A Senate subcommittee recently held a hearing on federal mental health spending for the fiscal year beginning on October 1st. The hearing focused on the demand for mental health services, the importance of Medicaid expansion funding, and innovations in mental health care and law enforcement training.
Every year the Appropriations Committees in the House and Senate write the bills that fund all the federal agencies for the next fiscal year. SAMHSA (the Substance Abuse and Mental Health Services Administration) and most other agencies that provide funding for mental health programs are funded through one of these appropriations bills.
Hearings such as this one are held early in the year so that the Committee members can learn about the issues that the spending bills address. Then they begin to write the bills and prioritize among the programs. Testifying at the hearing were members of the National Council on Behavioral Health and health systems administrators.
- The subcommittee heard testimony that the ability of behavioral health care providers to meet the demand for services is dependent upon a strong behavioral health workforce and that providers struggle to find qualified mental health professionals. Workforce shortages are caused in part by inadequate Medicaid rates providers receive, ultimately inhibiting providers’ ability to offer competitive salaries to employees.
- A witness from Washington State testified that a significant number of the 30,000 newly-eligible Medicaid enrollees received addiction care in the last year and the expansion population–individuals receiving health care for the first time–have tapped into other resources impacting their health, such as housing, employment, and care coordination.
- A healthcare administrator shared how his patients receive behavioral health care in the primary care setting because primary care is the “front door to the health care system,” for most patients. He also discussed the emerging and growing role of CCBHC’s to provide comprehensive care that meets the behavioral and physical health care needs of consumers.
- The President of the International Association of Chiefs of Police urged the committee to provide more funding for training law enforcement in de-escalation techniques to prevent individuals with mental illness from entering the criminal justice system.
Subcommittee Chairman Sen. Roy Blunt (R-MO) asked the panel how technologies like telehealth could be used to improve mental health treatment access in rural areas. The witnesses agreed that telehealth is an important tool for seeing patients in hard-to-reach areas and makes service delivery more efficient by eliminating travel time.
Chairman Blunt wrapped up the hearing by saying “Coverage is important, but coverage without access is not solving the problem,” implying that Congress needs to not only ensure that Americans have health care coverage, but that there needs to be an adequate number of providers available to serve them.
Early indications for the FY2018 budget are that domestic spending programs will face cuts to allow for an increase in military spending. You can find contact information for your representatives here