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���������� Note: The Mental Health Weekly ran a cover story last week giving national coverage to the dire need for Congressional action to approve COVID relief funding to the states and the devastating impact to essential community behavioral health services, including ���������� State, if they don’t.

���������� State Advocates Say Cuts Would Hurt MH Community
Mental Health Weekly June 22, 2020

���������� state community providers have been asked by state officials to brace themselves for an imminent 20% across-the-board cut to the public funding they need to provide basic services and support to consumers with mental health and substance use disorders.

Coupled with the current pandemic, the news is especially concerning, say advocates who are waiting for Congress to provide additional COVID-19 relief funding that would support core programs. The $3 trillion proposal for H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act), is considered “Phase Four” in the series of stimulus and relief packages following the COVID-19 crisis (see MHW, May 22).

“The Senate had declared the HEROES Act dead on arrival,” Harvey Rosenthal, CEO of the ���������� Association of Psychiatric Rehabilitation Services Inc., told MHW. “They (claimed that they) do not want to bail out states.” Sen. Mitch McConnell (R-Kentucky), Senate majority leader, has indicated considering the legislation sometime in July, Rosenthal said. “The White House, the Senate and the House all have different priorities,” he added.

Meanwhile, Gov. Andrew Cuomo says that unless Congress provides funding, he plans to cut $8 billion from the budget, said Rosenthal. The cut translates to 20% across the board cuts, he said.

Rosenthal repeated an oft used comment by Cuomo. Cuomo created the “How Are You, Really?” effort as part of a larger Mental Health Coalition campaign. The collaborative efforts unite leading mental health organizations across the country, creative and media platforms, advocates and celebrities to address the mental health crisis.

“Cuts are particularly devastating at a time when mental health needs have never been greater,” said Rosenthal.

‘Skyrocketing’ needs
“The need for all services is sky rocketing,” said Rosenthal. Experts are calling the resulting mental health crisis and trauma provoked by COVID-19 a “shadow pandemic,” he said. Rosenthal pointed to an op-ed he wrote in the Times Union emphasizing the need for lawmakers to take action.

“Congress must rise above the politics and immediately approve funding to the states over the next few weeks,” he wrote. “Governor Cuomo must ensure that frontline behavioral health agencies are exempted from any cuts and, instead, offer some strategic increases to ensure that this time around, help is available when ����������ers need it most.”

Rosenthal also wrote a letter June 5 to Sen. Chuck Schumer (D ����������) emphasizing the impact the denial of sufficient COVID-19 emergency funding to states and localities in the relief package would have on community mental health services across the state and nationally.

“As we are in the midst of one of the greatest challenges to the mental health of both our community and all Americans, we look once again to your leadership to not only protect but to expand services and support at a time when they are needed the most,” he wrote

The 20% proposal must be exempt (for mental health services), said Rosenthal, adding that demand is growing every day for needed provider services. “If the governor goes ahead with budget cuts, we will be firing staff and cutting services that won’t be restored by COVID money,” Rosenthal said. If funding does eventually come in, staff will already have been fired, he said.

Government Fix Needed
The executive director of the ���������� State Council for Community Behavioral Healthcare predicts that state cuts could potentially range from 20% to 40%. Medicaid and education are the largest areas of spending in ���������� state, said Lauri Cole. Needed funding for states and localities will depend on lawmakers coming together in Washington to release another emergency spending bill, she said.

“The federal government is the sole entity that can fix this,” Cole told MHW. The ���������� State Council for Community Behavioral Healthcare, she said, has spoken with state lawmakers “to make ���������� whole from a fiscal perspective.”

The council membership needs to be reimbursed for expenses they have had to shell out on personal protective equipment and technology purchases so that they could communicate with clients remotely through telehealth, telephonic and video modalities, she said.

“We want to take what we’ve learned from the COVID crisis and incorporate it into daily practice,” said Cole. The council wants to continue with the technology its members are currently using and the modalities that are helping them provide services to clients, such as telephonic, audio and video, to be continued and made permanent in the behavioral health space, she said.

“It doesn’t mean that everybody will use it all the time,” Cole said. “It does mean you want a robust toolbox of available solutions, which should be used and guided by clinical judgment.” It’s enhancing and empowering providers. Audio, video and telephone are the best solutions for providing care.

Cole added that the state requires outpatient clinicians to be available for emergencies and people are still living in residential and congregant care. “Not everybody is shut down,” she said. Additionally, people still need to receive their medications, and particularly, patients needing treatment for opioid use conditions, which providers are doing using mobile delivery.

Legislation Update
The NYS Council is pleased that the governor on June 18 signed (S. 8416/A.10404A) that authorizes Medicaid reimbursement for telephonic and tele-video health as a reimbursement modality for delivering care. When enacted, the legislation will validate an effective transformation that occurred in the behavioral health field related to outreach, engagement, treatment and support of individuals needing mental health and substance use disorder/addiction services during the COVID19 emergency disaster, according to a NYS Council memo.

“Telehealth is a very significant and powerful tool to have in your toolbox when something like COVID-19 occurs,” she said. ���������� generously waived a lot of barriers that were in place prior to COVID-19, she said. Cole noted that there has been a very significant uptake of the use of telehealth services to continue to provide emergency services to their clients. In addition, client satisfaction has gone up overall and no show rates are down for certain populations, she said. Many clients prefer this way of care, particularly those in rural parts of the state and those who have transportation-related issues, even in urban settings.