Champions include representatives from various state agencies, including:

1. Michigan Department of Health and Human Services

2. Minnesota Department of Human Services

3. Office of Strategy and Transformation at the Montana Department of Public Health & Human Services

4. North Carolina Department of Health and Human Services

5. Texas Health and Human Services

Beyond securing these critical points of contact in each state, state teams met with other relevant stakeholders, including legislators and representatives in local government to share and present on the access challenges experienced within the BDs community, BD SUMHAC’s advocacy, and ways they can get involved in this work.

• Michigan, Montana, North Carolina, and Texas completed this goal within the first year. With support from their state agency champion(s) and other stakeholders in MH and SUD facility licensing and regulatory affairs, these teams mapped and identified the relevant policies related to:

  1. Self-administration of medication

  2. Staff training and assistance on medication administration

  3. External provider-assisted administration of medications, e.g., a healthcare provider outside of the facility coming in to assist a patient with medication administration

  4. Facilities choosing to admit or deny patients based on perceived medical complexity (i.e., "cherry picking")

  5.  A patient’s ability to bring specialty medications (namely infusion and injection medications) from home (i.e., “brown bagging”)

  6. A patient’s ability to receive medications from a third party specialty pharmacy while receiving care in the facility (i.e., “White bagging”)

• Minnesota partially completed this goal within the first year. The team completed its landscape mapping for SUD facilities and residential MH facilities will continue to map and learn more about the regulations for inpatient MH facilities in 2025.

Here are some examples of goals each team will work towards in 2025 (Phase 2):

Michigan
The Michigan Department of Licensing and Regulatory Affairs (LARA) is currently undergoing a process of updating state regulations for MH and SUD facilities and the MI state team will share recommendations for proposed changes to the regulations. This is a tremendous opportunity for state advocates to directly impact regulations in their state and will have a significant impact on SUD and MH access policies for people with BDs and others who take infusion or injection medications.

Montana
Similar to Michigan, Montana’s Department of Public Health and Human Services (DPHHS) is undergoing a process of updating the Administrative Rules of Montana for MH and SUD treatment facilities. The MT state team will share proposed recommendations for new language. This is an exciting opportunity for state advocates to directly impact regulations in Montana and, if the team's proposed language is adopted, will have a significant impact on access to SUD and MH facilities for people with BD and others who take infusion or injection medications.

Minnesota
The MN state team will continue to map the regulatory landscape of MH facilities by engaging with relevant state officials at the MN Department of Health (DOH). The state team has been invited to present a Spark Session at an upcoming Minnesota Association of Resources for Recovery and Chemical Health(MARRCH) conference in the fall of 2024. MARRCH is a professional association of addiction treatment professionals and organizations striving to raise awareness about addiction and the power of recovery.

North Carolina
The NC team has determined that there are no regulatory barriers that prevent access to inpatient/residential behavioral health facilities in North Carolina. However, state government contacts shared that individual facilities may implement policies that limit access for people with chronic conditions or people who use infusion or injection medications. Therefore, it was recommended that the state team focus on facility education. The NC state team virtually presented to the state’s Local Management Entities/Managed Care Organizations and the state government contacts offered to advertise a BD SUMHAC webinar designed to educate facility staff. For next year, the NC state team will provide trainings to behavioral health providers on BDs, infusion and injection medications, and other related topics to support staff development across the state. The team will also engage with state legislators and private insurance providers on the current behavioral health access of the BD community and ways they can help facilitate access to these services. Contacts in the legislature recommended that the NC state team develop relationships with local private payers who may be willing to assist in the event of denials. 

Texas
The TX state team will work to add clarifying and inclusive language to Medicaid contracts on supporting patients with BDs and those who use infusion and injection medications. The team also aims to provide trainings to behavioral health providers on BDs, infusion and injection medications, and other related topics to support staff development across the state.