Congress seeking ‘common-sense solutions’ to unmet mental health needs

Congress is working on “common-sense solutions” to alleviate counties’ pressing mental and behavioral health needs, U.S. Rep. Andrea Salinas (D-Ore.), told attendees Feb. 23 at NACo Legislative Conference General Session. 

Salinas, a co-chair of the Congressional Bipartisan Mental Health Caucus, said she’s committed to advancing bipartisan solutions that improve access to mental health care and improve county officials’ ability to provide services in their communities. 

“Right now, it is too difficult to access providers … and get mental health care in a facility that is the right size and also the appropriate acuity level to meet patients’ needs,” Salinas said. “Because of this, too many people are having to access mental health care, as you all know, in the emergency room or in our jails. This is ineffective and it’s way too expensive.”

H.R. 1’s cost shift of SNAP and Medicaid dollars onto states will result in cuts to other vital programs at the local level to bridge that funding gap, Salinas noted. 

“We need to be clear eyed about the impact of these federal cuts on our state and local funds,” Salinas said. “… As county officials, you know better than anyone, you are on the front lines of providing those services to our communities. 

“Since Medicaid is the single largest payer of mental health services in our country, the cuts to the program will be significant and reverberate across the nation.”

In the wake of cuts to social safety net services, it’s imperative that Congress explore policy solutions that both mitigate the harm of the funding loss in the short-term and increase local capacity long-term, she noted. Last year, Salinas introduced the HOPE and Mental Wellbeing Act, which would cover three primary care visits per year without cost-sharing under Medicare and Medicaid. 

“We can encourage more people to get care when they are struggling, and when they identify it and when they are ready,” Salinas said. “And importantly, schedule that follow up appointment that is so crucial to care coordination and continuity.”

Salinas’ home state of Oregon has a shortage of nearly 4,000 beds across inpatient and residential treatment, with people who need care waiting up to six months for a bed, she said.  

The gap is one that counties across the country are facing, which is why Salinas introduced the Building Capacity for Care Act. The legislation would help address the bed shortage by providing localities with grant loans and loan guarantees to build up their facilities across the care continuum, she said. Salinas also supports the Michelle Alyssa Go Act, which would raise the Institute for Mental Disease (IMD) threshold from 16 beds to 36.

“These are the types of common-sense solutions that I feel like government can and should step in and help with right now,” Salinas said.  “… We should be able to get this done. This is a non-partisan issue, and would help on the ground deliver services for all of you right now.”

Along with the need to build more beds, the healthcare system needs more qualified clinicians to staff them, Salinas noted. Over half of the people in the country live in a Mental Health Professional Shortage Area. 

“We need to provide the treatment, prevention and recovery services our communities need,” Salinas said. 

Without change, the country is on track to have a severe shortage of providers, who will be “overscheduled, overburdened and likely underpaid” and it’s going to be hard to attract people to the field, she noted. 

According to Salinas, that’s why she introduced the STAR Plus Scholarship Act and the Mental Health Professionals Workforce Shortage Loan Repayment Act, which would create a dedicated pool of funding for students to pursue degrees in mental behavioral and substance use disorder treatment, giving preference to those who commit to practicing in rural and underserved areas.

To enact change, county officials must share with members of Congress the obstacles they’re facing in delivering mental and behavioral health care, Salinas said. 

“We need to hear your stories, we need to hear your challenges and what you’re facing, we need to understand what’s happening in your communities,” she said. “… Your knowledge can shape policy, influence the priorities we pursue and even improve bill text.”