By Peter Sullivan
March 8, 2016
Leaders of the Senate Health Committee released a bipartisan mental health bill late Monday evening that, while narrower than House legislation, seeks to jump start an effort that has been stalled there.
“One in five adults in this country suffers from a mental illness, and nearly 60 percent aren’t receiving the treatment they need,” Health Chairman Lamar Alexander (R-Tenn.) said in a statement. "This bill will help address this crisis by ensuring our federal programs and policies incorporate proven, scientific approaches to improve care for patients."
The Senate bill seeks to improve coordination of mental health programs by granting new powers to an assistant secretary, sets up a new office to encourage the adoption of evidence-based programs, and authorizes grants for topics like integrating physical and mental health services, though the amount of the funding will depend on the appropriations process.
The measure notably does not include many of the most significant, but also controversial, elements from Rep. Tim Murphy’s (R-Pa.) mental health bill in the House.
For example, Murphy’s bill includes financial incentives for states to adopt assisted outpatient treatment laws, where judges can order a mentally ill person to follow a treatment plan instead of being committed to a hospital. The Senate bill steers clear of the issue.
Murphy’s bill also changes health privacy regulations under a law known as the Health Insurance Portability and Accountability Act to make it easier to share information with caregivers about a mentally ill person’s treatment. The Senate bill takes the smaller step of seeking to provide resources to educate people about what the existing regulations are.
Controversial areas like these have contributed to the House bill being mired in disputes, and the Senate’s path appears to be smoother. The bill is scheduled for a committee markup on March 16.
The markup will also include a manager’s amendment making some additions to the bill, as well as a group of bills related to the prescription drug and heroin epidemic.
The Senate’s bill is the product of negotiations among Alexander, the committee’s top Democrat, Sen. Patty Murray (D-Wash.), as well as Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.).
Once the bill clears the Health Committee, it is expected to be combined with other proposals from other committees.
Importantly, that includes a provision from the Finance Committee to free up Medicaid to pay for more care at mental health institutions, something known as repealing the “IMD [Institutions for Mental Diseases] exclusion.” That change is seen as crucial to improving access to care, though its cost could complicate efforts.
The issue of guns also looms. The Health Committee is in talks with Sen. John Cornyn (R-Texas) about merging its mental health reforms with his proposal to improve treatment for people facing imprisonment.
Sen. Charles Schumer (D-N.Y.) last month denounced certain sections of Cornyn’s bill, saying they would make it easier for mentally ill people to get guns, which Cornyn strongly denied.