NAMI Minnesota Legislative Update

May 12, 2019

Last Week of Session - Action Needed

After months of hard work, we have finally made it to the last full week of the legislative session. Now more than ever, we are counting on every NAMI member to reach out to your legislator to advocate for a better mental health system. Every legislator needs to hear from us this week, but if your legislator sits on a conference committee, it is even more important for you to call or email your legislator and ask for their support on NAMI's positions.

Here are the conference committee members that will have the most impact on mental health so be sure to contact them about the issues below:

Human Services:

Chair Liebling from Rochester - 651-296-0573 Chair Moran from St Paul - 651-296-5158 Rep. Halverson from Eagan - 651-296-4128 Chair Schultz from Duluth - 651-296-2228 Rep. Hamilton from Mountain Lake - 651-296-5373 Chair Benson from Ham Lake - 651-296-3219 Chair Abeler from Anoka - 651-296-3733 Sen. Utke from Park Rapids - 651-296-9651 Sen. Jensen from Chaska - 651-296-4837 Rep. Marty from Roseville - 651-296-5645

NAMI supported provisions in the House

Children's Residential Mental Health Treatment: Many of Minnesota’s children’s residential mental health facilities were designated as Institutes of Mental Disease (IMDs), which prevents them from receiving federal MA reimbursement. Without state funding, the counties will bear 100% of the cost of care. The House bill appropriates $8.285 in FY 2020-2021 and $18.187 FY 2022-2023 to make up for the lost federal share for children’s residential

treatment and expand the number of Psychiatric Residential Treatment Facility (PRTF) beds. The senate does not include this funding.

Certified Community Behavioral Health Clinics (CCBHCs): CCHBCs are one stop shops where people can receive integrated mental health, substance use disorder, and primary care treatment in the community. However, the federal funding for this very successful pilot project is set to expire in July 2019. The House bill allocates $4.699 million in FY 2020-2021 and $18.170 million in FY 2022-2023 to sustain and expand Minnesota’s CCHBCs.

Transitions to Community: The Transitions to Community program provides the additional resources and support to ensure that people with complicated mental health needs can successfully be diverted or step-down from a state operated program to living in the community. The House bill appropriates $2.379 million in FY 2020-2021 and $4.638 million in FY 2022-2023 for the Transitions to Community Program.

Provider Tax: The provide tax is the primary funding source for the Health Care Access Fund (HCAF). The HCAF is a major funding source for the MA expansion population, as well as other important programs including tobacco cessation. If the provider tax expires, Minnesota will face a major budget shortfall and be forced to cut human services or other parts of the state budget like education or public safety. The Senate bill allows the provider tax to sunset, while the House bill reinstates the provider tax. We strongly support the decision to continue the provider tax in the House bill

Conversion Therapy: The House bill includes language to ban the use of conversion therapy, or the fraudulent practice to "cure" someone who is LGBTQ.

MFIP Child-Only: The House bill allocates $400,000 in base funding to allow for parents of children under the age of 6 on MFIP child-only to receive up to 20 hours of childcare a week on the recommendation of a mental health professional.

MFIP: The Minnesota Family Investment Program (MFIP) is a state program to support low-income families with young children. Living in poverty negatively impacts children’s mental health. The House bill increases the MFIP cash grant by $100 a month.

PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a very challenging health condition that can lead to ADHD, sudden mood changes, Obsessive Compulsive Disorder, and other physical challenges like hyperactivity or unusual, jerky movements. The House bill appropriates $158,000 in FY 2020-2021 and $210,000 in FY 2022-2023 to provide coverage for children with PANDAS.

Network Adequacy Reviews: Minnesotans are far more likely to experience narrow networks when they are seeking mental health treatment. The House bill increases staffing at the MN Department of Health to better enforce network adequacy requirements and adds appointment wait times as another

measure for determining network adequacy. The House bill appropriates $616,000 in base funding for this project.

Culturally Competent MH Treatment: An individual’s beliefs, norms, values, and language can all impact how we perceive and experience mental health conditions. Communities of color and new immigrants can face additional barriers to accessing treatment such as confusion about mental illnesses and language barriers. Even when they can access mental health treatment, they often receive worse care due to the lack of cultural competence. The House bill allocates $1 million in one-time funding to increase access to culturally competent mental health care.

