ALEXANDRIA, Va.—Mental Health America (MHA) is applauding Representatives Timothy Murphy (PA-18) and Eddie Bernice Johnson (TX-30) for making significant and positive revisions to their mental health reform legislation, the Helping Families in Mental Health Crisis Act of 2015 (H.R. 2646). The amended legislation passed late last night with a 17-13 vote in the House Energy and Commerce (E&C) Health Subcommittee, and will now move on to the full Committee for consideration.
The authors of H.R. 2646 yesterday offered a manager’s amendment that addressed many of MHA’s concerns with the original proposal. Additionally, for the first time during this process, the Democratic subcommittee members—led by Rep. Frank Pallone (NJ-3), also a longtime advocate for people with mental health concerns—offered a number of thoughtful amendments. While most of the Democrats’ amendments did not pass, both Rep. Murphy and E&C Committee Chairman Fred Upton (MI-6) made commitments to work with the Democratic members to make the bill even stronger during the full committee mark-up.
“This is an important milestone for everyone who wants to see balanced, comprehensive mental health systems reform become a reality in America,” said Paul Gionfriddo, MHA president and CEO. “Mental health is not and should not be a partisan issue, and it is clear that both sides want to get something done. Republicans and Democrats showed they are listening, and credit should be given to everyone for their sincere efforts to make a significant difference in the lives of those living with mental illness.”
The bill’s emphasis on moving upstream in the process – i.e., on intervening before Stage 4 – is a critical step forward toward treating mental illnesses like we treat every other chronic disease. H.R. 2646 focuses on screening and early intervention; community-based systems of care; enhancing the behavioral health workforce; innovation to develop new evidence-based programs; prevention; integration of health and behavioral health care, including measures to facilitate the sharing of health data needed for care integration; enforcement of parity in coverage between health and behavioral health services; and the elevation of behavioral health in the federal government, including increased coordination of services. These are all essential components of a sound care delivery system.
As amended, H.R. 2646 retains the key provisions that have been most important to MHA, and now includes the following as well:
- Retains the new innovation, demonstration, and early childhood prevention and early intervention grant programs, with authorized funding, and preference to programs serving young people;
- Improves the prospects for developing a peer workforce in clinical settings, by requiring a report on best practices around credentialing of peers who would work under clinical supervision (without affecting peers who do not), with a strong focus on recovery-oriented language;
- Includes Severe Emotional Disturbance (SED) with provisions related to Serious Mental Illness (SMI), and improves coordination with schools, opening the door to more services for children;
- Restores powers to federally-supported Protection & Advocacy entities, by limiting lobbying restrictions only to the use of federal funds for that purpose, and expanding duties from only abuse and neglect to abuse, neglect, and evidence-based community services, including supported housing, employment, and education;
- Clarifies that while states with Assisted Outpatient Treatment (AOT) programs will be eligible for incentive payments, no state will be penalized for not having an AOT program;
- Balances federal advisory councils that originally had been weighted toward clinical providers with equal representation by non-clinicians, including families and people with lived experience;
- Includes a requirement that the Interagency Council on Serious Mental Illness develop a plan to eliminate the incarceration of nonviolent offenders with mental illness within ten years, and direct the savings to prevention, early intervention, and integrated services included in the proposal;
- Loosens some of the archaic restrictions on allowing people to share their own behavioral health information at the same time they share their general health information (known as 42 CFR pt.2) by allowing sharing for treatment, payment, and health care operations, within organized health care systems, medical homes, Accountable Care Organizations (ACOs), and Health Information Exchanges (HIEs); and
- Changes the IMD exclusion section to make it more similar to waivers and rules in existence today, tightening its use.
“Prevention, early intervention, and recovery-oriented integrated treatment and services are far, far better than the revolving door of homelessness, infrequent hospitalization, and frequent incarceration that currently passes for this country’s mental health care system,” continued Gionfriddo. “We thank the subcommittee and urge the E&C Committee to advance mental health reform legislation as soon as possible. The time is now to erase the discrimination and stigma surrounding mental illness, to address mental health before Stage 4, and to intervene effectively to save lives and change the trajectories of people living with mental illnesses. MHA stands ready to work with all members of Congress to make this a reality.”
