Psychiatric Rehabilitation Association
Cherilyn Cepriano, CAE, JD, Vice President, Public Policy
The Senate was busy before heading out for congressional recess. On August 5, Senator Bill Cassidy (D-LA) and Senator Chris Murphy (D-CT) introduced the “Mental Health Reform Act of 2015,” S 1945 - a comprehensive legislative vehicle that seeks to reform the management and coordination of mental health and substance abuse treatment programs and services within the U.S. Department of Health and Human Services (HHS). This legislation is intended to be a Senate companion to the previously discussed House bill, the “Helping Families in Mental Health Crisis Act of 2015,” HR 2646, Sponsored by Representative Tim Murphy (R-PA-18), and for those who have focused on House Murphy bill, many sections of S 1945 will ring familiar.
Both S 1945 and HR 2646 propose fundamental changes to the Substance Abuse and Mental Health Services Administration (SAMHSA) including structural reorganization, calling for the creation of a Nationwide Strategy on Mental Health and Substance Abuse, and requiring a thorough evaluation of all programs and services. The bills seek to focusing SAMHSA programs on evidence-based care delivery, integration of behavioral and physical health care, and underserved populations, while encouraging innovation in care delivery. Both bills would also repeal the IMD exclusion and extend assisted outpatient treatment (AOT) grants authorized in the Protecting Access to Medicare Act of 2014, which PRA has opposed on the record.
However, S 1945 offers key points of departure from HR 2646, especially on issues where PRA has voiced concern. HR 2646 seeks to promote and incentivize AOT by: (1) giving states with AOT programs an incentive bonus Community Mental Health and Substance Abuse Block Grant (CMSBG), (2) earmarking 80 percent of the $20 million in authorized AOT grant funding for new programs, encouraging expansion, (3) focusing a review of state mental health programs through a lens of AOT, and (4) naming only AOT as a method of “outreach” to individuals with serious mental illness (although leaves to the Secretary to identify others). These provisions - to which PRA objected on the record in our statement on HR 2646 have been effectively remedied in S 1945. Further, S 1945 seeks to call the question on AOT by commissioning a strong study on comparative effectiveness of voluntary versus involuntary outpatient services based on outcomes for consumers - outcomes that are measured in terms of rehabilitation and recovery ranging from hospitalizations and incarcerations to housing, joblessness, and consumer satisfaction.
PRA is working closely with this just-introduced legislation and will share more information with our members as it comes available - including how you can participate in advocacy efforts related to these bills that may see legislative activity in the fall.