The National Coalition on Mental Health and Aging met on February 3, 2022. PowerPoint presentations are attached. The following is a summary of meeting highlights:

Update on 2022 Older Adult Mental Health Awareness Day Symposium

Kathleen Cameron, Vice Chair of NCMHA and Director the Center for Healthy Aging, reported that the 2022 Older Adult Mental Health Awareness Day Symposium will be Monday, May 16, 2022 from 10:00 a.m. to 4:30 p.m. Eastern Time.  The virtual event will be co-hosted by ACL, HRSA, NCOA, and SAMHSA, through NCOA’s CDSME Resource Center, and directed to a wide and diverse audience.  A save-the-date announcement will be released soon and registration will open in mid-March.  The event is offered at no charge.  Continuing Education credits will be available to licensed health and social service professionals through the E-4 Center at Rush University Medical Center.  HHS Secretary Xavier Becerra has been invited to open the Symposium.  The event will include sessions on topics including: trauma-informed care, practical strategies to navigate mental health resources and services, “looking beyond the doctor’s office” for services in the community, suicide prevention, the use of alcohol and cannabis, and the intersection of social determinants of health and mental health of older adults.  Each session will feature the voices of older adults who will share their lived experiences.

Congressional Healthcare and Mental Health Policy Update

NCMHA Chair Joel Miller presented a Congressional Healthcare and Mental Health Policy Update.

The full PowerPoint presentation is attached.  The following is a summary of points:

  • The Build Back Better bill passed by the House has not been brought to a vote in the Senate.  Portions of the bill may be introduced as separate pieces of legislation.
  • The current Continuing Resolution expires Feb. 18, 2022.
  • The Senate Finance Committee received responses to their request for information from over 200 organizations including NCMHA.
  • The Senate Finance Committee formed five work groups to address key behavioral health issues (chaired by Senators shown below):

o   Strengthening the Work Force (Stabenow/Gaines)

o   Integration, Coordination, and Access to Care (Cortez-Masto/Cornyn)

o   Ensuring Parity between Behavioral Health and Physical Health Care (Bennet/Portman)

o   Furthering the Use of Telehealth (Cardin/Thune)

o   Access to Behavioral Health for Children and Young People (Carper/Cassidy)

  • The latter work group held a hearing on Feb. 7.
  • The work groups will report to the full Committee in March.
  • The Senate HELP Committee, Co-Chaired by Sen. Patty Murray (D-WA) and Sen. Burr (R-NC) held a hearing on Feb. 1 on mental health and substance use disorders, addiction issues, workforce gaps, co-occurring disorders, and the minority fellowship program.   For more information, go to https://www.help.senate.gov/
  • There are growing bi-partisan initiatives on behavioral health.
  • The House Ways and Means Committee held a hearing Feb. 2 on “America’s Mental Health Crisis.”  The Legal Action Center provided testimony.  For more information, go to: https://waysandmeans.house.gov/
  • Joel provided a list of bills passed by the House, which are pending Senate Action.
  • Committees in the House and Senate have proposed additional funding for HRSA and SAMHSA but these proposals are on hold until a final spending bill is enacted.
  • The Defense Authorization Act for FY2022 includes mental health provisions for service members and families including treatment for eating disorders, mental health evaluations, scheduling mental health appointments, and suicide prevention.
  • Report from the Departments of Labor, HHS, and Treasurer on the 2022 Mental Health Parity and Addiction Equity Act Report to Congress. The report is available at:

https://www.hhs.gov/about/news/2022/01/25/us-dol-hhs-treasury-issue-2022-mental-health-parity-addiction-equity-act-report-to-congress.html

https://www.gao.gov/products/gao-22-104437

  • Commonwealth Fund Report on Older Adults Mental Health:

https://www.commonwealthfund.org/publications/issue-briefs/2022/jan/comparing-older-adults-mental-health-needs-and-access-treatment

Presentation on Improving Medicare’s Coverage of Substance Use Disorder Treatment – by Deborah Steinberg, Health Policy Attorney, Legal Action Center, and the public policy chair for the American Foundation for Suicide Prevention’s National Capital Area Chapter.   The following is a brief summary of the presentation:

  • In 2019 approximately 1.7 million Medicare beneficiaries were diagnosed with a substance use disorder (SUD) – 3.4 million in 2020;
  • Of those individuals, only about one in 10 of them receive treatment;
  • Access to treatment is even worse for those over 65 (6% for individuals ages 65+);
  • 38% of those 65+ said they didn’t receive care because of financial barriers, including insurance not covering treatment, whereas it was only about 28% for those under 65;
  • 80% of persons age 65+have an alcohol disorder or poly-substance use disorder;
  • We cross-walked what Medicare covers to the American Society of Addiction Medicine (ASAM) criteria which treats SID on a continuum starting with early intervention as the lowest level of care to medically managed (hospital care) as the highest level
  • Medicare does cover the least intensive and most intensive levels of SUD treatment, but not intermediate treatment such as intensive outpatient programs, partial hospitalization programs, and residential treatment;
  • Medicare has a 190-day lifetime limit on hospital services for psychiatric care and SUD treatment vs. no lifetime limit for medical conditions.
  • Medicare does not cover SUD treatment by all provider types.  Missing providers include: Licensed Professional Counselors, Certified Alcohol and Drug Counselors, and Peer Support Specialists.
  • Gaps also include: lack of coverage for free-standing SUD treatment facilities, ASAM levels of care, crisis services, contingency management, parity, and anti-discrimination protections.
  • Other barriers to care: insufficient access to providers, limited networks in Medicare Advantage plans, lack of culturally effective SUD providers, lack of standardized medical necessity criteria, prior medical authorization requirements, telehealth limitations, and custody exclusions.
  • To remedy these gaps and inequities, LAC recommends:

o   Amending the Social Security Act to authorize a full continuum of SUD care;

o   Apply the Mental Health Parity and Addiction Parity Act to Medicare; and

o   Regulatory and Sub-regulatory Actions by CMS.

NCMHA February 3, 2022 Quarterly Meeting Highlights