Ad­vo­cates cheer men­tal health re­forms in Cures bill

Modern Healthcare - - NEWS - By Har­ris Meyer

Congress took an im­por­tant first step in im­prov­ing the na­tion’s strug­gling sys­tem of care for mil­lions of Amer­i­cans suf­fer­ing from men­tal ill­ness and drug ad­dic­tion by in­clud­ing a sweep­ing pack­age of men­tal health­care and ad­dic­tion treat­ment re­forms as part of the 21st Cen­tury Cures Act.

The House-backed bill au­tho­rized $1 bil­lion over the next two years to ad­dress the na­tion’s opi­oid abuse cri­sis, and would au­tho­rize or re-au­tho­rize smaller amounts of fund­ing for a wide range of fed­eral grants for men­tal health and sub­stance abuse ser­vices. Congress would still have to ap­pro­pri­ate that money.

Men­tal health ad­vo­cates ex­pressed cau­tious op­ti­mism that Pres­i­den­t­elect Don­ald Trump’s ad­min­is­tra­tion and con­gres­sional Repub­li­can lead­ers will sup­port that fund­ing—even though House Speaker Paul Ryan and other GOP lead­ers have promised to cut taxes, boost mil­i­tary out­lays and re­duce dis­cre­tionary fed­eral spend­ing.

“A lot of ad­vo­cacy will have to oc­cur around get­ting some of th­ese ini­tia­tives funded,” said Ron Hon­berg, se­nior pol­icy ad­viser at the Na­tional Al­liance on Men­tal Ill­ness, a coali­tion of ad­vo­cacy groups. He and other ad­vo­cates worry, how­ever, that GOP plans to re­peal the Af­ford­able Care Act could un­der­cut the ben­e­fits of the new leg­is­la­tion.

For now, though, they are cel­e­brat­ing the pend­ing bill’s men­tal health pro­vi­sions, drawn mainly from the Help­ing Fam­i­lies in Men­tal Health Cri­sis Act, which passed the House 422-2 in July. The leg­is­la­tion cre­ates a new HHS as­sis­tant sec­re­tary in charge of men­tal health and sub­stance abuse disor­ders; au­tho­rizes grants for com­mu­nity treat­ment teams and as­sisted out­pa­tient treat­ment for non­co­op­er­a­tive pa­tients; and cre­ates a path to al­low Med­i­caid man­aged-care plans to pay for short­term in­pa­tient stays.

The House-backed bill au­tho­rized $1 bil­lion over the next two years to ad­dress the na­tion’s opi­oid abuse cri­sis.

In ad­di­tion, the bill re­quires HHS to clar­ify when providers may share pa­tient in­for­ma­tion. It would also step up en­force­ment of rules for in­sur­ers to cover men­tal health­care on par­ity with phys­i­cal health; boost sup­port for train­ing more men­tal health pro­fes­sion­als; help providers more eas­ily track avail­able in­pa­tient beds; sup­port a wide range of pro­grams to com­bat sui­cide and im­prove screen­ing, early di­ag­no­sis and early in­ter­ven­tion for men­tal ill­ness in chil­dren; and push to re­duce in­car­cer­a­tion of non­vi­o­lent, men­tally ill of­fend­ers.

Hos­pi­tals and physi­cians will wel­come a pro­vi­sion clar­i­fy­ing that Med­i­caid is al­lowed to pay providers for the de­liv­ery of men­tal health and pri­mary-care ser­vices to a pa­tient on the same day, end­ing a source of frus­tra­tion for pri­mary-care providers.

Providers and fam­i­lies of be­hav­ioral health pa­tients also may wel­come pro­vi­sions that re­quire HHS and the Of­fice for Civil Rights to clar­ify when providers can use pa­tient in­for­ma­tion pro­tected by the Health In­sur­ance Porta­bil­ity and Ac­count­abil­ity Act for treat­ment pur­poses and share such in­for­ma­tion with pa­tients’ fam­ily mem­bers and care­givers.

On opi­oid treat­ment, the new bill re­solves, for now, a par­ti­san bat­tle over fund­ing for the Com­pre­hen­sive Ad­dic­tion and Re­cov­ery Act, for which Pres­i­dent Barack Obama and con­gres­sional Democrats de­manded more money. CARA strength­ens pre­ven­tion, treat­ment and re­cov­ery ini­tia­tives by giv­ing providers and law en­force­ment of­fi­cials more tools to help drug ad­dicts and ex­pand­ing ac­cess to a drug to help re­verse over­doses.

Rep. Tim Mur­phy (R-Pa.), a psy­chol­o­gist who was the chief au­thor of the House men­tal health bill, said the single most im­por­tant pro­vi­sion is es­tab­lish­ing an as­sis­tant HHS sec­re­tary in charge of men­tal health and sub­stance abuse to drive and co­or­di­nate fed­eral pol­icy in this area. “We have to restruc­ture the agen­cies to work to­gether and make sure money is spent wisely and we’re fo­cus­ing on se­ri­ous men­tal ill­ness, not waste­ful feel-good things,” he said in an in­ter­view last month.


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