Senate HELP Committee Working on Broad Mental Health Bill

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By Nathaniel Weixel

Feb. 10 — The Senate HELP Committee is developing sweeping bipartisan legislation to overhaul the country’s mental health system and also address opioid addiction and treatment, according to lawmakers and aides.

Sen. Lamar Alexander (R-Tenn.), chairman of the Health, Education, Labor and Pensions Committee, told Bloomberg BNA Feb. 10 that he is working closely with Sens. Patty Murray (D-Wash.), Bill Cassidy (R-La.), and Chris Murphy (D-Conn.), who have co-sponsored the Mental Health Reform Act (S. 1945) that already has been introduced in the committee.

Both the House and the Senate are working on mental health reform legislation. However, with negotiations on the House bill seemingly stalled, the HELP Committee legislation has the most momentum.

Alexander said he also is working with the Senate Judiciary Committee on the legislation, which will include some provisions from S. 1945 but will go beyond any current proposals. Alexander said the goal is to get the bill released and marked up in March. A committee aide confirmed the bill will contain “many elements of the Cassidy/Murphy bill” but will be a “larger, broader bill.”

Another HELP committee aide said addressing the opioid epidemic crosses party lines, and language is needed that goes beyond what was included in S. 1945. Some of the opioid-related provisions that are being discussed include expanding access to medication-assisted treatment and increasing the availability of drugs that contain naloxone, which can counter overdoses that kill tens of thousands of people a year. Lawmakers also are discussing a prescription drug monitoring program, the aide said.

Elements of the Mental Health Reform Act that are being discussed include elements to address the shortage of mental health professionals, and a repeal of the Medicaid IMD exclusion, which prohibits Medicaid reimbursement for anyone over the age of 21 and under 65 who resides in an institution for mental diseases (IMD), even for treatment unrelated to mental illness.

Opioid Bill

Alexander said the bill is being negotiated alongside two Judiciary Committee bills: one to address opioid addiction (S. 524), and one that addresses mental health and the criminal justice system (S. 2002). Alexander said S. 524, the Comprehensive Addiction and Recovery Act, will be marked up Feb. 11. That measure authorizes the attorney general to award grants to address the national epidemics of prescription opioid abuse and heroin use.

Alexander said some of the provisions of the HELP legislation related to opioid abuse will be written into the Judiciary Committee's bill because they are outside the jurisdiction of his committee.

“Some of the opioid provisions will be in the Judiciary Committee bill that's being marked up [Feb. 11]. We’re working with Judiciary Committee on that, because some of those provisions have to do with our committee jurisdiction, but I don’t see a problem with solving that,” Alexander said. “We also plan to mark up a mental health bill in March and that will include several other provisions that have to do with the opioid epidemic.”

In a statement provided to Bloomberg BNA Feb. 10, an aide for Murray, the committee's ranking Democrat, said the senator is hopeful for a bipartisan compromise.

“Senator Murray has heard far too often from families in her home state and nationwide that when it comes to treating mental illness and substance abuse, too many neighbors, friends, and loved ones are falling through the cracks,” the aide said. “She is very hopeful that Democrats and Republicans will be able to reach agreement on policies that offer communities the resources to provide high-quality, integrated care to those struggling with mental illness and substance abuse.”

House Progress

On the House side, Rep. Tim Murphy (R-Pa.) told Bloomberg BNA Feb. 10 that negotiations on his mental health reform bill (H.R. 2646) are ongoing, despite the apparent frustration from Democrats on the Energy and Commerce Committees.

Earlier this month Democratic members of the Energy and Commerce health subcommittee, led by Reps. Gene Green (D-Texas) and Doris Matsui (D-Calif.), introduced the Comprehensive Behavioral Health and Recovery Act. The bill is being presented as the Democratic foil to Murphy's bill, the Helping Families in Mental Health Crisis Act (H.R. 2646) .

Murphy said much of the differences involve his proposed changes to the Health Insurance Portability and Accountability Act privacy law regarding the release of a patient's health information. “We're still working on HIPAA language,” Murphy said. However, the current policy “has to change. You just can’t have a system that cuts families out of care. Getting families members involved to help facilitate treatment for someone who doesn’t even think the disease exists in them—you have to do that. We need to work on the language,” Murphy said.

Murphy said he has been talking with senators as well as with Health and Human Services Secretary Sylvia Mathews Burwell, but there are still elements of the bill that need to be worked out. Murphy told Bloomberg BNA he thinks his bill can match up with the March time frame of Alexander's legislation.

To contact the reporter on this story: Nathaniel Weixel in Washington at nweixel@bna.com

To contact the editor responsible for this story: Brent Bierman at bbierman@bna.com