Sustaining Excellence in Medicaid Act of 2019

Mr. Speaker, I, too, rise today in strong support of this bipartisan bill that extends several key Medicaid programs, H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019.

Mr. Speaker, this is a bill that strengthens the healthcare safety net for our communities and provides long-term certainty for patients.

Mr. Speaker, I thank my colleague, Chairman Frank Pallone of the Energy and Commerce Committee, for his partnership and willingness to work in good faith on both sides of the aisle to get this done.

We passed a short-term extension of these programs back in March, Mr. Speaker, to ensure that patients were still protected as we ironed out the details. Today, we are delivering the long-term deal that I know we all wanted all along.

A big priority of mine in this package is the 2-year extension of the Excellence in Mental Health demonstration program at CMS. Eight States, including my home State of Oregon, are currently participating in this pilot program, which is designed to increase access to mental health and substance use treatment services.

Mr. Speaker, I include in the Record a letter from the Oregon AFSCME Council 75.

Oregon AFSCME Council 75,

June 18, 2019.

Members of the Oregon Delegation,

House of Representatives,

Washington, DC.

Dear Representatives: On behalf of the more than 25,000

Oregon AFSCME Council 75 members, we ask you to approve the

Empowering Beneficiaries, Ensuring Access, and Strengthening

Accountability Act of 2019 (H.R. 3253) when the House of

Representatives considers the bill this week.

We strongly support H.R. 3253 because it extends the

Certified Community Behavioral Health Clinics (CCBHC) program

through December 2021. On June 30, the CCBHCs in our state,

along with those in Minnesota, Missouri, Nevada, New Jersey,

New York, Oklahoma, and Pennsylvania, face extreme financial

threat. We appreciate that Representative Walden, in his

capacity as Ranking Member of the House Energy and Commerce

Committee, worked in bipartisan effort to avert the March 30

fiscal cliff in Oregon and Oklahoma and is an original co-

sponsor for H.R. 3253.

At Cascadia Behavioral Health in Portland Oregon, AFSCME

Council 75 members who are therapists, care coordinators,

crisis counselors, residential counselors, support staff and

other workers, deliver whole health care--integrated mental

health and addiction services, primary care and housing--

through the CCBHC program. These health care workers never

stop working to help those who want to get healthy and

recover. It is not just a job; it is a calling.

That core commitment to helping people heal is why

Alexandra Birch, a Qualified Mental Health Associate, cares

deeply about the CCBHC program. It has helped innovate and

improve the delivery of care. She was hired in 2017 as a Care

Coordinator at Cascadia because of an investment Congress

provided to the CCBHC program. In that role she is the glue

that connects primary care with behavioral health care and

makes sure care is focused on the whole patient.

In her work, Ms. Birch treats clients with anxiety and very

high blood pressure but who do not have an established

doctor; she is able to connect them to a doctor. She cares

for clients on certain anti-depressants that experienced

weight gain as a result, which put them at higher risk of

developing diabetes. Because of the investment Congress

provided in establishing CCBHCs, Ms. Birch can direct those

clients to inhouse primary care to monitor and prevent

diabetes.

For practitioners like Ms. Birch, Cascadia's capacity to

bring primary care into the outpatient behavioral health care

clinics is a game-changer. It enhances their delivery of

services and outcomes for their clients. From the frontline

perspective, the integration of behavioral health and primary

care in a CCBHC removes logistical and other obstacles to

consultation between providers. These consultations translate

into improved identification of the best route of care for a

client with complex physical and mental conditions with the

result of getting a client on the road to wellness much

quicker.

Cascadia's capacity to sustain and expand this level of

high-quality coordinated care to a vulnerable population

depends on the dedication and skills of workers like Ms.

Birch and congressional action to continue investing in the

CCBHC fiscal model that covers 100 percent of costs.

With the fiscal investment in CCBHCs, Congress allows

Cascadia staff to reach into the community to expand access

to behavioral health services for individuals with serious

mental illnesses. Cascadia works with Portland's 24-hour

mental health crisis emergency room, Unity Center Behavioral

Health. Cascadia staff establish crisis patients with

Cascadia primary care providers immediately after Unity

hospital care. This enables patients to continue medications

that ensure mental stability until they have fully connected

with Cascadia's mental health providers.

We urge you to pass H.R. 3253 and extend the CCBHC program.

It would be tragic to lose this funding that has sustained

and expanded vital behavioral and medical services to our

community.

Sincerely,

Stacy Chamberlin,

Executive Director.

Mr. Speaker, this is really important legislation.

Last year, my legislation, the SUPPORT for Patients and Communities Act, our opioids legislation, the most comprehensive bill to address a single drug crisis in our Nation's history, was signed into law. Our committee has made major strides in addressing the substance use disorder crisis that is plaguing our communities.

