Two Major Mental Health Bills Introduced in US Senate

Aug 10, 2015

Last week the U.S. Senate adjourned for its August recess but not before introducing two major mental health bills.

Mental Health Reform Act of 2015

Senators Bill Cassidy (R-La.) and Chris Murphy (D-Conn.) introduced The Mental Health Reform Act of 2015 (S. 1945), legislation to “comprehensively overhaul and strengthen America’s mental health care system.”

The bill addresses many of the same issues as the “Helping Families in Mental Health Crisis Act” (HR 2646) introduced by Representatives Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-La.) in the House of Representatives, although there are differences between the two bills as well.

S. 1945 includes proposals to:

• Establish an Assistant Secretary of Mental Health and Substance Use Disorders within the U.S. Department of Health and Human Services (HHS) to oversee grants and promote best practices in early diagnosis, treatment and rehabilitation;
• Create an exception to the Medicaid IMD exclusion for acute inpatient services furnished in state or private psychiatric hospitals;
• Permit same day billing in Medicaid for mental and physical healthcare services;
• Establish a new Mental Health Policy Laboratory within the Department of Health and Human Services (HHS) to fund innovation grants that identify new and effective models of care and demonstration grants to bring effective models to scale for adults and children;
• Authorize grants for states to facilitate more effective integration of physical and mental health services;
• Improve transparency and strengthen enforcement of the federal mental health and addictions parity law;
• Clarify the circumstances in which HIPAA permits health professionals to communicate information to family members or other caregivers, support training of health care providers about the circumstances in which information can be shared with caregivers.
• Establish a federal Interagency Serious Mental Illness Coordinating Committee to foster a more coordinated approach to research, services and supports for people with serious mental illness within the federal bureaucracy;
• Implement a new grant program to stimulate early intervention and mental health treatment for children, youth and transition age young adults.

S. 1945 does not contain any provisions restricting the activities of Protection and Advocacy for Individuals with Mental Illness (PAIMI) programs. It also does not include the provision in HR 2646 authorizing 2% incentive payments through the federal Mental Health Services Block Grant for states that implement Assisted Outpatient Treatment (AOT) programs.

It does however include a provision, also contained in HR 2646, that would extend authority to support AOT pilot programs for an additional two years through 2020. This program was first authorized in 2014 but it has not yet been implemented due to lack of funding.

NAMI supports S. 1945 as legislation that, in conjunction with HR 2646 in the House, helps advance the process of passing comprehensive mental health reform.

Statement by Senators Murphy and Cassidy about the Mental Health Reform Act of 2015. NAMI’s Executive Director, Mary Giliberti, is quoted.

The Mental Health and Safe Communities Act

This week, Senator John Cornyn (R-TX.) introduced the Mental Health and Safe Communities Act, a bill which has not yet been assigned a number. The major focus of the bill is on preventing unnecessary incarceration of people with mental illness and enhanced treatment and services for individuals with mental illness while incarcerated and following release.

The bill specifies that federal resources should be used to expand programs with proven effectiveness such as:

• Pre-trial screening and jail diversion programs
• Mental Health Courts
• Veterans Treatment Courts
• Crisis Intervention Team (CIT) programs for law enforcement and other first responders
• Forensic Assertive Community Treatment (FACT) programs
• Other evidence based approaches.

The bill also directs federal resources to be used for improving mental health and substance use treatment for people who are incarcerated and for services to assist people with mental illness reentering communities.

The Mental Health and Safe Communities Act additionally proposes to amend the National Instant Criminal Background Check System (NICS) program by clarifying when mental health records should be reported for inclusion in the system and when they shouldn’t. It is important to note that the bill does not propose to expand existing requirements but rather to make them clearer.

The bill would also replace the highly offensive terminology currently in the federal gun reporting law, “persons adjudicated as mentally defective” with more current and appropriate terminology, “persons adjudicated as incompetent.” Over a number of years NAMI has emphasized the need to make this change.

NAMI’s statement about Senator Cornyn’s bill.

Next Steps

The House and Senate have adjourned for August recess and will be returning to Washington after Labor Day. It is expected that both chambers will begin deliberations on several mental health bills, including the two described above, when they return. 

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