[NYAPRS Enews] More on Murphy-Cassidy Senate Mental Health Bill

[Harvey Rosenthal]

NYAPRS Note: Here's more on the bipartisan Senate mental health bill that was announced yesterday by co-sponsors Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.). See news conference video clip at http://www.murphy.senate.gov/view/senators-murphy-and-cassidy-introduce-comprehensive-overhaul-of-mental-health-system.

The bill is the second major piece of mental health legislation proposed this year, joining the one sponsored by House counterparts Reps. Tim Murphy (R-PA) and Eddie Bernice Johnson (D-TX).

According to Mental Health America, both bills emphasize "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."

The bill also includes new mental health funding, rather than re-appropriating existing mental health funds, according to MHA. It also apparently fully restores the functions and flexibility of the nation's Protection and Advocacy organizations' flexibility to promote recovery and non-discrimination for individuals with serious mental illness.

According to the articles below, the new Murphy-Cassidy bill does not have the appetite for increasing court mandated outpatient treatment (sometimes called AOT). Congressman Tim Murphy's bill had proposed an additional $20 million in demonstration programs and gave states a 2% increase in their block grant funding as an incentive to expand the use of court ordered treatment.

NYAPRS opposed this provision in Congressional testimony delivered earlier this year at a hearing on Rep. Murphy's bill
http://democrats.energycommerce.house.gov/sites/default/files/documents/Testimony-Rosenthal-HE-Mental-Health-2015-6-15.pdf).

Stay tuned for more details as we get them.

Senators Unveil Bipartisan Mental Health Bill
By Peter Sullivan - The Hill August 4, 2015

Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) introduced a bipartisan mental health reform bill on Tuesday.

The measure is partly intended as a response to mass gun shootings in each senator's state that were carried out by people with mental health issues.

"The families in Sandy Hook, they want changes to our nation's gun laws, but they don't want our disagreements over those issues to stop us from making bipartisan progress on other issues that are important like our broken mental health system," Murphy said, referring to the Connecticut town where 26 people, including 20 school children, were killed in December 2012.

The pair say their measure is similar to a bill championed by Rep. Tim Murphy (R-Pa.) in the House.

The House Energy and Commerce Committee held a hearing on his bill in June, and it is expected to be the starting point for bipartisan negotiations in the fall.

In the Senate, Cassidy said that he had a commitment from the Senate health committee to have a hearing on the bill in the fall.

The pair of senators say the need for their legislation is that one in five adults, or 44 million people, experience a mental illness per year.

Despite those statistics, the senators say the number of available psychiatric beds declined 14 percent in recent years, and families are often prevented by privacy laws from accessing crucial information to help care for family members with mental illness.

The bill would change the privacy law, known as HIPAA, and encourage education around existing requirements, with the aim of allowing family members to have more information about their mentally ill loved ones and better care for them.

The senators' legislation would create a new assistant secretary to oversee mental health. It also gives grants to improve integration of physical and mental health services and for early intervention in children who demonstrate risk factors for mental illness. It reforms Medicare and Medicaid to remove rules preventing patients from using physical and mental health services at the same place on the same day.

A more controversial provision involves Assisted Outpatient Treatment (AOT), where a judge can order someone with mental illness to follow a treatment plan.

The House bill incentivizes AOT through block grants, though the proposal has been scaled back from the original proposal. The Senate bill mostly steers clear of the issue, other than a pilot program.

Rep. Frank Pallone (D-N.J.), the top Democrat on the House Energy and Commerce Committee, objected to the HIPAA changes and AOT provisions in the House bill, and those issues are sure to come up during negotiations in the fall.

While the Senate measure is intended as a companion to the House bill, Cassidy said right now he is still focused on getting the bill out of committee.

"We've got our committee hearing in the fall, as we've been told, if we can advance it then, then we'll go to the next step," Cassidy said.

http://thehill.com/policy/healthcare/250245-senators-unveil-bipartisan-mental-health-bill
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Murphy Proposes Package Of Mental Health Reforms
By Tatiana Cirisano Connecticut Post  August 4, 2015

On the margins of a slew of mass shootings that have heightened awareness of mental illness, a growing stack of bills in Congress aim to overhaul the country's mental health system. The latest to join the effort is Connecticut Sen. Chris Murphy.

The Democrat introduced a bipartisan bill with Sen. Bill Cassidy, R-La., on Tuesday that would address what Murphy views as a "broken" mental health system in America by making mental health services more accessible.

More than 90,000 people in Connecticut are struggling with severe mental illness - and one in five adults nationwide. But nearly half of them will go untreated, often spiraling down a path of substance abuse, homelessness and even incarceration.

"It's past time for Band-Aid, small-scale fixes," Murphy said at a press conference.

Murphy said his bill is "part of a response" to a string of mass shootings across the country where the shooters were found to be mentally ill, including the Newtown shooting in 2012 where Adam Lanza fatally shot 20 children and six adults at Sandy Hook Elementary School.

Lanza, who was autistic, is believed to have suffered from a combination of obsessive compulsive disorder and anorexia, among other issues.

Murphy's bill would put mental and physical health services in the same building, establish grants for early intervention programs and repeal a provision in Medicaid that excludes inpatient care for many individuals between the ages of 22 and 64.

It would also appoint an assistant secretary of behavioral health, form a federal "Serious Mental Illness Coordination Committee" and establish a new mental health policy laboratory to find effective methods of care.

The reform effort comes after Murphy hosted 11 roundtables and listening sessions with local mental health advocates across Connecticut to hear their concerns.

"It's about elevating the conversation here in Washington, making sure that behavioral health has a seat at the table at (the Department of Health and Human Services) in a way that we just fundamentally don't believe it does today," Murphy said.

The bill doesn't touch on gun rights, an issue Murphy said should be dealt with separately from mental health reform. But he hopes his effort to strengthen the nation's mental health system will reduce the likelihood of violence.

"The families in Sandy Hook, they want changes to our nation's gun laws," Murphy said. "But they don't want our disagreements over those issues to stop us from making bipartisan progress on other issues that are important to them, like our broken mental health system."

Rep. Tim Murphy, a Pennsylvania Republican, is pushing a companion bill in the House. Both congressmen will focus on clarifying the patient privacy rules under the Health Information Portability and Accountability Act (HIPAA) to allow professionals to share information with parents and caregivers of the mentally ill.

Though the two bills align at many points - including their author's last name - Sen. Murphy's bill clashes with Rep. Murphy's on the issue of patients' rights.

While patients' rights advocates argue that the mentally ill should be entitled to the same freedoms as someone with a physical illness like diabetes, others suggest that patients with severe mental illness should be subjected to court-ordered medication plans, or assisted outpatient treatment (AOT).

The bill Rep. Murphy introduced last Congress required states to use AOT to receive federal funding for their mental health programs, although the provision was later dropped. The current House bill provides additional funding through block grants to states that use the court-ordered treatment plans.

But Connecticut is one of only five states in the country that lacks AOT, and Sen. Murphy said he won't support legislation that forces Connecticut to change this. The senator's bill provides money through block grants for states that improve outcomes, regardless of whether or not they use AOT.

Sen. Murphy's bill has the support of the National Alliance on Mental Illness and American Psychiatric Association, whose CEO and medical director, Saul Levin, applauded Murphy and Cassidy for their efforts at the press conference Tuesday.

He said their bill is part of a larger push in Congress to bring mental health reform to the forefront.

"The nation is beginning to run towards mental health care to take care of those with mental illness," Levin said.

http://www.ctpost.com/news/article/Murphy-proposes-package-of-mental-health-reforms-6424754.php#photo-8414210

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