PERLE MALKA, A CONCERNED CITIZEN

October 12, 2020

Perle Malka

1540 Vine St. #660

Los Angeles, CA 90028

Dear Dr. Robert R. Redfield,

Our health policy goals are to protect and promote the health of individuals and the community. However, with America's expansive range of policymaking bodies seeking to influence policy, it is impossible to offer a systematic analysis of health policy formulation. With the promise of a new election year, many of the state legislatures will soon reconvene to set forth health policy bills.

As the CDC director, you are undoubtedly aware of our nation's grave problems with mental health, with an estimated 50% of all Americans diagnosed with a mental illness or disorder at some point in their lifetime. While COVID-19 is indisputably a physical illness, the mental health consequences may be so great that some have called it the next COVID-19 mental health pandemic. Anticipated to increase, the population's risks of developing substance use, anxiety, depression, child abuse, domestic violence, and suicide. Particularly in the older population, we expect increased feelings of sadness and depression. Also, according to the Kaiser Health News Report, when compared with their white counterparts, African American adults are 20% more likely to experience mental health issues. Systemic racism exacerbates the adverse impacts of social determinants of health, causing racial health disparities in African Americans. Access to mental health care is becoming more of a pressing issue as COVID-19 cases continue to rise, many surrounded by loved ones holding vigil in their minds, even when they cannot be bedside. Moreover, there is a worry that some family members of critically ill COVID patients may develop a related syndrome, PICS-Family.

There have been positive outcomes of the COVID-19 pandemic. Lawmakers made significant changes in the waiving of federal and state telemedicine laws and when Democratic Gov. Gavin Newsom approved first-in-the-nation policies to require more comprehensive coverage of mental health and addiction. Perhaps as being the most consequential is a mental health parity bill SB-855, which requires state-regulated health

1540 Vine St. Apt 660, Los Angeles, CA 90028 (424) 239-8335

Page 1 of 2 insurers in the state of California to cover all medically necessary treatments for mental health and substance abuse disorders, from depression to opioid addiction. Another noteworthy bill is SB-803, which will permit peer providers— individuals with their own histories of mental illness who help other Californians navigate complex behavioral health issues — to be certified by the state. Once certified, they can bill Medi-Cal for their services. A lobbyist for the Sacramento-based Steinberg Institute, Julie Snyder, which advocates for mental health care policy reforms, called the new law an exemplary model for the rest of the country.

The mission of the CDC's Public Health Law Program is to advance the public's health through law. Paramount is the CDC's capacity to apply laws in order to achieve health protection goals and to develop the legal preparedness of the public health system to address all public health priorities. Many laws affect the work of HHS and, and in turn, the work of the CDC. Newsom’s visionary policies work to decriminalize mental illness through various avenues, lays the groundwork for transformational change in healthcare. Today, we stand at a transformative moment in history. As the national standard-bearer for health care advocacy ethics and practice, the CDC members must double their efforts toward equitable inclusion for individuals for whom justice has been historically withheld. We must aspire to eliminate racial-disparities whenever they present in health care. The CDC holds an important role in developing databases to monitor and track policy enactment, enact regulations and procedures, publish guidelines and recommendations, incentives, administrative actions, and voluntary practices. Given your position and the impending COVID-19 mental health pandemic, we urge you to advance such sound public policy and support and recommend such changes to be implemented nationwide.

As a student in Public Health, I am committed to the values and principles which underlie the ethical and professional practices of those who work in the area of health/patient advocacy. As a Californian resident, I am proud that Governor Newsom spearheaded the fight for mental health parity with his policies. We count on the CDC’s support to address this issue and lead governors in all states to follow in the footsteps of Gov. Newsom. We need to position America through policy to equitably meet the increased demand for mental health services, virtually or in-person. Valuing humanity, above all, moves us closer to our aspirational goals of health equity and healthcare access.

Sincerely yours,

Perle Malka

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