Meeting Summary
Public Policy Committee
National Council for Behavioral Health
Public Policy Committee
Washington, DC
June 3rd - 4th, 2013
Day 1
Tim Swinfard, the National Council’s Public Policy Committee Chair, began the meeting with
a welcome to the group and an overview of the agenda for the day.
Washington Healthcare Update –Dan Mendelson
Dan Mendelson, President, Avalere Health, LLC. Dan Mendelson began the meeting by
addressed the changing healthcare climate and the need to view the issue from different
perspectives. Dan focused on three areas:
1. The Evolving Payer Landscape  Managed markets orienting around coverage
expansion
 Increased fiscal pressure: Rate review, Medical Loss Ratio (MLR), Affordable
Care Act (ACA) taxes, and increased underwriting risk.
 Government markets are expanding (Medicaid, Medicare, Duals Demos)
providing tremendous opportunity for providers and increased access to mental
health care.
 Quality-based payments, demand for proof of claims.
 States have a large role to play in Medicaid expansion, pharmaceutical coverage,
exchanges, and defining Essential Health Benefits (EHB). These provide
opportunities for advocacy.
2. Consolidating Provider Environment  Providers increasingly integrating, at risk
for outcomes.
 We are shifting in the direction of value-based purchasing, Affordable Care
Organizations (ACOs) & Medical Homes, bundled payments, and payments
linked with outcomes.
 Care coordination and primary care are being encouraged; allow providers to
share in savings.
 Hospital financing strategies must adapt to the times to survive.
3. Increasing Consumer Accountability  Access to information and financial
burden growing
 Government wants consumers who are knowledgeable, make good decisions,
and where cost-sharing promotes smart use of resources; however, in reality
this doesn’t always happen. Consumers aren’t necessarily receiving good
information and doctors may react negatively towards more patients who are
more informed.
 Risk in Cost-sharing: it can implicitly discriminate against certain consumers
who may need more specific or intense care. Formularies for insurance
payments are such that injectables and other behavioral health medications are
email: communications@thenationalcouncil.org | phone: 202.684.7457
Meeting Summary

Public Policy Committee
being assigned to higher tiers, making these medications more expensive and
less accessible.
Cost-sharing that leads to increased co-pays can negatively affect consumer
behavior.
National Council Legislative Update (Excellence Act, Mental Health First Aid,
Appropriations, Block Grants) – Chuck Ingoglia, Al Guida, Catherine Finley & Amanda
Deaver
Chuck Ingoglia, Senior Vice President Public Policy, National Council for Behavioral Health,
gave a brief update on what has occurred in the past year related to the National Council’s
legislative efforts:
 Recent tragedies have led to national discussions regarding the mental health safety
net. President Obama created a gun control task force-subset of recommendations
that included recommendations to improve the nation’s mental health system,
including the proliferation of Mental Health First Aid.
 Both the Mental Health First Aid Act (S. 153/H.R. 274) and the Excellence in Mental
Health Act (S. 264/H.R. 1263) have strong bipartisan support in both the House and
the Senate.
 Now that we have an official score on the Excellence in Mental Health Act, we
continue to pursue an offset.
Al Guida, Guide Consulting Services, Inc. and lobbyist for the National Council, discussed the
current progress on the Excellence in Mental Health Act, offering that in addition to having
bipartisan support, conversations have revolved around the implications for reducing
Medicaid costs for the individuals that would be served by the enhanced safety net.
Medicaid eligible individuals with comorbid behavioral and medical conditions cost on
average $35,000 per year, while adults without these conditions cost on average $4,000 per
year.
Mr. Guida also discussed the Mental Health First Aid Act, which is the first piece of
legislation relating to mental health to reach the Senate Committee on Health, Education,
Labor, and Pensions since 2000. Moving forward, it is imperative that we continue to focus
our efforts on targeted advocacy towards those who are most influential in the committees
of jurisdiction. National Council members interested in getting involved in advocacy for
Mental Health First Aid should contact Chuck Ingoglia (ChuckI@thenationalcouncil.org)
Catherine Finley, Partner at Thorn Run Partners and lobbyist for the National Council, is a
former long-time Republican staffer on Capitol Hill. Ms. Finley noted that we need to focus
our efforts on appropriate messaging related to the Excellence in Mental Health Act and the
Mental Health First Aid Act. The gun control debate has created an opportunity to discuss
mental health needs on both sides of the isle. She has engaged in targeted outreach to the
National Rifle Association as well as other non-traditional partners such as law enforcement
and other public safety officials. Ms. Finley concluded the discussion by emphasizing the
influential role that Association Executives and Board Members can play as constituents.
