Things can move very quickly in DC when the right people are motivated. Case in point: Speaker of the House Paul Ryan (R-WI) signaled that he wanted mental health legislation to reach a floor vote this year. So while H.R. 2646, sometimes known as the Murphy bill, seemed to be languishing, the leadership of the Energy and Commerce Committee worked to bring the bill to mark-up last Wednesday, June 15.
Some people opine that our democracy intends for citizens to advocate hard for their principles while accepting that competing points of views must also be acknowledged when moving legislation. Others believe that people should hold tight to their principles, never relenting.
Depending on your own philosophy, last week’s committee mark-up outcome is cause for celebration, acceptance of the inevitable, or reason to keep up the fight. Following is an overview of the bill that was voted out of committee. Insiders are saying that Speaker Ryan wants a full chamber vote later this summer.
A critical component of mental health care is peer support, which is rooted in mutual respect to provide knowledge and emotional and social support based on the lived-experience of a mental health condition or substance use disorder. This support, often delivered by a peer specialist, received both recognition and funding. The bill seeks to “increase the number of… trained peers, recovery coaches, mental health and addiction specialists, prevention specialists, and pre-masters addiction counselors” by earmarking $10 million for training, as well as mandating a two-year study on best practices for peer specialist training programs.
Having a voice at the table
This legislation mandates the creation of an Interdepartmental Serious Mental Illness Coordinating Committee. Serving on this committee, directed by the Secretary of Health and Human Services, are the secretaries and directors of twelve federal agencies, as well as two members with lived-experience and at least one member who is a state-certified peer specialist.
The committee, among other duties, reports to Congress on advances made in research relating to intervention, diagnosis, treatment, and recovery. Due one year and five years after enactment, this report will provide outcome measurements for federally-funded public health programs. Outcomes measured include suicide rates, emergency room visits, hospitalizations, and rates of employment, as well as recommendations for reducing incarceration and homelessness.
The main sticking points in the original bill were broadening Assisted Outpatient Treatment (AOT) and making HIPPA regulations less restrictive. The bill that passed out of committee does not contain the original 2% increase in state block grants for AOT purposes; however, it does extend and increase the amount of AOT grants to states without an AOT program.
Instead of addressing HIPAA’s strictures, the committee agreed on new provider education programs to clarify which patient information can and cannot be shared with family members.
Mental health parity
The committee eliminated language that would have strengthened enforcement of mental health parity via CMS investigation and reporting. Rep. Joe Kennedy (D-MA) introduced several mental health parity amendments, but withdrew them upon assurances from Chairman Fred Upton (R-MI) that the committee will have mental health parity hearings in September.
Organizations and advocates within the mental health community have varying opinions on the merits of HR 2646. You can expect to see more published opinions over the next few weeks, and if and when the bill comes up for a full House vote later this summer. Below are links to a few of the published opinions to date.
- Why do you support or oppose passage of H.R. 2646?
- What will you do to make your voice heard?