By Paul Gionfriddo, MHA president and CEO
It’s a whole new ballgame in Congress this year. People are talking to one another, instead of shouting at one another. And there is a sense that as a result comprehensive mental health reform legislation will finally get serious consideration.
Last week, I testified at a Congressional hearing on HR 2646 – the 2015 Helping Families in Mental Health Crisis Act. It’s a brand new bill from the one we saw last year that we were unable to support. It emphasizes screening, secondary and tertiary prevention, early intervention, and care integration in multiple places, fitting nicely within MHA’s Prevention-Early Intervention-Integration-Recovery (PEIR) framework. It removes the mandate for AOT. It elevates the lead federal mental health agency. It seeks to enhance the mental health workforce. And it keeps many good provisions from last year – especially in the area of suicide prevention – that are greatly needed.
So what led to the changes this year? I think it’s because we’ve been successful at advocating for mental health services “B4Stage4,”and because affiliates and advocates throughout MHA spoke up for a different approach this year.
But in an extraordinary moment, the lead sponsor, Representative Tim Murphy, wrapped up the hearing by crediting us directly for the changed approach in the bill.
So where do we go from here?
Our position is this: this bill is a good starting point.
That means there’s still work to be done. We need to protect the good things in the bill, and hope Congress will fix a few things, too.
Among these are the provisions related to Protection and Advocacy services for people with mental health concerns.
This year’s proposal does not reduce funding for these needed legal services by up to 85 percent, as last year’s did. But it limits too greatly the activities in which Protection and Advocacy organizations can engage. The good news is that the sponsors have already agreed to move their position. So we are arguing that in addition to abuse and neglect cases, these advocates must be allowed to help people with housing, employment, education, treatment, and community services and supports. And we think they still must play a role in educating policymakers and the public on best practices and policy.
Adding a provision to end the incarceration of nonviolent people with mental illness is another priority for us.
No one believes that these individuals should be “treated” in jails and prisons, and changing this could also capture the funds needed to support the new programs called for in this bill. At $50,000 per year for 362,000+ jail inmates with mental illnesses, that would come to roughly $17.8 billion – plenty to go around.
Another area in which we think there could be a better approach is in changing the HIPAA provisions so that behavioral health and general health data are treated exactly the same way.
Because you can’t integrate healthcare when you segregate healthcare information. And you can’t treat a whole patient with half a medical record.
In the coming days and weeks, we intend to continue to make our views known, and participate in a positive way in the deliberations over this proposal – and a counterpart Murphy-Cassidy proposal that will be introduced in the Senate (that’s Senator Chris Murphy, not Representative Tim Murphy, who along with Senator Bill Cassidy is crafting a Senate bill).
Here’s what else we’re doing, that we’d encourage you to do, too. We’re talking to members of Congress in both parties, because this is not a partisan issue. We’re talking to Rep. Tim Murphy, the lead House sponsor, to explain our positions and ask for his support.
We’re keeping an open dialogue going with affiliates and advocates. In the coming weeks, we’ll be providing tools and talking points for effective advocacy, including ideas for blog posts, op edits, and social media posts. And we hope you’ll also feel free to tweet encouragement and support for MHA’s views to the sponsors of the legislation.
We’re calling on everyone to do all they can to help us get the best bill possible – one that, when all is said and done, we feel comfortable saying that we support.
We know that no legislation will be perfect, or include everything we want. But we’ve come a long way this past year, and have a long way yet to go!