Psychiatry Residency: The legislature previously funded a residency program for primary care. While the legislation was intended to include child and adult psychiatrists – one the scarcest mental health professionals in Minnesota – a mistake in the legislation limited the program to three years when psychiatry residents require 4 years. The House language extends the length of the residency program from 3 to 4 years so that psychiatrists can benefit from the program. This change has no fiscal cost.

County Share of State-Operated Treatment: When a person civilly committed to state-operated treatment no longer meets criteria for treatment at the state-operated mental health programs, the counties are responsible for 100% of the cost of care if there are any delays in the patients discharge from the facility. The House bill includes policy language that creates a process for the counties to dispute these payments under certain circumstances, including if they were notified of the change over a weekend or holiday.

Step-Therapy: Step-therapy or “fail-first” protocols require a health plan enrollee to fail on cheaper prescription medications first, even if they have already had a positive outcome from another medication. Last year, the legislature created new consumer protections around the use of step-therapy protocols to limit access to life-changing and life-saving prescription medications. The House bill includes language that would extend these consumer protections to MA fee-for-service programs.

Uniform Standards: This simplifies and clarifies he mental health system. Included are new standards for crisis services.

NAMI supported provisions in the Senate

Permanent Supportive Housing: For people with serious mental illnesses to successfully transition from homelessness to a stable housing situation, they will often require the additional resources permanent supportive housing provides. The Senate bill allocates $2 million in one-time dollars for permanent supportive housing for adults with serious mental illnesses.

Yellow-Line Program: Too many people with mental illnesses end up in the criminal justice system because they do not receive appropriate mental health

treatment. The Yellow-Line program is a very successful program that diverts people charged with a nonviolent crime from the criminal justice system if they would be better served by mental health or substance use disorder treatment. The Senate appropriates $1 million one-time funding to sustain the Yellow-Line pilot project in Blue Earth county and expand to new areas of the state.

Shelter-Linked Mental Health: Many youth experiencing homelessness also have a mental illness. Using the very successful school-linked model, shelter-linked mental health allows for the co-location of a mental health professional at the youth homeless shelter. This will reduce the barriers for homeless youth to access the mental health services they need. The Senate bill allocates $500,000 in one-time funding for shelter linked mental health services.

Loan Forgiveness: We can’t build our mental health system without expanding our mental health workforce. The Senate bill allocates $354,000 in one-time funding for loan forgiveness for mental health professionals who will work in rural areas with a workforce shortage.

Pre and postpartum mood disorders: The Senate bill allocates $100,000 in one-time funding for grants to provide mental health treatment and services for women experiencing pre and post-partum mood disorders.

Specialized Supervision Project: Too many people with mental illnesses enter the criminal justice system because of the lack of coordinated care and community mental health resources. The Senate bill includes language for a pilot project in Anoka County to provide case management and other mental health supports for adult offenders on parole, supervised release, or pretrial status who are found to have a serious mental illness.

NAMI supported provisions in both bills

School-Linked Mental Health Grants: School-linked mental health grants support mental health professionals co-locating at schools where the students already are, greatly increasing access to mental health care. The Senate Education bill appropriates $5 million dollars in one-time funding for school-linked mental health grants. The Senate HHS omnibus includes $500,000 to use telemedicine for the delivery of school-linked mental health services. The House bill appropriates $9.384 million in FY 2020-2021 and $10.586 in FY 2022-2023. We appreciate the investment that both bills make, but prefer the increased base funding for school-linked mental health in the House bill.

Mental Health Parity: Mental health parity regulations require private health plans to cover mental health and substance use disorder services the way they would other health conditions like diabetes or heart disease. Both the House and Senate omnibus bills include language to grant the Department of Commerce the authority to access information from health plans regarding non-quantitative treatment limits (NQTLs) such as prior-authorization

requirements, claim denials, out of network care, and other information deemed appropriate by the Commissioner of Commerce. We strongly support increasing enforcement of mental health parity in both bills and prefer the language in the House bill.

Suicide Prevention: Minnesota’s suicide rate is increasing dramatically. In 2017, 783 Minnesotans died by suicide, which is twice the number as those who died by an opioid overdose. The Senate bill appropriates $2.642 million in one-time funding for a suicide prevention lifeline. The House bill includes $7.46 million in base funding for a comprehensive suicide prevention programs including the zero-suicide model, a suicide prevention lifeline, and an online suicide prevention training for teachers. The Senate funds the online training in the E-12 omnibus bill. We support the more comprehensive investment for suicide prevention in the House bill.

