Highlights from the 2019 NACBHDD Legislative and Policy Conference

Early each year, NACBHDD hosts a Legislative and Policy Conference. The purpose of this event is to provide the latest policy and practice information to county behavioral health and I/DD leaders, and also to foster the opportunity for these leaders to visit their representatives on Capitol Hill to advocate for needed legislative improvements.

The 2019 conference was no exception. I would like to highlight some of the activities from our conference, held March 4-6 in Washington, D.C.

Considerable focus was devoted this year to the need to expand Medicaid federal financial participation to pre-adjudicated persons incarcerated in county and city jails. Of particular concern are those who suffer from health problems, including mental illness, addiction and I/DD conditions. Better healthcare for these people in county and city jails would promote earlier release, more successful community re-adjustment and reduced jail recidivism.

NACBHDD has joined a very new coalition led by the National Association of Counties (NACo) and the National Sheriffs Association (NSA) to advocate for this essential change. During the course of our conference, NACBHDD co-sponsored a Hill briefing on this subject with NACo and NSA (which can be found here), and also participated in a meeting of the NACo Health Committee, where potential Medicaid 1115 waivers were discussed with staff from the federal Centers for Medicare and Medicaid Services. Without a doubt, the time has arrived for making these key changes in how the federal Medicaid program operates.

For the very first time, our conference welcomed a leader from NSA, Sheriff Dave Mahoney from Dane County, Wisconsin. Mahoney spoke very passionately about the inappropriateness of incarcerating persons with mental and addictive conditions in his large county jail. Like other conference participants, the sheriff sees the solution in better community services, not in inappropriate incarceration.

The conference was exceptionally pleased to host the new director of the Office of National Drug Control Policy (ONDCP), James Carroll. The director made comments about the new ONDCP Strategic Plan, which emphasizes prevention, treatment, rehabilitation and recovery, as well as interdiction of illicit drugs, particularly fentanyl from China. He was presented with the NACBHDD federal leadership award for the assertive work he has undertaken across the federal government to improve collaboration and coordination in a joint effort to reduce drug addiction in America.

This year’s conference was organized primarily by the NACBHDD State Association Directors Committee, with an eye toward new developments that will impact county policy and services.  Several key sessions included: Progress on Medicaid by a Panel of State Association Directors; Solving Workforce Issues at the State Level; Key National Developments in the Medicaid Program; State Brain Drain; ACES Training for Providers; Value Purchasing for I/DD Services; and National Update on Suicide and Suicide Prevention.

Of very special note, our conference again was delighted to welcome Assistant Secretary Dr. Elinore McCance-Katz of SAMHSA. McCance-Katz provided a rousing overview of SAMHSA programs, with special emphasis on those that provide care for persons who suffer from opioid addiction or serious mental illness. Attendees were very pleased to learn that SAMHSA programs are growing and that they are reaching more persons who need effective care.

Each year, NACBHDD also makes a series of awards to members, related partners, members of Congress and Hill staff. This year’s Robert Egnew Lifetime Achievement Award was given to Dr. Alfredo Aguirre of San Diego County for his excellent work as county behavioral health director over many years; our partner award went to Director Nick Macchione, Health and Social Services Department in San Diego County, for his outstanding work at the county and national levels in implementing the Healthy Counties Initiative. Five members of the U.S. House received awards, as did four members of the U.S. Senate, and five staff members from the House and Senate. A very special thank you award was given to Mitch Anderson, our outgoing NACBHDD president, who also will be retiring from his county directorship in April.

We all look forward to an equally stimulating conference in 2020.