts in legislative districts in the states. Some of the efforts reported back include:
- More than 2500 legislative contacts in State Capitols;
- 139 letters sent to members of Congress; and
- Monthly calls conducted by RPC representatives with the MHA affiliates in their assigned states regarding legislative developments and providing technical assistance for advocacy.
The RPC looks forward to intensifying its efforts in 2019 and looks forward to another year of outstanding meetings and accomplishments.