TEFRA: The Senate bill makes it easier to enroll in TEFRA through the MNsure portal. The bill also allocates $14.609 million in FY 2020-2021 and $21.013 million in FY 2022-2023 to decrease parental fees for TEFRA. The House bill makes it easier to enroll in TEFRA through the MNsure portal. The bill also allocates $2.501 million in FY 2020-2021 and $3.072 million in FY 2022-2023 to reduce parental fees for TEFRA. We support the language and funding in the Senate bill

MA Spenddown: People on Medical Assistance are required to spenddown to below the federal poverty level in order to be eligible. This can place a significant financial burden on people with disabilities. The Senate bill allocates $1.145 million in FY 2020-2021 and $48.879 in FY 2022-2023 to eventually eliminate the MA spenddown. The House bill allocates $0 in FY 2020-2021 and $3.478 million in FY 2022-2023 to reduce the MA spenddown. We support the language and funding in the Senate bill.

Mobile Crisis: Mobile crisis teams are a vital part of our mental health continuum that provides mental health services in the community to someone experiencing a mental health crisis. The Senate bill allocates $8.3 million dollars in one-time funding to fund mobile crisis teams across the state. This funding is available until June 30, 2023. The House includes $830,000 in base funding for mobile crisis teams in Southeastern Minnesota. We support the language and funding in the Senate bill

Competency Restoration Task Force: Like many other states, Minnesota has many more people being committed because they are found incompetent to stand trial. This is a very complicated issue with many moving parts – including the 48 hour rule – and Minnesota still does not have the information necessary to resolve this challenge in a comprehensive manner. Both the House and Senate appropriate $136,000 in one-time funding to create a competency restoration task force. While both bills are very similar, NAMI Minnesota prefers the more recent House language which reflects the requirements to receive support from the Council of State Government.

Tobacco Cessation: People with mental illnesses smoke at very high rates and

can face additional challenges attempting to stop their tobacco use. Unfortunately, the funding stream for most of Minnesota’s tobacco prevention services are set to expire as soon as 2020. Both the House and Senate allocate $4.346 million in FY 2020-2021 and $5.756 million in FY 2022-2023.

Room and Board: Both bills contain language to streamline room and board costs for residential programs.

Language NAMI opposes

Waiver Limits: The Senate bill sets a cap on the number of people who would be eligible for Medical Assistance Waivers and requires someone to leave the program before another person with a disability who qualifies for an MA waiver could enter the program. This will be particularly challenging for people with mental illnesses because anyone who is hospitalized or receives residential treatment for 30 days or more loses their MA waiver. People with mental illnesses already face additional hurdles to qualify for a MA waiver, so adding a cap will make this process even more challenging to navigate. While this may decrease what Minnesota spends on MA waivers, the needs of people with mental illnesses will not disappear because of this policy change. Should this pass, NAMI Minnesota expects that people with mental illnesses will be hospitalized at higher rates and will be at an increased risk of entering the criminal justice system.

PCA Eligibility: The Senate bill makes the eligibility requirements more restrictive by requiring that someone need help with at least one critical Activity of Daily Living (ADL) - eating, transfers, mobility, and toileting - or have a behavior that shows increased vulnerability due to cognitive deficits or socially inappropriate behavior that requires assistance at least four times per week. NAMI Minnesota appreciates that the PCA program is under a tremendous amount of pressure, but these changes will make it even more challenging for people with mental illnesses to qualify for PCA support.

MA Coverage for Dental and Vision: The Senate bill removes dental and vision coverage from the MA benefit set for people on MA expansion. This change will not impact those on MA due to disability. NAMI Minnesota opposes these changes because of the importance of receiving preventative dental and vision care. This is particularly important for people with mental illnesses because many medications have dry mouth as a side-effect, which leads to higher cavity rates. Without this coverage, we can expect an increase in emergency room visits to receive dental care.

Education

Chair Davnie from Minneapolis - 651-296-0173 Chair Youakim from Hopkins - 651-296-5496 Rep. Pinto from St. Paul - 651-296-4199 Rep. Sandstede from Hibbing - 651-296-0172 Rep. Urdahl from Grove City - 651-296-4344 Chair Nelson from Rochester - 651-296-4848 Sen. Weber from Luverne - 651-296-5070 Sen. Eichorn from Grand Rapids - 651-296-7079 Sen. Jasinski from Faribault - 651-296-0284 Sen. Wiger from Maplewood - 651-296-6820

NAMI supported provision in the House

Intermediate School Districts: The House appropriates $5.4 million to have mental health professionals in the classroom at Intermediate School Districts, special education cooperatives and level 4 programs. The Senate funding for school-linked dollars can also be used for these programs, but the appropriation is not large enough to accommodate so many eligible uses.

