Q&A: Rep. Matt Claman on his mental health education bill and the Dunleavy Administration’s legal challenges

Representative Matt Claman of West Anchorage was elected to the Alaska State House in 2014. As Chair of the Judiciary Committee and a member of the Health & Social Services Committee, Rep. Claman has a unique perspective to offer on the budgets cuts introduced by the Dunleavy Administration last year and the legal fights that have ensued since. The “Slash and Burn” approach, as described by some, roiled communities across the state, where cuts were proposed to services such as adult dental preventive care for Medicaid recipients and medical transportation services for rural Alaskans. Following an onslaught of public backlash and several lawsuits, the administration reversed course

I caught up with Rep. Claman on the first day of Alaska’s 2020 legislative session to discuss the approach legislators are taking to the budget process following a tumultuous year, as well as a bill he’s pre-filed that expands existing health education requirements to include a mental health curriculum in all K-12 health classrooms.

 

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Michael Goldberg: What are your hopes and expectations for health reform this session?

Rep. Matt Claman: I think the first priority is a more realistic approach to Medicaid funding here in Alaska. We’ve seen over the last year that the Governor has unrealistic and, it appears, unfounded beliefs that the administration could achieve certain cuts without running afoul of federal laws and regulatory requirements. As a result, we are seeing what is likely to be one of the largest supplemental budgets in Alaska history to fund Medicaid at the levels required by the federal government.”

MG: Can you give us an update on the legal fights over the budget cuts the Governor made, or attempted to make last year? These cuts were expected to affect, among other areas, Medicaid dental adult dental preventive care as well as medical transportation. 

MC: So far, the governor’s office isn’t proposing any further cuts. As far as the adult dental Medicaid cuts, which we twice tried to reverse in the House before the Governor issued line item vetos, in the last two months they’ve acknowledged that they weren’t allowed to do those cuts. They’re putting the money back in the supplemental budget. There were payments to hospitals that were blocked by a lawsuit and I don’t believe they’re trying to make any cuts to funding for hospitals. Third, they are required to make payments to doctors and they may not have put enough money in the budget to make those required payments. I would anticipate that in the budget process we’ll be trying to make the budget more accurately reflect the required payments. I think the budget needs to reflect what we will in fact have to pay, rather than thinking we can pretend there’s a cut and come back next year for another supplemental.

The governor is now involved in 13 or 14 different lawsuits on a variety of issues, from Medicaid to funding efforts to labor rights, and in every case the Governor has lost so far. He’s got this long history of legal losses, and there are so many that I haven’t had the chance to study them all. In the case brought by the hospital association, I agreed with their position and I’m glad they won.”

MG: You’ve pre-filed legislation that expands existing health education requirements to include a mental health curriculum in all K-12 health classrooms. The goal is to make sure students are adequately educated on vital information about mental health symptoms, resources, and treatment. Can you expand on the role that information, the ways it’s shaped and the degree to which it’s accessible, plays in either exacerbating or ameliorating the mental health crisis. Are we seeing a correlation between information and outcomes?

MC: In large measure, there is a correlation between information and outcomes. In the more narrow area of K-12 education, we’ve had health education classes in our schools for decades. Three of the areas that health education has covered historically have been good diet, the role of exercise in maintaining a healthy weight, and while subject to controversy over the level of detail provided; sex education has been part of the health curriculum in schools for decades. 

Mental health education has not been part of that. The idea for this bill is to make sure that mental health education becomes part of the curriculum. First and foremost, we are seeing more and more people with mental health challenges and by adding that to the public health curriculum in schools we are acknowledging that these are real medical issues and not something to be ashamed of. In the same way that if you had a bad chest cold, you shouldn’t be at school if you’re suffering from mental health challenges, and that’s good public health. The notion that someone would be suffering from mental health challenges at a particular time, it shouldn’t be something they should be ashamed to talk about. I’m under no illusion that talking about mental health challenges will solve every issue we have in our country with mental health. But at least being able to talk about it and feel like it’s a normal thing to be able to talk about is a very positive step.”

MG: I hear you highlighting the role that stigma plays in dissuading youth from seeking out mental health treatment. Can you talk more about that?

MC: Overcoming the stigma has been something we’ve been trying to deal with for many years. Not just with mental health but with other health concerns that carry with them certain stigmas. But I’ll tell you, the biggest factor in bringing this bill forward was the huge support from both young adults and high school kids who have learned about this proposal and have gotten on board with a lot of excitement. The consistent thing they tell me is that we need this in our schools, “everyday I go in the halls and talk with people about dealing with mental health challenges and we don’t even talk about it in our health classes.” What’s wrong with this picture? I hear from these young folks and I’m inspired. These issues have been in the darkness for too long, it’s time to make these changes.”

MG: One more noteworthy thing is that the governor’s office, continuing the efforts from the prior administration has worked to get what’s called the 1115 waiver, which relates to mental health and substance abuse treatment covered by Medicaid, approved by the federal government. In discussion about this administration’s commitment to the 1115 waiver, they did acknowledge they would no longer be taking any steps to move back from Medicaid expansion that was started by the prior administration. Although earlier the governor had talked about trying to withdraw from Medicaid expansion, they are no longer trying to do that, in large part because they see the huge benefit to Alaskans in mental and health and substance abuse treatment allowed by the 11-15 waiver.    

This conversation has been edited for clarity and length.