The Excellence in Mental Health demonstration continues that good work by increasing Medicaid reimbursement for community-based mental health and addiction treatment services. This 2-year extension for the participating States will give us time for a full evaluation to determine the effectiveness of the program and whether it should be expanded.

Also included in this bill is an extension for the Money Follows the Person program through fiscal year 2024. This provides resources to State Medicaid programs to help individuals with chronic conditions and disabilities transition back into their communities.

We also secured an extension of what is known as the spousal impoverishment provisions in Medicaid. To be

clear, this bill actually helps keep spouses of elderly patients from impoverishment and out of costly nursing home settings. For spouses of patients receiving home or community-based care, the bill will protect them from impractical reductions in their income or resources and ensures that they can live out their lives with independence and dignity.

Finally, we clarified the authority of State Medicaid fraud and abuse control units that investigate and prosecute abuse and neglect of Medicaid beneficiaries. This is simply good government. It is good government oversight, and it protects patients who are some of America's most vulnerable.

In closing, Mr. Speaker, I thank my good friends on the Energy and Commerce Committee for their work on the bill: Dr. Burgess, Mr. Guthrie, Mr. Upton, Mr. Walberg, and their counterparts on the Democratic side, Ms. Eshoo, Mrs. Dingell, Ms. Matsui, Mr. Welch, and, of course, Chairman Pallone.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3253) to provide for certain extensions with respect to the Medicaid program under title XIX of the Social Security Act, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on H.R. 3253.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019.

This Saturday, June 22, marks the 20th anniversary of the landmark Supreme Court decision in Olmstead, which held that people with disabilities must receive services in the most community-integrated setting possible. It is fitting that, today, the House of Representatives will pass legislation that helps advance the promise of Olmstead by ensuring that there are programs in place to help people transition to and live in the community with their families and friends, while keeping them safe from abuse and neglect.

It also ensures people will continue to be able to receive mental health and substance use disorder treatment when they need it the most, and, finally, it makes commonsense improvements to ensure that drug companies pay their fair share in rebates to the Medicaid program.

I am proud to say that this bill provides much-needed funding to support the highly successful Money Follows the Person program, while making important program improvements that will help the program better serve the people it is intended to help.

Money Follows the Person helps ensure that seniors and people with disabilities are able to live in their homes and in their communities. It provides States with vital funding and supports to ensure that they continue to help people move out of institutions.

Earlier this year, I held a roundtable discussion in my district with patients, providers, and advocates to talk about the challenges we face in providing long-term care in this country. Every participant supported reauthorizing Money Follows the Person because it makes it easier for people to get care in the setting of their choice. By passing this bill today, we are giving hope to those who need it.

I want to thank my friend and colleague, Representative Guthrie, for his commitment to this program and his leadership on this issue. It has been an honor to work with him on it.

Next, this legislation ensures that partners of people receiving home and community-based services will have the resources they need to meet their living expenses. Without this important protection, married beneficiaries would face the awful choice between impoverishing the spouse or entering an institution. I am proud that we will be able to further extend this protection.

I also want to thank my friend on the other side of the aisle, my fellow Michigander, Fred Upton, for his continued leadership and support on this issue.

H.R. 3253 also ensures that people receiving home and community-based services receive the same protections from abuse and neglect as people in nursing facilities. By allowing Medicaid Fraud Control Units to investigate home and community-based services providers as well as nursing facilities, this bill extends an important protection to some of our most vulnerable populations.

This bipartisan bill would not have been possible without the leadership of Representatives Welch and Walberg, and I want to thank them for their hard work to protect Medicaid beneficiaries from abuse.

This bill also extends the promising Excellence in Mental Health demonstration for an additional 2 years. As we continue to struggle through the opioid epidemic, this program ensures that people with substance use disorder and mental health issues can receive critical treatment when they need it the most. The early results of the demonstration have been promising, and this extension will allow States to build on that success.

I want to thank Representatives Matsui and Mullin for their ongoing support of this program.

Finally, this legislation adopts a commonsense proposal to ensure drug companies pay their fair share in Medicaid rebates. It will help provide additional funds to State Medicaid programs that are struggling to pay for increasingly expensive prescription drugs.

I want to thank Representatives Kennedy and Jason Smith for their leadership on this issue.

I urge my colleagues to support the passage of H.R. 3253, and I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentlewoman from California (Ms. Matsui).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, in closing, I want to echo the words of my colleague, Mr. Guthrie, and thank all of those who helped bring this bill to the floor today. I give particular thanks to Chairman Pallone and Ranking Member Walden for their leadership.

Mr. Speaker, I urge all Members to support H.R. 3253.

As a caregiver, I have met so many people in the last few years who are desperate and scared and who need us to care. This bill does that. I hope the House today will show this country we can act bipartisanly, giving hope.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019.

