• Mental Health Provisions in New Compromise Gun Law

    In the wake of the school shooting on May 24, 2022 in Uvalde, Texas, federal lawmakers worked to build a bipartisan new law that would restrict the availability of guns to certain individuals. One challenge lawmakers faced in crafting the bill was ensuring that it would have enough support to pass in a deeply divided US Senate. 

    Many Republican lawmakers expressed preferences that policies to address mental health needs be included alongside policies restricting the availability of guns. The compromise they reached involved both. 

    What’s Included in the New Law

    The final legislation was signed by President Biden on Saturday, June 25, 2022. Media coverage has understandably focused on the gun-related elements of the new law—but several meaningful elements related to mental health care were included as well. Here, we’ll review the mental health provisions of S. 2938—the Bipartisan Safer Communities Act.

    New Federal Funding

    The most significant provisions related to mental health care have to do with federal funding. The bill authorizes: 

    • $250 million in grants for the community mental health services block grant program
    • $40 million for the National Child Traumatic Stress Network
    • $240 million for Project AWARE, which provides grants to states to help them promote mental health awareness, training, and access in school systems
    • $120 million for Mental Health Awareness Training
    • $150 million for the National Suicide Prevention Lifeline, which launched July 16 as 988 nationwide
    • $50 million in grants to States for indirect costs related to expansion of school-based services through Medicaid or the Children’s Health Insurance Program (CHIP)

    Finally, the bill provides $1 billion in new funding for schools, split evenly between School Based Mental Health Services Grants and Mental Health Services Professional Demonstration Grants. These funds flow through grants to states because states, rather than the federal government, operate their school systems.

    Taken together, these provisions amount to almost $2 billion in funding for various mental health programs. Critics have argued that focusing on mental health in the wake of school shootings serves as a distraction from gun regulation, and that the gun-related provisions in the new law are weak. 

    Some have also suggested that many elements of this bill, including the funding for the National Suicide Prevention Lifeline, would have been funded one way or another even if this specific bill did not exist. 

    However, the additional funding for mental health programs in the new law is substantive. It is likely to support the development of new mental health programs as well as the expansion of existing ones, particularly for children and adolescents with mental health needs. 

    In addition to the major funding listed above, the bill includes some more minor provisions as well.

    Funding for demonstration programs

    Demonstration programs under this law are time-limited programs where states can test different ways of making community mental health care more effective and efficient. Grant funding for these programs has been extended under the new law for two to four years, depending on specific provisions. 

    Technical support and guidance

    The law stipulates that within 18 months, the federal government will provide states with more guidance on improving access to telehealth for services covered under Medicaid and CHIP. 

    Such guidance often takes the form of documents like this telehealth toolkit, issued at the height of the COVID-19 pandemic, about how states can effectively access and administer federal funding in ways that benefit the public.

    Further areas of guidance include best practices for billing for services, including the recommended voluntary billing does, modifiers, and place of service designations. The guidance will also include strategies to help providers offer culturally competent care via telehealth, including to people with disabilities, medically underserved and rural communities, and other marginalized groups. 

    What to Make of the Bill Overall

    People’s opinions of the bill so far appear to largely depend on how people feel more generally about gun legislation. Those who favor stricter gun control appear to generally support the bill—less because of the mental health provisions and more because the bill is at least some form of Congressional action on guns. Those who generally oppose gun legislation appear to generally oppose this bill, for the same reason. 

    Whatever you may think about the gun restrictions in the bill, the mental health provisions appear to be more than simply lip service, and instead do seem to represent a meaningful federal investment of new funds in mental health care.

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