States May Miss 988 Implementation Deadline

“We have to be able to provide services” when 988 goes live, said Kansas House Health and Human Services Committee Chair Brenda Landwehr (R) in an interview. Kansas lawmakers talk a lot about the need to address mental health, she said: “Put up or shut up.”

It isn't clear whether CTIA will resume lobbying states about capping the size of 988 fees and limiting the scope of services for which the fees could be used. It was criticized in July by Democratic Sens. Ron Wyden and Jeff Merkley of Oregon and Chris Murphy of Connecticut (see 2107150063). CTIA didn't comment Friday. Its last public activity on 988 was testimony in July before the Massachusetts Joint Committee on Mental Health, Substance Use and Recovery regarding pending legislation there, per CTIA's website.

Kennedy Forum Policy Fellow Lauren Finke said CTIA has supposedly shifted lobbying from statehouses to the federal level, focusing on possible follow-up legislation on 988. She said it is likely CTIA could remain active lobbying legislatures in larger states like California.

On Sunday, 10-digit dialing to accommodate 988 was to have become mandatory in 82 area codes in 36 states, Verizon said last week. Ten-digit dialing previously was optional there, it said. Local calls dialed using only seven digits won't be completed and the caller might get a recording that the call can't be completed as dialed. State commissions including from Indiana, Michigan and Washington released consumer alerts last week.

For states that haven't passed legislation beefing up their emergency call center systems, calls to 988 will still be directed to the National Suicide Prevention Lifeline, but call centers might not have the resources to answer all the incoming calls promptly, emailed David Lloyd, Kennedy Forum senior policy fellow. He said it's expected that call volume could triple with the easy-to-remember three-digit number, plus pandemic-related mental health impacts. Without legislation, states aren't likely to have a coordinated system of behavioral health crisis response and stabilization, he said.

Many state legislators remain unaware of 988 going national in July, said Debbie Plotnick, Mental Health America senior vice president-state and federal advocacy. States that were working on legislation in 2021 and likely will revisit the issue in 2022 include Idaho, Montana, Kentucky and Kansas, she said. Texas, Nebraska and Alabama have enacted legislation to study implementation, she said. Some states have enacted laws that don't include levying fees but have other sources of funding for both hotline expenses and crisis response services, such as Utah, Illinois, Indiana and Oregon, she said.

Not every state will need legislation, as some will handle it administratively with existing resources, said Danna Mauch, Massachusetts Association for Mental Health president. She said Massachusetts, which has pending bills that would support implementation of 988 and improve 911's ability to respond to a behavioral health crisis, also has the option of tackling 988 rollout using resources that include federal community mental health and substance abuse block grants.

Optimism

A Massachusetts 988 proposal could advance soon.

The legislature’s mental health panel Senate Chairman Julian Cyr (D) filed S-1274 in January and his committee heard testimony on the bill in July. Cyr shares concerns that not all states may implement 988 by July, he told us. Massachusetts legislators “certainly don’t want to miss any opportunities like this.”

Cyr would be surprised if his own committee held up S-1274, and leadership supports passing mental health legislation, he said. “It’s not that unusual the bill isn’t terribly far along” because the Massachusetts has a two-year calendar, he said. Cyr got the written CTIA testimony, but nobody spoke in opposition at the hearing, he said. “I have yet to sit down with the wireless industry to hear their concerns.” There's state precedent for consumer fees that pay for public safety, he stressed: “Mental health response is very clearly public safety.”

Kansas lawmakers will try again in January on a bill that stalled in 2021 after carriers raised fee concerns, Landwehr said. “We were putting a 50 cent charge on all phones and the telecoms came out big time against it, and then legislators opposed it because of the 50 cents.” Verizon, T-Mobile and AT&T mostly supported HB-2281 but raised concerns about the monthly fee per line in one-on-one talks with Landwehr, and CTIA took issue in testimony at a Feb. 22 committee hearing, she said. Landwehr told her state's U.S. Sen. Jerry Moran (R) about it, she said.

Next year’s Kansas bill will again start at 50 cents, an amount that would cover mobile crisis units and shore up call centers, Landwehr said: “We’re hoping that people have had time to think about it.” T-Mobile and AT&T offered to work on a compromise, but Verizon doesn’t want to compromise, she said. “There is not a business in this country that is not impacted financially by mental health issues,” Landwehr noted. “It’s a big cost to every single budget that a state has.”

Carriers

“Verizon fully supports funding any necessary 988 infrastructure enhancements to connect suicide prevention calls” and “will be ready on day one to ensure customers' calls to 988 are quickly connected,” a spokesperson emailed. “We don't believe that the entire cost of treating Kansans who most need these services should be exclusively borne by imposing new fees on wireless customers' monthly bills. Instead, these important services should be funded from a variety of federal and state revenue sources.”

AT&T thinks a "fee-based approach should be a transparent and affordable with consistent review to ensure appropriate 988 funds allocation," a spokesperson emailed Friday. "To help support and implement a successful 988 program, state lawmakers should additionally fund 988 services through general revenue.” T-Mobile didn’t comment.

A fresh Idaho 988 bill will be introduced in the House or Senate this January, after SB-1125 failed this year, Senate Health and Welfare Committee Chair Fred Martin (R) told us. The legislature passed only a resolution supporting the mental health hotline. Not all legislators saw SB-1225 as urgent to enact in 2021 given the 2022 deadline, and carriers resisted the proposed $1 monthly fee per phone line, he said. “I got the message that it was probably premature and we needed to wait.” Martin is open to what can pass but thinks it should cover costs, he said.

California’s AB-988 needed more time in a large state with diverse interests, bill sponsor Assemblymember Rebecca Bauer-Kahan (D) told us. “We’re really optimistic” about next year, she said. In January, AB-988 will pick up from where it left off in the Senate Rules Committee because the California legislature has a two-year calendar. CTIA testified about its fee concerns in California, but Bauer-Kahan said she doesn’t believe the concerns got much traction among lawmakers. State policymakers “are committed to providing a working, comprehensive response to [the] mental health crisis,” she said: That requires funding more than “just the phone centers.”

California's failure to adopt the bill introduced early this year, AB-988, isn't concerning since it's common for comprehensive bills to go into the second year of a two-year bill cycle, Finke said. "Time is ticking" and the state possibly won't have anything passed by July 16, she said. "It's tight for everybody in every state," she said. Even if California doesn't adopt 988 legislation before July 16, the state announced in September it's putting $20 million toward its emergency call center network to support 988's launch. Theresa Comstock, president of the state Association of Local Behavioral Health Boards & Commissions, said the state has a patchwork of different programs for responding to crises and it's unclear if the fees proposed in AB-988 would be enough to cover operation of mobile crisis teams.