Letter: COVID-19 Relief Needed for Children’s Behavioral Health System

Testimony & Public Comments

April 15, 2020

Dear Minority Leader Schumer, Senator Gillibrand, and the New York State Congressional Delegation:

The Healthy Minds, Healthy Kids Campaign is a statewide coalition of behavioral health providers, advocates, and New York families, joining together to create the public and political will necessary to ensure that all children and adolescents in New York receive the high-quality behavioral health services they need. We thank you for your continued leadership in ensuring the well-being of children and families in New York as you develop and negotiate a fourth federal relief package in response to the COVID-19 crisis.

In New York and across the country, COVID-19 is exacerbating children’s unmet mental health needs, as children face new behavioral health challenges resulting from isolation, economic and housing insecurity, family loss, and heightened child welfare risks. We must act now to provide the supports children and families need during and following this crisis.

The Healthy Minds, Healthy Kids Campaign endorses the letter recently submitted to Congress on behalf of numerous national mental health partners (attached) requesting emergency appropriations to prevent the behavioral health system from collapsing and to mitigate a greater public health and economic crisis from untreated mental illness and addiction. In endorsing these proposals, we offer the following recommendations to ensure that children and families are not left behind in COVID-19 relief efforts:

1. For any funding appropriated for behavioral health emergency appropriations, we urge you to ensure at least 25% is dedicated to children’s services and infrastructure. The long-term effects of this pandemic on children will be immense. Extensive research on adverse childhood experiences tells us that the kinds of trauma caused by COVID-19 – including economic and housing insecurity, heightened risk of child welfare involvement, disruptions in mental health care, and loss of loved ones – have long-lasting repercussions

The New York State Congressional Delegation

U.S. House of Representatives

across the health and wellbeing of children as they become adults. Dollars spent now to address and prevent these harms to children will have a multiplier effect, both in terms of improving children’s outcomes, and for reducing costs across sectors. We urge you to maximize investments in behavioral health by devoting a significant portion to children’s services and infrastructure. This funding could also be used to provide support for families struggling to facilitate behavioral services for their children while also juggling remote schooling, potential job loss, illness, and other related challenges.

  1. Create a fund for pandemic preparedness for the children’s behavioral health sector. In New York, children’s behavioral health providers have faced a double challenge of inadequate resources to prepare for COVID-19, as well as widespread fiscal challenges associated with the transition to remote operations. Congregate care settings in particular have been largely overlooked in the pandemic response, despite serving children who are often medically fragile and require 24-hour care. Settings like Residential Treatment Facilities are intended to keep children out of ERs and hospitals, where they will be at greater risk of infection and will add to an already overburdened system. Without adequate protection and compensation, congregate care providers will struggle to prevent hospitalizations and support highly vulnerable populations.

    Unfortunately, we know that we are likely to experience the re-emergence of this virus even after this first crisis ends. As clinics shut down without adequate support, we are at risk of never recovering an already inadequate supply of clinical behavioral supports. This could in turn lead to a collapsed infrastructure of clinical services, at a time when children will most need support to address the trauma of COVID-19 and its associated repercussions. Additional supports must be provided to help the children’s behavioral health sector cope with the current crisis and prepare for the next.

  2. Increase funding for telehealth services by an additional $500 million, and ensure funding is available for ongoing costs. We appreciate the inclusion in the CARES Act of $200 million to help health care providers provide connected care services to patients at their homes or mobile locations. However, too many families and providers still struggle to connect to services remotely. Clinics lack the infrastructure and resources necessary to conduct telehealth. Many families, particularly those in rural areas, lack not only the necessary equipment, but also adequate internet connectivity.

    We strongly support allowing Medicaid to reimburse providers for telehealth and telepsychiatry services, including to address ongoing challenges families face such as internet connectivity. Given the likely length and recurrence of this crisis, it is essential that States can establish a sustainable infrastructure for telehealth.


4. Devote funding to behavioral health screenings, clinical care, and referrals capability tied to the upcoming school year cycle. When children return to school, the preparedness of the school and community-based behavioral health system will play a critical role in identifying and providing mental health support and treatment to students impacted by the emergency. Children returning to school will have faced profound shocks and challenges, whether from personal loss of family members, economic stresses from job loss, housing or food insecurity, and a myriad of other traumatic experiences arising from and exacerbated by COVID-19. We urge Congress to increase in-school clinical capability, including in conjunction with community based providers, to respond quickly and manage children’s behavioral health needs created by this crisis.

These actions and investments are not only timely, but also necessary to ensure that children and families are able to weather this crisis and be put on a path to recovery afterwards. We look forward to continuing to work with you and your colleagues on further relief efforts as this situation develops over the coming weeks, months and year.

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