NAMI Minnesota Legislative Update

May 17, 2020

Legislative Session Ends in Hours

The 2020 legislative session is almost over and all official business must be completed by midnight on Sunday (tonight), though they will continue to meet on Monday where they will hear speeches of members who are retiring. Although it is very likely that the legislature will return for a special session, there is still a lot of work that needs to be done yet tonight. This includes passing omnibus health and human services policy bills, an education policy bill, appropriating funding for emergency rental assistance, and hopefully negotiating a bonding bill with resources for the development and preservation of affordable housing.

On Monday, the Human Services Policy Bill, SF 3322, from Senator Abeler was passed by the Senate. The bill included important NAMI priorities:

Civil Commitment: NAMI Minnesota and a number of key stakeholders have worked for three years to comprehensively re-write of the civil commitment chapter in state law. Key changes include updating outdated language, allowing all mental health professionals to initiate a 72-Hour hold, creating a new engagement service to help people with serious mental illnesses seek treatment voluntarily and avoid civil commitment, ensuring that a commitment won't end due to lost paperwork, and numerous technical changes. This legislation DOES NOT change the standard for civil commitment.

Youth ACT: NAMI Minnesota legislation that allows for children's crisis teams to provide supports in hospital emergency rooms and urgent care settings, which adult crisis teams are currently able to do. There are also policy changes to Youth Assertive Community Treatment (ACT) Teams such as allowing a family peer specialist to be part of the treatment team.

Psychiatric Residential Treatment Facilities (PRTFs): NAMI supported policy changes on PRTFs. Key changes include no longer having the state medical review agent determine whether treatment at a PRTF is medically necessary but use utilization review instead.

Fetal Alcohol Spectrum Disorder (FASD): Requires a child entering the foster care system to receive a FASD screening.

Foster Care: Requires a foster care provider to contact the foster child's biological family if it is in the best interest of the child as soon as possible but no later than 72 hours.

Crisis Teams: Allows children's mental health crisis teams to provide care in the ERs, like adult teams do.

Families First: Makes policy changes in order to implement new requirements from the Federal Families First Legislation. NAMI Minnesota opposed an earlier version of this language that would require a relative search in order for a child to voluntarily receive residential mental health treatment. This provisions were removed and NAMI Minnesota no longer opposes these sections of the bill.

It also gives DHS the ability to keep their emergency authority for 60 days after the peacetime emergency ends, which would address the three visit limit and use of HIPAA compliant equipment for telemedicine. There is a small provision limiting access to knives and other items in state operated group homes for people with mental illnesses that are provisionally discharged from the MN Security Hospital. DBT will also be paid for under Medical Assistance for teens. The bill is scheduled to be voted on by the House tonight.

NAMI Minnesota would like to briefly thank Sen. Abeler for his very heartfelt apology for using the word suicide inappropriately during a passionate floor debate. We know Sen. Abeler to be a friend of the mental health community and recognize that it was not his intention to upset anyone with his comments.

On Saturday, the house held a floor vote on their bonding bill. The House bonding bill included around $1 million for a regional crisis facility in St. Louis County. The bonding bill was not able to secure bipartisan support and so it did not reach the 3/5 majority necessary for passage. It needed just six more votes. Their bonding bill included $214 in Housing Infrastructure bonds and the rest in GO bonds for refurbishing public housing. The House also moved Rep. Hausman's bill which has housing bonds to the general register just in case the Senate goes forward with their independent housing bill.

The Senate released their initial bonding bill on Saturday at the Capital Investment Committee. The Senate bonding bill includes $12 million for Regional Behavioral Health Crisis Facilities grants. NAMI worked out language last year to ensure that these facilities will connect people to actual mental health treatment and not become central receiving centers, which are most often a new revolving door in the criminal justice system. Senator Senjem mentioned that housing dollars would be included in a different bill. Senator Marty spoke on the Senate floor about the importance of housing in helping people reach recovery and spoke about the coalition Home4All of which NAMI is a member. He said we are in a housing crisis and the bill needs to have more money for housing.

