Legislative Action: The Next Step
By unifying regional health care, human services and behavioral health organizations, Kids’ Minds Matter has successfully made a tangible difference for the families and children in Southwest Florida. However, we need the power of our state and national governments to continue improving access to services, which were already severely lacking throughout Florida and nationally prior to the pandemic. We need your help to achieve these legislative goals.
Legislative advocacy by citizens with elected officials and leaders is the most direct way to cause change in government policy. Change driven by working with legislatures makes sure they are aware of what is important to the electorate through phone calls, emails and letters about issues.
Please write to your elected officials and ask them to address mental health workforce shortages, insurance reimbursement and availability, and expanding coverage that are impacting your community’s access to quality pediatric mental and behavioral healthcare. Together, we can accomplish real change.
Falling Further Behind
2020 Community Health Needs Assessment
Statewide, according to Florida Hospital Association:
- 13% of youth experience at least one major depressive episode a year
- The state has 204 federally designated mental health professional shortage areas, the 7th highest in the country
- 4% of youth have a substance abuse disorder
- 75% percent of adults diagnosed had an undiagnosed mental illness as a child
Lee County trails the national average in many areas:
- Access to a mental health provider
- Lee County: 99.7 providers for every 100,000 people
- National: 202.8 providers for every 100,000 people
- Age-adjusted suicide
- Lee County: 14.8 suicides for every 100,000
- National: 13.9 suicides for every 100,000
- Age-adjusted unintentional drug deaths
- Lee County: 31.4 drug deaths for every 100,000
- National: 18.1 drug deaths for every 100,000
Legislative Strategy
The goal of Kids’ Minds Matter’s advocacy is to emphasize pediatric behavioral health legislative priorities with state and federal stakeholders to achieve positive outcomes for patients.
These initiatives will benefit not only those seeking treatment. Research has proven that mental health medical treatment, whether administered in person or via telehealth, provides benefits that exceed its costs.
Outcome Achieved
Extend flexibilities that were provided during the COVID-19 pandemic for telehealth (and audio appointments and other care), including for behavioral health services, and remove Medicaid prior authorization requirement for seeking these services. Support future telemedicine legislation that requires certified clinical care being properly reimbursed and further encourages utilization.
Why:
- Flexibility allowed during the pandemic has improved care and health outcomes and reducing costs.
- Telehealth has been associated with lower 30-day readmissions than patients without timely post-discharge follow-up.
- Telehealth and audio appointments allow those in remote areas to have greater and timely access to behavioral and mental health appointments.
- Large segments of the population dealing with behavioral health issues receive no treatment whatsoever, and others who seek it out experience inadequate levels of care.
- Telehealth may help reduce rising workforce shortages.
The PHE is ending on May 11, 2023. The Consolidation Appropriations Act of 2023 has extended the telehealth flexibilities authorized during COVID-19 until December 31, 2024.
Key Initiative: Equal Treatment in Insurance Payments
Seeking the equal treatment of mental health conditions and substance use disorders in insurance plans. Despite the passage of federal legislation to ensure health care parity, including the Mental Health Parity and Addiction Equity Act (MHPAEA), financial requirements and reimbursement rates applied to behavioral health services remain more restrictive compared to medical or surgical services.
Why:
- Health insurance plans, from private individual and group coverage to the Medicare program, have long imposed barriers that limit access to needed behavioral health care for both mental and substance-use disorders, with far-reaching and often tragic results.
- The widespread practice of providing unequal coverage for behavioral health and other medical care not only limits access to needed care but subjects many Americans to the risk of major financial losses from out-of-pocket costs.
- Primary care services were reimbursed 23.8% more than behavioral health care in 2017.
- Lower reimbursement for behavioral health increases costs to the patient, and increased costs can result in reduced utilization of these critical services.
- Studies have found that equalizing specialty behavioral health and general medical benefits will not increase total healthcare expenses at all or will increase them by only a very modest amount of total healthcare premium. The real cost lies in not treating behavioral health disorders.
Key Initiative: Address Health Care Workforce Shortages
Pursue action that will reduce workforce shortages, including modifications to Graduate Medical Education funding, licensure reciprocity, grant and incentive programs for the nursing workforce, and ensuring the visa authorization process is structured to expedite admission of qualified international medical staff.
Why:
- Florida is ranked 42nd in the nation when comparing the ratio of patients for each mental health provider (550:1).
- By 2035 Florida could face a shortage of 59,100 nurses and 36,000 physicians.
- The United States and the Florida are experiencing a behavioral crisis that requires immediate action. The growth in demand for pediatric and adult behavioral health interventions in Southwest Florida over the past four years has well exceeded our collective ability to treat those in need.
Key Initiative: Support Funding for Critical Programs
- Funding for development, support and build of the Golisano Children’s Hospital’s Down Syndrome Clinic with the mission of improving the quality of life for about 5,000 children with Down syndrome and their families by offering coordinated assessments, connections to resources, education and advocacy. Children with Down syndrome usually have delays in physical, intellectual and language development, and they require specialized services to help them reach their full potential. SUPPORT DOWN SYNDROME CLINIC
- Funding the Golisano Children’s Hospital Autism Testing Demonstration Project to integrate communication and symbolic behavior scales development profile screening for infants and toddlers 6 to 24 months old, testing for validity and reliability. For decades, it was thought that ASD could not be diagnosed and treated until a child was about 3. Now screening tools can identify children and risk at 18 months old and even younger. The earlier in life ASD can be identified and treated, the better. SUPPORT FLORIDA AUTISM TESTING
- Funding to develop and build the Southwest Florida Autism Center to serve as a medical and social services treatment facility for children and young adults with Autism Spectrum Disorder (ASD). This center will link early intervention, early access to screening, healthcare services and treatment, behavioral health, education and vocational community partners with family engagement to properly help the young child to young adult with ASD have a self-sufficient and productive future. SUPPORT FLORIDA AUTISM CENTER
- Funding the evaluation and construction of the National Center of Pediatric Special Needs Medical Program, which will serve as a “all inclusive—under one roof” medical and social services and treatment facility for children and young adults with special needs, including autism and Down syndrome. SUPPORT PEDIATRIC SPECIAL NEEDS
Key Initiative: Improve Access to Mental Health Services
The Mental Health Reform Reauthorization Act of 2022 will extend key block grant programs, expand access to pediatric mental health and help boost the mental health workforce. The legislation reauthorizes key programs approved in a 2016 law set to expire in September 2022.
The Senate Finance committee is preparing to launch its own package to improve mental health.
The legislation would include many components including:
- Helping Kids Cope Act – increasing access to grants for pediatric behavioral health
- Improving Access to Mental Health Act 2023 – improve access to mental health services under the Medicare program
- EASE (Enhance Access to Support Essential) Behavioral Health Services Act – SUPPORT for Patients and Communities Act to provide for Medicare and Medicaid mental and behavioral health treatment through telehealth
- KEEP Telehealth Options Act of 2023 – expand access to telehealth services under the Medicare, Medicaid, and Children’s Health Insurance programs during the COVID-19 emergency
Why:
The legislative push comes as lawmakers are hoping to improve access to mental health services after the devastating impact of the COVID-19 pandemic.
