Congress: Say yes to Excellence Act expansion

Imagine this. Your loved one behaving erratically by reacting to voices in their head. What do you do? Where do you go? Who do you call? 

You don’t want to have to drive five hours to see a psychiatrist. And you don’t have time to make an appointment to see someone in two weeks. You are worried and need help. 

The sad truth is that in too many communities in America, that help is simply not available. 

After decades of funding cuts, our nation’s overburdened, underfunded mental health and addiction system is failing to reach far too many people.

Each year, only 40 percent of Americans with a mental health condition receive treatment. And a mere 10 percent of those with an addiction receive it. 

The lack of ready access to behavioral health services has a profound impact across many aspects of American life. First responders and law enforcement agencies report increasing encounters with individuals experiencing acute psychiatric symptoms – leading directly to a “boarding” crisis in hospital emergency rooms. Up to half of homeless people have an untreated mental illness. Nearly 10 percent of all persons residing in nursing facilities nationwide are non-elderly adults with severe mental illnesses – with the most common diagnosis being schizophrenia. Meanwhile, the opioid crisis sweeping our nation causes upwards of 40 overdose deaths per day. 

Congress must speak out and say clearly: nursing homes, county jails, homeless shelters and hospital emergency rooms can no longer serve as the de facto behavioral health system in the greatest country in the world. The current arrangements are inhumane and, perhaps just as importantly, hugely expensive.

We can do better.

And 24 states have started the work to do just that.  

But only eight will cross the finish line.  

Under the groundbreaking bipartisan Excellence in Mental Health Act, passed last year, 24 states have been given the chance to transform the way mental health and addiction care are delivered. 

Championed by Sens. Debbie StabenowDebbie StabenowMichigan Dems highlight Flint with unanimous opposition to CR How Congress averted shutdown Senate passes funding bill to avoid shutdown MORE (D-Mich.) and Roy BluntRoy BluntDem groups target Blunt with .3 million ad campaign The Trail 2016: Just a little kick Senate rivals gear up for debates MORE (R-Mo.) and Reps. Doris Matsui (D-Calif.) and Leonard Lance (R-N.J.), the Excellence Act envisions the delivery of comprehensive community based care – high quality, high value services for people with addictions and mental illnesses.  

For people living with an addiction or mental illness, the Excellence Act will enable providers to offer a full range of options—from acute detoxification to ongoing recovery support, and more. 

The states funded under the Excellence Act will offer 24-hour crisis care in their communities for that child who is hearing voices. Through an intensive array of services specifically designed to meet his individual needs – including engaging his family as partners in the process – he will have the care he deserves in the community where he lives. And as a parent, you will know the care is high quality, because the services delivered are based on the latest evidence-based practices. 

As behavioral health providers, we are on the front lines of our nation’s mental health and addiction crisis. We see the need in our communities. Yet too many of us have had to reduce staff, scale back services or close programs in the face of sustained funding cuts. 

The Excellence Act is game changing, not only because it will transform the quality of care delivered, but because it is sustainable. For the first time, organizations that provide these services will be able to deliver quality care at a rate that covers their costs of doing businesses.  

The Excellence Act demonstration offers our communities a different future. 

It is too bad only eight of us will be able to get there.  

Current law limits participation to only eight of the 24 states that are now engaged in the one-year demonstration planning process. That means only a third of us will be able to continue the work we are starting now.  

The people living in those 16 states don’t deserve to be left without access to care simply because of an eight-state limitation in a statute they have never heard of. States that are trying to transform their delivery systems don’t deserve to be left out. Every American deserves the best.  

That is why the Excellence Act should be expanded to all 24 states. 

Mental health is on Congress’ mind. Literally dozens of bills, hundreds of hours and countless reams of paper have been spent considering the right course of action to bring care to more Americans. 

While Congress is debating the best way forward on these important bills, we have started working to advance the availability of care in our communities. Congress should expand the Excellence Act so we can continue this work. 

Because 100 percent of Americans with a mental health condition deserve treatment … and 100 percent of those with an addiction deserve treatment. 

And because when you call to get help for your loved one, you don’t want to hear that a statute has prevented your state from delivering the care he or she needs. 

Your loved one deserves care.

And the only answer you should hear is “yes.”

Chandler is executive director of the Iowa Association of Community Providers. Castle is chief executive officer of the Texas Council of Community Centers.

Also signatory to this opinion are:  Tom Chard, Executive Director, Alaska Behavioral Health Association; Rusty Selix, Executive Director, California Council of Community Mental Health Agencies; Jeffrey Walter, Interim Chief Executive Officer, Connecticut Community Providers Association; Sara Howe, Chief Executive Officer, Illinois Alcoholism and Drug Dependence Association; Marvin Lindsey, Chief Executive Officer, Community Behavioral Healthcare Association of Illinois; Janet Stover, Executive Director, Illinois Association of Rehabilitation Facilities; Matthew Brooks, Chief Executive Officer, Indiana Council of Community Mental Health Centers; Shelly Steve Shannon, Executive Director, Kentucky Association of Regional Programs; Shannon Hall, Chief Executive Officer, Community Behavioral Health Association of Maryland; Vicker DiGravio, President and CEO, Association for Behavioral Healthcare (Massachusetts); Bob Sheehan, Chief Executive Officer, Michigan Association of Community Mental Health Boards; Claire Wilson, Executive Director, Minnesota Association of Community Mental Health Programs; Brent McGinty, President and CEO, Missouri Coalition for Community Behavioral Healthcare; Debra Wentz, Chief Executive Officer, New Jersey Association of Mental Health and Addiction Agencies; Lauri Cole, Executive Director, New York State Council for Community Behavioral Healthcare; Mary Hooper, Executive Director, North Carolina Council of Community Programs; Phillip Saperia, Executive Director, Coalition of Behavioral Health Agencies (New York); Julia Jernigan, Executive Director, Oklahoma Substance Abuse Services Alliance (OSASA); Cherryl Ramirez, Executive Director, Association of Oregon Community Mental Health Programs; Richard Edley, Chief Executive Officer, Rehabilitation and Community Providers Association; and David Spencer, Executive Director, Substance Use and Mental Health Leadership Council of Rhode Island.