NYAPRS Note: The House Energy and Commerce Committee will begin formal review of Rep. Tim Murphy’s controversial mental health legislation tomorrow at 3pm. See http://energycommerce.house.gov/hearings for links to watch the hearing.
This marks the beginning of a process concerning both House and Senate mental health legislation that is expected to continue well into next spring.
NYAPRS has long opposed this bill’s provisions that weaken Protection and Advocacy programs, reduce rather than better educate around HIPAA privacy protections, eliminates SAMSHA’s essential role, presses for expansion of involuntary outpatient commitment initiatives and invests untold billions in expanding inpatient rather than community based approaches.
At the same time, there are provisions in numerous bills before Congress that could improve mental health policy and care. More later this week….
GOP’s Newtown Bill Stirs Tensions
By Peter Sullivan The Hill October 30, 2015
Tensions are flaring in the House over a sweeping mental health reform bill that is slated to move forward next week.
The legislation from Rep. Tim Murphy (R-Pa.), billed as the Republican response to the Newtown elementary school shooting in 2012, is finally set to get committee consideration on Wednesday at a markup in the Energy and Commerce Committee.
But Democrats on the committee are objecting to several provisions in the bill and say what was once cast as a bipartisan negotiation has been anything but.
While the committee could advance the bill along party lines, a bipartisan vote would give the legislation more momentum and a better chance of seeing floor time.
In July, Energy and Commerce Chairman Fred Upton (R-Mich.) and ranking member Frank Pallone Jr. (D-N.J.) expressed hope that mental health could be the next big area of bipartisan agreement on the committee, following a rare unanimous vote in May on a medical innovation bill called 21st Century Cures.
But it hasn’t turned out that way. There were some meetings that Democratic and Republican committee staff had with mental health advocates in August, but there were never full negotiations between staff over changes to the bill.
Last Friday, 19 of the 23 Democrats on the Energy and Commerce Committee wrote a letter laying out strong opposition to several of the core provisions of the mental health legislation.
“They put this letter forth because they’re incredibly frustrated that we haven’t been able to get a compromise on mental health,” said a Democratic aide.
Upton acknowledged in an interview that “we’re not where I’d like to be” on the bill, but he expressed hope that the markup in the health subcommittee next week would be a step toward bipartisan progress.
“I’ve looked over [Murphy’s] shoulder, convened a couple meetings, met with outside groups,” Upton said. “You know, we’re not where I’d like to be necessarily, but moving forward next week, it’s just the subcommittee mark, so we got a ways to go.”
“I think the markup date in subcommittee will hopefully prompt folks on both sides to see if they can’t come to some [agreement],” Upton added.
Upton said Murphy has made “a number of changes” to the bill. “Is that enough to get a good number of the Democrats on board? We’ll see.”
Democrats say they can’t judge the changes to the bill because they haven’t seen them.
The bill does have some Democratic support, mostly from lawmakers who are not on the Energy and Commerce Committee. It has 154 cosponsors, and 43 are Democrats.
One of the most controversial areas of Murphy’s bill is its changes to a health privacy law known as the Health Insurance Portability and Accountability Act (HIPAA), aimed at allowing caregivers and family members to have more information about a mentally ill person’s care. Democrats warn in their letter that they think the loss of privacy protection would deter mentally ill people from seeking care.
Another controversial provision would give financial incentives for states to adopt what is known as Assisted Outpatient Treatment (AOT), where judges can mandate treatment for patients with serious mental illness.
“The use of the court system and law enforcement to force individuals into care is a dramatic departure from how individuals, particularly those who pose no imminent threat to themselves or others, obtain health care services in this country,” the Democrats write in their letter.
Murphy’s bill has divided mental health advocacy groups, and some who support it had a sharp response to the Democrats’ letter.
Andrew Sperling, director of federal legislative advocacy at the National Alliance on Mental Illness, called the Democrats’ missive a “Molotov cocktail” lobbed at Murphy.
“We don’t know what the path forward is if they’re demanding removal of essentially almost the entire bill,” he added.
Murphy, a trained psychologist, also feels very strongly about his bill.
After Democratic staff held a meeting with advocates in July, Murphy wrote a strongly worded message on his Facebook page, calling it a “secret meeting” to take down his bill and adding: “I just can’t fathom the bigotry against individuals with brain illness.”
“My impression is [Democrats] have felt like they have not had a lot of opportunity to have back and forth dialogue with Dr. Murphy,” said Charles Ingoglia, vice president of the National Council for Behavioral Health, which supports some of Murphy’s bill but objects to other parts.
Murphy spokeswoman Gretchen Andersen said the congressman has been meeting with Democrats on and off the committee throughout the process.
“His door is always open,” she said. “My boss is definitely willing to listen to what they have to bring to the table. That’s just in his nature as a psychologist.”
Murphy and Democratic co-author Rep. Eddie Bernice Johnson (Texas) wrote a response to the Democratic letter on Thursday saying, “We remain open and hopeful that a positive discussion can take place.”
There are unanswered questions over how to pay for the bill. Committee Republicans are waiting for a Congressional Budget Office cost estimate before working out those details.
Ingoglia said that some of the costly measures in the bill, like repealing a ban on Medicaid paying for certain care at mental health facilities, could be dropped because of a lack of ways to pay for them.
Despite the turmoil, supporters see mental health reform as a realistic goal this Congress.
Since the shooting at Newtown, there have been a spate of mass shootings that have reignited the national debate over gun control and amplified calls from both parties for some kind of action to improve care for the mentally ill.
Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) have a bipartisan bill in the Senate that is similar to the House bill but has steered clear of as many controversial HIPAA and AOT provisions.
Sen. Murphy said Thursday that there are “better odds of a mental health reform bill passing this Congress than legislation on virtually any other issue.”
Rep. Joe Kennedy III (D-Mass.), one of the signers of the Energy and Commerce letter, also expressed hope that a bipartisan agreement could be reached.
“I sure hope they are open to making changes,” he said, adding, “Things can move pretty quickly when there’s a desire to move quickly.”
http://thehill.com/policy/healthcare/258620-gops-newtown-bill-stirs-tensions