These pieces of legislation support jobs, bring in local funding, and help reduce healthcare
costs in the long run.
email: communications@thenationalcouncil.org | phone: 202.684.7457
Meeting Summary
Public Policy Committee
Amanda Deaver, Prism Public Affairs and consultant to the National Council, has been doing
PR for the National Council with a focus on maximizing exposure in support of our
legislative priorities, both within Congress as well as among the general public. In 6-8
weeks she has reached 153 million people. Ms. Deaver has accomplished this through:
 8 op-eds in 10 outlets by National Council members and interested 3rd parties
 21 radio interviews by Linda Rosenberg
o Packaged news story and pre-ordered-over 1000 stations-estimated 38
million listeners
 April 11th FOX News story featuring Chuck Ingoglia, which had 1.5 million viewers
 Comprehensive coverage on Excellence in Mental Health Act from Politico
 Banner advertisements targeting Senate offices
 Kickoff media event with Senator Stabenow and key 3rd parties (i.e. Veterans,
service and law enforcement groups)
During the discussion, the panel emphasized the current window of opportunity for the
field. The opportunity to move depends on the legislative landscape, which rapidly changes.
Action Items:
 Catherine discussed the strength of relationships on the local level such as a
relationship between community mental health centers and first responders.
Catherine provided the Sheriff’s Association with the National Council’s contact list
to facilitate a connection, and the audience expressed interest in receiving the
Sheriffs contact information as well.
CMS Update on Behavioral Health Policy
Barbara Edwards & John O’Brien, Disabled and Elderly Health Programs Group, Center for
Medicaid Services (CMS), addressed the role of CMS in developing stronger, more deliberate
policy for Medicaid services. Barbara Edwards emphasized the need for more robust mental
health prevention and treatment services, as well as consumer choice and family
involvement. Barbara highlighted a few key activities and strategies aimed at achieving
these needs:
 Integrated physical and mental health treatment - 10 health homes in 10 states.
 MH/SU services for youth – reminding states about mandatory screenings;
disseminating screening tools; involving State Medicaid directors to coordinate
efforts at local level; info bulletin for key strategies on identification and referral.
 Youth in foster care – incorporating trauma care; better use of psychotropic
medications; more effective use of therapeutic foster care; collaborating with the
Substance Abuse and Mental Health Service Administration (SAMHSA).
 Emotional disturbances – a Medicaid demonstration program on home &
community based care had tremendous success (final report in-progress). Homebased services cost 69% less than care provided in Psychiatric Residential
Treatment Facility (PRTF). Outcomes maintained or increased across all domains.
 Community Integration – slow moving as it’s difficult to pull together across
disabilities; involving the Department of Justice (DOJ) in violations of the Americans
with Disabilities Act.
email: communications@thenationalcouncil.org | phone: 202.684.7457
Meeting Summary
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Public Policy Committee
Policy Implementation – involving the Department of Housing and Urban
Development (HUD), CMS, and SAMHSA in our work; invited states to do on-theground reform and are compiling best practices.
John O’Brien focused his attention on the need for quality measures for behavioral health
and the fact that it has been difficult to identify these in the past. In addition, John addressed
round two of the Health Care Innovation Awards. John highlighted that project proposals
must test new service delivery and payment models that allow for higher quality care as
well as lower costs. They are seeking proposals in 4 key areas:
 Models designed to rapidly reduce public health care expenditures in outpatient
and or post-acute settings.
 Models that improve care for populations with specialized needs settings.
 Models that test ideas innovative financial and clinical models.
 Models that focus on engaging beneficiaries, prevention, wellness, and
comprehensive care that extend beyond clinical service delivery.