NAMI Minnesota is very disappointed that the bonding bill included almost nothing

for affordable housing. There were zero dollars for housing infrastructure bonds and only $2 million in general obligation bonds to refurbish public housing units. This is extremely disappointing and comes nowhere near an acceptable bonding investment in affordable housing. We have heard that a separate bill will be released in the Senate which will link housing infrastructure bonding to policy loosening regulations for the construction of housing.

The other health and human services policy bill passed the House last night and will be taken up tonight in the Senate. Key provisions include:

authorize pharmacists to prescribe self-administered nicotine replacement medications, and opiate antagonists used for overdoses;

require health care providers to give patients their own health information and records within 30 days of a written request;

allow pharmacists to change patients’ medications to a therapeutically equivalent drug, should the prescribed medication be unavailable due to a shortage caused by the COVID-19 pandemic.

The House was discussing its education bill as we sent this out. The bill does include NAMI Minnesota legislation that requires all teachers to have training in student mental health. Currently only Tier 3 and Tier 4 licensed teachers are required to have this training.

The House passed a $22 million dollar public safety omnibus bill, HF 3156, largely on party lines. The largest portion of the appropriations would go the Department of Corrections to address overtime and staffing issues as well as bolster community services for people on probation and parole. These provisions include funding for cognitive behavioral therapy, sex offender treatment, and increased housing alternatives. The bill also includes policies to respond to COVID-19 like granting the Commissioner of Corrections emergency powers to release people with non-violent convictions and less than six months left on their prison sentence. Another provision would extend beyond the pandemic and would give the Commissioner of Corrections more freedom to use single bunk cells for residents in prisons when possible instead of double bunking. You can read more details of the omnibus bill here. There is no companion in the Senate so the bill will likely not go anywhere.

An amendment was adopted from Rep. Munson to allow examinations and special considerations for people with traumatic brain injuries, a history of stroke, or fetal alcohol spectrum disorder before they are sentenced for a crime. This amendment has problematic language as it would require costly examinations after people have been sentenced when a mechanism already exists to catch people with mental impairments before and during a criminal trial. However, the amendment did spark discussions about criminal justice and mental illness on the House floor. It’s important

to note that traumatic brain injury and mental illnesses are not the same thing though they may overlap in some individuals.

Rep. Mariani pointed out the need to address overrepresentation in the justice system and the inability of jails and prisons to adequately treat people with mental illnesses. He also mentioned legislation that was not included in the omnibus bill that would have created a planning group to decriminalize mental illness. NAMI Minnesota will continue to advocate for direct and meaningful changes to divert people from the justice system and we look forward to working at the legislature next year to that end.

SF 3258 was passed off the House floor Sunday and will go to the governor. This is a consensus public safety policy bill and would provide free menstrual hygiene products for people in prison among other non-controversial policy. Several House members including Chair Mariani, the chief author of the bill, expressed disappointment in legislation that was absent from the omnibus bill. While some points were made on partisan lines, there were several bipartisan public safety policies that failed to move in the Senate. The Senate Judiciary and Public Safety Finance and Policy Committee has been noted several times in the last week for inaction during the pandemic. When SF 3258 was passed off the Senate floor on Thursday, Sen. Bigham noted her disappointment that bipartisan legislation, SF 4318 /HF 4304, had died in the Senate Public Safety Committee that would have protected information gathered during counseling sessions for first responders. This is important for law enforcement officers who fear that seeking counseling for trauma may threaten their career or be used against them in an investigation. This bill was heard in the House Public Safety Committee in April; however, the Senate Public Safety Committee has not met since March.

The House passed its Agriculture bill and it included an increase of $40,000 for additional community outreach on farms and rural mental health services including the 24-hour hotline, service availability and mental health forums.

On Wednesday, the House passed SF 3357, an omnibus judiciary civil policy bill. The bill lessens restrictions and makes a number of changes to guardianship and conservatorship laws. These laws govern when a court gives legal authority to a person to make personal decisions for another individual who cannot provide for their own basic needs. The bill changes the term “ward” to “protected person” in statute, updates the Bill of Rights for Protected Persons, and requires courts to consider the least restrictive means of assisting a protected person. Other provisions allow a person under guardianship to control their wages and requires notice to family members when a person under guardianship has a significant medical change. Provisions for legal guardians are also included such as allowing them to seek restraining orders on a protected person’s behalf and allowing professional guardians to delegate authority for short periods with court permission. The bill is now with the Governor to be signed.

