Letter to Mitch McConnell, Senate Majority Leader; Chuck Schumer, Senate Minority Leader; Nancy Pelosi, House Speaker; and Kevin McCarthy, House Minority Leader - In Bipartisan Letter, Lawmakers Seek Emergency Funding for Behavioral Health Organizations in Next Coronavirus Stimulus Package

Letter

Dear Majority Leader McConnell, Minority Leader Schumer, Speaker Pelosi, and Minority
Leader McCarthy:

As you negotiate the next stimulus package to mitigate the health and economic effects of the
coronavirus disease 2019 (COVID-19) pandemic, we request that you provide emergency
funding to mental health disorder and addiction treatment providers across the country. Many
organizations that primarily treat individuals with mental health and/or substance use disorders
(collectively, behavioral health organizations or "BHOs") are at risk of closing their doors as a
result of the COVID-19 pandemic. The immediate and long-term effects of this cannot be
overstated as millions of Americans rely on BHOs to address their mental health and substance
use disorder treatment needs. As such, we request that you provide at least $38.5 billion in
emergency funding to BHOs across the country that utilize evidence-based practices, with a
significant portion of these emergency funds set aside for BHOs enrolled in Medicaid and
provide care to underserved groups, or those who otherwise lack coverage for needed behavioral
and mental health care.

Millions of individuals, children, and families across the country struggle with mental illness or
addiction each and every day. According to the 2018 National Survey on Drug Use and Health,
nearly 1 in 5 adults, over 47 million people, reported struggling with mental illness, and over 10
million reported suicidal thoughts. These numbers are particularly concerning among the
nation's youth. 1 in 7 youth aged 12 to 17, or 3.5 million adolescents, reported experiencing a
major depressive episode in 2018, and record numbers of adolescents have attempted or considered suicide in recent years. In addition to age disparities, it has been found that people of
color, people from lower socioeconomic backgrounds, and people living in rural communities
are less likely to have access to mental health care and more likely to receive lower quality care.
Further, over 20 million Americans are living with substance use disorder, including 2 million
who have opioid use disorder.

The numbers of Americans struggling with mental illness will only continue to grow as families
and individuals face the emotional and economic repercussions of the pandemic. A recent poll
found that the pandemic and its resultant social and economic impacts are already taking a heavy
toll on Americans' mental health. 45 percent of respondents reported that the pandemic is
negatively affecting their mental health, up from 32 percent just a month prior. Experts have
even suggested that long-term social distancing from friends, loved ones, and a departure from
routine may have both short- and long-term psychological effects. This, compounded with
increasing financial strain and underlying disparities in mental health care access and quality of
care, could have dire consequences. Anecdotal reports have indicated that rates of consumption
of alcohol and other addictive substances are on the rise. Furthermore, social distancing
measures have created barriers to accessing treatment, which has only been exacerbated by a
scarcity of available providers as they either fall ill or become overloaded with patients.

BHOs are crucial to the provision of behavioral health care to Americans across the country who
rely on them for a variety of services, but are being burdened by the pandemic. BHOs may
provide counseling services to individuals, families, and children struggling with depression,
Post-Traumatic Stress Disorder, and countless other mental illnesses. Additionally, licensed
practitioners at BHOs may provide lifesaving medication assisted treatment to individuals with
opioid and other substance use disorders. Without this medical treatment, patients in recovery are at higher risk for relapse, overdose, or overdose related death. These services will become all
the more important as COVID-19 continues to spread and the need for mental health disorder
and addiction treatment services grows. However, because of the health and economic impacts of
the pandemic and the growing number of patients, many BHOs are at risk of closing their doors.
Some BHOs have projected nearly $40 billion in lost revenue as a direct result of increased staff
overtime to meet patient need, increased need for PPE, and the implementation of telehealth
services.10 The impact of such a shortfall would be significant, particularly as the COVID-19
pandemic continues to disrupt the lives of all Americans.

BHOs have not been sufficiently included in response efforts to date. Congress has passed four
stimulus packages to bolster the nation's response to COVID-19. However, none have addressed
the growing challenge to and need for BHOs. With a growing number of Americans in need of
behavioral health services and many BHOs at risk of closing, the nation is headed towards
another public health crisis. To avert another large-scale public health crisis, we must pass a
stimulus package that prioritizes the financial security of these vital health care providers and the
health of millions of Americans. As such, we respectfully request that at least $38.5 billion in
emergency aid is provided to BHOs that can meet at least one of the following three criteria:
accredited by an independent, national accrediting organization or receive state or tribal funding
or qualify as community mental health centers as defined in Section 1913(c) of the Public Health
Service Act. This will allow these critical mental health and addiction treatment providers to keep
their doors open and continue providing crucial treatment to Americans during these trying
times. We are also supportive of efforts, led by our colleagues, to boost critical funding at the
Department of Health and Human Services for mental and behavioral health initiatives, including
the Community Mental Health Services Block Grant, the National Child Traumatic Stress
Network, and other Centers for Disease Control and Prevention, Substance Abuse and Mental
Health Services Administration (SAMHSA), Indian Health Service (IHS), and Health Resources
and Services Administration programs, as well as specific programs that support the mental and
behavioral health of American Indian and Alaska Native populations like the SAMHSA Tribal
Behavioral Health Grants, and funding for the Mental Health and Alcohol & Substance Abuse
line items in the IHS budget.

We thank you for your attention to this matter and look forward to working together to ensure
that any economic stimulus package provides much needed relief for our nation's BHOs.