Legislative Update 8/16/2021: Children’s mental health and Nebraska legislative hearings

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This is the legislative update for August 16, 2021. View all updates here.



The August 16, 2021 legislative update includes highlights from both federal and state legislatures.

Federal

Congress

The Senate has joined the House in recess until September after passing an infrastructure package and a budget resolution. The budget resolution provides a framework for legislation, but we expect to see a focus on human infrastructure through the budget reconciliation process (Translation: a process for passing legislation that can only be used for policies that change spending or revenues).

The House is expected to briefly return the week of August 23 to vote on the Senate’s budget resolution and then go back in recess.

The legislation that Congress will be considering this fall through the reconciliation process will present an opportunity to advance policies that will help children. It is important that during the congressional research, children’s hospitals take advantage of this upcoming opportunity. They need to continue to tell senators and representatives that Congress should take action this year to address the ongoing crisis in children’s mental health, as well as support investments to sustain the nation’s pediatric infrastructure.

On August 6, Reps. Lisa Blunt Rochester, D-Del., and Brian Fitzpatrick, R-Pa introduced a measure specific to pediatric mental health. The proposal’s elements include (but are not limited to):

  • Extend immediate relief to the pediatric health care safety net in response to the surge in children’s mental health needs across the care continuum by strengthening federal Medicaid support for pediatric mental health by ~$2 billion annually. Options for Congress include:
    • Enacting a 20% increase to the federal Medicaid match (FMAP) for pediatric mental health services for 3 to 5 years
    • Increasing Medicaid provider rates for pediatric mental health services to Medicare levels for 3 to 5 years
  • Extend telehealth flexibility, including policies relating to audio-only services, and lifting originating site restrictions and geographic limitations. These have all been addressed in the Nebraska legislature, but the conversation has not been continuous across the country.
  • Improve access through better integration and coordination across the continuum of care. This would involve Congress establishing a new designated pool of grant funding of $500 million annually for five years under the oversight of the Health Resources and Services Administration (HRSA). It would ensure that children receive the right care in the right place — all in a timely manner. This includes support for community-based care coordination activities that integrate and coordinate pediatric behavioral health resources and care across the diverse settings unique to each community. The funding should have the flexibility to fund a broad range of activities, such as:
    • Community health workers or navigators to coordinate family access
    • Pediatric practice integration
    • Funding to support telehealth treatment and pediatric training for crisis response
    • Mental and behavioral health urgent care
    • Community-based initiatives (e.g., partnerships with schools)
    • Initiatives to decompress emergency departments, including crisis access coordination, partial hospitalization, step down residency programs, and intensive outpatient programs

State Updates

Nebraska Legislature

The January, 2022 legislative session is going to be a busy one. Children’s is beginning to prepare by having stakeholder work groups and personal discussions with the leaders of Nebraska.

As discussed in previous legislative updates, Nebraska has a significant amount of American Rescue Plan Act (ARPA) funds to support one-time funding initiatives throughout the state. Stakeholders across Nebraska and sectors are preparing their proposals to Appropriations Committee members to begin petitioning for their piece of the pie.

At some point, Nebraska is expected to receive nearly $1 billion in federal COVID-19 relief funds. However, we have only seen nearly $550 million so far. The Governor is expected to release his budget proposal late-fall as a roadmap for the budget-setting committee to consider where opportunities overlap and where contention may form.

Children’s has successfully hosted a number of these key lawmakers to the new Hubbard tower this week and has gained support for our vision to prioritize the growing needs of children in the state — specifically as it relates to their mental health.

Formal public hearings on these topics will begin in October, but funding priorities aren’t the only important issue on the table today. We have been personally invited to testify on a number of interim study hearings as the safety-net provider for children in the state. In two short weeks, we will first testify at the St. Francis Ministries Oversight Committee, followed by maternal child initiatives mid-September.

You can stream the following hearings live at the Nebraska Legislature’s website:

Tuesday, August 31

  • Special Committee — St. Francis Ministries Oversight Committee: Dr. Suzanne Haney invited to testify by Senator John Arch, chair of the Oversight Committee and the HHS Committee

Tuesday, September 14

  • LR221 (Sen. Tony Vargas): Interim study to examine maternal and infant mortality and morbidity
  • LR142 (Sen. Machaela Cavanaugh): Interim study to determine whether legislation should be enacted to provide for additional supports and further address the issue of maternal depression in Nebraska

Wednesday, September 15

  • LR143 (Sen. John Stinner): Interim study to examine the mental and behavioral health needs of Nebraskans, assess the shortages of providers, and determine what is needed to ensure an adequate behavioral health service delivery system (Children’s is welcomed as invited testimony)
  • LR163 (Sen. John Stinner): Interim study to examine post-acute placement challenges in Nebraska’s healthcare system

Wednesday, October 6

  • LR212 (Sen. Mike McDonnell): Interim study to study the healthcare workforce in Nebraska

Thursday, October 7

  • LR178 (Sen. Anna Wishart): Interim study to solicit input from Nebraskans regarding funds from the federal American Rescue Plan Act of 2021
  • LR179 (Sen. Machaela Cavanaugh): Interim study to examine funding mechanisms in the American Rescue Plan Act of 2021

Back to School Guidance

Children’s has been essential to the numerous public and private stakeholder meetings between school board members, superintendents and parents. Just last week, the Nebraska Child Health & Education Alliance — which Children’s chairs — released updated guidance on safely returning to school. The guidance also includes links to the Fall 2021 University of Nebraska Medical Center COVID-19 Back to School Playbook and Children’s Hospital & Medical Center Vaccine Campaign.

The Nebraska Child Health & Education Alliance is a coalition of entities that advocate for children’s access to quality health care and education across Nebraska. For more information, view the NCHEA website.

(Sources: CHA, Nebraska Legislature, NCHEA)

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