Nonexclusionary Disciplinary Policies: Students of color and students with mental illnesses are much more likely to be suspended or expelled. NAMI supports the house language to develop alternatives to suspension and expulsion to reduce these disparities and address the underlying issues leading to suspensions.

Paraprofessional Training Aid: We support the House language to ensure that paraprofessionals have adequate training on an annual basis and the appropriate time to review a student’s IEP before they begin working alone with that student.

Trauma-Informed Schools: We support the $6 million investment the House makes to provide trauma-informed support for their students and to promote restorative practices and non-exclusionary disciplinary policies.

Special Education: The House makes a significant increase in special education funding. Countless Minnesota students with mental illnesses receive their education through special education services, but the financial pressure is significant for Minnesota public schools. NAMI Minnesota supports the robust funding increase made by the House to address the local districts share of special education expenses.

NAMI supported provisions in the Senate

School-linked mental health: the Senate appropriation for school-linked is in the Education bill. We prefer the greater investment in the House HHS bill and

would request that the policy language be moved to the HHS bill. Suicide Prevention: The Senate bill appropriates $480,000 for an online,

evidence-based suicide prevention training for teachers and other school staff to recognize the signs of a mental health crisis and know when to refer a student to a mental health professional. The House funds a similar program in the HHS omnibus bill. We hope that this suicide prevention training continues to move forward this session.

NAMI supported provisions in both bills

Safe Schools Revenue: The House allows for the use the revenue to support restorative justice, social and emotional learning, and other evidence-based practices and the Senate language to allow schools to use these resources to provide school-linked mental health services via telemedicine. We are in support of all of these being included.

Mental Health Education: Giving every school district access to age-appropriate mental health curriculum for grades 4-12, including material on suicide prevention, will make sure every school has the resources to educate their students about what mental illnesses are and when they need to reach out for help. This provision has no fiscal impact and does not make an unfunded mandate on school districts. NAMI appreciates that both the House and Senate included language in their omnibus bills but we prefer the Senate language.

Language NAMI has concerns with

Special Education Legislative Workgroup: NAMI Minnesota has concerns with the special-education work group in the House language. Much of this work has already been done. NAMI is also opposed to language requiring schools to review the medications a child is on to manage a mental illness. Schools do not prescribe medications and therefore do not have the authority to review any of the medications that a student has been prescribed. This provision would violate HIPAA and we would ask that it be removed.

Judiciary and Public Safety

Chair Mariani from St. Paul - 651-296-9714 Chair Lesch from St. Paul - 651-296-3305 Rep. Moller from Shoreview - 651-296-0141

Rep. Pinto from St. Paul - 651-296-4199 Rep. Zerwas from Elk River - 651-296-4237 Chair Limmer from Maple Grove - 651-296-2159 Sen. Bruce Anderson from Buffalo Township - 651-296-5981 Sen. Johnson from East Grand Forks - 651-296-5782 Sen. Lang from Olivia - 651-296-4918 Sen. Latz from St. Louis Park - 651-297-8065

NAMI supported provisions in the House bill

Corrections Ombudsperson: NAMI Minnesota also strongly supports the House language to reinstate the Corrections Ombudsperson, which will serve as a neutral arbiter to resolve disputes or complaints from prisons and jails. Minnesota has been without a Corrections Ombudsperson since the program was eliminated in 2003. This has left a major gap in our corrections system with many people feeling as if their voice is not being heard. Restarting the Corrections Ombudsperson will increase prison safety and ensure that there is independent oversight of Minnesota prisons and jails.

Solitary Confinement: The house bill includes NAMI supported language to increase transparency and create some new protections around the use of restrictive housing or solitary confinement. This is a bipartisan proposal with the support of the Department of Corrections. The house language authorizes the use of restrictive housing in statute, creates a continuum of disciplinary infractions and ensures that solitary confinement is only used for the most severe or persistent violations, requires that everyone placed in solitary confinement receives a mental health screening, and requires the Department of Corrections to provide a report to the legislature on the use of solitary confinement. NAMI Minnesota has worked on this policy for years and we hope it will finally be accepted this session.

