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Pallone Highlights Key Democratic Priorities in H.R. 2646, Helping Families in Mental Health Crisis Act

Jun 15, 2016
Press Release

Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ) delivered the following remarks at an Energy and Commerce Committee markup on H.R. 2646, the Helping Families in Mental Health Crisis Act:

Mr. Chairman, I’d like to strike the last word.  Today we are meeting to mark up an updated version of H.R. 2646, the Helping Families in Mental Health Crisis Act.  I’d like to thank the Chairman and his staff for their dedication and commitment to reaching bipartisan agreement on this measure. 

I strongly support the bill before the Committee.  It is a vastly better bill than the one we considered at the subcommittee markup, and it is a reflection of what is possible on this Committee when we work together in a bipartisan manner. 

The bill we are considering today removes the provisions of H.R. 2646 that concerned many Democrats, such as the elimination of SAMHSA as an agency, and provisions that we believe took an unnecessarily coercive and counterproductive approach to the delivery of care to individuals with mental illness.

Moreover, it includes a number of new provisions that we felt were needed to make the bill more meaningful, including some of the provisions that Democrats offered as part of our substitute at the Subcommittee markup.  For instance, the bill includes a new Assertive Community Treatment grant program, which funds a community-based, voluntary, and evidence-based approach to the treatment of mental illness.  It includes a provision to enhance community-based crisis response systems and funds the development of bed registries for inpatient psychiatric and residential community mental health and substance use disorder treatment facilities.  And it includes a new grant program to develop suicide prevention strategies for adults ages 25 and older—the population currently experiencing the highest number of suicides.

The new draft includes a major win for our most vulnerable children struggling with serious mental illness in Medicaid:  an affirmative entitlement that ensures that any child, anywhere in the country, that is receiving residential psychiatric treatment is eligible to receive comprehensive Early and Periodic Screening, Diagnostic, and Treatment services, known as EPSDT, in Medicaid, from their choice of provider.

This new provision, which was part of the Democratic substitute that was offered at the subcommittee markup, gives kids in inpatient psychiatric treatment the same benefits all children receive in Medicaid. This is a long overdue correction to a basic inequity in the statute.  EPSDT is a comprehensive set of screenings for kids in Medicaid that diagnose certain conditions, and when a problem is found because of an EPSDT screening, the child is assured treatment, even if that service is not part of the state’s standard benefit plan.  All children in Medicaid are affirmatively entitled to this benefit package, with the exception of kids in psychiatric treatment.

Today, states are not required to provide comprehensive EPSDT benefits for kids in inpatient psychiatric care.  I’m proud to say that this new bill fixes this issue, which has been a longstanding legislative proposal in the President’s budget.  This important provision is fully paid for by requiring electronic verification of in-home visits for personal care services or home health in Medicaid.  I am glad we have reached bipartisan agreement on both of these policies.  

The new draft also acknowledges the incredible confusion surrounding the current HIPAA privacy rule and addresses it in two ways.  First, it requires the Department of Health and Human Services to implement regulations that clarify certain circumstances where HIPAA allows and does not allow a provider to share protected health information.  And second, it requires HHS to create model training programs to educate health care providers and administrators, patients, and families on what health information can be shared and for what reason.  I want to thank Ms. Matsui for her leadership and expertise in such a complicated and controversial issue.  It’s important that we get patient privacy right, and I believe this language strikes the right balance.

While I am pleased with bill before us today, I want to be clear that Democrats hope this bill is the beginning, rather than the end, of our efforts to strengthen the mental health system in this country.  While this bill is a positive step forward, it is hardly a comprehensive effort to address all the problems in our mental health system. 

For instance, while I’m happy we were able to include the Senate language on mental health parity in the draft we will be marking up, we need to do more. The guidance, reports, and action plan included in this draft are a first step towards ensuring that insurers are covering behavioral health at the same level as physical health.  But I hope this committee can work together going forward to take more meaningful steps, like those Mr. Kennedy included in his legislation and that we included in the Democratic substitute, to hold insurers accountable for not following the law.

There is still a lot of work to be done.  But the success of our efforts thus far and Chairman Upton’s willingness to work on a bipartisan basis gives me reason to believe that we can achieve more in this space.

Again, I thank Chairman Upton, Oversight and Investigations Subcommittee Chairman Murphy for working with us on this important bill.  I also want to thank my Democratic colleagues for the invaluable contributions they have made to this latest draft. I am committed to continuing work in a bipartisan fashion to see H.R. 2646 get signed into law, and I hope that we can continue to work together on these issues moving forward.