WASHINGTON — Two senators are leading a bipartisan effort to reauthorize a bill focused on mental health care.
When Sen. Bill Cassidy, MD (R-La.), and Sen. Chris Murphy (D-Conn.) set out to craft a mental health bill, they agreed to disagree on some issues , “but it turns out we had much, much more common ground than we had disagreements,” Cassidy said last week during a briefing with reporters. These areas of agreement culminated in the Mental Health Reform Act 2015, “something that [Sen.] Alexander Lamar [R-Tenn., former chair of the Senate Health, Education, Labor, & Pensions (HELP) Committee] was the most significant mental health reform of the past 30 years. »
This 2015 bill was incorporated into the 21st Century Cures Act, which was passed by Congress in 2016. Elements included creating an office of the assistant secretary for mental health, improving access of children to mental health care by providing grants to integrate behavioral health care into primary care offices, and promote coordination of mental health services, Cassidy noted.
The 2016 law now needs updating, Murphy said during the briefing. “We have improved federal mental health policy in the wake of this pandemic, but there is more need than ever,” he said. “A lot of the work in this bill is to reauthorize the programs from the 2016 bill and move forward…Our hope is that we will be able to bring this bill to the [HELP] committee, including perhaps other priorities for members, and to be able to present a comprehensive package of mental health reforms this year.
Provisions of the reauthorization bill include:
- Authorize a significant increase in funding for the Mental Health Services Block Grant to help states provide mental health services
- Promote increased quality of programs for people with serious mental illness, including improving coordination of services for this population between the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA)
- Reauthorize the program to promote the integration of primary and behavioral health care at the Health Resources and Services Administration (HRSA), which places behavioral health specialists in primary care offices
- Increase recruitment of a diverse mental health workforce by expanding SAMHSA’s Minority Fellowship Program
- Promoting access to mental health services by authorizing $25 million to support states’ ability to enforce existing mental health parity laws
Ask by MedPage today whether the legislation would help alleviate the shortage of mental hospital beds for children, Cassidy said “that will generally be a Medicaid issue” because the pediatric population is generally covered by Medicaid and the Children’s Health Insurance Program ( CHIP); these programs do not fall under the jurisdiction of the HELP committee, so they are not directly addressed in the bill. As for the cost of the reauthorization measure, it is estimated that it will add an additional $39 million to authorized spending beyond what was appropriated for the bill in fiscal year 2022.
Murphy said that while Medicare and Medicaid issues are outside the committee’s purview, “there are Medicare and Medicaid elements here, and one of the things we’ve included is pressure points on the CMS to ensure that care for people with severe mental illness in Medicare and Medicaid meets the standard of care…which, of course, does not include sitting in a hospital room. emergency room for 5-10 days at a time, so we have language in this bill that I think will prompt other more immediate action by CMS on the standard of care for emergency room stays.”
Another important part of the bill is improving data collection, Murphy said. “Right now, it’s very difficult for a decision maker to access SAMHSA data and determine the average length of stay a child has in an emergency room across the country. We need to be able to to have better data that is more easily accessible from HHS, and in particular SAMHSA, in order to solve the problems States need it too, so there is a section of this bill that encourages SAMHSA to improve its collection and its data sharing.
Senators were asked about their concerns regarding the passage of the reauthorization bill. Murphy cited “time” as his biggest concern. “We obviously don’t have a lot of time before these programs expire, and the HELP committee has a bunch of different priorities,” he said. “My feeling is that it’s near the top of [HELP Committee chair] Sen. [Patty] by Murray [D-Wash.] list, so I think we can find time on the committee’s calendar to have this presented to the committee. »
“I don’t think we’ve overstepped the bounds with this legislation,” Murphy added. “There are not as many new programs as the 2016 bill; this bill really reauthorized and refined those programs. There are new authorities here, but given the time crunch we’re in, we have tried to prepare a bill that will not hit roadblocks.”
Cassidy said his advice on crafting the bill was “Don’t let the perfect be the enemy of the good, and especially when you’re talking about mental health, doing something good can do a lot of good…DC is quite polarized, but in this [situation], every family is impacted. I think we come to a lot of common ground that can help us.”