[Congressional Record Volume 167, Number 106 (Thursday, June 17, 2021)]
[Senate]
[Pages S4612-S4614]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    EXCELLENCE IN MENTAL HEALTH AND ADDICTION TREATMENT ACT OF 2021

  Ms. STABENOW. Mr. President, I am here today and soon on the floor my 
good friend Senator Roy Blunt of Missouri will be here as well to talk 
about an issue that we both care very, very passionately about. In 
fact, on October 31, 2013, which I guess it is amazing how time flies, 
but in 2013, Senator Blunt and I stood here on the Senate floor 
together to mark a very important anniversary. It was 50 years to the 
day after President Kennedy signed into law the Community Mental Health 
Act--50 years to the day. And, tragically, it was the last piece of 
legislation he ever signed, and it was one of the most important.
  The Community Mental Health Act was groundbreaking; its goal, to 
provide full funding for comprehensive mental health services in the 
community. How important. Unfortunately, that has yet to fully happen. 
Instead, behavioral health is funded primarily through grants that 
start and then the grant stops. You would never say to someone who is 
having a heart attack: We would love to help you, but we are so sorry 
the grant ran out. Can you

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come back in 6 months? And yet that is what we say to people with 
mental illness or a substance abuse disorder. Every day, multiple times 
a day, that is what people hear.
  These people who need help aren't abstractions, they are our moms and 
dads and brothers and sisters and sons and daughters and friends and, 
in fact, us. I am so grateful to Members who have shared their own 
mental health stories; that includes my friend, Senator Tina Smith, who 
bravely shared her own struggle with depression that so, so many of us 
have had throughout our lives.
  We know that with the right support, people who live with some kind 
of a mental health challenge can thrive. They do. I have often told the 
story of growing up in Clare, MI, a little rural town, where my dad had 
struggles and was misdiagnosed for years and finally, finally, finally, 
correctly diagnosed as being bipolar and getting the support and help 
with medication he needed, and he was able to thrive after that. And 
that is what I want to have for every person in Michigan, every family 
in Michigan, every family across the country.
  Unfortunately, far too many people still struggle to get the support 
that they need. We certainly have seen that during the COVID-19 
pandemic, and it has gotten much, much worse, unfortunately, with 
everything everybody has had to go through.
  One CDC report found that last June, twice as many people as usual 
said they were experiencing symptoms of anxiety and depression--not 
surprising--and 11 percent of Americans have reported having serious 
thoughts of suicide in the past 30 days--in the past 30 days. And, 
tragically, 200 Americans are dying every day due to opioid overdoses, 
according to the CDC. And that is up 34 percent since the pandemic 
started--34 percent. Clearly, we need to do more to get people the 
mental health care and the substance abuse treatment that they need and 
that they deserve.
  The good news is, we are well on our way to ensuring that healthcare 
above the neck will be treated like healthcare below the neck. This is 
an effort that Senator Blunt and I have now been working on since that 
day we came to the floor in 2013. We are well on the way to finally 
seeing President Kennedy's vision become a reality.
  Not long ago, Senator Blunt and I, as I mentioned before, after that 
floor speech, introduced something called the Excellence in Mental 
Health Act. It was signed into law in 2014. It created certified 
community behavioral health clinics, which are funded just like 
federally qualified health centers. You have high standards, the clinic 
meets the standards, and then they get fully funded through the 
healthcare system.
  It requires these clinics to provide a comprehensive set of services 
to everyone who walks through the door, including 24/7, 365 days a year 
crisis services, outpatient mental health and substance abuse 
treatment, and immediate screenings, risk assessments, and diagnosis. 
And just as important, it requires care coordination, including 
partnerships with emergency rooms and law enforcement and veterans 
organizations.
  Ten States, including Missouri and Michigan, have been selected for 
full participation in the program. And startup grants have been 
extended now to a number of clinics across the country--40 States, plus 
the District of Columbia, 300 community clinics being funded to get 
things started so far, and we have more coming because of the American 
Rescue Plan. These clinics are already making a huge difference.
  We just had a hearing in the Finance Committee this week from those 
speaking strongly about this model, this being the model for care in 
the community. Just as community health centers are the model of care 
for physical healthcare, certified community behavioral health clinics 
are now the model for mental health and addiction services.

