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Grassley Q&A: COVID-19 & Mental Health

With U.S. Senator Chuck Grassley

Q: Why are you working to expand access to behavioral health care?

A: Even before the pandemic, Iowans at my 99 county meetings often brought up barriers to mental health care, particularly in rural areas of the state. The issue has gained even more urgency when lockdowns, remote learning and mask mandates contributed to social isolation and a spike in suicide and emergency room visits for suspected attempts among younger generations. Mental health experts warned of a “tsunami of suicides” when COVID-19 hit our shores and restrictions on campuses, businesses and travel followed. As then-chairman of the Senate Finance Committee, I wrote legislation to expand access to telehealth services, including behavioral health appointments, in pandemic relief laws enacted in 2020. At the end of 2021, I led efforts to make telehealth services for mental health care permanent under Medicare. That tipped the scale and prompted a number of states to do the same for Medicaid, including Iowa. Since then, overwhelming support among patients and providers factored into my work this Congress to continue comprehensive telehealth coverage even after the pandemic. I’m co-sponsoring CONNECT for Health Act that would make permanent telehealth flexibilities and the Protecting Rural Telehealth Access Act that would make telehealth flexibilities permanent for critical access hospitals. Iowa has 82 critical access hospitals. This would reach a broad cross section of Iowans across the state.

My support to end the mental health care coverage disparity started years ago with bipartisan reforms led by Sens. Paul Wellstone and Pete Domenici. The Mental Health Parity and Addiction Equity Act of 2008 prevents insurance providers from imposing limits on coverage for behavioral health services compared to other medical care benefits. In this Congress, I’m building on legislation I wrote in 2019, the Advancing Care for Exceptional (ACE) Kids Act. Signed into law by President Trump, the ACE Act empowers families who are managing complex medical conditions, including mental health support services, for children covered by Medicaid. It makes it possible for health care providers to coordinate care, lower costs and improve quality outcomes for families shouldering extraordinary burdens to get the best possible care for their kids. My update would streamline the screening and provider enrollment process for Medicaid providers serving children with complex medical conditions and help ensure a child’s physical and mental health care providers are working together. For parents who may reach their wits’ end to obtain the best care for their child, these reforms will help them navigate the best path forward to achieve the best outcome for their precious children.

Q: How else are you leveraging your leadership at the policymaking table to bolster mental health services in Iowa?

A: When I chaired the Senate Finance Committee, I also advanced reforms that allowed health care providers to integrate behavioral health care services with substance abuse disorder supports in one site. Iowa has 11 Certified Community Behavioral Health Clinics serving local residents in a one-stop visit for behavioral health care. These clinics are located in Cedar RapidsCouncil BluffsDes MoinesDubuqueFort DodgeLe MarsLeonSpencerWaterloo (2), and Mason City.  In Des Moines, Primary Health Care uses federal workforce dollars to help fund its graduate medical education (GME) programs. I’ve worked to rinse wasteful spending from GME programs to ensure scarce resources are used to address workforce shortages in our health care delivery system. In 2020, I pushed to expand funding for this program to meet demand. My office also recently helped Clive Behavioral Health cut federal red tape to get up and running to serve Iowans.

Last summer, I visited Vera French Community Mental Health Center in Davenport. The input I got from administrators and health care professionals there in the Quad Cities informed my decision to support a bipartisan bill that would require Medicare to cover services provided by licensed mental health care counselors and marriage and family therapists so that they are able to provide behavioral health services to older adults. My bipartisan efforts to get over-the-counter hearing aids on the shelf will help bring more affordable choices to seniors and boost mental wellness caused by social isolation due to hearing impairment.

Throughout my work on behalf of Iowans, I’ve led the way to strengthen mental health awareness and supports for farmers, veterans, police officers and foster youth. COVID-19 has taken the lives of too many loved ones among us. Whether from a delayed cancer diagnosis, the virus itself or death by suicide, the pandemic has delivered grievous challenges to American society. Like many Americans, Iowans want to return to normalcy once and for all. Normalizing appointments and expanding services for mental health care is one silver lining that will continue long after we put the pandemic behind us.

For Iowans in need of emergency assistance, contact the national suicide prevention hotline, 24/7 at (800) 273-TALK. Or text HELLO to the crisis text line 741741.

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