the national association of county behavioral health and developmental disability directors nacbhdd

1. The National Association of County Behavioral Health and Developmental Disability DirectorsNACBHDD Federal Update Maeghan Gilmore, MPH Director of Government Affairs and Public Policy

2. Current authorization - $50 million Appropriated $5 million the last two years FY 2008 � appropriated $10 million Popular with Congress � reauthorization is scheduled for next year Proposed authorization - $75 million FY 2008 � both chambers appropriated $10 million Reauthorization is scheduled for next year, however both chambers would like to do that work this year.FY 2008 � both chambers appropriated $10 million Reauthorization is scheduled for next year, however both chambers would like to do that work this year.

3. Mental health and addiction Parity Senate � Mental Health Parity Act of 2007 (S. 558) House - The Paul Wellstone Mental Health and Addictions Parity Act of 2007 (H.R. 1424)

4. Mental health and addictions Parity House bill (H.R. 1424) Marked up and moved from the Education and Labor Committee Needs to be marked up and moved out of the Energy and Commerce and Ways and Means Committees Senate bill (S. 558) Manager�s amendment �hot-lined� with a hold Advocacy working to get this moving. Those committees have had other issues on their schedule.Advocacy working to get this moving. Those committees have had other issues on their schedule.

5. Veterans Issues A lot of focus in Washington, DC on returning veterans� mental health and addiction issues Veterans� Mental Health Outreach & Access Act of 2007 (S. 38 H.R. 2689) Readjustment and mental health services Contracts with Community Mental Health Centers and other qualified entities for provision of services

6. Children�s State Insurance Program (CHIP) Both the House and Senate passed their respective bills prior to the August recess Costs/addresses other entitlements No word on conferencing of these bills Veto threat Deadline - September 30, 2007 Could see a continuing resolution. Funding would remain the same and issues would not be addressed including parity in this program.Could see a continuing resolution. Funding would remain the same and issues would not be addressed including parity in this program.

7. CHIP continued Senate 45 cent tobacco tax increase Addresses mental health parity No moratorium language regarding the Medicaid Rehabilitation Option

8. CHIP continued House 61 cent tobacco tax increase and savings from Medicare Advantage Plans Mental Health parity Includes language of a one year moratorium regarding the Rehab. Option Addresses Medicare mental health parity Codifies protections for 6 classifications, which include anticonvulsants and anti-depressants of drugs in Medicare Part D Also takes away cost sharing for individuals living in the community, under home and community based waivers, enrolled in Medicare Part D Bullet 6 had only previously addressed those who lived in institutions - Language was included to eliminate Medicare Part D cost-sharing for dual-eligible (Medicare and Medicaid) individuals who reside in community-based settings.� Currently, co-pays do not apply to individuals in nursing homes and institutional settings, creating an institutional bias.�Bullet 6 had only previously addressed those who lived in institutions - Language was included to eliminate Medicare Part D cost-sharing for dual-eligible (Medicare and Medicaid) individuals who reside in community-based settings.� Currently, co-pays do not apply to individuals in nursing homes and institutional settings, creating an institutional bias.�

9. Medicaid Rehabilitation Option Notice of Proposed Rule Making (NPRM) published in the Federal Register on August 13, 2007. Areas of concern Advocacy activity

10. Rehab. Option � areas of concern Intrinsic Element Standard Maintenance of functioning Habilitation services �bundling� of services (case/day rates) Positive elements of the proposed rule

11. Rehab Option Comments due to CMS by October 12, 2007. Working with members to develop comments Working with other organizations and Congress to include a one year moratorium What are the options after a veto?What are the options after a veto?

12. Fiscal Year (FY) 2008 Appropriations House and Senate need to complete work Veto threats for many spending bills Congress restored many of the Administration�s proposed cuts Outlook Stop gap spending bills (Continuing resolutions) Omnibus bill Combination of both

13. Thank You! Maeghan Gilmore 202-661-8816 mgilmore@nacbhd.org