A Great Session for NAMI: Legislative Summary
By Chris Bouneff, executive director | July 19, 2017
We’re past due for an update, which means we have plenty to report. If you’ve followed along with the Legislature this year, you know that the session finished with a flourish in July.
And for NAMI in Oregon, it was all good news at the close of the 2017 Legislature, which is one of our most productive sessions ever. Here’s our high-level rundown:
* NAMI’s housing legislation. NAMI first proposed its Mental Health Housing Development Incentive Fund in the 2013 session and offered it again in 2015. Each time the legislation was well-received, and the Legislature even allocated funding for the concept. But they never passed the bill. And so each session we’d rely on what’s called a “budget note” so that the money would be spent the way we intended.
No more. The House and Senate each passed House Bill 3063 unanimously. NAMI’s housing concept is now an actual state fund — the Housing for Mental Health Fund. (Not the catchiest of names. However, a win is a win.)
In the future, when we advocate for funding for housing, we have a place to invest that money. We have a standing advisory group to help determine what that money will fund. And we have a predictable process by which communities around Oregon can organize to propose projects that will increase access to housing for people living with serious mental illness and substance use disorders.
We didn’t win new funding. About $5 million in leftover mental health housing funding from 2015 will be used to seed the new Housing for Mental Health Fund.
Still. We have Fund with a capital F. Now we can focus on investing in the Fund and on encouraging organizations in our various communities to go after funding to develop more housing.
* Access to medications. When it was first proposed, House Bill 2300 would have significantly curtailed access to mental health medications. When we were done, HB 2300 took on the problem of poor prescribing practices the way NAMI had hoped — by focusing on prescribing itself.
Essentially, HB 2300 establishes a special workgroup with broad expertise in mental health medications and treatments that will help develop treatment “algorithms” that can be used to educate prescribers about medications and accompanying psychosocial therapies. Rather than restrict access to medications, Oregon can utilize the algorithm to improve prescribing practices and to educate clinicians such as primary care physicians about the various evidence-based treatments that may or may not accompany medication.
This was a year that any bill with a fiscal impact had little to no chance of passing, even one with a modest impact such as HB 2300. Yet HB 2300 passed unanimously in the House and with only one no vote in the Senate.
* Children’s mental health care system. The acute care system for children is nearly on the verge of collapse. There are too few residential treatment beds, and too many kids who need help.
Among the barriers to accessing care is a lack of coordination among providers, payers, hospitals, and state and county agencies. Kids can often sit in an emergency room or in hospital inpatient for weeks only because a residential treatment bed cannot be found. And to find one, case managers often have to call through a list of providers every single day.
Enter Senate Bill 944, which creates a centralized call center that will track open beds and serve as one-stop shopping for hospitals and other health care providers that are seeking residential treatment beds for kids. It’s a modest bill that doesn’t solve the capacity issue. But it will help.
* The state budget. Remember that $1.8 billion revenue hole at the start of the session? It seemed daunting at the time. Some likened it to a fiscal cliff that the state was on the verge of falling over.
And then we didn’t. State economists pared down the shortfall in May when they forecast a strong economy. Then lawmakers passed some measures to save a couple of hundred of million. Then the governor and lawmakers looked at other cost-saving measures.
Before we knew it, the only system facing a cliff was Medicaid. And lawmakers, hospitals and health plans came up with a provider tax that, when matched by federal Medicaid funding, would raise about $550 million to maintain Oregon’s expanded Medicaid system.
Still, there are clouds looming on the horizon. There’s general agreement that Oregon has delayed a number of important decisions to a later date, among them tax and revenue reform and the unfunded liability for the Public Employee Retirement System.
* These are just a few of the major issues with which we were involved this past session. We’ve written about our success with HB 3090 and HB 3091 in past updates. There also were a number of other bills, such as SB 860, which could have a positive impact on health insurance parity regulation in Oregon.
It was a busy session — probably the most successful since 2005 when we passed health insurance parity legislation. There isn’t one bill that stands out like parity did in 2005. But when you look at our total body of work, we did a lot that when combined should have a positive impact for individuals and families affected by mental illness.