Congress continues to work on a variety of legislative proposals to address issues related to mental and behavioral health and substance abuse, including the epidemic of opioid abuse that has garnered major national attention. Both political parties see these as important priorities, though they don’t always agree on how to best address them.
Much of Congress’s attention has been focused on two pieces of legislation: H.R. 2646, the Helping Families in Mental Health Crisis Act (Rep. Tim Murphy, R-PA) and S. 1945, the Mental Health Reform Act (Sen. Chris Murphy, D-CT and Sen. Bill Cassidy, R-LA). While not identical bills, they take a similar approach to mental health reform, including major restructuring of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the creation of a new Assistant Secretary for Mental Health and Substance Use Disorders at HHS, along with a concentrated focus on inpatient treatment for serious mental illness and corresponding patient privacy concerns. The bills also include provisions to boost the mental health workforce, invest in tele-mental health, and reauthorize a variety of successful state and local grants. In addition, both bills include provisions of particular interest to health centers, such as allowing same-day billing for mental and physical health visits in Medicaid, and extending FTCA coverage to health center volunteer providers.
The latest action on this legislation came on November 4, 2015, when, after a late night mark-up and consideration of dozens of amendments, the Energy and Commerce Health Subcommittee voted largely along party lines to move Rep. Tim Murphy’s mental health legislation forward. While the underlying legislation has 162 bipartisan cosponsors, Committee Democrats highlighted their concerns that the bill would dismantle SAMHSA, create overly broad exemptions to HIPAA privacy laws, and incentivize states to adopt assisted outpatient treatment (AOT) laws. They also voiced disapproval that certain provisions of the original bill which had bipartisan support were removed over cost concerns, including a section that would have extended Meaningful Use incentives for Health IT adoption to behavioral health providers. The bill will now move to the full committee for further consideration, but no date has been scheduled at this point.
NACHC is continuing to work with coalitions and leading mental and behavioral health stakeholders to monitor and inform these and other related pieces of legislation. NACHC staff have also been working with key Congressional staff to try to ensure that any legislation that ultimately passes Congress includes a focus on behavioral health integration into primary care settings, an effort that was emphasized by Health Resources and Services Administration (HRSA) Acting Administrator Jim Macrae on October 29 when he testified at a Senate HELP Committee hearing entitled “Mental Health and Substance Use Disorders in America: Priorities, Challenges, and Opportunities.”
In addition to broader mental and behavioral health care reform, Congress has also focused on bills to address substance abuse, including the growing opioid addiction crisis in certain parts of the country. On October 8, 2015 the Energy and Commerce Health Subcommittee held a hearing entitled “Examining Legislative Proposals to Combat our Nation’s Drug Abuse Crisis.” Among the bills discussed at that hearing were H.R. 2536, the Recovery Enhancement for Addiction Treatment (TREAT) Act, which would lift the current patient cap on physicians prescribing buprenorphine, and allow nurse practitioners and physicians assistants to prescribe; and H.R. 3680, the Co-Prescribing to Reduce Overdoses Act, which would establish a grant program for co-prescribing opioid overdose reversal drugs to eligible entities, including FQHCs. We’ve heard from many health center advocates who are interested in these issues, and we welcome any feedback you have on these bills and their potential impact on your health center and your patients. Please share any comments with the NACHC Federal Affairs staff at firstname.lastname@example.org.