Today, Rep. Tim Murphy (R-Pa.) and Rep. Eddie Bernice Johnson (D-Texas) reintroduced the Helping Families in Mental Health Crisis Act, H.R. 2646. The revamped bill builds on the previous bipartisan version that was introduced in 2013, and aims to improve access, shore up the workforce, drive evidence-based care, and provide alternatives to institutionalization.
“We’re still digesting,” Charles Ingoglia, senior vice president of public policy and practice improvement for the National Council for Behavioral Health, tells Behavioral Healthcare. “On first read, there are some things that stand out to us that we applaud the authors for including. It extends the Certified Community Behavioral Health Clinic demo by two states and two years, for a total of 10 states and four years. It contains the behavioral health IT legislation that amends and extends the Meaningful Use program to include additional behavioral health practitioners and facilities. And it has very strong language around parity enforcement.”
Ingoglia says many elements in HR 2646 seem positive.
“In general, we continue to be grateful to Chairman Murphy for the attention that he is focusing on mental health issues,” he says.
Murphy is Chairman of the House Energy & Commerce Oversight and Investigations Subcommittee.
Of course, like most policy proposals, not everyone applauds the entire bill. Among the key points of contention are:
1. How the bill creates a new federal position of “Assistant Secretary for Mental Health and Substance Use Disorders” within the Department of Health & Human Services to supplant SAMHSA; and
2. Provisions that require states to have laws that promote the greater use of assisted outpatient therapy (AOT) in order to recieve block-grant funds.
In section 102 of HR2646, the new secretary would take over for SAMHSA immediately:
“The Secretary of Health and Human Services shall delegate to the Assistant Secretary all duties and authorities that as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration.”
Murphy is a psychologist who has often criticized SAMHSA as ineffective, saying it is only focusing on “soft” outcomes and general wellness for the masses rather than practical help for those with serious mental illness. “It’s as if SAMHSA doesn’t believe serious mental illness exists,” Murphy said at a hearing in 2013. He also pointed out in a statement released today that, “The leading federal mental health agency”—meaning SAMHSA—“does not employ any mental health professionals, such as psychiatrists or psychologists.”
Murphy has also criticized the way SAMHSA doles out the grant money, saying evidence-based practices are not among the criteria for earning grants but should be.
According to HR 2646, the new Assistant Secretary (who must have mental health credentials) would coordinate programs across different agencies and promote evidence-based practices in grant-making programs. New tasks would include sharing information on all federal parity-law investigations with the public and establishing a national policy to increase the behavioral health workforce. There is also a coordination committee and other new posts created through the bill.
Many providers have been demanding that the federal incentive money for EHR system investments be extended to mental health providers, who were left out of the original program. HR 2646 includes such a provision. As of April 2015, more than 456,000 other healthcare providers received payment for participating in the Medicare and Medicaid EHR incentive programs, to the tune of $20.5 billion.