Some might be wondering why it took six months for House Democrats to issue an answer to the Helping Families in Mental Health Crisis Act of 2013. The Republican bill was released by Rep. Tim Murphy (R-Pa.) last December. Rep. Ron Barber (D-Ariz.) was the lead sponsor of the Democrats’ version, The Strengthening Mental Health in Our Communities Act of 2014, proposed May 6. He had been working on changes to the Murphy bill, but eventually opted for a new piece of legislation.
Barber had been approached by Murphy last year about working on a mental health bill together, but it was clear that there were deep-set ideological differences.
Working with the mental health community after the Newtown, Conn., tragedy, Barber’s staff had heard that two key provisions of the Murphy bill were unpopular: outpatient commitment; and eviscerating the Substance Abuse and Mental Health Administration (SAMHSA). But there was no move by Murphy to compromise.
Barber’s bill keeps SAMHSA intact and retains SAMHSA’s Protection and Advocacy (P&A) initiative. The P&A is particularly important to Barber in light of his experience in the field where he witnessed abuse and neglect.
Another provision of the Murphy bill calls for changes in HIPAA to provide a carveout for providers to share information with family members. Barber would not change HIPAA because providers are already able to communicate with caregivers and law enforcement under its rules.
Industry leaders applaud
“There are things to like about both bills,” said Chuck Ingoglia, vice president for public policy at the National Council for Behavioral Health. “We’re grateful to Chairman Murphy and Congressman Barber.”
Asked which side the National Council was on, Ingoglia said: “We don’t view this in terms of sides.” Instead, the goal is to “move the conversation forward,” he said.
Meanwhile, at SAMHSA, the attitude is philosophical. The Barber bill would add reporting requirements to the Community Mental Health Block Grant “to make sure the states are utilizing the funds in the way the statute intends,” said Brian Altman, SAMHSA’s legislative director. But the Murphy bill would move the block grant out of SAMHSA completely. Still, Altman does point out that the Murphy bill would divert 5 percent of the block grant, which is for services to patients, to create the new office of assistant secretary, which would be outside of SAMHSA.
“Given the hit some of the states have taken in terms of state funding for mental health, I question the value of this,” he said.
Asked whether any bill has a chance of passing, he responded: “It’s Congress, and it’s 2014.”
However, mental health is on the radar screen of the public and Congress now more than ever. “That can be a very good thing,” Altman said. “But it can also lead to other outcomes” that aren’t so good, such as associating all gun violence with people with mental illness. The school shootings in Newton played a role in making the public and the media aware of how the behavioral health system could be advanced and enhanced,” he said.
Ingoglia said that it’s unlikely there will be major legislation before November, with the elections coming up. “We would be hopeful for some kind of movement in committee,” he said. “There are obviously differences of opinion.”