Thank you to all the NAMI advocates who contacted their legislators asking for the

passage of a bonding bill with a significant investment in affordable housing.

NAMI will provide a comprehensive break-down of what was passed in next week's edition of the legislative update.

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News from the State Level

Shelter In Place Executive Order Expires

Governor Walz has extended the public health emergency through June 12, this extends the eviction moratorium as well as the emergency waivers made by DHS and other state agencies. However, Governor Walz chose not to extend the shelter in place executive order, albeit with some restrictions on the types of gatherings and businesses that can open during the public health emergency. Bars, Restaurants, and Religious gatherings with more than ten people are still closed. Furthermore, at-risk populations are strongly encouraged to stay at home. This includes:

People 65 years and older. People living in a nursing home or a long-term care facility, as defined by the

Commissioner of Health. People of any age with underlying medical conditions, particularly if not well

controlled, including: People with chronic lung disease or moderate to severe asthma. People who have serious heart conditions. People who are immunocompromised (caused by cancer treatment,

smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, or prolonged use of corticosteroids and other immune weakening medications).

People with severe obesity (body mass index (BMI) of 40 or higher). People with diabetes. vi. People with chronic kidney disease

undergoing dialysis. People with liver disease.

This list is not comprehensive and you should consult your doctor to determine whether or not you should continue to remain at home. When leaving your home, it is strongly recommended for everyone to wear a manufactured or homemade cloth mask.

Governor Lifts Up Children’s Mental HealthGovernor Walz shared the state COVID-19 mental health support website in a tweet last week on Children’s Mental Health Awareness Day. The tweet read “As a parent and teacher, the mental health of our children is a top priority, especially during this pandemic. On Children's Mental Health Awareness Day, we want to make sure our children have the resources they need.” We’re grateful that the Governor is highlighting children’s mental health during these trying times.

Governor Walz Signs Bill on Prescription Drug Price Transparency

NAMI Minnesota is pleased to report that Governor Walz has signed legislation that will increase transparency around sudden and dramatic increases in prescription drug costs. This legislation had bipartisan support and was carried by Sen. Rosen and Sen. Morrison. Despite opposition from lobbyists associated with prescription drug manufacturers, drug companies will now have to provide an explanation when the price of a prescription drug increases significantly in the past year, including the cost of manufacturing the drug, any marketing costs, and the price of the medication when it first entered the market. Despite partisan jockeying at the end of session, it is important to remember that bipartisan work is still being done. (MinnPost)

Criminal Justice Update

Advocates Caution Reopening of Hennepin District CourtsNAMI Minnesota signed onto a letter from the Legal Rights Center to the Chief Judge of the Hennepin District Court, Ivy S. Bernhardson, with concerns about reopening criminal calendars without appropriate safety measures during the COVID-19 pandemic. Advocates from the Legal Rights Center were made aware of plans to reopen these court calendars, which would require people to come to court, yet there were little to no provisions for cleaning shared areas and meeting rooms outside of courtrooms, and no screening of individuals before entering the courthouse. NAMI signed on out of concern that people with serious mental illnesses and underlying medical conditions would be put at risk of contracting COVID-19. The letter recommends that accessible communication about any plans be shared with the public, and proper safety, screening, and cleaning procedures be enacted before

reopening the courts. The Minnesota Supreme Court Chief Justice, Lorie Gildea, issued an order last week in response to the expiration of the stay-at-home order. The order provides a plan for the gradual and safe reopening of the courts including a detailed preparedness plan that district courts are expected to follow. NAMI will continue to monitor this issue as it develops.

News from Federal Level

US House Passes New COVID-19 Package

The House has just passed the HEROES Act, which provides much needed funding for the response to the COVID-19 pandemic. Here are the items that will most directly impact the mental health community.

EMERGENCY HOUSING ASSISTANCE

$100 billion in emergency rental assistance for people experiencing housing instability or homelessness.

