Nebraska lawmakers are considering a bill to ensure managed health care companies cannot limit the state reimbursement rate for mental health service providers.

Advocates for the bill want to make sure in the future, the companies could not negotiate a lower rate. Right now, there's no requirement they use the posted rates, it has just been the practice. Legislative Bill 380 would keep "guardrails" in place.

Annette Dubas, executive director of the Nebraska Association of Behavioral Health Organizations, said providers have worked for 20 years just to get the reimbursement rates to meet the minimum state standards.

"Nebraska's rates were, two decades ago, towards the bottom," Dubas pointed out. "We've worked hard over those last two decades to get rates built up. It comes down to the ability to build capacity, so that people who are in need of mental health care can access that mental health care."

Dubas noted the bill was introduced after Nebraska autism care providers had to fight an effort to reduce their reimbursement rates last year. It awaits action in committee. Dubas emphasized her group opposes an amendment to remove the minimum pay "guardrails."

Dubas explained low wages and often challenging working conditions already make it difficult to find mental health care professionals, and lower reimbursement rates mean even lower wages and less stable employment. She added protecting the rates already in place is critical to ensuring the ability to recruit and retain workers.

"If rates do not stay up where they need to be, it just puts that much more pressure on these providers to be able not only bring in new workforce, but to retain the workforce that they have," Dubas explained. "Burnout is a huge issue."

Dubas added any rate adjustment legislation could also complicate a reimbursement process she described as already confusing and complex in Nebraska.

After a legislative session which opened doors to expand mental health care services across Montana, a state commission said it is considering the Billings area to build the state's second forensic facility.

For people involved in Montana's justice system whom a judge has deemed not mentally fit for their own defense, there are 53 beds in the state's only forensic facility in Galen. The daily waitlist hovers at about 100 people.

Matt Kuntz, executive director of the National Alliance on Mental Illness-Montana, said it is not meeting the immense need.

"It's just a really bad situation for the people that are in the jails, for the people that are caring for them, for the taxpayers," Kuntz outlined. "It just doesn't work for anybody."

At a recent commission meeting, Montana Department of Public Health and Human Services Director Charlie Brereton said the state is identifying a location for a new facility. The department received nearly $27 million from the state in April to fund project planning.

Kuntz noted the Montana Legislature passed many bills this session centered on mental health care.

"We really were able to get big wins in access to outpatient care, access to crisis care and for people in need of forensic hospital," Kuntz explained. "Overall, it was really an amazing legislative session for Montanans with mental health conditions."

Other mental health legislation will boost school-based services, youth in residential care, the state's 988 crisis line and certified community behavioral health clinics.


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The California Parent and Youth Helpline is in serious jeopardy after Gov. Gavin Newsom cut it from the new state budget, saying the money was needed to support medical services.

Advocates said they are puzzled because the governor has championed the helpline for years, and lawmakers approved $3 million from a separate fund dedicated to mental health, which does not affect the deficit.

Lisa Pion-Berlin, president and CEO of the nonprofit Parents Anonymous, which runs the helpline, said it is still operating 24/7, for now.

"We're holding on for the next month or so," Pion-Berlin pointed out. "But we need the state to step up, or one of these well-off philanthropists who cares about having that immediate help for emotional support, which is so vital."

Advocates are hoping funding can be restored via a budget trailer bill in the next few weeks. People can call or text and reach the helpline's trained counselors at 877-427-2736. The free helpline has connected with more than 120,000 people since its inception five years ago, and the website CAParentYouthHelpline.org has reached a million more.

Pion-Berlin noted a study in the Journal of Technology in Human Services found a call to the helpline can quickly ease parents' suffering and feelings of isolation.

"The research said that 85% of the callers in less than 30 minutes feel more positive, more hopeful and able to address their issues," Pion-Berlin reported. "There is no other service or pill I know that can do that in 30 minutes or less."

Parents Anonymous also offers free weekly support groups to steer parents and kids through emotional crises of all kinds.

Minnesota teens are using their summer break to set aside added stress and anxiety they deal with during school and as the age group gets more attention for its mental health needs, parents of younger kids are urged not to miss warning signs.

The Minnesota chapter of the American Academy of Pediatrics hosted a discussion coinciding with the start of summer. As parents spend more time with their kids over the next few months, health professionals said persistent behavioral issues among preschool age children should not completely be written off as phases.

Dr. Helen Egger, a child psychiatrist, said key data is consistent with other age groups.

"The rate of impairing mental health disorders in preschool children, here we're talking about children 2-5, is actually the same as the rate in older children and adults," Egger explained.

The Centers for Disease Control and Prevention has noted the number of adolescents reporting poor mental health is increasing. For younger kids, Egger pointed out pediatricians and parents need to be mindful of things like excessive tantrums or trouble eating and sleeping. She warned there is a misconception kids are resilient and those problems will fade away.

Egger added there is a connection between parental stress and behavioral issues in young children. She recommended parents take an active role in family therapy interventions to benefit the whole household.

"Sixty percent of the families who, when they started therapy, said that they had an unmanageable level of stress," Egger noted. "For 60% after 12 or more sessions, they were at a manageable level of stress."

Egger emphasized Minnesota has strong resources for parents to turn to when figuring out the appropriate interventions. She pointed to the website for the Minnesota Association for Children's Mental Health as a key option.


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