THE HEALS ACT & MENTAL HEALTH
The Senate released a first draft of the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act, the long-awaited 4th legislative COVID-19 relief package. Like the CARES Act, which was signed into law in March, it includes important victories for mental health and substance use care. NAMI has been advocating to include mental health priorities in this bill. We still have work to do to get this bill – with all of our priorities – over the finish line. Below is a summary of what is in the bill and what we’re still advocating to include:
NAMI priorities in the HEALS Act
The HEALS Act includes several provisions that will impact people with mental health conditions, including:
1. Support for state and local mental health, substance use and suicide prevention service
NAMI has been increasingly concerned with potential budget cuts to mental health services at the state level and has been advocating for flexible funds through the Substance Abuse and Mental Health Services Administration (SAMHSA) to help states fill gaps in their mental health and substance use services. The HEALS Act would include $4.5 billion in funding for SAMHSA:
$2 billion for the Community Mental Health Services Block Grant (note that 50% of these funds must go directly to mental health centers rather than through state mental health agencies, which is the typical process for the block grant)
$1.5 billion for the Substance Abuse Prevention & Treatment Block Grant
$600 million for the Certified Community Behavioral Health Clinic (CCBHC) expansion program
$250 million for emergency mental health and substance use grants
$100 million for Project AWARE (Advancing Wellness and Resiliency in Education)
$50 million for suicide prevention
$15 million for behavioral health services for Tribes
Note: The bill would also allow (but does not require) SAMHSA to waive current block grant requirements regarding allowable activities, timelines, or reporting requirements.
2. Extension of Telehealth
One positive outcome of this crisis has been the increase in availability of telehealth services for those that need them, particularly in rural and frontier areas. The HEALS Act would extend the current Medicare flexibilities to provide telehealth through Dec. 31, 2021 or the end of the public health emergency, whichever is later. It would also require a report on the impact of these telehealth flexibilities, and it would require the Department of Health and Human Services (HHS) to post data on the use of telehealth and make legislative recommendations to Congress on permanent changes.
3. Increased resources for the "provider fund"
While Congress has passed funding for provider relief in past COVID-19 packages, the process to disburse those funds has largely left out behavioral health providers. To ensure that these providers are able to keep providing services, it is critical that they receive funds. The HEALS Act would provide an additional $25 billion to the Public Health and Social Services Emergency Fund (“provider fund”) to support providers who have increased expenses or lost revenues due to COVID-19. The bill would give flexibility to HHS regarding eligibility for these funds.
4. Support for non-profit organizations
NAMI advocated for nonprofit loans and loan forgiveness in earlier bills, mainly through the Paycheck Protection Program (PPP). The HEALS Act would simplify or waive some of the documentation requirements for forgiveness of loans under $150,000 and simplify requirements for loans between $150,000 and $2 million. The Act would also make second loans available through a Paycheck Protection Program Second Draw program to organizations that have already received a PPP loan (if they employ 300 or fewer employees and can show that they have experienced at least a 50% reduction in revenue during the first or second quarter of 2020 compared to the same time in 2019).
In addition to the advocacy priorities noted above, the HEALS Act would provide $200 million to the National Institute of Mental Health (NIMH) and $64 million for the National Institute on Minority Health and Health Disparities.
NAMI is grateful for the inclusion of the significant mental health priorities above. However, more is needed to address the mental health and substance use needs of our nation due to this pandemic. As a result, we continue to advocate for the following:
1. Health coverage for people reentering the community
To prevent the spread of COVID-19 in overcrowded jails and prisons, many jurisdictions are releasing individuals who have mental health and substance use disorders. It is critical that they have access to treatment as they reenter the community. NAMI supports inclusion of The Medicaid Reentry Act, which would provide needed Medicaid coverage for many justice-involved people with mental illness starting 30 days prior to their release.
2. Medicaid FMAP increase
NAMI supports an additional temporary 7.8 percentage point increase in the Federal Medical Assistance Percentage (FMAP). Congress has already passed a 6.2 percentage point increase in FMAP, but a further FMAP increase would mean that the federal government would pay more of the cost of Medicaid programs, which are a critical source of mental health care. This would help state dollars go further and preserve mental health services at a time of escalating need.
3. Addressing emergency housing needs
NAMI supports a national uniform moratorium on evictions through Dec. 31, 2021 or the end of the public health emergency, whichever is later. Without this, evictions are expected to rapidly rise. NAMI also supports $100 billion for emergency rental assistance and $11.5 billion for the Emergency Solutions Grant (ESG) program to address the needs of homeless individuals and families. These programs are essential to keeping individuals in housing, which is critical to protecting their physical and mental health during this crisis.
4. Relief for non-profits
NAMI organizations continue to struggle with the financial burden of this crisis while also having to significantly alter their programming and resources to meet the needs in their community. NAMI will continue to advocate for additional resources to support nonprofits, including programs to prevent nonprofit layoffs and an extension and increase of the “above-the-line” charitable deduction, which promotes charitable giving. Currently, this is capped at $300, but the nonprofit community is advocating that it be raised significantly.
STAY TUNED FOR MORE ADVOCACY ACTION
THANK YOU! NAMI advocates sent over 33,000 emails to the Senate to “make mental health a priority” in the next COVID-19 package, and many of you had meetings with key Senators to discuss our priorities, gather intel and help inform next steps. You and the mental health advocates across the country made a real difference.
WHAT'S NEXT? The House and Senate bills have significant differences. Congressional leaders and the White House are negotiating differing priorities to arrive at a final bill. With the moratorium on evictions and increased unemployment benefits about to expire at the end of this week, there is increasing pressure for Congress to come to an agreement quickly
We will need your advocacy firepower as this COVID-response legislation moves forward. Negotiations are ongoing, and we will keep you updated on new developments and on ways to influence the legislation. In the meantime, we are grateful for the loud voice of our NAMI advocates, and we thank you for helping mental health gain a prominent place in the HEALS Act.