  More than half of these clinics provide same-day services. Now, that 
may not seem like much, but the truth of the matter is--and this has 
been true for years in Michigan because of lack of funding--they only 
are able to help people with the most severe problems. So if you want 
to walk in and connect with somebody and express a concern, you are 
probably not going to get any services--certainly, not that day--under 
the old system. Now, more than half of these clinics provide same-day 
services. Nearly all of them offer treatment within a week. Think about 
someone with a substance abuse issue, as well as a mental illness. Time 
is everything. And if someone is reaching out for help, they need to 
get that help right away.
  Ninety-five percent of these clinics have been engaged in one or more 
innovative practices with law enforcement. It has actually been 
incredible to hear what is being done with local law enforcement. So 
when the police officers are called to the scene, and it is clearly an 
issue that may involve mental illness or substance abuse, they are able 
to immediately connect up with those who can provide those services 
instead of having to take somebody to jail when they shouldn't be in 
jail. And we know that many, many people in many cases around the 
country, the majority of people who are in the jail are people who 
actually need mental health help or substance abuse help. And so there 
is wonderful collaboration now through these clinics going on.
  Statistics from the Department of Health and Human Services show that 
people who have received services at clinics--it is amazing numbers. I 
will just mention three: sixty-three percent fewer emergency rooms 
visits. I have heard from so many police officers talking about they 
are called to the scene, they take someone into custody who really just 
needs help, and then they go to the emergency rooms or other services, 
and the officer, then, sits there all day or longer with them or family 
members waiting, waiting, waiting because there are not the services 
that they need. So with the certified behavioral health centers, we 
have 63 percent fewer visits to emergency rooms for people who have a 
substance abuse problem or mental illness.
  Sixty percent less time in jail. We are debating a lot these days 
about the role of law enforcement and more calls, as we definitely 
need, to have support services in the community. Through the work of 
certified community behavioral health clinics in the communities where 
they exist, there has been a 60-percent reduction in folks going to 
jail. Instead, they are getting the help they need.
  And we have seen almost a 41-percent decrease in homelessness--
another major way that people end up on the street or in a shelter when 
what they need is help.
  Currently, about 1.5 million people are accessing these services, and 
it is a start. We did it originally as a demonstration to show that 
this could actually work and make a significant difference and actually 
save community resources, in addiction to providing people the help 
that they need and deserve. But we need to do more, and that is why we 
are speaking today.
  President Kennedy believed that these services should be available to 
everyone who needs them, and Senator Blunt and I agree. That is why 
this week we introduced our Excellence in Mental Health and Addiction 
Treatment Act of 2021. This legislation will expand these high-quality 
mental health and addiction treatment services across the country. This 
is the next step for States and communities across the country to be 
able to have the healthcare funding to provide high-quality services 
that we know work.
  This is going to give every State the opportunity to create certified 
community behavioral health clinics in their communities. Just imagine 
what that could mean for a veteran who is living with post-traumatic 
stress or a young mom who recently had a baby and is struggling with 
postpartum depression or a college student who is working to overcome 
his substance use disorder, stay in school, and earn a degree but just 
needs some help and support to be able to make that happen.
  Right now, only about 11 percent of people with substance use 
disorders get help in any given year. Think about that, 11 percent; 
about 11 percent of those struggling with an addiction are able to get 
help in any given year. Well, Senator Blunt and I aren't going to stop 
until 100 percent of people with substance abuse disorders and other 
mental illnesses are able to access the care that they need to thrive.
  This is really an important moment because we, over the last several 
years, have designed working with various administrations now, designed 
quality

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standards. We have demonstrated that providing these services makes a 
difference. We have strong support from law enforcement. We have strong 
support from the healthcare community, from the mental health and 
substance abuse community in a broad way.
  It is exciting to see this be something that really is bipartisan. I 
am so thrilled we have colleagues on both sides of the aisle who are 
supporting this effort signing on. We have more people signing on every 
day. That is because we believe in these clinics. We believe in the 
services and this way of providing services. We have seen it for 
ourselves, how it can change people's lives and give people the 
opportunity to be able to thrive.
  When we introduced our original legislation, I spoke with Malkia 
Newman, whom I have known for many years. She lived for over 30 years 
with undiagnosed and untreated bipolar disorder. She finally got the 
treatment she needed through the community mental health system. And 
what she has done is truly amazing. We had Malkia come and speak as a 
witness for our healthcare subcommittee hearing in Finance that Senator 
Daines and I did a few weeks ago, and she was amazing.
  Malkia is team supervisor for the CNS Healthcare Anti-Stigma Program 
in Waterford, MI. She is a peer educator. She is developing and leading 
programming in Michigan and sharing her expertise all across the 
country. She is an ordained minister, and she is a board member of the 
Oakland Community Health Network, where she has served several terms as 
board chair and vice chair.
  Last month, when she testified at our Senate Finance Health 
Subcommittee hearing, she said: I am living proof. I am living proof. I 
am an advocate, and I am proud to speak on behalf of those who have not 
yet found their voice.
  Malkia found her voice. It is time to make sure that everyone in our 
communities has the support they need to do the same.
  I am looking forward to working with my friend Senator Blunt and all 
of our colleagues who have already signed on as original cosponsors, 
and we welcome everyone in this body to join us in moving forward 
legislation that we have demonstrated makes a difference--saving money, 
saving lives. It is now time to make these services available across 
the country.
  I yield the floor.
  The PRESIDING OFFICER (Ms. Cortez Masto). The Senator from Michigan.
  Ms. STABENOW. I just wanted to let my friend Senator Blunt, whom I 
have been talking about now on the floor--I just wanted to say, with 
him here--and I knew he was going to be here shortly, but I just want 
to say again what a real pleasure and honor it has been to partner with 
my friend Senator Blunt in this really major movement to transform the 
way we fund community mental health and addiction services.
  And our Presiding Officer has also been a leader in this. I want to 
thank her for that as well. But I just want to thank my partner, as I 
was indicating before we came down, on the 50th anniversary of 
President Kennedy's signing his last bill.
  And I am pleased we have been able to pick up the torch, and we are 
going to get it over the finish line and make sure these wonderful 
services are available across the country.
  Mr. BLUNT. Thank you. Madam President.
  The PRESIDING OFFICER. The Senator from Missouri

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