This legislation will extend the Money Follows the Person program through 2024. This important program provides resources to State Medicaid programs to help individuals with chronic conditions and disabilities transition from institutions back into local communities if they choose to do so.

Money Follows the Person offers a choice for individuals who often have very limited options. This program allows the person to choose where they would like to receive their care.

This legislation will also extend the Spousal Impoverishment program through 2024.

H.R. 3253 will also extend the Excellence in Mental Health demonstration for 2 years. The Excellence Act is designed to increase Americans' access to community health in substance use treatment services.

In addition, this bill will clarify the authority of State Medicaid fraud and abuse control units. This clarification will give these important units the authority to investigate and prosecute abuse and neglect of Medicaid beneficiaries in noninstitutional settings, as well as broaden the permissible use of Federal Medicaid fraud and abuse control units to screen complaints or reports alleging potential abuse or neglect of Medicaid beneficiaries.

I have enjoyed working with my colleague from Michigan, my friend, Mrs. Dingell, and the hard work that she has put into this program, both this Congress and the previous Congress, to move this forward.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Michigan (Mr. Walberg).

Mr. Speaker, I yield 3 minutes to the gentleman from Oregon (Mr. Walden), the Republican leader of the Energy and Commerce Committee and my good friend.

Mr. Speaker, I yield myself as much time as I may consume.

Mr. Speaker, in closing, I thank Chairman Pallone, Republican leader Walden, and the Energy and Commerce Committee staff for their hard work to help this bipartisan package come together.

Mr. Speaker, I also thank my colleague, Congresswoman Debbie Dingell, for working with me on extending Medicaid Follows the Person. I also thank my colleagues, Representative Matsui, Representative Eshoo, Representative Welch, and Representative Walberg, for their hard work on this package.

Mr. Speaker, I urge my colleagues to support this bill, and I yield back the balance of my time.

Mr. Speaker, I rise today in support of H.R. 3253, which takes several important steps to strengthen the Medicaid program; and I thank my friends and colleagues, Representatives Dingell and Guthrie, for this legislation.

I am especially pleased that the bill includes a piece of bipartisan legislation I authored, along with my colleague from Vermont, Congressman Welch.

Our legislation broadens the authority of Medicaid Fraud Control Units to better protect the most vulnerable and bring bad actors to justice.

Medicaid Fraud Control Units are charged with investigating and prosecuting State Medicaid provider fraud and resident abuse complaints in Medicaid-funded healthcare facilities. Nationally, these units contributed to 2,500 convictions and $1.8 billion in recovered funds in 2017 alone. They are a vital instrument of justice for protecting Medicaid beneficiaries from abuse.

However, current law prevents these units from investigating cases of patient abuse in noninstitutional settings, such as home-based care. It doesn't make sense.

Our committee has heard from States that have had to turn a blind eye to cases of abuse simply because the abuse occurred in a noninstitutional setting. This arbitrary restriction simply does not make sense.

There has been substantial growth in home and community-based services

since the initial statute was enacted decades ago. It is time that we update the law so we are not needlessly tying the hands of those who are charged with protecting the most vulnerable. Our legislation will empower attorneys general to expand the scope of their States' fraud units so they can combat patient abuse wherever it might occur.

This reform has broad bipartisan support from AGs in red States and blue States. It is just common sense, and it will help better serve those in need.

Once again, I thank my colleagues on the great Energy and Commerce Committee for their bipartisan collaboration. I encourage passage of

Mr. Speaker, I rise in support of the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 and its provisions extending critical access to mental health and addiction treatment.

Let's be clear: One in five Americans live with a mental illness. Nearly all of us have a friend, a family member, or neighbor who has been diagnosed. Mental illness touches all our lives in some way.

When we passed the Excellence in Mental Health Act in 2014, we made an investment in behavioral health that expanded access to necessary treatment. Eight States established community-based clinics providing 24-hour crisis care, better coordinating physical, mental, and substance abuse treatment. This provided much-needed support to patients and their families.

In combating opioid addiction, Certified Community Behavioral Health Centers are already making a difference. In the first year of implementation, these clinics served nearly 400,000 patients with serious mental health and addiction disorders, providing 80,000 individuals with lifesaving treatment for the first time.

Headline after headline tells us we need to preserve and, importantly, expand access to programs like this. While the bill before us will extend funding to programs in eight existing States for the next 2\1/2\ years, our work here is far from done.

People are struggling with the stigma of mental illness and substance use disorder across the country. Every American should have access to the same top-notch care as patients in the pilot programs. That is why I will continue to be a fierce advocate for expansion of the Certified Community Behavioral Health Centers program. I look forward to continue working with my colleagues so that we can create new opportunities to expand access to mental healthcare and conquer the addiction crisis that has harmed far too many families.