Corrections Officer Staffing Increase: NAMI Minnesota strongly supports the House language to increase the number of corrections officers in our prison system. This investment will increase the safety in our prisons for both staff and inmates, while also providing greater opportunities for prison inmates to participate in programming and other rehabilitative activities. The targeted increase in behavioral health staff to support people in restrictive housing or solitary confinement is another welcome investment that NAMI supports. We hope that both staffing increases will be accepted in the conference committee.

Alternatives to Incarceration: We support the House language that expands the data that is reported for the alternatives to incarceration program and funding to expand access to community treatment options under the alternative to incarceration program.

Specialized Mental Health Community Supervision: We support the House

language to start a pilot project in two counties without a mental health court to provide coordinated supports for people with mental illnesses on probation, parole, supervised release, or pretrial status.

Juvenile Justice: The House language includes many impactful changes for juvenile justice including preventing unnecessary shackling in a courtroom, grant funding for JDAI, developing alternatives to arrest for certain juvenile offenders, and the creation of a risk assessment tool to determine if a child should be released from preadjudication detention. NAMI supports this language and hope it is adopted in conference committee.

Guardian Ad-Litem: NAMI supports the House language to increase funding for Guardian Ad-Litems. These individuals play an essential role in the Judicial System to ensure that the child’s best interests are taken into account in the legal process.

Public defenders: We support the House language to increase funding for public defenders, which have been consistently underfunded in Minnesota.

Police training: We appreciate that both the House and the Senate allocate funding for police training. Crisis Intervention Training and de-escalation techniques allow for police officers to have productive and non-confrontational encounters with people with mental illnesses. NAMI prefers the larger House investment for this important program.

Cannabis Task Force: Given the link between marijuana use and psychosis, NAMI Minnesota supports decriminalizing marijuana possession but has significant concerns with the legalization of marijuana. We request that the Cannabis task force language include a psychiatrist on the task force. The psychiatrists have done important work on the impact of marijuana use and their perspective should be heard on the task force.

Data Sharing in Jails: We support the House language to allow for sharing a positive mental health screening with the county. This will help people with mental illnesses leaving the jail to get connected with resources and mental health services.

Agriculture Department, Rural Development, and Housing Finance

Chair Poppe from Austin - 651-296-9552 Chair Hausman from St. Paul - 651-296-3824 Chair Pelowski from Winona - 651-296-1924 Rep. Vang from Brooklyn Center - 651-296-3709 Rep. Gunther from Fairmont - 651-296-3240 Chair Westrom from Elbow Lake - 651-296-3826 Chair Weber from Luverne - 651-296-5650 Sen. Goggin from Red Wing - 651-296-5612 Sen. Draheim from Madison Lake - 651-296-1279

Sen. Dziedzic from Minneapolis - 651-296-7809

NAMI supported provisions in the House

Bridges Housing Voucher: The House bill increases funding for the Bridges Housing voucher by $2 million over the biennium. This is a voucher for adults with a serious mental illness who are on a wait list to receive a section 8 rental voucher.

Jobs

Chair Mahoney from St. Paul - 651-296-4277 Chair Wagenius from Minneapolis - 651-296-4200 Rep. Stephenson from Coon Rapids - 651-296-5513 Rep. Long from Minneapolis - 651-296-5375 Rep. Hassan from Minneapolis - 651-296-0294 Chair Pratt from Prior Lake - 651-296-5245 Chair Dahms from Redwood Falls - 651-296-8138 Chair Osmek from Mound - 651-296-1282 Chair Housely from St. Marys Point -651-296-4351 Sen. Simonson from Duluth - 651-296-4188

NAMI supported provision in the House

DEED Study: The House appropriates $100,000 for a study by the Department of Employment and Economic Development (DEED) to determine what barriers people with mental illnesses face when seeking a job, as ways that DEED can better serve people with mental illnesses.

NAMI supported provisions in the Senate

IPS: Makes a one-time $2 million increase for Individual Placements and Supports (IPS). This evidence-based program is the most effective resource we have to help people with serious mental illnesses find work. There are currently 23 IPS programs, leaving 39 Minnesota counties without access to this effective program.

NAMI supported provisions in both bills

Vocational Rehabilitation Services: NAMI appreciates that both bills increase the funding for Vocational Rehabilitation services. While it is not always easy for people with mental illnesses to enroll in this program due to the inability to accept new people into the program, Vocational Rehabilitation services are a vital support for people with disabilities to accomplish their employment goals.

