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Update on Federal Mental Health Reform Legislation

By June 10, 2016November 24th, 2020No Comments
Mental Health Reform is on the verge of actually happening! Montanans, please contact Representative Ryan Zinke and ask him to support H.R. 2646. You can leave a message at this link or call his office at 202-225-3211.

Update from NAMI’s national policy staff.

Date:     June 9, 2016
RE:          Update: Vote on Mental Health Reform in the House E&C Committee
Current status
You have helped us send over 80,000 emails, 230,000 petition signatures, and hundreds of tweets to Congress asking them to pass mental health reform now. Your efforts, along with Congressional meetings, have helped lead to unprecedented bipartisan discussions, balanced bill language and a vote on a revised version of H.R. 2646, the Helping Families in Mental Health Crisis Act, on Wed, June 15th in the House Energy & Commerce Committee.
We need your help
Please share this memo and upcoming Advocacy Alerts with your networks. Urge everyone you know to keep up the pressure on Congress by emailing or calling their U.S. Representatives and urge them to support H.R. 2646 and bring it to a vote.
Key additions in proposed draft
The items below represent new provisions in H.R. 2646:

  •  Requires an independent external audit of SAMHSA (provision from H.R. 4435).
  • Creates a grant program to support ACT programs (provision from H.R. 4435).
  • Creates a grant program to enhance crisis response services and to develop psychiatric bed tracking (provision from H.R. 4435).
  • Requires a study of peer support specialist programs.
  • Authorizes grants for telehealth child psychiatry (provision from S. 2680)
  • Creates a Minority Fellowship Program to increase the number of culturally competent mental health and substance use disorder professionals (provision from H.R. 4435 and S. 2680 amendment).
  • Requires a study on mental health and substance use disorder workforce within 2 years. 

Notable provisions retained from prior draft
The items below represent helpful provisions that remain in the proposed draft of H.R. 2646:

  • Continues the 5% set-aside for evidence-based programs that address early serious mental illness, such as First Episode Psychosis (FEP). Allows states to withhold up to 10% of funds for these purposes.
  • Creates an Interdepartmental Serious Mental Illness Coordinating Committee to produce a plan to improve outcomes for people with mental illness, including reducing incarceration, reducing homelessness and increasing employment.
  • Promotes use of evidence-based practices and innovative programs.
  • Permits Medicaid billing of primary care and mental health or substance use services provided the same day in the same facility (known as same-day billing).
  • Requires a GAO study on mental health insurance parity.

Significant changes in proposed draft
The following represent significant modifications of prior language to address divergent perspectives on contentious issues:

  • Creates a new Assistant Secretary for Mental Health and Substance Use Disorders, but retains the position and authority of the SAMHSA Administrator.
  • Requires that the Secretary of Health and Human Services create an independent grievance procedure for complaints against PAIMIs (there is already a grievance process, but it is not necessarily independent) and prohibits use of federal funds to lobby (current law). Previous bill restrictions on the scope of PAIMI work have been removed.
  • Extends existing AOT grant program, but eliminates the previous 2% mental health block grant increase to incentivize AOT laws.
  • Replaces previous language on HIPAA with a “Sense of Congress” that outlines need for clarity regarding HIPAA, but does not change the law. Requires the U.S. Department of Health and Human Services (HHS) to issue final regulations within 1 year to clarify circumstances in which a health care provider may share protected health information.
  • Allows Medicaid managed care organizations (MCOs) to pay for short-term stays (no more than 15 days per month) of adults ages 21-65 in psychiatric hospitals and facilities (known as IMD exclusion). This provision codifies what is in recently released Medicaid managed care rule.

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