May 10, 2022
The article (below) describing two senators working together on a bipartisan effort to pass a bill that would reauthorize programs resulting from passage of the 2016 (federal) 21st Century CURES Act. And yesterday, Senator Charles Schumer held a press conference on Long Island where he was joined by local state leaders to include our NYS Council Public Policy Chair, Dr. Jeffrey Reynolds, to highlight his ongoing work to secure $3.2B in federal funds that would go to states across the country to address the fentanyl opioid overdose crisis. Today is National Fentanyl Awareness Day, fyi. More to follow.Two Senators on Different Sides Unite on Mental Health Law Reauthorization
by Joyce Frieden, MedPage Today, 5/10/22
WASHINGTON — Two senators are spearheading a bipartisan effort to reauthorize a bill focusing on mental health care.
When Sen. Bill Cassidy, MD (R-La.), and Sen. Chris Murphy (D-Conn.) set out to develop 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 resulted in the Mental Health Reform Act of 2015, “something which [Sen.] Lamar Alexander [R-Tenn., former chair of the Senate Health, Education, Labor, & Pensions (HELP) Committee] said was the most significant reform of mental health in the last 30 years.”
That 2015 bill was incorporated into the 21st Century Cures Act, which passed Congress in 2016. Elements included establishing an Office of the Assistant Secretary for Mental Health, improving children’s access to mental health care by providing grants to integrate behavioral healthcare into primary care offices, and promoting coordination of mental health benefits, Cassidy noted.
The 2016 law now needs to be updated, Murphy said at the briefing. “We did improve federal mental health policy in the wake of this pandemic, but there are more needs now than ever,” he said. “Much of the work in this bill is reauthorizing the programs from the 2016 bill and moving on … Our hope is that we will be able to bring this bill to the [HELP] committee, perhaps including other priorities for members, and be able to report out this year a comprehensive mental health reform package.”
Provisions in the reauthorization bill include:
* Authorizing a significant increase in funding for the Mental Health Services Block Grant to help states provide mental health services
* Promoting increased quality of programs for those with a serious mental illness, including by 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)
* Reauthorizing the Promoting Integration of Primary and Behavioral Health Care program at the Health Resources and Services Administration (HRSA), which puts behavioral health specialists in primary care offices
* Increasing 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
Asked by MedPage Today whether the legislation would help ease the shortage of psychiatric hospital beds for children, Cassidy said that “that is typically going to be a Medicaid issue” because the pediatric population is typically covered by Medicaid and the Children’s Health Insurance Program (CHIP); those programs are not within the HELP Committee’s jurisdiction, so they’re not directly addressed in the bill. As to the reauthorization measure’s cost, it’s estimated to add another $39 million in authorized spending above what was appropriated for the bill in fiscal year 2022.
Murphy said although Medicare and Medicaid issues are outside the committee’s jurisdiction, “there are some pieces here relative to Medicare and Medicaid, and one of the things we’ve included is some pressure points on CMS to make sure that care for people with serious mental illness in Medicare and Medicaid meets the standard of care … which of course does not include sitting in an emergency room for 5 to 10 days at a time. So we do have some language in this bill that I think will prompt some more immediate action from CMS on standard of care relative to stays in the emergency room.”
Improving data collection is another important part of the bill, Murphy said. “Right now, it’s really hard for a policymaker to go into SAMHSA data and find out what the average length of stay is for a child in an emergency room across the country. We need to be able to have better, more easily accessible data from HHS, and in particular from SAMHSA, in order to problem-solve. States need that too. So there’s a section of this bill which incentivizes SAMHSA to improve their data collection and data-sharing.”
The senators were asked about their concerns regarding getting the reauthorization bill passed. Murphy cited “time” as his biggest concern. “We obviously don’t have a lot of time left before these programs expire, and the HELP Committee has a bunch of different priorities,” he said. “My sense is that this is near the top of [HELP Committee chair] Sen. [Patty] Murray’s [D-Wash.] list, so I think we’ll be able to find time on the committee’s calendar to get this before the committee.”
“I don’t think we’ve overreached with this legislation,” Murphy added. “This does not have as many new programs as the 2016 bill does; this bill was really reauthorizing and refining those programs. There’s some new authorities here, but understanding the time crunch we’re under, we’ve tried to put together a bill that won’t hit roadblocks.”
Cassidy said his advice on crafting the bill has been “Don’t let the perfect be the enemy of the good, and particularly when you’re talking about mental health, doing something good can do a powerful amount of good … D.C. is pretty polarized, but in this [situation], every family is impacted. I think that we’re coming to a lot of common ground that can help us.”