2020 Advocacy and Public Policy Focus
NAMI St. Louis is an affiliate of the National Alliance on Mental Illness, a grassroots organization dedicated to building better lives for individuals and families affected by mental illness. Our public policy focus outlines key objectives and policy positions that support our goal of ensuring that people living with mental illness receive the treatment and supports necessary to lead full and satisfying lives as valued members of the community. Our public policy focus is developed in conjunction with advocacy priorities of our state and national NAMI offices. We will also respond to issues and efforts that arise during the year that are not listed on this document but support our goal.
Our Top Priorities
- Continue open access to all psychotropic medications
- Enforce mental health insurance parity laws
- Pass constitutional amendment to expand Medicaid in Missouri
- Secure state funding for the MO Child Psychiatry Access Project
- Eliminate the death penalty for people with mental illness
- Re-instate Missouri low-income housing tax credits
- Create national 3-digit number (988) to call for mental health emergencies
1) Open Access to Psychotropic Medications – The right medications are key to recovery for many children and adults with mental health conditions. People need choices because individuals react differently to different medications. Additionally, restricting antipsychotic medications shifts costs to the wrong places. Preferred drug lists, prior authorization and other restrictions pose substantial risks for people with serious mental health conditions. Medication failures can lead to emergency room visits, hospitalization, school failure, job loss‐‐even incarceration or suicide. NAMI St. Louis supports the SB 666 which makes changes to current law to enhance open access. Under this act, no restrictions shall be imposed for any individual antipsychotic medication.
2) Mental Health Insurance Parity – Mental health care is just as important as other medical care. Over 11 years ago, President George W. Bush signed legislation into law requiring insurers to cover mental health and addiction care in the same way they cover other medical care. Unfortunately, due to how complex the law is, it isn’t always followed. When laws are not followed, patients don’t get the treatment they need, which leads to increased illness and sometimes even death. Additional transparency and accountability is need to make sure that individuals and small business owners get what they pay for when they buy health insurance policies. Parity legislation that establishes reporting requirements for insurers to demonstrate how they design and apply their managed care tactics and that specifies how state insurance departments can implement parity and report on their activities — such as that passed in Tennessee should be adopted in Missouri. NAMI St. Louis supports legislation that will enhance enforcement of the Missouri Parity Law.
3) Medicaid Expansion – Medicaid provides vital community-based, behavioral health services for low-income children and adults who live with mental illness and substance use disorders. Medicaid helps people stabilize and recover, reducing reliance on hospitalization and other public services. NAMI St. Louis supports the collection of signatures to embed the program in Missouri’s Constitution through an amendment on the ballot next year. NAMI St. Louis will work with advocates to collect the signatures needed for a petition.
4) MO Child Psychiatry Access Project – Although 1 in 5 youth live with a mental health condition, less than half receive needed services. Undiagnosed, untreated, or inadequately treated mental health conditions can affect a youth’s ability to learn, grow, and develop. Because there is a severe shortage of child psychiatrists in Missouri, many children with behavioral health issues are treated by primary care providers who have little or no formal education in this area. The MO Child Psychiatry Access Project (MO CPAP) provides telephonic consultations to pediatricians and primary care providers who are treating pediatric patients with mild to mid-level mental health conditions giving them additional knowledge and confidence in treating these disorders. NAMI St. Louis supports state funding for the MO CPAP and will work with the MO CPAP Sustainability Committee to ensure funding will continue after grants are completed.
5) Death Penalty for People with Mental Illness, Elimination of – For the last two legislative sessions in Missouri, Rep. Tom Hannegan has filed a bill that essentially eliminates the death penalty for people with mental illness. Last year, the bill provided that a person cannot be sentenced to death if he or she raises the issue that he or she suffered from a serious mental illness at the time of the commission of the offense. Our state already excludes people with intellectual disabilities from the death penalty. NAMI opposes the execution of individuals who when committing the crime had serious mental illness or mental disability. This mental illness or disability must be severe enough that they have a significantly impaired ability to appreciate the consequences or wrongfulness of their actions, exercise rational judgment or control their conduct in conformance with the law. Substance abuse disorders do not meet this criteria. NAMI St. Louis supports the passage of such a bill and will seek a sponsor for a bill similar to Rep. Hannegan’s again in the 2020 Legislative Session.
6) Low Income Housing Tax Credits – Missouri has provided low income housing tax credits for decades until just recently when former Governor Eric Greitens took them out of the budget. Several years ago, the MO Housing Development Commission created a “special needs” carve out for MO low income-housing tax credits which essentially means that one-third of state tax credits were utilized for building housing for people with mental and physical disabilities. NAMI St. Louis supports the reinstatement of state low-income housing tax credits so that more low-income housing can be created in Missouri, especially for people with special needs.
7) 3-Digit National Mental Health Emergency Number – When somebody is in a mental health crisis, timing is critical. Just a few seconds can save a life. Right now, there is no national easy-to-remember 3-digit (988) number to call for a mental health crisis and suicide prevention. The bi-partisan Senate Bill 2661, the National Suicide Hotline Designation Act, would not only fund the hotline but also give states resources to better respond to mental health crises. NAMI St. Louis supports S. 2661.