Discussion with National Association of State Medicaid Directors – Matt Salo and
Andrea Maresca
There was an open dialogue with Matt Salo & Andre Maresca, National Association of
Medicaid Directors, in response to their letter opposing the payment methodology
contained in the Excellence in Mental Health Act. Matt provided a summary of NAMD’s letter
and responded to questions and comments from the Public Policy Committee. We agreed to
disagree on the positions of each association.
Closing Remarks – Linda Rosenberg
Linda Rosenberg, Executive Director, The National Council for Behavioral Health, wrapped
up the day by giving us a quick rundown on her attendance at White House sponsored
National Conference on Mental Health, which brought together advocates, elected officials,
faith leaders, and others to discuss ways to reduce the stigma of mental illness. Linda noted
that President Obama spoke about taking mental health out of the shadows, and the fact
that recovery is possible. Arne Duncan, Secretary of Education, highlighted the use of social
media as a new tactic to reduce the stigma of mental illness and narrow the generational
divide.
Day 2
Tim Swinfard, the National Council’s Public Policy Committee Chair, began day 2 of the
meeting with a welcome to the group and an overview of the agenda for the day.
Excellence in Mental Health Act – Alex Sheff
Alex Sheff, Legislative Assistant for Senator Debbie Stabenow, provided an update on the
Excellence in Mental Health Act. The Excellence in Mental Health Act aims to increase access
to community behavioral health services for all Americans and to improve Medicaid
reimbursement for community behavioral health services. Alex Sheff stressed the need to
address this last step in mental health parity and raise the bar in both the quality and
quantity of services we’re providing. Alex remains hopeful that when gun legislation is
likely reconsidered in July, the Excellence in Mental Health Act was regain attention. Alex
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Meeting Summary
Public Policy Committee
reminded everyone that Sen. Stabenow is 100% committed to getting this bill passed and
that this is an opportune time to fight for this legislation.
Enrollment Best Practices – Kevin Malone and Jennifer Sullivan
Kevin Malone, SAMHSA and Jennifer Sullivan, Enroll America provided an update on
innovative enrollment activities that are currently in the works. Kevin began by highlighting
a number of SAMHSA’s resources that will help providers educate the public on the ACA and
will maximize enrollment. Their new website (www.healthcare.gov/marketplace), will soon
house online enrollment applications, training toolkits, videos, and print materials, which
have been specially formatted based on their market research.
Next, Jennifer Sullivan provided an update on Enroll America’s activities and highlighted
new resources that will be useful for community providers. Jennifer stressed 4 key
messages that have been shown to increase enrollment among the uninsured and
encouraged National Council members to use this messaging (and customize) when talking
to individuals’ newly-eligible for insurance:
1. All insurance plans will have to cover doctor visits, hospitalizations, maternity care,
emergency room care, and prescriptions.
2. You may be able to get financial help to pay for a health insurance plan.
3. If you have a pre-existing condition, insurance plans cannot deny you coverage.
4. All insurance plans will have to show the costs and what is covered in simple
language with no fine print.
Finally, Jennifer highlighted the results of one of their research projects, which found that
only 22% of uninsured Americans knew that health reform could help them. Jennifer
stressed the need to develop a “no wrong door” policy through an integrated and
centralized system.
For more information on Enroll America’s best practices in outreach and enrollment, state
navigator and assister developments, statewide marketing and outreach plans and maps of
the uninsured by county, visit their website at www.enrollamerica.org.
HUD Update: ACA Implementation and Olmstead Implementation - Jennifer Leimaile
Ho
Jennifer Leimaile Ho, U.S. Department of Housing & Urban Development, wrapped up the
meeting by discussing the Affordable Care Act as it relates to Olmstead. Jennifer stressed the
need for assisted housing for persons with disabilities to provide community-based options
rather than institutional settings to remain in compliance with Olmstead. Jennifer
concluded by discussing current efforts in place aimed at ending homelessness among
Veterans, families, and children; and that there is still an unmet need for community
supportive housing.
email: communications@thenationalcouncil.org | phone: 202.684.7457