The bill also includes funds for Section 811, the Emergency Solutions Grant program and project-based rental assistance. The HEROES Act also clarifies that multifamily property owners can use funds from Section 811 and project-based assistance to help residents in congregate housing (group homes) who may need to self-isolate or quarantine, including the use of funds to pay for motel rooms.

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) – $3 billion

$1.5 billion for the Substance Abuse Prevention and Treatment Block Grant $1 billion for the Community Mental Health Services Block Grant $100 million for Project AWARE, which includes Mental Health First Aid in

schools $10 million for the National Child Traumatic Stress Network $265 million for emergency response grants to address immediate behavioral

health needs as a result of COVID-19 $25 million for the Suicide Lifeline and Disaster Distress Helpline $150 million for tribes, tribal organizations, urban Indian health organizations,

or health service providers to tribes across a variety of programs Establishes a technical assistance center at SAMHSA that will support public or

nonprofit entities and public health professionals seeking to establish or expand access to mental health and substance use services associated with the COVID-19 public health emergency

Authorizes SAMHSA to award grants to support local, tribal, and state substance use efforts that need further assistance as a result of COVID-19 for the purposes of:

Preventing and controlling the spread of infectious diseases the consequences of such diseases for individuals living with SUD

Overdose education, counseling, and health education for individuals at risk of SUD

PUBLIC HEALTH & SOCIAL SERVICES EMERGENCY FUND – $175 billion

$100 billion to make payments under the Health Care Provider Relief Fund Grants for hospitals and health care providers to be reimbursed health care

related expenses or lost revenue directly attributable to the public health emergency resulting from coronavirus. The bill also establishes a program for distributing these funds to include an application for providers and specific formulas to determine “health care related expenses and lost revenue.”

Eligible expenses for reimbursement include medical supplies and PPE, retention of workforce, building or construction of temporary structures and more

Lost revenues determined by net patient revenue from corresponding 2019 quarter minus net patient revenue in 2020 minus savings during the calendar quarter attributable to foregone wages, payroll taxes, etc.

$75 billion for expenses necessary for testing, contact tracing, and other activities necessary to effectively monitor and suppress COVID-19

PAYCHECK PROTECTION PROGRAM

The covered period, previously set to expire on June 30, 2020, is extended to December 31, 2020

The previously established loan period of 8 weeks has been extended to 24 weeks

Eligibility, previously limited, is expanded to all 501(c)s, included those with in excess of 500 employees

Establishes a carve out of 25% of existing funds for nonprofits regardless of size, at least half of which (12.5%) is allocated for nonprofits with fewer than 500 employees

Removes the limitation, previously set to 25%, on the non-payroll portion of a forgivable loan

NATIONAL INSTITUTE OF MENTAL HEALTH

Directs NIMH to support research on the mental health consequences of COVID-19, including the impact on health care providers.

NATIONAL SUICIDE HOTLINE DESIGNATION

Designates 9-8-8 as the universal dialing code for the National Suicide Prevention Lifeline

Allows states to impose a fee or charge on voice service subscribers’ bills for the support or implementation of 9-8-8 services for the support of the National Suicide Prevention Lifeline

Requires the FCC to evaluate and submit a report to Congress on the feasibility and cost of automatically providing the dispatchable location of calls to 9-8-8

Requires SAMHSA to submit a report to Congress that details a strategy for offering support or providing technical assistance for training programs for National Suicide Prevention Lifeline counselors to increase competency in serving LGBTQ youth

While much can change, Majority Leader McConnell has not expressed interest in such an expansive funding package. (National Council)

NAMI Signs On to Letter to Minnesota Congressional Delegation

NAMI Minnesota was happy to join the Minnesota Council of Nonprofits and the Minnesota Budget project to engage our delegation on the significant financial pressure that the COVID-19 response has placed on state budgets. To meet this urgent need, the letter calls for flexible dollars to balance state budgets and an increase in Medical Assistance dollars. You can read the full letter here.

Updates from NAMI Minnesota

NAMI Legislative CommitteeMeetings are held on the second Tuesday of every month at 6 PM and in April will be

by phone or zoom. To be added to the email list, contact Sam Smith.

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