Higher Education

Chair Bernardy from New Brighton - 651-296-7189 Rep. Pryor from Minnetonka - 651-296-3964 Rep. Lien from Moorhead - 651-296-5515 Rep. Klevorn from Plymouth - 651-296-5496 Rep. Nornes from Fergus Falls - 651-296-8871 Chair Paul Anderson from Plymouth - 651-296-9261 Sen. Draheim from Madison Lake - 651-296-1279 Sen. Jensen from Chaska - 651-296-4837 Sen. Relph from St. Cloud - 651-296-5713 Sen. Clausen from Apple Valley - 651-296-4120

NAMI supported provisions in both bills

College-Linked Mental Health: Both bills include funding for mental health professionals to co-locate and provide mental health services for students at community colleges. This program is modeled off the very successful school-linked mental service.

Opioid Bill: NAMI had been strongly advocating for funding for Native American Healers. We had been told that it would be included in the Opioid bill of the HHS bill but it wasn't. Please let Sen. Rosen and Rep Olson know that it should be included.

Thank you for contacting your legislator if they are on a conference committee. All you have to do is identify yourself as a NAMI member, briefly share your personal story, and then encourage them to include the NAMI supported legislation we have briefly outlined.

Majority Leader Gazelka, Speaker Hortman, and Governor Walz have still not reached a final agreement on budget targets for the year, or the amount of money that the state will spend across the different areas in state government. We need to keep the pressure on leadership to ensure that a compromise is reached with a meaningful

investment in mental health services.

Call Now!It is vitally important for every NAMI member to contact Speaker Hortman and Majority leader Gazelka to encourage them to increase funding for the mental health system and to adopt a strong spending target for Health and Human Services. Here is their contact info:

Speaker Hortman - 651-296-4280 Majority Leader Gazelka - 651-296-4875

When you call these legislators, be sure and mention that you are a NAMI member!

Find out who represents you

Click here

News from the State Level

St. Cloud Doing Innovative Work in Criminal Justice

Stearns County, CentraCare, local law enforcment, Central MN Community Mental Health Center and the St. Cloud VA have all partnered to provide coordinated treatment and diversion for people with mental illnesses who are cycling repeatedly through emergency rooms, jails, and other parts of the criminal justice system. Together, this group meets once a week to share information and consider whether someone currently in a local county jail would benefit from a mental health intervention. Once this person is discharged, they can receive mental health care at a local clinic. While this program is still relatively new, the early returns are quite exciting and point towards a way to ensure that people with mental illnesses are connected with the resources they need. To learn more about this exciting program, you can read this article from MPR.

Conversion Therapy Legislation Still in Play

NAMI Minnesota has partnered with OutFront Minnesota and many other organizations to ban conversion therapy, or the cruel practice of trying to "cure" someone who is LGBTQ. Being gay is not a mental illness and the research clearly

indicates that conversion therapy is both ineffective and harmful. This NAMI supported legislation was included in the House Health and Human Services omnibus bill, but was not added to the Senate bill despite a long and passionate floor debate. The Star Tribune published a very powerful article on the effort to ban conversion therapy and the personal dimensions for many legislators. To learn more, you can read the full article here.

MN Legislative Actions

Conference CommitteeThe Public Safety Conference Committee began by hearing the testimony of Commissioner Schnell. The Commissioner began by noting the significant needs for his department that are reflected in the Governor's budget and the House bill. Without these major investments, Commissioner Schnell argued that the legislature would be compromising the safety of our prison system. Key items in the House bill that Commissioner Schnell supported also included restarting the corrections ombudsperson, instituting solitary confinement reforms, and meeting the healthcare needs of prison inmates.

Rep. Zerwas was given the opportunity to walk through his legislation on solitary confinement reforms. During his walk-through, Rep. Zerwas emphasized the need for additional transparency, as well as new protections to ensure that solitary confinement is reserved for only the most significant or persistent disciplinary violations. Rep. Zerwas concluded by noting that he has worked on this issue for three years and it was time to get something done. When asked about the Departments position on this NAMI legislation, Commissioner Schnell responded that this policy is critically important for the Department.

