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NEK Mental Health Legislative Priorities

Legislative Agenda 2022 

PRIORITY: Address Workforce Crisis and Surge in demand for Community-based Mental Health, Developmental and Substance Use Disorder Services due to COVID 

 ADVOCACY ALERT 

 You can make a difference in solving the crisis in Vermonter’s mental health, developmental disability, and substance use disorder services by advocating for a 10% Medicaid rate increase for designated and specialized service agencies. 

 IT’S EASY – DO IT NOW 

 Go to the Legislative website: https://legislature.vermont.gov/ 

  1. Look up your local legislators, both House and Senate (you can access list here too)
  2. Use the contact information to call or email them 
  3. Tell them your story – whether staff, family, or person who uses services 
  4. Explain the impact of underfunding and workforce shortages on you and those you care about 
  5. Ask for a 10% Medicaid rate increase for fiscal year 2023 to reduce our staffing crisis 
  6. DO NOT do this on your agency’s time or your agency email/phones – USE PERSONAL EMAIL/PHONE ONLY

Remember, your legislators are there to serve you. By reaching out to them you are helping them do their jobs. They want to know what’s important to their constituents and improve the lives of Vermonters in their communities. Chances are they have been personally affected by mental health conditions, developmental disabilities and/or substance use disorders. Attached is factsheet but use your own words and share your own experiences.   

FY23 Budget Act 

  • Increase Medicaid rates by 10% to enable higher compensation for I/DD, mental health. and SUD services to address demand for services and historically high vacancy and turnover rates.
  • Require the Administration to establish and propose funding for predictable scheduled rate increases aligned with state employees, healthcare, or education sectors. 
  • Develop and expand educational opportunities, such as tuition assistance, scholarships, and loan repayment for workforce development, particularly for those providing developmental disability services.
  • Implement strategies in Health Care Workforce Strategic Plan and direct further focus on mental health, I/DD and SUD workforce.
  • Actively explore implementation of Certified Community Behavioral Health Center at the state level.  

OTHER ISSUES 

 Prioritize current or anticipated gaps in services for investments  

  • Focus on addressing populations who are subacute but residing in hospitals when less expensive, less restrictive resources could meet their needs 
  • Expand mental health resources for nursing home care 
  • Expand community-based residential resources, such as the MyPad model, over more investment in general adult inpatient beds. 
  • Fully fund mobile crisis and effective alternative models of crisis services to match resources to expectations and invest in the most cost-effective models for both children and adults 
  • Fully fund increasing demand for outpatient mental health services

 Strengthen investment in home and community-based services in All Payer Model 

  • Ensure cost-effective investments in community-based services are expanded 
  • Build on the successful pilots for care coordination between DAs and hospital emergency departments
  • Strengthen community care coordination

Educate on ADAP plans for payment reform and require transparency and Stakeholder involvement in payment reform process 

  • Require strong stakeholder engagement (people who use services, providers, etc) and use learnings from other payment reform processes to inform ADAP payment reform
  • Ensure alignment with other state payment reform processes
  • Any additional layers of administration/management should require an increase in funding.  The assumption that a new layer will reduce overall costs is flawed. 

  Support peer-based services both within DA/SSAs and at peer-run organizations. 

  • Support Bill to develop peer certification program, training, and Medicaid reimbursement with amendment to include DA/SSAs in the list of organizations not required to have all peer employees certified and adjustment to the language comparing occupancy rates.
  • Support Concept of Peer-based respite programs within the context of limited funding for community-based mental health system

 Expand Access to affordable housing 

  • Develop housing vouchers for people served by the DS HCBS Waiver to create independent housing options.  
  • Improve the flexibility of the housing vouchers administered by the Department of Mental Health because restrictive eligibility practices are leaving people in need homeless and housing vouchers underutilized.

 Address mental health needs of individuals in the criminal justice system  

  • Develop community programs and participate in trainings to improves services for people with serious mental illness and criminal justice involvement as part of Justice Reinvestment initiative
  • Use of Force Legislation has had difficult impact on role of law enforcement in collaborating with DAs – Work with stakeholders to address

  Maintain Expanded Access to Mental Health Services 

  • Continue and expand funding for alternatives to emergency department services with urgent care initiatives such as: PUCK,  Cahoots, etc.