During a discussion of the ombudsperson for corrections, Rep. Mariani discussed a recent trip he took to a prison where he learned that the ombudsman functioned on behalf of both the guards and inmates. Commissioner Schnell echoed this observation and suggested that the ombudsperson for corrections serves the broadest interests of both inmates and staff and will lead to meaningful change in the prison system. Other items that were discussed in the walk-through included the need to increase funding for the public defender program, the importance of diversion programs to keep people with mental illnesses out of the criminal justice system, and important work to better serve youth who have entered the juvenile justice system.

The Health and Human Services committee met throughout the week as they walked through both the House and Senate omnibus bills. On Thursday during a walkthrough on the Disability articles, Assistant Commissioner Wilson testified about the concerns the Department of Human Services (DHS) has with the hard caps on the number of Home and Community Based Services (HCBS) waivers, including the CADI waiver that supports people with mental illnesses to live in the community. Assistant Commissioner Wilson noted that the caps supported by Sen. Abeler would not ease the workforce shortage, but it would place additional pressure on other, more expensive parts of the healthcare system. Assistant Commissioner Wilson also observed that DHS was mostly in alignment with the Senate work on MNchoices, but the department has concerns making the assessment optional.

The Health and Human Services conference committee met again on Friday morning and walked through the mental health articles in both bills. This was a very high level discussion about the investments both bills make in our mental health system. The conference committee work will become more meaningful as soon as Leadership can reach a compromise on budget targets.

News from Federal Level

Congress Introduces New Opioid Bill

Congress has just moved forward with a new bill that would invest $100 million over the next decade to respond to the opioid epidemic. The Comprehensive Addiction Resources Emergency (CARE) act focuses on recovery residences, new grant programs to help people with substance use disorder obtain employment, and incentives for states to strengthen addiction programs in their MA benefit set. Here are the key pieces:

Targeted grants to states, territories, tribal governments, counties, and cities with those most impacted by overdoses receiving extra support to carry out tailored responses and activities.

Research, public health surveillance, and training to support health professionals providing treatment for substance use disorders.

Expanded access to treatment via investments in innovative service delivery, programs to expand provider capacity, and supports for workers with or at risk for substance use disorders to maintain and gain employment.

Expanded access to overdose reversal drugs by providing Naloxone to first

responders, public health departments, and the public.

This is a welcome investment that will improve our substance use disorder treatment services. (National Council)

Trump Administration Releases More Information on Drug Control Strategy

The Office of National Drug Control Policy (ONDCP) is the part of the Trump Administration responsible for leading the national response to substance use disorder issues including the opioid epidemic. Last week, the ONDCP released their overarching goals for the work they will do over the next 5 years:

Reducing the number of drug overdose deaths by 15 percent within 5 years. Educating the public about drug use, with an emphasis on reducing illicit drug

use among youth Increasing access to evidence-based addiction treatment, including

medication-assisted treatment, which is largely considered the gold standard for addiction treatment when used in concert with counseling.

Increasing mandatory prescriber education and continuing training on best practices and current clinical guidelines.

Reducing nationwide opioid prescriptions by increasing education on and adherence to prescribing practices for pain management.

Increasing Prescription Drug Monitoring Program (PDMP) usage across the country, and working to allow PDMPs to better communicate with one another.

Reducing the availability of illicit drugs in the country by preventing their production in Colombia and Mexico specifically, by disrupting their supply chains on the internet, through the mail, and across borders, and by increasing their price and decreasing purity.

While it is reassuring to see the Trump Administration continue to focus on the opioid epidemic, these goals still lack detail and may not be aggressive enough to meaningfully respond to the opioid epidemic. (National Council)

Bill Introductions

Senate

SF 2866 (Abeler): Replaces the provider tax with a fee on Hospitals and HMOs as a funding source for the Health Care Access Fund. Referred to Health and Human Services Finance and Policy. While we appreciate the effort to find an alternative funding source for the Health Care Access Fund, NAMI Minnesota has concerns that this tax will not raise enough money and is at risk of a legal challenge. NAMI Minnesota supports reinstating the provider tax.

HouseNo relevant bills were introduced in the House this week.

Updates from NAMI Minnesota

NAMI Legislative CommitteeMeetings are generally held on the second Tuesday of every month at 6 PM at the NAMI Minnesota office. The May meeting is cancelled due to the unpredictability of the last week of session. You can also join by phone. To be added to the email list, contact Sam Smith.

Due to hectic schedule at the end of the Legislative Session, next week's legislative committee meeting is cancelled.

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